Acceptability of a lifelogging wearable camera in older adults with mild cognitive impairment: a mixed-method study

Perspectives and expectations of stroke survivors using egocentric cameras for monitoring hand function at home: a mixed methods study

PURPOSE

Most stroke survivors have remaining upper limb impairment six months after stroke and require additional rehabilitation and help from family members to enhance their performance of daily activities. First-person (egocentric) video has been proposed to capture the activities of daily living (ADLs) of stroke survivors in order to assess their hand function at home. This study explored the experiences and expectations of stroke survivors regarding the use of egocentric cameras in daily life for rehabilitation applications.

METHODS

Twenty-one chronic stroke survivors recruited for the study were asked to record three sessions of 1.5 h of video of their ADLs at home over two weeks. Their experiences and expectations after completing the recordings were discussed using a structured questionnaire and a semi-structured interview. The questionnaire and interview data were analysed using descriptive statistics and content analysis, respectively. The results were further integrated using a mixed methods analysis for mutual explanation and elaboration.

RESULTS

The themes generated were Camera Usability, Privacy Concerns Related to Home Recordings, Future Use of the Camera in Public, and Information Usefulness. The participants perceived that the camera was easy to use, the information obtained from the recordings was beneficial, and no major concerns about recording at home. A discreet camera and a solution to privacy issues were prerequisites to recording tasks in public.

CONCLUSIONS

There was high acceptance among stroke survivors regarding the use of wearable cameras for rehabilitation purposes in the future. Concerns to be managed include discomfort, self-consciousness, and the privacy of others.Implications for rehabilitationThe egocentric camera was easy for the stroke survivors to use at home. However, they expressed a preference for cameras to be less noticeable and lighter in the future to minimize self-consciousness and discomfort.Expectations for future use of an egocentric camera for upper limb rehabilitation at home from the perspectives of stroke survivors included receiving feedback on their hand function in daily life and guidance on how to improve function.Privacy concerns of stroke survivors regarding recording activities of daily living were mostly avoidable by planning in advance. However, some personal hygiene tasks and virtual meetings were recorded by accident. A checklist of common activities that may raise privacy issues can be provided along with the camera to serve as a reminder to avoid these issues.

A scoping review of metaverse in emergency medicine

BACKGROUND

Interest in the metaverse has been growing worldwide as the virtual environment provides opportunities for highly immersive and interactive experiences. Metaverse has gradually gained acceptance in the medical field with the advancement of technologies such as big data, the Internet of Things, and 5 G mobile networks. The demand for and development of metaverse are different in diverse subspecialties owing to patients with varying degrees of clinical disease. Hence, we aim to explore the application of metaverse in acute medicine by reviewing published studies and the clinical management of patients.

METHOD

Our review examined the published articles about the concept of metaverse roadmap, and four additional domains were extracted: education, prehospital and disaster medicine, diagnosis and treatment application, and administrative affairs.

RESULTS

Augmented reality (AR) and virtual reality (VR) integration have broad applications in education and clinical training. VR-related studies surpassed AR-related studies in the emergency medicine field. The metaverse roadmap revealed that lifelogging and mirror world are still developing fields of the metaverse.

CONCLUSION

Our findings provide insight into the features, application, development, and potential of a metaverse in emergency medicine. This study will enable emergency care systems to be better equipped to face future challenges.

Feasibility and Acceptability of Wearable Cameras to Assess Self-care in People With Heart Failure: Pilot Study

BACKGROUND

Heart failure (HF) is a common chronic condition that affects over 26 million people worldwide. It is a progressive and debilitating disease with a broad symptom profile, intermittently marked by periods of acute decompensation. People with HF generally do not self-manage their condition well (eg, monitoring symptoms, taking medications regularly, physical activity, etc). A better understanding of self-care activities and what factors may indicate deterioration is warranted.

OBJECTIVE

The aim of this study was to determine the feasibility and acceptability of using wearable cameras to assess self-care activities in people with HF. The study objectives were to (1) explore whether changes in self-care activities could be identified prior to hospitalization and (2) determine the acceptability of wearable cameras to people with HF.

