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Zijlstra E, van der Zwaag B, Kullak S, Rogers A, Walker D, van Dellen S, Mobach M. A randomized controlled trial of Golden Ratio, Feng Shui, and evidence based design in healthcare. PLoS One 2024; 19:e0303032. [PMID: 38837979 PMCID: PMC11152261 DOI: 10.1371/journal.pone.0303032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/11/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND In a global effort to design better hospital buildings for people and organizations, some design principles are still surrounded by great mystery. The aim of this online study was to compare anxiety in an existing single-bed inpatient hospital room with three redesigns of this room in accordance with the principles of Golden Ratio, Feng Shui, and Evidence-Based Design. METHODS In this online multi-arm parallel-group randomized trial participants were randomly assigned (1:1:1:1) to one of four conditions, namely Golden Ratio condition, Feng Shui condition, Evidence-Based Design condition, or the control condition. The primary outcomes were anxiety, sense of control, social support, positive distraction, and pleasantness of the room. FINDINGS Between June 24, 2022, and August 22, 2022, 558 individuals were randomly assigned to one of the four conditions, 137 participants to the control condition, 138 participants to the Golden Ratio condition, 140 participants to the Feng Shui condition, and 143 participants to the Evidence-Based Design condition. Compared with baseline, participants assigned to the Evidence-Based Design condition experienced less anxiety (mean difference -1.35, 95% CI -2.15 to -0.55, Cohen's d = 0.40, p < 0.001). Results also showed a significant indirect effect of the Feng Shui condition on anxiety through the pleasantness of the room (B = -0.85, CI = -1.29 to -0.45) and social support (B = -0.33, CI = -0.56 to -0.13). Pleasantness of the room and social support were mediators of change in anxiety in the Evidence-Based Design and Feng Shui conditions. In contrast, application of the design principle Golden Ratio showed no effect on anxiety and remains a myth. INTERPRETATION To our knowledge, this is the first randomized controlled trial linking design principles directly to anxiety in hospital rooms. The findings of our study suggest that Feng Shui and Evidence-Based Design hospital rooms can mitigate anxiety by creating a pleasant looking hospital room that fosters access to social support. CLINICAL TRIAL REGISTRATION The trial is registered with ISRCTN, ISRCTN10480033.
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Affiliation(s)
- Emma Zijlstra
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Bart van der Zwaag
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Sabine Kullak
- International Feng Shui Association, Singapore, Singapore
| | - Ab Rogers
- Ab Rogers Design, London, United Kingdom
| | | | - Sjoukje van Dellen
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Mark Mobach
- Research Group Facility Management, Hanze University of Applied Sciences, Groningen, The Netherlands
- Research Group Spatial Environment and the User, The Hague University of Applied Sciences, The Hague, The Netherlands
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Kosan E, Krois J, Wingenfeld K, Deuter CE, Gaudin R, Schwendicke F. Patients' Perspectives on Artificial Intelligence in Dentistry: A Controlled Study. J Clin Med 2022; 11:jcm11082143. [PMID: 35456236 PMCID: PMC9032784 DOI: 10.3390/jcm11082143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 01/31/2023] Open
Abstract
Background: As artificial intelligence (AI) becomes increasingly important in modern dentistry, we aimed to assess patients’ perspectives on AI in dentistry specifically for radiographic caries detection and the impact of AI-based diagnosis on patients’ trust. Methods: Validated questionnaires with Likert-scale batteries (1: “strongly disagree” to 5: “strongly agree”) were used to query participants’ experiences with dental radiographs and their knowledge/attitudes towards AI as well as to assess how AI-based communication of a diagnosis impacted their trust, belief, and understanding. Analyses of variance and ordinal logistic regression (OLR) were used (p < 0.05). Results: Patients were convinced that “AI is useful” (mean Likert ± standard deviation 4.2 ± 0.8) and did not fear AI in general (2.2 ± 1.0) nor in dentistry (1.6 ± 0.8). Age, education, and employment status were significantly associated with patients’ attitudes towards AI for dental diagnostics. When shown a radiograph with a caries lesion highlighted by an arrow, patients recognized the lesion significantly less often than when using AI-generated coloured overlays highlighting the lesion (p < 0.0005). AI-based communication did not significantly affect patients’ trust in dentists’ diagnosis (p = 0.44; OLR). Conclusions: Patients showed a positive attitude towards AI in dentistry. AI-supported diagnostics may assist communicating radiographic findings by increasing patients’ ability to recognize caries lesions on dental radiographs.
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Affiliation(s)
- Esra Kosan
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral Diagnostics and Digital Health and Health Services Research, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.K.); (F.S.)
