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Piau A, Steinmeyer Z, Mattek N, Lindauer A, Sharma N, Bouranis N, Wild K, Kaye J. Caregiving in Older Adults; Experiences and Attitudes toward Smart Technologies. J Clin Med 2023; 12:jcm12051789. [PMID: 36902576 PMCID: PMC10003197 DOI: 10.3390/jcm12051789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/25/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
(1) Background: The development of assistive technologies has become a key solution to reduce caregiver burden. The objective of this study was to survey caregivers on perceptions and beliefs about the future of modern technology in caregiving. (2) Methods: Demographics and clinical caregiver characteristics were collected via an online survey along with the perceptions and willingness to adopt technologies to support caregiving. Comparisons were made between those who considered themselves caregivers and those who never did. (3) Results: 398 responses (mean age 65) were analyzed. Health and caregiving status of the respondents (e.g., schedule of care) and of the care recipient were described. The perceptions and willingness to use technologies were generally positive without significant differences between those who ever considered themselves as caregivers and those who never did. The most valued features were the monitoring of falls (81%), medication use (78%), and changes in physical functioning (73%). For caregiving support, the greatest endorsements were reported for one-on-one options with similar scores for both online and in-person alternatives. Important concerns were expressed about privacy, obtrusiveness, and technological maturity. (4) Conclusions: Online surveys as a source of health information on caregiving may be an effective guide in developing care-assisting technologies receiving end users' feedback. Caregiver experience, whether positive or negative, was correlated to health habits such as alcohol use or sleep. This study provides insight on caregivers' needs and perceptions regarding caregiving according to their socio-demographic and health status.
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Affiliation(s)
- Antoine Piau
- Internal Medicine and Gerontology, University Hospital of Toulouse, Université Paul Sabatier, 31062 Toulouse, France
| | - Zara Steinmeyer
- Internal Medicine and Gerontology, University Hospital of Toulouse, Université Paul Sabatier, 31062 Toulouse, France
- Correspondence: ; Tel.: +33-561322392
| | - Nora Mattek
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR 97239, USA
| | - Allison Lindauer
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR 97239, USA
| | - Nicole Sharma
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR 97239, USA
| | - Nicole Bouranis
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR 97239, USA
| | - Katherine Wild
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR 97239, USA
| | - Jeffrey Kaye
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR 97239, USA
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Bentley SA, Black AA, Hindmarsh GP, Owsley C, Wood JM. Concept Mapping to Identify Content for a Performance-Based Measure of Low Luminance Vision-Related Activities of Daily Living. Transl Vis Sci Technol 2022; 11:27. [PMID: 36166222 PMCID: PMC9526368 DOI: 10.1167/tvst.11.9.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to identify low luminance activities of daily living (ADL) relevant to adults with vision impairment using a concept-mapping approach. Methods “Group concept mapping” was utilized to identify specific ADLs that persons with vision impairment find challenging under low light conditions. In the first “brainstorming” phase, 24 adults with vision impairment from a range of eye conditions (mean age = 73 years, SD = 14 years) and 26 international low vision experts (mean experience = 22, SD = 11 years) generated statements to the focus prompt, “Thinking as broadly as possible, generate a list of statements detailing specific day-to-day activities a person with vision impairment might find challenging under low light conditions, such as in a poorly lit room or outside at dusk.” In the second phase, participants sorted activities by similarity and rated the importance of each activity. Multidimensional scaling and hierarchical cluster analysis were applied to produce concept maps showing clusters of prioritized activities. Results One hundred thirteen unique ideas/activities were generated, rated and sorted. Eight clusters were identified (from highest to lowest importance): hazard detection and safety outside; social interactions; navigation; near reading; selfcare and safety at home; distance spotting; searching around the home; and cooking and cleaning. Conclusions The conceptual framework and low luminance ADLs identified (the most important being hazard detection and safety outside, and social interactions) provide a basis for developing a performance-based measure of low luminance visual function. Translational Relevance A performance-based measure of low luminance vision-related ADLs is required for comprehensively and objectively assessing efficacy of eye treatments and low vision rehabilitation outcomes in adults with vision impairment.