METHODS

A total of 30 people recently diagnosed with HF wore a camera for a maximum of 30 days; the camera took a photo every 30 seconds in the forward-facing direction. At the end of the study, all 30 participants were presented with 8 statements of acceptability, scored on a 5-point Likert scale. To determine whether camera images could identify changes in self-care activities and lifestyle risk factors before hospitalization, we analyzed images from participants (n=8) who were hospitalized during the 30-day study period. Images from the period immediately prior to hospitalization and a comparison were selected for each participant. Images were manually coded according to 9 different event categories relating to self-care and lifestyle risk factors, and events were compared between the 2 periods.

RESULTS

The participants reported high acceptability for wearing the cameras, as most strongly agreed or agreed that they were comfortable to wear (28/30, 93%) and easy to use (30/30, 100%). The results of the camera image analysis showed that participants undertook fewer activities of daily living (P=.008) and were more sedentary (P=.02) prior to being hospitalized, compared to a period nonadjacent to hospitalization.

CONCLUSIONS

Adults with HF were accepting of using a wearable camera for periods within a 30-day time frame. Wearable cameras were a feasible approach for providing data on selected self-care activities and lifestyle risk factors for HF and offer the potential to be a valuable tool for improving our understanding of self-care.

Acceptance and Privacy Perceptions Toward Video-based Active and Assisted Living technologies: Scoping Review (Preprint)

BACKGROUND

The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized.

OBJECTIVE

With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology.

METHODS

A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review.

RESULTS

Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies.

CONCLUSIONS

This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user- and real life-targeting research is needed to assess the acceptance of proposed solutions.

Feasibility and efficacy of TouchCare system using application for older adults living alone: a pilot pre-experimental study

BACKGROUND

With the number of older people living alone continuously rising, health-monitoring systems using information and communication technology (ICT) have been developed to manage their health issues. Life logging and human body communication sensor, types of ICT, have been adapted to manage and monitor health status of the elderly. However, its feasibility and efficacy remain unclear. This study aimed to examine the feasibility of TouchCare system which combined life logging with human body communication technology and its effect on the physical and psychological status of older adults living alone.

METHODS

The TouchCare system, which consisted of a wearable watch, touchpad sensors, TouchCare application, and context-aware artificial intelligence, was developed by DNX Co. Ltd and used by the participants for 5 months. Out of the 111 selected participants, 91 replied to the satisfaction survey, and 22 participated in further investigation regarding their physical and psychological status. Finally, health assessment from 14 participants and sensor data from 13 participants (mean age = 77.4; SD = 3.8) were analyzed to compare their health status and health-related behaviors before and after use of the system.

RESULTS

Out of the 91 participants who took the survey, 51.6% were satisfied with the system. Nutritional status (pre-intervention (10.6 ± 2.0) vs. post-intervention (11.8 ± 1.9), P = 0.04) and fall efficacy (pre-intervention (89.2 ± 15.3) vs. post-intervention (99.9 ± 0.5), P = 0.001) significantly improved after use of the system. Chronic pain (pre-intervention (4.8 ± 2.5) vs. post-intervention (4.4 ± 3.7), P = 0.78) and depressive symptoms (pre-intervention (5.7 ± 3.9) vs. post-intervention (5.4 ± 3.1), P = 0.60) reduced, while cognitive function (pre-intervention (4.1 ± 1.4) vs. post-intervention (4.6 ± 1.1), P = 0.15) and physical performance related to walking improved (pre-intervention (3.9 ± 0.2) vs. post-intervention (4.0 ± 0), P = 0.35), but were not significant. Behaviors related to physical activity and gait improved after use of the system; touch counts of refrigerator and microwave also increased with a decrease in night touch counts.