- Correspondence: ; Tel.: +49-030-45066-2248
| | - Joachim Krois
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral Diagnostics and Digital Health and Health Services Research, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.K.); (F.S.)
| | - Katja Wingenfeld
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Hindenburgdamm 30, 12200 Berlin, Germany; (K.W.); (C.E.D.)
| | - Christian Eric Deuter
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Hindenburgdamm 30, 12200 Berlin, Germany; (K.W.); (C.E.D.)
| | - Robert Gaudin
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Hindenburgdamm 30, 12200 Berlin, Germany;
| | - Falk Schwendicke
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral Diagnostics and Digital Health and Health Services Research, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.K.); (F.S.)
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Nordin S, Sturge J, Ayoub M, Jones A, McKee K, Dahlberg L, Meijering L, Elf M. The Role of Information and Communication Technology (ICT) for Older Adults' Decision-Making Related to Health, and Health and Social Care Services in Daily Life-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010151. [PMID: 35010408 PMCID: PMC8750227 DOI: 10.3390/ijerph19010151] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 05/08/2023]
Abstract
Information and communication technology (ICT) can potentially support older adults in making decisions and increase their involvement in decision-making processes. Although the range of technical products has expanded in various areas of society, knowledge is lacking on the influence that ICT has on older adults' decision-making in everyday situations. Based on the literature, we aimed to provide an overview of the role of ICT in home-dwelling older adults' decision-making in relation to health, and health and social care services. A scoping review of articles published between 2010 and 2020 was undertaken by searching five electronic databases. Finally, 12 articles using qualitative, quantitative, and mixed-method designs were included. The articles were published in journals representing biology and medicine, nursing, informatics, and computer science. A majority of the articles were published in the last five years, and most articles came from European countries. The results are presented in three categories: (i) form and function of ICT for decision-making, (ii) perceived value and effect of ICT for decision-making, and (iii) factors influencing ICT use for decision-making. According to our findings, ICT for decision-making in relation to health, and health and social care services was more implicitly described than explicitly described, and we conclude that more research on this topic is needed. Future research should engage older adults and health professionals in developing technology based on their needs. Further, factors that influence older adults' use of ICT should be evaluated to ensure that it is successfully integrated into their daily lives.
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Affiliation(s)
- Susanna Nordin
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
- Correspondence:
| | - Jodi Sturge
- Population Research Center, Urban and Regional Studies Institute, Faculty of Spatial Sciences, University of Groningen, P.O. Box 800, 9700 AV Groningen, The Netherlands; (J.S.); (L.M.)
| | - Maria Ayoub
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
| | - Allyson Jones
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada;
| | - Kevin McKee
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
| | - Lena Dahlberg
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
- Aging Research Center, Karolinska Institutet & Stockholm University, 171 77 Stockholm, Sweden
| | - Louise Meijering
- Population Research Center, Urban and Regional Studies Institute, Faculty of Spatial Sciences, University of Groningen, P.O. Box 800, 9700 AV Groningen, The Netherlands; (J.S.); (L.M.)
| | - Marie Elf
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
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Chen R, Dai F, Yang H, Zhang X, Zhang H, Liu M. Caring behaviours perceived by elderly residents and their associated factors in nursing homes in Zhengzhou City of China: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e126-e134. [PMID: 33278313 DOI: 10.1111/hsc.13252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 08/30/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
Caring is an evidence-supported behaviour or activity which can meet nursing home residents' needs. China has an ever-increasing number of care-dependent individuals in nursing homes. It is important to explore the caring behaviours and to understand the factors associated with the caring behaviours perceived by elderly residents in nursing homes. This will contribute to an evidence-based approach with which to assist healthcare services. This study aims to explore the perceived caring needs, associated behaviours, and their associated factors identified by elderly residents in nursing homes. Fourteen semi-structured interviews were conducted with elderly residents from five nursing homes in three districts across Zhengzhou City, China. Interviews were transcribed verbatim and analysed using the Colaizzi phenomenological method. Five themes and fourteen sub-themes were identified. The availability of health services, a livable environment, and social communication were the main caring needs identified. Nursing assistant factors and resident factors were the main influencers. This study provides valuable information on the need to carry out standardised training of nursing assistants and how to adjust the goal of care in nursing home residents. The medical support, psychological counselling, livable environment, recreational and cultural services as well as caring literacy about nursing assistants in the nursing homes, however, need to be further enhanced to meet the residents' diversified caring needs.