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Affiliation(s)
- Sharon A Bentley
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Gregory P Hindmarsh
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joanne M Wood
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
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Choukou MA, Shortly T, Leclerc N, Freier D, Lessard G, Demers L, Auger C. Evaluating the acceptance of ambient assisted living technology (AALT) in rehabilitation: A scoping review. Int J Med Inform 2021; 150:104461. [PMID: 33892446 DOI: 10.1016/j.ijmedinf.2021.104461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/05/2021] [Accepted: 04/06/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Ambient assisted living technologies (AALTs) are being used to help community-dwelling older adults (OAs) age in place. Although many AALT are available, their acceptance (perceived usefulness, ease of use, intention to use and actual usage) is needed to improve their design and impact. This study aims to 1) identify AALTs that underwent an acceptance evaluation in rehabilitation contexts, 2) identify methodological tools and approaches to measure acceptance in ambient assisted living (AAL) in rehabilitation research, and 3) summarize AALT acceptance results in existing rehabilitation literature with a focus on peer-reviewed scientific articles. METHODS A scoping review was conducted in the following databases: Medline, Embase, Cinahl, and PsycInfo, following the Arksey and O'Malley framework (2009). Four acceptance attributes were extracted: 'user acceptance', 'perceived usefulness', 'ease of use', and 'intention to use'. Data regarding AALT, participants, acceptance evaluation methods and results were extracted. RESULTS A total of 21 articles were included among 634 studies retrieved from the literature. We identified 51 AALTs dedicated to various rehabilitation contexts, most of which focused on monitoring OAs' activities and environmental changes. Acceptance of AALT was evaluated using interviews, questionnaires, focus groups, informal feedback, observation, card sort tasks, and surveys. Although OAs intend to use - or can perceive the usefulness of - AALTs, they are hesitant to accept the technology and have concerns about its adoption. DISCUSSION AND CONCLUSIONS The assessment of AALT acceptance in contexts of rehabilitation requires more comprehensive and standardized methodologies. The use of mixed-methods research is encouraged to cover the needs of particular studies. The timing of acceptance assessment should be considered throughout technology development phases to maximize AALT implementation.
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Affiliation(s)
- Mohamed-Amine Choukou
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada; Centre on Aging, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada.
| | - Taylor Shortly
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Nicole Leclerc
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Derek Freier
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Genevieve Lessard
- Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6363 Hudson Road, Montreal, Quebec, H3S 1M9, Canada
| | - Louise Demers
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre Intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, 4565 Queen Mary Road, Montreal, Quebec, H3W 1W5, Canada
| | - Claudine Auger
- Centre for Interdisciplinary Research in Rehabilitation of the Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), 6363 Hudson Road, Montreal, Quebec, H3S 1M9, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada
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Abstract
BACKGROUND Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits at rehabilitation clinics to receive training to learn to use VAE. These people may be able to overcome barriers to care through remote, Internet-based consultation (i.e. telerehabilitation). OBJECTIVES To compare the effects of telerehabilitation with face-to-face (e.g. in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and near reading ability in people with visual function loss due to any ocular condition. Secondary objectives were to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for VAE devices, and patient satisfaction ratings. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 6); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the Internet was not introduced to the public until 1982. We last searched the electronic databases on 24 June 2019. SELECTION CRITERIA We planned to include randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants diagnosed with low vision were undergoing low vision rehabilitation using an Internet, web-based technology compared with an approach involving in-person consultations. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts and then full-text articles against the eligibility criteria. We planned to have two review authors independently abstract data from the included studies. Any discrepancies were resolved by discussion. MAIN RESULTS We identified two ongoing studies, but did not find any completed RCTs and CCTs that met the inclusion criteria for this review. We did not conduct a quantitative analysis. We discussed review articles on telemedicine for facilitating communication with elderly individuals or for providing remote ophthalmological care. AUTHORS' CONCLUSIONS We did not find any evidence from RCTs or CCTs on the efficacy of using telerehabilitation for remote delivery of rehabilitation services to individuals with low vision. Given the disease burden and the growing interest in telemedicine, the two ongoing studies, when completed, may provide evidence in understanding the potential for telerehabilitation as a platform for providing services to people with low vision.
