The Wayfinding Questionnaire as a Self-report Screening Instrument for Navigation-related Complaints After Stroke: Internal Validity in Healthy Respondents and Chronic Mild Stroke Patients

Investigating the Influences of Healthcare Facility Features on Wayfinding Performance and Associated Stress Using Virtual Reality

OBJECTIVE

This study examined the influences of healthcare facility interior features on users' wayfinding performance and the relationship between stress and wayfinding.

BACKGROUND

General hospitals in China always present significant wayfinding problems due to their sizes and complexity. Poor wayfinding often leads to a frustrating and stressful user experience. It has not been fully understood how hospital indoor features affect wayfinding and whether an individual's stress levels are associated with wayfinding performance.

METHOD

We conducted an experiment in which 117 college students, aged 18-33 (M = 21.88, SD = 3.01), performed two tasks in virtual reality environments of outpatient clinics. Stress (skin conductance response) and wayfinding performance (distance ratio and time ratio) were measured. Participants' sense of orientation, navigation ability, distance estimation, and spatial anxiety were captured by a survey.

RESULTS

Male participants reported a significantly better sense of orientation and less spatial anxiety than females. Participants' stress levels were lower with outdoor window views compared to those without outdoor views. With more environmental features (landmarks and outdoor window views) added to the environments, participants showed significantly better wayfinding performance. No significant relationship was found between wayfinding performance and participants' stress levels in this study.

CONCLUSION

While individual environmental factors might not have a significant influence, combining multiple elements such as window views and landmarks could lead to better wayfinding performance. More research is needed to examine the relationship between stress and wayfinding.

Testing a Model of Human Spatial Navigation Attitudes towards Global Navigation Satellite Systems

Global navigation satellite systems (GNSS) can provide better data quality for different purposes; however, some age groups might lie outside its use. Understanding the barriers to its adoption is of interest in different fields. This work aims at developing a measurement instrument of the adoption attitudes towards this technology and examining the relationship of variables such as age and gender. A UTAUT model was tested on 350 participants. The main results can be summarised as follows: (i) the proposed GNSS scale on human spatial navigation attitudes towards geopositioning technology showed optimal psychometric properties; (ii) although statistically significant differences were found in the Wayfinding Questionnaire (WQ) between men and women, these did not reach the level of statistical significance for the scores on attitudes towards GNSS; (iii) by testing a model on human spatial navigation attitudes towards geopositioning technology, it was possible to show a higher relationship with age in women.

Is It Just Face Blindness? Exploring Developmental Comorbidity in Individuals with Self-Reported Developmental Prosopagnosia

Developmental prosopagnosia (DP)—or ‘face blindness’—refers to life-long problems with facial recognition in the absence of brain injury. We know that neurodevelopmental disorders tend to co-occur, and this study aims to explore if individuals with self-reported DP also report indications of other neurodevelopmental disorders, deficits, or conditions (developmental comorbidity). In total, 115 individuals with self-reported DP participated in this online cross-sectional survey. Face recognition impairment was measured with a validated self-report instrument. Indications of difficulties with navigation, math, reading, or spelling were measured with a tailored questionnaire using items from published sources. Additional diagnoses were measured with direct questions. We also included open-ended questions about cognitive strengths and difficulties. Results: Overall, 57% reported at minimum one developmental comorbidity of interest, with most reflecting specific cognitive impairment (e.g., in memory or object recognition) rather than diagnostic categories (e.g., ADHD, dyslexia). Interestingly, many participants reported cognitive skills or strengths within the same domains that others reported impairment, indicating a diverse pattern of cognitive strengths and difficulties in this sample. The frequency and diversity of self-reported developmental comorbidity suggests that face recognition could be important to consider in future investigations of neurodevelopmental comorbidity patterns.

Quality of self-reported cognition: effects of age and gender on spatial navigation self-reports

Subjective measures of cognitive abilities are often used in various environments, such as clinical, experimental, and professional settings. Here, we assess the quality of such measures, specifically looking into the impact of age and gender. Spatial navigation ability will be used as an exemplary case, given its large individual variation and relevance to the healthy aging process. With a navigation experiment and a self-report questionnaire, the objective and subjective navigation performance of 7150 participants (age 18-89 years) was measured. Results showed the participants provided informative estimates of their cognitive performance. However, strong systematic biases were present related to age and gender. Overestimation increased with increasing age. Overestimation was also found for males, whereas underestimation was found for females. Consideration of such biases is recommended when implementing self-report measures of cognition and considering the potential impact these biases may have on cognitive functioning itself.