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Affiliation(s)
- Ruiyun Chen
- Henan Provincial People's Hospital, Zhengzhou, China
- Zhengzhou University People's Hospital, Zhengzhou, China
- Henan University People's Hospital, Zhengzhou, China
| | - Fumin Dai
- Henan Provincial People's Hospital, Zhengzhou, China
- Zhengzhou University People's Hospital, Zhengzhou, China
- Henan University People's Hospital, Zhengzhou, China
| | - Hui Yang
- Henan Provincial People's Hospital, Zhengzhou, China
- Zhengzhou University People's Hospital, Zhengzhou, China
- Henan University People's Hospital, Zhengzhou, China
| | - Xi Zhang
- Zhengzhou Railway Vocational and Technical College, Zhengzhou, China
| | - Hongmei Zhang
- Henan Provincial People's Hospital, Zhengzhou, China
- Zhengzhou University People's Hospital, Zhengzhou, China
- Henan University People's Hospital, Zhengzhou, China
| | - Minhui Liu
- Henan Provincial People's Hospital, Zhengzhou, China
- Xiangya Nursing School, Central South University, Changsha, China
- Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, MD, USA
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Vimarlund V, Borycki EM, Kushniruk AW, Avenberg K. Ambient Assisted Living: Identifying New Challenges and Needs for Digital Technologies and Service Innovation. Yearb Med Inform 2021; 30:141-149. [PMID: 33882606 PMCID: PMC8416233 DOI: 10.1055/s-0041-1726492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background
: The ambient assisted living (AAL) market is rapidly becoming fundamental to the delivery of health and social care services for the elderly. Worldwide many different steps have been taken to increase the engagement of older adults with these technologies. Much of this work has focused on the development of novel digital services that increase wellbeing or tackle social challenges.
Aim
: The aim of the study was to identify and describe the demands for AAL-services from the perspective of older adults. We also examine the challenges and needs of the ambient assisted living market using a needs based approach.
Method
: An exploratory case study was conducted with an aim to capture information about older adults’ demands for AAL services. A survey was used to collect the data. The survey study respondents validated the results.
Results
: The results of the study indicate that the area of AAL needs be studied from a multiple-sided market perspective. Our research suggests there is a need to describe and understand the factors that facilitate or constrain the implementation of services with focus on health and social care. There is also a need to describe and analyze the relationship between policy and practice and its effects on the AAL market. It is necessary to capture expressed demand, to identify market challenges at the macro level and to be able to understand how services should operate and serve older adults in practice. Such research is critical to the development of guidance for policy makers, suppliers and service providers.
Discussion
: Older adults are asking for intelligent, assistive living solutions that help them to continue to live independent lives and remain socially included in their networks, associations, and communities. The elderly need services that stimulate and maintain their physical and intellectual capital. The development of innovative AAL environments is, however, a complex social process that involves the use and delivery of innovative ICT–based services. The implementation and use of AAL to support older adults involve service providers and elderly consumers.
Conclusions
: The results of the study may be of interest to policy makers, entrepreneurs, technology suppliers, service providers and health and social care organizations, who are willing to innovate and influence the development of the AAL market through their choices and decisions.
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Affiliation(s)
- Vivian Vimarlund
- Professor School of Engineering, Department of Computer and Information Science, Linköping University, Sweden, Co-Chair WG Ambient Assisted Living
| | - Elizabeth M Borycki
- Professor, School of Health Information Science, University of Victoria, Canada, Chair WG Ambient Assisted Living
| | - Andre W Kushniruk
- Professor and Director, School of Health Information Science, University of Victoria, Canada
| | - Kerstin Avenberg
- On behalf of the Swedish interest organizations for Elderly, Stockholm, Sweden. Member of SeniorNet and Active Seniors non-profit organizations
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Conde-Caballero D, Rivero-Jiménez B, Cipriano-Crespo C, Jesus-Azabal M, Garcia-Alonso J, Mariano-Juárez L. Treatment Adherence in Chronic Conditions during Ageing: Uses, Functionalities, and Cultural Adaptation of the Assistant on Care and Health Offline (ACHO) in Rural Areas. J Pers Med 2021; 11:173. [PMID: 33801439 PMCID: PMC7999645 DOI: 10.3390/jpm11030173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/16/2022] Open
Abstract
The increasingly common scenario of an ageing population is related to a rise in the prevalence of problems associated with chronic conditions and comorbidities. Polypharmacy is frequent among this population, and it is a situation that can create medication management and adherence issues. This article introduces the features and functionalities of a voice assistant (Assistant on Health and Care Offline, ACHO) that aims to facilitate treatment adherence among elderly adults. Specifically adapted for its use in rural contexts, it does not require an Internet connection. Its development consisted of two stages: a first stage of problem diagnosis, in which the classic tools of ethnographic fieldwork were used, and a second stage of design implementing methodologies developed by Ambient Assisted Living (AAL) programmes. The main design characteristic of this new digital care system is that it is adapted to the needs of its end-users. It includes features such as voice customisation and the personal identification of medication, it can be connected to other digital devices, and information is introduced and supervised by healthcare professionals. These custom features introduce a safer medication administration procedure, improve supervision strategies, and increase patients' trust in the prescription process.