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Affiliation(s)
- Ava K Bittner
- UCLA Stein Eye InstituteOphthalmology200 Stein Plaza DrivewayLos AngelesCaliforniaUSA90095
| | - Patrick D Yoshinaga
- Marshall B Ketchum UniversitySouthern California College of Optometry2575 Yorba Linda BoulevardFullertonCaliforniaUSA92831
| | | | - Tianjing Li
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 North Wolfe Street, E6011BaltimoreMarylandUSA21205
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Offermann-van Heek J, Ziefle M. Nothing Else Matters! Trade-Offs Between Perceived Benefits and Barriers of AAL Technology Usage. Front Public Health 2019; 7:134. [PMID: 31245342 PMCID: PMC6581733 DOI: 10.3389/fpubh.2019.00134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/13/2019] [Indexed: 01/27/2023] Open
Abstract
Ambient assisted living (AAL) technologies present one approach to counter the challenges of demographic change in terms of an aging population, rising care needs, and lacking care personnel by supporting (older) people in need of care and enabling a longer and more independent staying at own home. Although the number of studies focusing on AAL users' acceptance and perception has increased in the last years, trade-off decisions-the weighing of perceived benefits and barriers of technology usage-have not been studied so far. Nevertheless, this is of high relevance: A realistic evaluation of adoption behaviors in different stakeholders (patients, care personnel) requires an understanding of exactly the weighing process of benefits against the barriers in line with the decision of the final willingness to use AAL technology. The current study applied a conjoint analysis approach and investigates people's decision behavior to use an AAL system for a family member in need of care. Study participants (n = 140) had to decide between realistic care scenarios consisting of different options of two benefits (increase in safety, relief of caring burden of relatives) and two barriers (access to personal data and data handling) of technology usage. Results revealed data access and privacy to be most relevant for the decision to use AAL technology at home. However, care experience essentially influenced the decision patterns. For the care experienced group, data access should be limited to most trusted persons and close relatives, rather than to medical professionals. The most important reasons to use AAL are the emotional relief and the felt safety for the person in care. For care novices, in contrast, data access should be in the exclusive responsibility of medical professionals. The reasons that militate in favor of using AAL technology are the increase in process efficiency and medical safety. The results are useful to develop user-tailored technology concepts and derive user-specific communication guidelines within and across clinical and home care contexts.
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Batsis JA, Boateng GG, Seo LM, Petersen CL, Fortuna KL, Wechsler EV, Peterson RJ, Cook SB, Pidgeon D, Dokko RS, Halter RJ, Kotz DF. Development and Usability Assessment of a Connected Resistance Exercise Band Application for Strength-Monitoring. WORLD ACADEMY OF SCIENCE, ENGINEERING AND TECHNOLOGY 2019; 13:340-348. [PMID: 31205628 PMCID: PMC6570823 DOI: 10.5281/zenodo] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Resistance exercise bands are a core component of any physical activity strengthening program. Strength training can mitigate the development of sarcopenia, the loss of muscle mass or strength and function with aging. Yet, the adherence of such behavioral exercise strategies in a home-based setting are fraught with issues of monitoring and compliance. Our group developed a Bluetooth-enabled resistance exercise band capable of transmitting data to an open-source platform. In this work, we developed an application to capture this information in real-time, and conducted three usability studies in two mixed-aged groups of participants (n=6 each) and a group of older adults with obesity participating in a weight-loss intervention (n=20). The system was favorable, acceptable and provided iterative information that could assist in future deployment on ubiquitous platforms. Our formative work provides the foundation to deliver home-based monitoring interventions in a high-risk, older adult population.
