What are the perceptions of people living with dementia, family carers, professionals and other potential stakeholders to the use of global positioning systems to promote safer outdoor walking?: a qualitative literature review

The Ethics of Electronic Tracking Devices in Dementia Care: An Interview Study with Developers

Wandering is a symptom of dementia that can have devastating consequences on the lives of persons living with dementia and their families and caregivers. Increasingly, caregivers are turning towards electronic tracking devices to help manage wandering. Ethical questions have been raised regarding these location-based technologies and although qualitative research has been conducted to gain better insight into various stakeholders' views on the topic, developers of these technologies have been largely excluded. No qualitative research has focused on developers' perceptions of ethics related to electronic tracking devices. To address this, we performed a qualitative semi-structured interview study based on grounded theory. We interviewed 15 developers of electronic tracking devices to better understand how they perceive ethical issues surrounding the design, development, and use of these devices within dementia care. Our results reveal that developers are strongly motivated by moral considerations and believe that including stakeholders throughout the development process is critical for success. Developers felt a strong sense of moral obligation towards topics within their control and a weaker sense of moral obligation towards topics outside their control. This leads to a perceived moral boundary between development and use, where some moral responsibility is shifted to end-users.

An Integrative Review of the Feasibility and Effects of the Use of Location-Tracking Devices by Persons Living With Cognitive Impairment

OBJECTIVES

This study aimed to examine the effects of location-tracking devices on persons living with cognitive impairment, investigate facilitators of and barriers to using the devices, and provide future directions for the use of the devices.

METHODS

An integrative review was conducted using 5 databases: PubMed, Embase, Web of Science, CINAHL, and Scopus. From the 1429 initially identified studies, 10 were included in the review.

RESULTS

Location-tracking devices benefited persons living with cognitive impairment and their informal caregivers. The devices brought more independence to persons living with cognitive impairment, allowing them to go outside and feel safer there. Furthermore, the devices reduced the caregivers' worries about their loved ones being lost.

CONCLUSIONS

Location-tracking devices have the potential to increase independence in persons living with cognitive impairment and to decrease psychological stress in informal caregivers. In the future, ways to minimize the barriers to using location-tracking devices need to be determined.

Information and communication technology for physical activity in persons living with dementia: A systematic review with implications for evidence-based practice

BACKGROUND

Persons living with dementia often encounter many difficulties in their community due to functional limitations. Information and Communication Technology (ICT) could be useful to monitor changes in their physical function. However, there is a lack of systematic reviews about using ICT for physical activity.

AIM

This review aimed to synthesize the literature regarding the use of ICT to monitor the physical activity of persons living with dementia.

METHODS

A systematic search was conducted in five electronic databases using search terms derived from the Patient, Intervention, Comparison, Outcome (PICO) framework. We included articles published in English from 2011 to 2021. Quality of the included studies was evaluated by two independent authors using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Thirty-three quantitative studies were included for review. Included studies showed fairly good quality in the MMAT evaluation. Wearable devices were mainly employed (88%). The ICTs were used to objectively measure physical activity, activity status, gait, and circadian rhythm. ICTs have been utilized for four purposes: (1) comparing physical activity within the dementia subgroups or with the normal group, (2) exploring the relationship with other variables, 3) examining the experimental study's outcomes, and (4) checking the sensors' feasibility. The results demonstrated that ICT devices were feasible to use in persons living with dementia in the community, helpful for monitoring the physical activity of persons living with dementia, and useful for improving physical activity when properly incorporated in care planning.

LINKING EVIDENCE TO ACTION

ICTs can help gather objective data regarding the type, intensity, and level of physical activity in persons living with dementia without time constraints. Also, ICTs use in persons living with dementia in the community was acceptable. We suggest future studies to activate and use ICTs in dementia research.

Identifying adoption and usability factors of locator devices for persons living with dementia

A growing number of Canadians live with dementia. Strategies to reduce the risks of getting lost include physical barriers, restraints and medications. However, these strategies can restrict one’s participation in meaningful activities and reduce quality of life. Locator devices can be used to manage safety risks while also supporting engagement and independence among persons living with dementia. As more locator devices become available on the market, adoption rates would be affected by certain factors. There is no clear, standardized approach to identify the factors that have an influence on the acceptance and usability of locator devices for persons with dementia and their care partners. This project aimed to identify factors related to acceptance and usability of locator devices that are important to individuals with dementia, their care partners, service providers and technology developers. Qualitative description and conventional content analysis guided our approach. We conducted 5 focus groups with 21 participants. Trustworthiness strategies included multiple data sources, data verification for accuracy and peer debrief. Five overarching factors emerged as critical aspects in the acceptance and usability of locator devices. These factors were inclusivity, simplicity, features, physical properties and ethics. Participants thought that locator devices do not adequately consider privacy and stigma. Therefore, the acceptance and usability of locator devices could be enhanced if privacy and stigma are addressed. The factors identified will inform the creation of an acceptance and usability scale for locator devices used by persons living with dementia, their care partners and service providers.

Acceptance, adoption, and usability of information and communication technologies for people living with dementia and their care partners: a systematic review

PURPOSE

This review aims to examine the instruments, approaches, scales, or assessment tools used to evaluate technology acceptance, technology adoption, and usability of information and communication technologies (ICTs) for people living with dementia and their care partners.

METHODS

A systematic literature review was conducted. Studies that explored the use of instruments, approaches, scales, or assessment tools to evaluate the technology acceptance and usability of ICTs for people living with dementia and their care partners were identified through five databases: Medline, EMBASE, CINAHL, Web of Science, and Scopus.

RESULTS

We included 74 out of 2182 papers. The most common scales used included the System Usability Scale (SUS) (11%), the ISONORM 9241/10 Questionnaire (4%), and the Post-Study System Usability Questionnaire (PSSUQ) (4%). Most (59%) of the included approaches, however, were bespoke (i.e., created by the authors for a particular study) and were not named. The approaches or tools used to assess technology acceptance, technology adoption, and usability of ICTs that applied to people living with dementia had an average of 15 items and used an average of 5.23 scale points.

CONCLUSION

There is no clear, standardised approach for assessing the technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The findings of this review may be used by academics to design and implement improved and more consistent assessment tools to assess technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners.IMPLICATIONS FOR REHABILITATIONThe number of ICTs for people with dementia and their care partners that can be used for rehabilitation is increasingThe most commonly recognized assessment tools used in this study were the SUS, ISONORM 9241/10, and PSSUQ questionnaires.For the custom assessment tools, the average number of items included in this study was 15 with five-point bidirectional labelling.There is no clear, standardized approach for assessing the technology acceptance, technology adoption, or usability of ICTs for people with dementia and their care partners.