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Affiliation(s)
- David Conde-Caballero
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (D.C.-C.); (L.M.-J.)
| | - Borja Rivero-Jiménez
- Department of Computer and Telematic Systems Engineering, Polytechnic School, University of Extremadura, 10003 Cáceres, Spain; (M.J.-A.); (J.G.-A.)
| | - Carmen Cipriano-Crespo
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla La Mancha, 13071 Ciudad Real, Spain;
| | - Manuel Jesus-Azabal
- Department of Computer and Telematic Systems Engineering, Polytechnic School, University of Extremadura, 10003 Cáceres, Spain; (M.J.-A.); (J.G.-A.)
| | - Jose Garcia-Alonso
- Department of Computer and Telematic Systems Engineering, Polytechnic School, University of Extremadura, 10003 Cáceres, Spain; (M.J.-A.); (J.G.-A.)
| | - Lorenzo Mariano-Juárez
- Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (D.C.-C.); (L.M.-J.)
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‘Consumption as Work’ - Questioning the Meaning of ‘Retirement’ in the Self-Service Economy. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09317-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractThis article contributes to the establishment of a new perspective in the debate on how to respond to the economic and social challenges of ageing society. It re-examines the productive activity of older people through the lens of the self-service economy and initiates a discussion on how the self-service economy can be leveraged to help deal with some of the challenges created by an ageing population. The article’s main argument is built on the growing importance of self-service and the potential for older consumers to engage in such production/consumption. The substantial efficiency gains surrounding increased levels of self-service are illustrated. The potential of the retired population engaging in self-service and thus dampen the life cycle deficit is highlighted. Self-service activity by older consumers is presented as a type of productive activity and as forming part of older people’s contribution to society. It is argued that the growing self-service nature of consumption brings the meaning of ‘retirement’ even further into question. The policy implications of self-service are explored and a wide range of suggestions for further research areas related to self-service and the older consumer are put forward.
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De Regge M, Van Baelen F, Beirão G, Den Ambtman A, De Pourcq K, Dias JC, Kandampully J. Personal and Interpersonal Drivers that Contribute to the Intention to Use Gerontechnologies. Gerontology 2019; 66:176-186. [PMID: 31480067 DOI: 10.1159/000502113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 07/15/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Over the past few years, various new types of technologies have been introduced, which have been tailored to meet the specific needs of older adults by incorporating gerontological design principles (i.e., "gerontechnologies"). However, it has been difficult to motivate older adults to adopt and use these new technologies. Therefore, it is crucial to better understand not only the role of personal drivers but also the family influences on older adults. OBJECTIVE This research goes beyond traditional technology acceptance theories by investigating the role of personal (e.g., inherent novelty seeking) and interpersonal drivers (e.g., influence of family) in stimulating older adults to use gerontechnologies. Nine hypotheses, building on traditional and new technology acceptance theories, were developed and tested. METHODS This research applies a cross-sectional study design. Therefore, a face-to-face survey instrument was developed building on a qualitative pilot study and validated scales. Three hundred and four older adults (minimum age = 70 years) were willing to participate as well as one of their family members. Structural equation modeling was applied to analyze the hypothesized conceptual model. RESULTS Our results extend the seminal technology acceptance theories by adding personal (i.e., inherent novelty seeking p = 0.017) and interpersonal drivers. More specifically, it was found that the attitude toward gerontechnologies was influenced by family tech savviness (i.e., people who often use technology), as this relationship is fully mediated through the social norms of older adults (p = 0.014). The same was found for older adults' trust in the family member's technology knowledge (p ≤ 0.001). Here, the relationship with older adults' attitude toward gerontechnologies was partially mediated by the older adults' trust in technology. CONCLUSION This study identified important personal and interpersonal drivers that influence attitudes toward and intentions to use gerontechnologies. To foster technology acceptance among older adults, it was found that it is important to strengthen the trust in and the attitude toward gerontechnologies. Furthermore, family members' knowledge and beliefs in technology were the keys to promoting the actual use of gerontechnologies among older adults. Furthermore, the families' trust in gerontechnologies and the provision of access to technology can improve their attitudes toward technology and usage intentions for the older relative.