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Affiliation(s)
- J A Batsis
- Dartmouth-Hitchcock, Geisel School of Medicine at Dartmouth College, and The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, 03756 USA
| | - G G Boateng
- Dartmouth College, Hanover, NH, 03755, USA. He is now with the Eidgenössische Technische Hochschule Zürich ETH, Zurich, Switzerland
| | - L M Seo
- Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA
| | - C L Petersen
- Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, 03756 USA
| | - K L Fortuna
- Dartmouth-Hitchcock and the Geisel School of Medicine, Lebanon, NH, 03756 USA
| | - E V Wechsler
- Thayer School of Engineering at Dartmouth College, Hanover, NH, 03755, USA
| | | | - S B Cook
- University of New Hampshire, Durham, NH 03824, USA
| | - D Pidgeon
- Dartmouth-Hitchcock, Lebanon, NH, 03756 USA
| | - R S Dokko
- Dartmouth College, Hanover, NH, 03755, USA
| | - R J Halter
- Thayer School of Engineering at Dartmouth College, Hanover, NH, 03755, USA
| | - D F Kotz
- Dartmouth College, Hanover, NH, 03755, USA
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Batsis JA, Boateng GG, Seo LM, Petersen CL, Fortuna KL, Wechsler EV, Peterson RJ, Cook SB, Pidgeon D, Dokko RS, Halter RJ, Kotz DF. Development and Usability Assessment of a Connected Resistance Exercise Band Application for Strength-Monitoring. WORLD ACADEMY OF SCIENCE, ENGINEERING AND TECHNOLOGY 2019; 13:340-348. [PMID: 31205628 PMCID: PMC6570823 DOI: 10.5281/zenodo,] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Resistance exercise bands are a core component of any physical activity strengthening program. Strength training can mitigate the development of sarcopenia, the loss of muscle mass or strength and function with aging. Yet, the adherence of such behavioral exercise strategies in a home-based setting are fraught with issues of monitoring and compliance. Our group developed a Bluetooth-enabled resistance exercise band capable of transmitting data to an open-source platform. In this work, we developed an application to capture this information in real-time, and conducted three usability studies in two mixed-aged groups of participants (n=6 each) and a group of older adults with obesity participating in a weight-loss intervention (n=20). The system was favorable, acceptable and provided iterative information that could assist in future deployment on ubiquitous platforms. Our formative work provides the foundation to deliver home-based monitoring interventions in a high-risk, older adult population.
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Affiliation(s)
- J A Batsis
- Dartmouth-Hitchcock, Geisel School of Medicine at Dartmouth College, and The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, 03756 USA
| | - G G Boateng
- Dartmouth College, Hanover, NH, 03755, USA. He is now with the Eidgenössische Technische Hochschule Zürich ETH, Zurich, Switzerland
| | - L M Seo
- Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA
| | - C L Petersen
- Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, 03756 USA
| | - K L Fortuna
- Dartmouth-Hitchcock and the Geisel School of Medicine, Lebanon, NH, 03756 USA
| | - E V Wechsler
- Thayer School of Engineering at Dartmouth College, Hanover, NH, 03755, USA
| | | | - S B Cook
- University of New Hampshire, Durham, NH 03824, USA
| | - D Pidgeon
- Dartmouth-Hitchcock, Lebanon, NH, 03756 USA
| | - R S Dokko
- Dartmouth College, Hanover, NH, 03755, USA
| | - R J Halter
- Thayer School of Engineering at Dartmouth College, Hanover, NH, 03755, USA
| | - D F Kotz
- Dartmouth College, Hanover, NH, 03755, USA
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Offermann-van Heek J, Ziefle M. They Don't Care About Us! Care Personnel's Perspectives on Ambient Assisted Living Technology Usage: Scenario-Based Survey Study. JMIR Rehabil Assist Technol 2018; 5:e10424. [PMID: 30249592 PMCID: PMC6231777 DOI: 10.2196/10424] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/29/2018] [Accepted: 06/16/2018] [Indexed: 11/30/2022] Open
Abstract
Background Demographic change represents enormous burdens for the care sectors, resulting in high proportions of (older) people in need of care and a lack of care staff. Ambient Assisted Living (AAL) technologies have the potential to support the bottlenecks in care supply but are not yet in widespread use in professional care contexts. Objective The objective of our study was to investigate professional caregivers’ AAL technology acceptance and their perception regarding specific technologies, data handling, perceived benefits, and barriers. In particular, this study focuses on the perspectives on AAL technologies differing between care professionals working in diverse care contexts to examine the extent to which the care context influences the acceptance of assistive technologies. Methods A Web-based survey (N=170) was carried out focusing on professional caregivers including medical, geriatric, and disabled people’s caregivers. Based on a scenario, the participants were asked for their perceptions concerning specific technologies, specific types of gathered data, and potential benefits of and barriers to AAL technology usage. Results The care context significantly impacted the evaluations of AAL technologies (F14,220=2.514; P=.002). Professional caregivers of disabled people had a significantly more critical attitude toward AAL technologies than medical and geriatric caregivers, indicated (1) by being the only caregiver group that rejected evaluations of AAL technology acceptance (F2,118=4.570; P=.01) and specific technologies (F2,118=11.727; P<.001) applied for gathering data and (2) by the comparatively lowest agreements referring to the evaluations of data types (F2,118=4.073, P=.02) that are allowed to be gathered. Conclusions AAL technology acceptance is critical because of technology implementation reasons, especially in the care of people with disabilities. AAL technologies in care contexts have to be tailored to care professional’s needs and concerns (“care about us”). The results contribute to a broader understanding of professional caregivers’ needs referring to specific data and technology configurations and enclose major differences concerning diverse care contexts. Integrating these findings into user group-tailored technology concepts and communication strategies will support a sustainable adoption of AAL systems in professional care contexts.