CONCLUSIONS

The TouchCare system was acceptable to older people living alone, and it efficiently managed their daily living while promoting their health-related behaviors. Further experimental studies are required to verify the effectiveness of the system, and to develop the system which meet the individualized needs of older people living alone.

Effects of the use of autobiographical photographs on emotional induction in older adults: a systematic review

There is evidence to support the positive contribution of autobiographical recall based techniques on individuals' quality of life, mood and cognitive functioning. In this review, we analyzed the effects of the use of personal photographs in interventions based on autobiographical memory in older people with and without cognitive impairment. The PRISMA guidelines for systematic reviews were followed. The search was carried out in the electronic databases Web of Sciences (WOS), Medline (PubMed), SCIELO and PsycInfo (American Psychological Association). The articles based on clinical trials selected were evaluated using the PEDRo scale, which is specific to this type of article. Of the 1098 articles initially found, 6 met the inclusion criteria. The final articles focused their intervention on the use of autobiographical photographs as a means of stimulation. The results show that the use of photographs in different autobiographical recall stimulation techniques is associated with higher scores on well-being and quality of life, as well as with improvements in personal identity and cognitive functioning. This suggests that using personal photographs shows promise in enhancing the effect of these types of interventions in healthy or cognitively impaired older adults.

Analyzing technology acceptance and perception of privacy in ambient assisted living for using sensor-based technologies

People increasingly use various technologies that enable them to ease their everyday lives in different areas. Not only wearable devices are gaining ground, but also sensor-based ambient devices and systems are increasingly perceived as beneficial in supporting users. Especially older and/or frail persons can benefit from the so-called lifelogging technologies assisting the users in different activities and supporting their mobility and autonomy. This paper empirically investigates users’ technology acceptance and privacy perceptions related to sensor-based applications implemented in private environments (i.e., passive infrared sensors for presence detection, humidity and temperature sensors for ambient monitoring, magnetic sensors for user-furniture interaction). For this purpose, we designed an online survey entitled “Acceptance and privacy perceptions of sensor-based lifelogging technologies” and collected data from N = 312 German adults. In terms of user acceptance, statistical analyses revealed that participants strongly agree on the benefits of such sensor-based ambient technologies, also perceiving these as useful and easy to use. Nevertheless, their intention to use the sensor-based applications was still rather limited. The evaluation of privacy perceptions showed that participants highly value their privacy and hence require a high degree of protection for their personal data. The potential users assessed the collection of data especially in the most intimate spaces of domestic environments, such as bathrooms and bedrooms, as critical. On the other hand, participants were also willing to provide complete data transparency in case of an acute risk to their health. Our results suggest that users’ perceptions of personal privacy largely affect the acceptance and successful adoption of sensor-based lifelogging in home environments.

Effects of an art-based intervention in older adults with mild cognitive impairment: a randomised controlled trial

BACKGROUND

Art-based interventions may delay cognitive decline and improve health-related outcomes in older adults with mild cognitive impairment (MCI).

OBJECTIVE

To examine the effects of the Creative Expressive Arts-based Storytelling (CrEAS) program compared to active and waitlist controls on neurocognitive and other health-related outcomes in older people with MCI.

DESIGN

Three-arm parallel-group, randomised controlled design.

PARTICIPANTS

One-hundred and thirty-five adults with MCI (mean age: 70.93 ± 6.91 years).

METHODS

Participants were randomly assigned to intervention (CrEAS, n = 45), active control (n = 45) or waitlist control (n = 45) groups. Interventions were applied once per week for 24 weeks. The primary outcome was global cognitive function; secondary outcomes were specific cognition domains (memory, executive function, language and attention) and other health-related outcomes (anxiety, depression and quality of life [QoL]). All variables were measured at baseline (T0), 24-week follow-up (T1) and 48-week follow-up (T2).