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Affiliation(s)
- Melissa De Regge
- Strategic Policy Cell, Ghent University Hospital, Ghent, Belgium, .,Department of Management, Organisation and Innovation, Faculty of Economics and Business Administration, Ghent University, Ghent, Belgium,
| | - Freek Van Baelen
- Department of Commercial Economics and Entrepreneurship, University College Ghent, Ghent, Belgium
| | - Gabriela Beirão
- INESC TEC and Faculty of Engineering, University of Porto, Porto, Portugal
| | - Anouk Den Ambtman
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands and UNamur, Namur, Belgium
| | - Kaat De Pourcq
- Department of Management, Organisation and Innovation, Faculty of Economics and Business Administration, Ghent University, Ghent, Belgium
| | | | - Jay Kandampully
- Consumer Sciences, The Ohio State University, Columbus, Ohio, USA
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Park YH, Chang HK, Lee MH, Lee SH. Community-dwelling older adults' needs and acceptance regarding the use of robot technology to assist with daily living performance. BMC Geriatr 2019; 19:208. [PMID: 31382887 PMCID: PMC6683338 DOI: 10.1186/s12877-019-1227-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 07/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rate of aging in Korea is extremely fast compared to major countries. We examined the key demands of community-dwelling older adults with regard to Connected Active Space technology, which provides tailored assistance with daily living performance through robotic services. METHODS This study is based on a mixed-method design, through a quantitative survey (n = 234) first phase, followed by a qualitative study with focus group interviews (n = 23) to explore the needs and acceptance of community-dwelling aged people concerning the application of robot technology in their daily lives. RESULTS The scores concerning the need for and acceptance of robot services to assist daily living performance were high, at 7.2 and 7.9 out of 10 points, respectively. Further, for both needs and acceptance, timely reaction to emergency situations, early detection of emergency situations, help to locate objects, assistance with mobility, and assistance in memory recall were prioritized (in that order). In a thematic analysis of qualitative data from three focus-group interviews, a 'mismatch between desires and functional capacity' was the core characteristic of living as an older person and 'being a friend and helper' was the most desired trait of a robot service. CONCLUSION Although most of the participants lived independently, they regularly experienced difficulties regarding buying products, transportation, using phones, and preparing meals. If appropriate assistance technology is developed, this population can maintain its independence. Thus, it is necessary to address main needs, including detecting and addressing emergency situations, locating objects, assisting mobility and memory recall, and assisting with daily living performance. New robot services that can be tailored to the functions or abilities of the elderly must be developed based on individually collected information.
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Affiliation(s)
- Yeon-Hwan Park
- College of Nursing of Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea, 03080.,Research Institute of Nursing Science of Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea, 03080
| | - Hee Kyung Chang
- College of Nursing Senior Health Research Center of the Health & Science Institute, Gyeongsang National University, 15, Jinju-daero 816beon-gil, Jinju-si, Gyeongsangnam-do, Republic of Korea, 52727.
| | - Min Hye Lee
- College of Nursing of Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea, 03080
| | - Seong Hyeon Lee
- College of Nursing of Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea, 03080
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Sallinen M, Hentonen O, Teeri S. Ethical dilemmas related to the use of safety technology in service house environments. Scand J Caring Sci 2019; 34:199-205. [PMID: 31250937 DOI: 10.1111/scs.12721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/14/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of technology in care of older adults has increased rapidly in recent years and is anticipated to increase further in the future. Technological devices and appliances have been developed to promote the safety and independence of older adults living in different settings. However, technology may also be perceived as a threat, and using technology could involve characteristics that may restrict especially patients' autonomy. AIMS AND METHODS The aim of this study was to explore ethical dilemmas as experienced and expressed by older adults living in service house environment and their family members. The study was carried out in two service house units in Southwest Finland by conducting thematic interviews of service home residents aged 80-92 years (n = 12) and their relatives (n = 5). The interview data were analysed using inductive content analysis to identify similarities and differences across the data. The findings were categorised under three categories: supervision vs. privacy, fear of losing human contact, autonomy and freedom. FINDINGS The participants appreciated the homely environment they had and preferred increasing the amount of staff over increasing technological surveillance. However, the residents were willing to accept also technological systems and solutions if they strengthened one's feeling of security. Fear of losing human contacts and one's privacy due to implementation technological systems was expressed by the older adults. Both the residents and their relatives emphasised the autonomy of the older adult in decision-making concerning the use of technological services. CONCLUSIONS In conclusion, thorough discussion about autonomy, freedom and privacy is needed before applying new technologies to service house environments. Possibilities for drafting a 'technological will' where the resident could define under what circumstances technology can be used in his/her case and who can decide about it should be explored in the future.