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Affiliation(s)
| | - Martina Ziefle
- Human-Computer Interaction Center, RWTH Aachen University, Aachen, Germany
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Identification of Approaches to Improve Patient Trust in Health Systems: A Group Concept Mapping Study. J Healthc Manag 2018; 63:e116-e129. [PMID: 30180038 DOI: 10.1097/jhm-d-17-00037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
EXECUTIVE SUMMARY Higher levels of institutional trust have been associated with increased preventive healthcare use, greater adherence to treatment plans, and improved overall self-rated health status. However, little attention has been paid to understanding approaches to improve patient institutional trust. This study used group concept mapping to elicit patient perspectives on ways to improve patient trust. Eighteen insured individuals living in Delaware County, Pennsylvania, participated in the concept mapping sessions. Participants first brainstormed in a group setting to develop a list of ideas about how systems could improve trust, then each participant sorted the ideas into thematic domains and rated the statements based on both importance and feasibility. Four primary domains for improving institutional trust emerged: privacy, patient-provider relationship, respect for patients, and health system guidelines. Multiple action items to improve patient trust of the system were provided for each domain, and participants rated the "privacy" domain as the most feasible and important to address.We suggest that future local efforts to build institutional trust implement processes to improve the protection of patient privacy, support patient-provider relationships, and engender respect for patients, and that institutions develop system-level guidelines to support these principles. Next steps involve exploring the importance of these domains across other populations and developing and testing targeted interventions.
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Ienca M, Wangmo T, Jotterand F, Kressig RW, Elger B. Ethical Design of Intelligent Assistive Technologies for Dementia: A Descriptive Review. SCIENCE AND ENGINEERING ETHICS 2018; 24:1035-1055. [PMID: 28940133 DOI: 10.1007/s11948-017-9976-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/05/2017] [Indexed: 05/16/2023]
Abstract
The use of Intelligent Assistive Technology (IAT) in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products.
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Affiliation(s)
- Marcello Ienca
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland.
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Fabrice Jotterand
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
- Center for Bioethics and Medical Humanities, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Reto W Kressig
- Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland
- Chair of Geriatrics, University of Basel, Basel, Switzerland
| | - Bernice Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
- Center for Legal Medicine, University of Geneva, Geneva, Switzerland
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Abstract
Mixed methods research is important to health services research because the integrated qualitative and quantitative investigation can give a more comprehensive understanding of complex interventions such as telehealth than can a single-method study. Further, mixed methods research is applicable to translational research and program evaluation. Study designs relevant to telehealth research are described and supported by examples. Quality assessment tools, frameworks to assist in the reporting and review of mixed methods research, and related methodologies are also discussed.
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Affiliation(s)
- Liam J Caffery
- Centre for Online Health, The University of Queensland, Brisbane, Australia
| | - Melinda Martin-Khan
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Research in Geriatric Medicine, Brisbane, The University of Queensland, Australia
| | - Victoria Wade
- Discipline of General Practice, The University of Adelaide, Adelaide, Australia
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Fang JY, Li JL, Li ZH, Xu DM, Chen C, Xie B, Chen H, Au WW. Attitudes towards acceptance of an innovative home-based and remote sensing rehabilitation protocol among cardiovascular patients in Shantou, China. J Geriatr Cardiol 2016; 13:326-32. [PMID: 27403142 PMCID: PMC4921545 DOI: 10.11909/j.issn.1671-5411.2016.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/18/2016] [Accepted: 03/15/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cardiac rehabilitation (CR) protocols have diversified to include home-based cardiac tele-rehabilitation (HBCTR) as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients' attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. METHODS Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional (PCI) surgery, patients completed the survey. RESULTS Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age (OR: 0.92, 95% CI: 0.86-0.98; P = 0.007), average family monthly income (OR: 0.13, 95% CI: 0.05-0.34; P < 0.001), education level (OR: 0.24, 95% CI: 0.10-0.59; P = 0.002) and physical exercise time (OR: 0.19, 95% CI: 0.06-0.56; P = 0.003) were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected: enhanced safety and independence (28.3%), ability to self-monitor physical conditions daily (25.4%), and having automatic and emergency alert (23.1%). Reasons for refusal were: too cumbersome operation (34.3%) and unnecessary protocol (19.4%). CONCLUSIONS Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation.