RESULTS

Participants in the CrEAS group showed significantly higher global cognitive function (adjusted mean difference [MD] = -0.905, 95% confidence interval [CI] -1.748 to -0.062; P = 0.038) and QoL (adjusted MD = -4.150, 95% CI -6.447 to -1.853; P = 0.001) and lower depression symptoms (adjusted MD = 2.902, 95% CI 0.699-5.104; P = 0.011) post-intervention at the 24-week follow-up compared with the active control group. At 48-week follow-up, only the Auditory Verbal Learning Test Immediate recall score was significantly improved compared with the active control group (adjusted MD = -2.941, 95% CI -5.262 to -0.620; P = 0.014).

CONCLUSIONS

Older adults with MCI who participated in the CrEAS program improved their neuropsychological outcomes and QoL and reduced their rate of cognitive deterioration.

Now you see it! Using wearable cameras to gain insights into the lived experience of cardiovascular conditions

Wearable cameras offer an innovative way to discover new insights into the lived experience of people with cardiovascular conditions. Wearable cameras can be used alone or supplement more traditional research methods, such as interviews and participant observations. This paper provides an overview of the benefits of using wearable cameras for data collection and outlines some key considerations for researchers and clinicians interested in this method. We provide a case study describing a study design using wearable cameras and how the data were used.

Validation of an Automated Wearable Camera-Based Image-Assisted Recall Method and the 24-h Recall Method for Assessing Women's Time Allocation in a Nutritionally Vulnerable Population: The Case of Rural Uganda

Accurate data are essential for investigating relationships between maternal time-use patterns and nutritional outcomes. The 24 h recall (24HR) has traditionally been used to collect time-use data, however, automated wearable cameras (AWCs) with an image-assisted recall (IAR) may reduce recall bias. This study aimed to evaluate their concurrent criterion validity for assessing women’s time use in rural Eastern Ugandan. Women’s (n = 211) time allocations estimated via the AWC-IAR and 24HR methods were compared with direct observation (criterion method) using the Bland–Altman limits of agreement (LOA) method of analysis and Cronbach’s coefficient alpha (time allocation) or Cohen’s κ (concurrent activities). Systematic bias varied from 1 min (domestic chores) to 226 min (caregiving) for 24HR and 1 min (own production) to 109 min (socializing) for AWC-IAR. The LOAs were within 2 h for employment, own production, and self-care for 24HR and AWC-IAR but exceeded 11 h (24HR) and 9 h (AWC-IAR) for caregiving and socializing. The LOAs were within four concurrent activities for 24HR (−1.1 to 3.7) and AWC-IAR (−3.2 to 3.2). Cronbach’s alpha for time allocation ranged from 0.1728 (socializing) to 0.8056 (own production) for 24HR and 0.2270 (socializing) to 0.7938 (own production) for AWC-IAR. For assessing women’s time allocations at the population level, the 24HR and AWC-IAR methods are accurate and reliable for employment, own production, and domestic chores but poor for caregiving and socializing. The results of this study suggest the need to revisit previously published research investigating the associations between women’s time allocations and nutrition outcomes.

Tiresias: A low-cost networked UWB radar system for in-home monitoring of dementia patients

This paper describes Tiresias, a low-cost, unobtrusive networked radar system designed to monitor vulnerable patients in domestic environments and provide high quality behavioural and health data. Dementia is a disease that affects millions worldwide and progressively degrades an individual's ability to care for themselves. Eventually most people living with dementia will need to reside in assisted living facilities as they become unable to care for themselves. Understanding the effects dementia has on ability to self-care and extending the length of time people living with dementia can remain living independently are key goals of dementia research and care. The networked radar system proposed in this paper is designed to provide high quality behavioural and health data from domestic environments. This is achieved using multiple radar sensors networked together with their data outputs integrated and processed to produce high confidence measures of position and movement. It is hoped the data produced by this system will both provide insights into how dementia progresses, and also help monitor vulnerable individuals in their own homes, allowing them to remain independent longer than would otherwise be possible.

Perspectives and recommendations of individuals with tetraplegia regarding wearable cameras for monitoring hand function at home: Insights from a community-based study

CONTEXT

Wearable cameras have great potential for producing novel outcome measures of upper limb (UL) function and guiding care in individuals with cervical spinal cord injury (cSCI) living in the community. However, little is known about the perspectives of individuals with cSCI on the potential adoption of this technology.