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Affiliation(s)
- Merja Sallinen
- Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland
| | - Outi Hentonen
- Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland
| | - Sari Teeri
- Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland
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Sundgren S, Stolt M, Suhonen R. Ethical issues related to the use of gerontechnology in older people care: A scoping review. Nurs Ethics 2019; 27:88-103. [PMID: 31113266 DOI: 10.1177/0969733019845132] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Demographic trends indicate growth of population aged 65 and older in Western countries. One of the greatest challenges is to provide high-quality care for all. Technological solutions designed for older people, gerontechnology, can somewhat balance the gap between resources and the increasing demand of healthcare services. However, there are also ethical issues in the use of gerontechnology that need to be pointed out. PURPOSE To describe what ethical issues are related to the use of gerontechnology in the care of community-dwelling older people. METHODS A scoping review was performed to identify and analyse studies concerning ethical issues when using gerontechnology in the home care of older people. The literature search was limited to studies published after 1990 and addressed to the electronic databases CINAHL, PubMed, Cochrane, Medic, IEEE Explore and Web of Science. The search was performed in July-August 2018. Data from empirical studies were analysed using thematic analysis. ETHICAL CONSIDERATIONS This scoping review was conducted in accordance with good scientific practice. The work of other researchers was respected and cited appropriately. RESULTS A total of 17 studies were identified. Two main themes were found. 'Balancing between the benefits of using gerontechnology and the basic rights of older people', consisted of the subthemes safety, privacy and autonomy. The other main theme, 'Gerontechnology as a risk of insecurity for older people', included the subthemes fear of losing human contact and concern and fear. Surveillance and monitoring technologies were mainly studied. CONCLUSION These results suggest that there may be ethical issues related to the use of gerontechnology and they must therefore be taken into consideration when implementing technology in the care of community-dwelling older people.
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Affiliation(s)
| | | | - Riitta Suhonen
- University of Turku, Finland; Turku University Hospital, Finland; City of Turku, Welfare Division, Finland
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Lehoux P, Grimard D. When robots care: Public deliberations on how technology and humans may support independent living for older adults. Soc Sci Med 2018; 211:330-337. [PMID: 30015242 DOI: 10.1016/j.socscimed.2018.06.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 12/01/2022]
Abstract
While assistive robots receive growing attention as a potential solution to support older adults to live independently, several scholars question the underlying social, ethical and health policy assumptions. One perplexing issue is determining whether assistive robots should be introduced to supplement caregivers or substitute them. Current state of knowledge indicates that users and caregivers consider that robots should not aim to replace humans, but could perform certain tasks. This begs the question of the nature and scope of the tasks that can be delegated to robots and of those that should remain under human responsibility. Considering that such tasks entail a range of actions that affect the meaning of caregiving and care receiving, this article offers sociological insights into the ways in which members of the public reason around assistive actions, be they performed by humans, machines or both. Drawing on a prospective public deliberation study that took place in Quebec (Canada) in 2014 with participants (n = 63) of different age groups, our findings clarify how they envisage what robots can and cannot do to assist older people, and when and why delegating certain tasks to robots becomes problematic. A better understanding of where the publics draw a limit in the substitution of humans by robots refocuses policymakers' attention on what good care entails in modern healthcare systems.
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Affiliation(s)
- P Lehoux
- Department of Health Management, Evaluation and Policy, University of Montreal, Institute of Public Health Research of University of Montreal (IRSPUM), University of Montreal Research Chair on Responsible Innovation in Health, P.O. Box 6128, Branch Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.
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Algilani S, Langius-Eklöf A, Kihlgren A, Blomberg K. An interactive ICT platform for early assessment and management of patient-reported concerns among older adults living in ordinary housing - development and feasibility. J Clin Nurs 2017; 26:1575-1583. [PMID: 27381423 DOI: 10.1111/jocn.13468] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To develop and test feasibility and acceptability of an interactive ICT platform integrated in a tablet for collecting and managing patient-reported concerns of older adults in home care. BACKGROUND Using different ICT applications, for example interactive tablets for self-assessment of health and health issues based on health monitoring as well as other somatic and psychiatric monitoring systems may improve quality of life, staff and patient communication and feelings of being reassured. The European Commission hypothesises that introduction of ICT applications to the older population will enable improved health. However, evidence-based and user-based applications are scarce. DESIGN The design is underpinned by the Medical Research Council's complex intervention evaluation framework. A mixed-method approach was used combining interviews with older adults and healthcare professionals, and logged quantitative data. METHODS In cooperation with a health management company, a platform operated by an interactive application for reporting and managing health-related problems in real time was developed. Eight older adults receiving home care were recruited to test feasibility. They were equipped with the application and reported three times weekly over four weeks, and afterwards interviewed about their experiences. Three nurses caring for them were interviewed. The logged data were extracted as a coded file. RESULTS The older adults reported as instructed, in total 107 reports (Mean 13). The most frequent concerns were pain, fatigue and dizziness. The older adults experienced the application as meaningful with overall positive effects as well as potential benefits for the nurses involved. CONCLUSIONS The overall findings in this study indicated high feasibility among older adults using the ICT platform. The study's results support further development of the platform, as well as tests in full-scale studies and in other populations. RELEVANCE TO CLINICAL PRACTICE An ICT platform increased the older adults' perception of involvement and facilitated communication between the patient and nurses.