Category-selective deficits are the exception and not the rule: Evidence from a case-series of 64 patients with ventral occipito-temporal cortex damage

The organisational principles of the visual ventral stream are still highly debated, particularly the relative association/dissociation between word and face recognition and the degree of lateralisation of the underlying processes. Reports of dissociations between word and face recognition stem from single case-studies of category selective impairments, and neuroimaging investigations of healthy participants. Despite the historical reliance on single case-studies, more recent group studies have highlighted a greater commonality between word and face recognition. Studying individual patients with rare selective deficits misses (a) important variability between patients, (b) systematic associations between task performance, and (c) patients with mild, severe and/or non-selective impairments; meaning that the full spectrum of deficits is unknown. The Back of the Brain project assessed the range and specificity of visual perceptual impairment in 64 patients with posterior cerebral artery stroke recruited based on lesion localization and not behavioural performance. Word, object, and face processing were measured with comparable tests across different levels of processing to investigate associations and dissociations across domains. We present two complementary analyses of the extensive behavioural battery: (1) a data-driven analysis of the whole patient group, and (2) a single-subject case-series analysis testing for deficits and dissociations in each individual patient. In both analyses, the general organisational principle was of associations between words, objects, and faces even following unilateral lesions. The majority of patients either showed deficits across all domains or in no domain, suggesting a spectrum of visuo-perceptual deficits post stroke. Dissociations were observed, but they were the exception and not the rule: Category-selective impairments were found in only a minority of patients, all of whom showed disproportionate deficits for words. Interestingly, such selective word impairments were found following both left and right hemisphere lesions. This large-scale investigation of posterior cerebral artery stroke patients highlights the bilateral representation of visual perceptual function.

Large-scale assessment of human navigation ability across the lifespan

Navigation ability is particularly sensitive to aging. Evidence of aging patterns is largely restricted to comparing young adults and elderly and limited in the variety of navigation tasks used. Therefore, we designed a novel task battery to assess navigation ability in a very large, representative sample (N = 11,887, 8–100 years). The main aim was to measure navigation ability across the lifespan in a brief, yet comprehensive manner. Tasks included landmark knowledge, egocentric and allocentric location knowledge, and path knowledge for a route and survey perspective. Additionally, factors that potentially contribute to navigation ability were considered; gender, spatial experience and spatial anxiety. Increase in performance with age in children was found for allocentric location knowledge and for route-based path knowledge. Age related decline was found for all five tasks, each with clearly discernible aging patterns, substantiated the claim that each task distinctively contributes to the assessment of navigation ability. This study provides an in depth examination of navigation ability across dissociable functional domains and describes cognitive changes across the lifespan. The outcome supports the use of this task battery for brief assessment of navigation for experimental and clinical purposes.

Wayfinding Strategy and Gender - Testing the Mediating Effects of Wayfinding Experience, Personality and Emotions

Background

Individual differences have been seen to play a key role in spatial orientation. Gender implications have been previously described but little is known about how other variables, such as wayfinding anxiety, emotional difficulties and wayfinding experience can mediate this relationship.

Methods

A group of 269 participants were involved in this study and completed questionnaires on their self-reported allocentric orientation strategy, wayfinding experience and satisfaction with the ability for wayfinding. Emotional outcomes were also investigated: spatial and trait anxiety, neuroticism, difficulties in emotion regulation, and personal safety. First, a principal component analysis was conducted and the studied variables were grouped into four components: outdoor wayfinding experience, wayfinding-related fear, emotional difficulties, and effective wayfinding skill. Afterwards, structural equation modelling was performed, using the MPLUS statistical program.

Results

The results showed that gender constitutes a predictor for using an effective wayfinding skill and for feeling wayfinding-related fear. However, outdoor wayfinding experience, wayfinding-related fear and emotional difficulties did not mediate the relationship between effective wayfinding skill and gender.

Conclusion

These results highlight the differential contribution of gender in the emotions that are experienced during spatial orientation and emotions that are related to other types of situations. The limitations, strengths and theoretical implications of the proposed model are discussed. Further investigation is needed in order to understand the role of emotions in spatial orientation.

Memory for Object Location in Augmented Reality: The Role of Gender and the Relationship Among Spatial and Anxiety Outcomes

The potential of augmented reality (AR) technology for the study of spatial memory and orientation is a new research field. AR defines systems that attempt to enhance the user’s experience with the physical world. In our app, we enhance the sense of sight by adding interactive 3D elements to the real environment. Our app can be used in any real environment so that the experimental conditions during the tasks and the way in which an individual navigates are similar to those used in real life. With AR, the experimenter has a high level of control of the task and can store the participant’s responses accurately. The classical factors that influence an individual’s performance on virtual spatial tasks are gender and cognitive factors. The influence of emotional factors on spatial performance has been studied more recently. Since AR tasks for the study of spatial memory and spatial orientation are new developments, little is known about the factors that are related to performance on tasks of this type. In our study, we tested 46 young adults (26 women) in an AR object-location task that was performed in a building. The participants had to memorize the position of eight virtual objects while they were walking through the environment. We also assessed the participants’ performance on an object-recall task, a map-pointing task, and a paper-and-pencil spatial orientation task. The self-reported importance of different spatial strategies for wayfinding and the levels of trait anxiety and wayfinding anxiety were also evaluated. Our findings indicate that men performed better on the spatial paper-and-pencil test and spent more time completing the learning phase of the AR task. The spatial memory for the location of the objects in AR and on the map correlated positively. Anxiety was related to individual differences in the self-reported use of a spatial orientation strategy, but the association among them was weak. Trait anxiety was positively related to the time employed by the participants during the learning phase of the AR task, whereas wayfinding anxiety correlated negatively with the preference for an orientation strategy. Our results highlight the importance of anxiety in spatial orientation.