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Affiliation(s)
- Jia-Ying Fang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Ji-Lin Li
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zhong-Han Li
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Duan-Min Xu
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chang Chen
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Bin Xie
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Helen Chen
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - William W Au
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
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Abstract
BACKGROUND Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits at rehabilitation clinics. These people may be able to overcome barriers to care through remote, Internet-based consultation (i.e., telerehabilitation). OBJECTIVES To compare the effects of telerehabilitation with face-to-face (e.g., in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and reading speed in people with visual function loss due to any ocular condition. Secondary objectives are to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for visual assistive equipment devices, and patient satisfaction ratings. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2015 Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1980 to June 2015), EMBASE (January 1980 to June 2015), PubMed (1980 to June 2015), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the Internet was not introduced to the public until 1982. We last searched the electronic databases on 15 June 2015. SELECTION CRITERIA We planned to include randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants were diagnosed with low vision and were undergoing low vision rehabilitation using an Internet, web-based technology compared with an approach based on in-person consultations. DATA COLLECTION AND ANALYSIS Two authors independently screened titles and abstracts, and then full-text articles against the eligibility criteria. We planned to have two authors independently abstract data from included studies. We resolved discrepancies by discussion. MAIN RESULTS We did not find any study that met the inclusion criteria for this review and, hence, we did not conduct a quantitative analysis. As a part of the background, we discussed review articles on telemedicine for facilitating communication with elderly individuals or for providing remote ophthalmological care. AUTHORS' CONCLUSIONS We did not find any evidence on whether the use of telerehabilitation is feasible or a potentially viable means to remotely deliver rehabilitation services to individuals with low vision. Given the disease burden and the growing interest in telemedicine, there is a need for future pilot studies and subsequent clinical trials to explore the potential for telerehabilitation as a platform for providing services to people with low vision.
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Affiliation(s)
- Ava K Bittner
- Nova Southeastern University, College of Optometry, Ft Lauderdale, Florida, USA
| | | | - Patrick D Yoshinaga
- Southern California College of Optometry, Marshall B Ketchum University, Fullerton, California, USA
| | - Tianjing Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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14
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Abstract
ABSTRACTWith demographic changes and the growing numbers of older people living alone, concerns have been raised about the care of the ageing population. Increasingly, developments in technology are being seen as the solution to these concerns. For those who do not see themselves as old or frail enough to require personal care provision, and who prefer to maintain their identity as autonomous and independent individuals, the development of assistive technologies such as ambient home monitoring systems is one answer. However, this involves careful negotiations with older people's understandings of safety and privacy, and their experiences and relationships with technology, their carers and relevant service-providers. In two trials of a home monitoring system funded by the United Kingdom Technology Strategy Board, older people were interviewed pre-trial and post-trial about their perspectives on these issues. This paper presents a conceptual analysis of the qualitative data using a sociological framework of trust that considers habitual action, and relationships with kin and with wider institutions. The research found that older people's habits and norms do not need to be disrupted by the ambient system. What was of more importance was relationships between the older person and her or his ‘monitor’ based on trust, as well as institutional providers who need to instil or earn trust.
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15
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Ambient Intelligence from Senior Citizens’ Perspectives: Understanding Privacy Concerns, Technology Acceptance, and Expectations. LECTURE NOTES IN COMPUTER SCIENCE 2015. [DOI: 10.1007/978-3-319-26005-1_4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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16
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Boman IL, Bartfai A. The first step in using a robot in brain injury rehabilitation: patients’ and health-care professionals’ perspective. Disabil Rehabil Assist Technol 2014; 10:365-70. [DOI: 10.3109/17483107.2014.913712] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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