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Affiliation(s)
- Samal Algilani
- Nutrition and Physical Activity Research Centre (NUPARC), Faculty of Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Annica Kihlgren
- Nutrition and Physical Activity Research Centre (NUPARC), Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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14
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15
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Kolkowska E, Avatare Nöu A, Sjölinder M, Scandurra I. To Capture the Diverse Needs of Welfare Technology Stakeholders – Evaluation of a Value Matrix. HUMAN ASPECTS OF IT FOR THE AGED POPULATION. APPLICATIONS, SERVICES AND CONTEXTS 2017. [DOI: 10.1007/978-3-319-58536-9_32] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Older people, assistive technologies, and the barriers to adoption: A systematic review. Int J Med Inform 2016; 94:112-6. [PMID: 27573318 DOI: 10.1016/j.ijmedinf.2016.07.004] [Citation(s) in RCA: 168] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 06/28/2016] [Accepted: 07/06/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Older people generally prefer to continue living in their own homes rather than move into residential age care institutions. Assistive technologies and sensors in the home environment and/or bodily worn systems that monitor people's movement might contribute to an increased sense of safety and security at home. However, their use can raise ethical anxieties as little is known about how older persons perceive assistive and monitoring technologies. OBJECTIVES To review the main barriers to the adoption of assistive technologies (ATs) by older adults in order to uncover issues of concern from empirical studies and to arrange these issues from the most critical to the least critical. METHOD A 4-step systematic review was conducted using empirical studies: locating and identifying relevant articles; screening of located articles; examination of full text articles for inclusion/exclusion; and detail examination of the 44 articles included. RESULTS Privacy is a top critical concern to older adults, registering a 34% of the total articles examined. Two other equally potent barriers to the adoption of ATs were trust and functionality/added value representing 27 and 25 per cent each respectively of the total studies examined. Also of serious concerns are cost of ATs and ease of use and suitability for daily use (23%) each respectively, perception of "no need" (20%), stigma (18%), and fear of dependence and lack of training (16%) each respectively. These underlying factors are generation/cohort effects and physical decline relating to aging, and negative attitudes toward technologies such as the so-called "gerontechnologies" specifically targeting older adults. However, more and more older adults adopt different kinds of ATs in order to fit in with the society. CONCLUSIONS The identified underlying factors are generation/cohort effects and physical decline relating to aging, and negative attitudes toward technologies. The negative attitudes that are most frequently associated with technologies such as the so-called "gerontechnologies" specifically targeting older adults contain stigmatizing symbolism that might prevent them from adopting them.
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Olsson A, Skovdahl K, Engström M. Using diffusion of innovation theory to describe perceptions of a passive positioning alarm among persons with mild dementia: a repeated interview study. BMC Geriatr 2016; 16:3. [PMID: 26745961 PMCID: PMC4706660 DOI: 10.1186/s12877-016-0183-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Problems with memory and decline in cognitive abilities are common during development of dementia. Different kinds of technologies may be useful in supporting persons with dementia and their relatives in daily life. Tracking technologies have the potential to improve independence among persons with dementia. Consequently, the aim of the present study was to describe perceptions of a passive positioning alarm (PPA) among persons with mild dementia. METHODS A repeated interview study was conducted in Sweden with a strategic sample of 11 persons with mild dementia. Roger's Diffusion of Innovation Theory was used to deductively analyse the data. RESULTS Regarding the advantages of the PPA, participants described perceived safety and security for, both themselves, and their relatives, as well as freedom and independence. However, they also expressed concern about the cost of the PPA, reflected on who might be the receiver of the alarm from the PPA, emphasized the importance of opportunities to test the device before becoming a user and early introduction before their problems start, thus allowing them to decide for themselves. CONCLUSIONS Supporting persons with dementia in their own homes using, e.g., a PPA may enable them and their relatives to remain longer in their own homes and be safer in their own neighbourhoods.
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Affiliation(s)
- Annakarin Olsson
- Faculty of Health and Occupational Studies, University of Gävle, 80176, Gävle, Sweden.
| | - Kirsti Skovdahl
- Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 235, 3603, Kongsberg, Norway.
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, 80176, Gävle, Sweden. .,Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden.