OBJECTIVE

To analyze feedback from individuals with cSCI regarding the use of wearable cameras to record daily activities at home, in order to define guidelines for improving the design of this technology and fostering its implementation to optimize UL rehabilitation.

DESIGN

Mixed-methods study.

PARTICIPANTS

Thirteen adults with cSCI C3-C8 AIS A-D impairment.

MEASURES

Interview including survey and semi-structured questions.

RESULTS

Participants felt that this technology can provide naturalistic information regarding hand use to clinicians and researchers, which in turn can lead to better assessments of UL function and optimized therapies. Participants described the technology as easy-to-use but often reported discomfort that prevented them from conducting long recordings of fully natural activities. Privacy concerns included the possibility to capture household members and personal information displayed on objects (e.g. smartphones).

CONCLUSION

We provide the first set of guidelines to help researchers and therapists understand which steps need to be taken to translate wearable cameras into outpatient care and community-based research for UL rehabilitation. These guidelines include miniaturized and easy-to-wear cameras, as well as multiple measures for preventing privacy concerns such as avoiding public spaces and providing control over the recordings (e.g. start and stop the recordings at any time, keep or delete a recording).

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Enabling Older Adults' Health Self-Management through Self-Report and Visualization-A Systematic Literature Review

Aging is associated with a progressive decline in health, resulting in increased medical care and costs. Mobile technology may facilitate health self-management, thus increasing the quality of care and reducing costs. Although the development of technology offers opportunities in monitoring the health of older adults, it is not clear whether these technologies allow older adults to manage their health data themselves. This paper presents a review of the literature on mobile health technologies for older adults, focusing on whether these technologies enable the visualization of monitored data and the self-reporting of additional information by the older adults. The systematic search considered studies published between 2009 and 2019 in five online databases. We screened 609 articles and identified 95 that met our inclusion and exclusion criteria. Smartphones and tablets are the most frequently reported technology for older adults to enter additional data to the one that is monitored automatically. The recorded information is displayed on the monitoring device and screens of external devices such as computers. Future designs of mobile health technology should allow older users to enter additional information and visualize data; this could enable them to understand their own data as well as improve their experience with technology.

The Effects of Exposure to Recent Autobiographical Events on Declarative Memory in Amnestic Mild Cognitive Impairment: A Preliminary Pilot Study

BACKGROUND

Individuals with amnestic Mild Cognitive Impairment (aMCI) are at heightened risk of developing Alzheimer's dementia. In recent years, much attention has been given to the search for new interventions to slow down the progression of cognitive decline of these patients. Wearable digital camera devices are one form of new technology that captures images of one's life events, so they constitute a promising method to be used as a means to stimulate recent autobiographical memory.

OBJECTIVE

This preliminary study investigates the ability of a new cognitive intervention based on exposure to recent autobiographical memory captured by wearable cameras to improve episodic memory in patients with aMCI.

METHODS

Seventeen subjects wore a wearable camera while they went about their daily activities. The images captured were converted into eight different 3-minute films containing the most relevant information of each event. The intervention involved eight individualized weekly sessions during which patients were exposed to a different autobiographical event each week. Besides, several specific questions were formulated within each session. Clinical questionnaires assessing cognitive reserve, premorbid intelligence, depression, and anxiety were administered at baseline. Measures of objective episodic memory were applied at baseline and at post-treatment.

RESULTS

Significant improvements were observed at post-treatment in memory measures, and significant associations were found between memory change scores and age and cognitive reserve. Anyway, these associations did not reach statistical significance after adjusting for multiple comparisons.

CONCLUSION

The present study provides preliminary evidence that aMCI patients may benefit from a cognitive intervention program based on re-experiencing recent autobiographical events. However, future studies incorporating a control group will be needed to confirm these preliminary findings.