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Vaismoradi M, Wang IL, Turunen H, Bondas T. Older people's experiences of care in nursing homes: a meta-synthesis. Int Nurs Rev 2015; 63:111-21. [DOI: 10.1111/inr.12232] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Inger-Lise Wang
- Faculty of Professional Studies; University of Nordland; Bodø Norway
| | - Hannele Turunen
- Department of Nursing Science; Kuopio Campus; University of Eastern Finland; Kuopio Finland
| | - Terese Bondas
- Faculty of Professional Studies; University of Nordland; Bodø Norway
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Beedholm K, Frederiksen K, Frederiksen AMS, Lomborg K. Attitudes to a robot bathtub in Danish elder care: A hermeneutic interview study. Nurs Health Sci 2015; 17:280-6. [PMID: 25655980 DOI: 10.1111/nhs.12184] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 09/29/2014] [Accepted: 10/15/2014] [Indexed: 11/26/2022]
Abstract
In Western countries, assistive technology is implemented on a large scale in elder care settings. Only a few studies have attempted to explore the different attitudes to assistive technology among various groups of users. In this study, we investigated and explained the different attitudes among the involved leaders, nursing staff, and older people to a newly-implemented robot bathtub. Qualitative analyses of eight interviews with managers, nursing staff, and the older users revealed that the informants focused on different aspects (process, values, and functionality, respectively), used different implicit quality criteria, and ascribed different symbolic significance to the robot bathtub. Thus, the study demonstrated how attitudes toward the robot bathtub were connected to the informants' institutional role. The findings challenge the current paradigm, where technology is expected to operate as a passive tool, simply facilitating desired human acts and interactions. Further studies drawing on the epistemological and ontological perceptions of science technology studies are needed in order to understand human rationalities in the assistive technology context and to offer new insights into how technology "works" in organizations.
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Affiliation(s)
- Kirsten Beedholm
- Department of Public Health, Section for Nursing, Aarhus University, Aarhus, Denmark
| | - Kirsten Frederiksen
- Department of Public Health, Section for Nursing, Aarhus University, Aarhus, Denmark
| | | | - Kirsten Lomborg
- Department of Public Health, Section for Nursing, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
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Fischer SH, David D, Crotty BH, Dierks M, Safran C. Acceptance and use of health information technology by community-dwelling elders. Int J Med Inform 2014; 83:624-35. [PMID: 24996581 DOI: 10.1016/j.ijmedinf.2014.06.005] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 05/16/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES With the worldwide population growing in age, information technology may help meet important needs to prepare and support patients and families for aging. We sought to explore the use and acceptance of information technology for health among the elderly by reviewing the existing literature. METHODS Review of literature using PubMed and Google Scholar, references from relevant papers, and consultation with experts. RESULTS Elderly people approach the Internet and health information technology differently than younger people, but have growing rates of adoption. Assistive technology, such as sensors or home monitors, may help 'aging in place', but these have not been thoroughly evaluated. Elders face many barriers in using technology for healthcare decision-making, including issues with familiarity, willingness to ask for help, trust of the technology, privacy, and design challenges. CONCLUSIONS Barriers must be addressed for these tools to be available to this growing population. Design, education, research, and policy all play roles in addressing these barriers to acceptance and use.
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Affiliation(s)
- Shira H Fischer
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States; RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, United States.
| | - Daniel David
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States; Jonas Foundation Scholar, School of Nursing, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave., Boston, MA 02115, United States
| | - Bradley H Crotty
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States
| | - Meghan Dierks
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States
| | - Charles Safran
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States
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Nordgren A. Personal health monitoring: ethical considerations for stakeholders. JOURNAL OF INFORMATION COMMUNICATION & ETHICS IN SOCIETY 2013. [DOI: 10.1108/jices-06-2013-0015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Harrefors C, Sävenstedt S, Lundquist A, Lundquist B, Axelsson K. Professional Caregivers' Perceptions on how Persons with Mild Dementia Might Experience the Usage of a Digital Photo Diary. Open Nurs J 2012; 6:20-9. [PMID: 22509232 PMCID: PMC3322432 DOI: 10.2174/1874434601206010020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 01/23/2012] [Accepted: 01/27/2012] [Indexed: 11/22/2022] Open
Abstract
Cognitive impairments influence the possibility of persons with dementia to remember daily events and maintain a sense of self. In order to address these problems a digital photo diary was developed to capture information about events in daily life. The device consisted of a wearable digital camera, smart phone with Global Positioning System (GPS) and a home memory station with computer for uploading the photographs and touch screen. The aim of this study was to describe professional caregiver's perceptions on how persons with mild dementia might experience the usage of this digital photo diary from both a situation when wearing the camera and a situation when viewing the uploaded photos, through a questionnaire with 408 respondents. In order to catch the professional caregivers' perceptions a questionnaire with the semantic differential technique was used and the main question was "How do you think Hilda (the fictive person in the questionnaire) feels when she is using the digital photo diary?". The factor analysis revealed three factors; Sense of autonomy, Sense of self-esteem and Sense of trust. An interesting conclusion that can be drawn is that professional caregivers had an overall positive view of the usage of digital photo diary as supporting autonomy for persons with mild dementia. The meaningfulness of each situation when wearing the camera and viewing the uploaded pictures to be used in two different situations and a part of an integrated assistive device has to be considered separately. Individual needs and desires of the person who is living with dementia and the context of each individual has to be reflected on and taken into account before implementing assistive digital devices as a tool in care.
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Affiliation(s)
| | - Stefan Sävenstedt
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | | | | | - Karin Axelsson
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
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