They Don't Care About Us! Care Personnel's Perspectives on Ambient Assisted Living Technology Usage: Scenario-Based Survey Study

Anxiety, depression, perceived executive function and sugar sweetened beverages: a causal mediation analysis in Mexican young adults

There is the notion that dysregulation of executive function (EF), which disrupts behavior and cognitive processes, may explain the emotional impairment which leads to increasing sugar sweetened beverages (SSBs) intake. We aimed to test whether anxiety and depression mediate the association between self-reported problems in EF and sugar sweetened beverage intake in Mexican adults between 18-40 years. An open survey advertised as a 'mental health and sugar sweetened beverages study' was conducted, participants were recruited through Facebook ads. Males and females, between 18-40 years, able to read and write, and currently residing in Mexico were included. We analyzed data using causal mediation analysis with latent variables using a structural equation modelling framework. Significant indirect effects were found for somatic symptoms of depression (β = 6.601, SE = 2.657, p < .05) and anxiety (β = .679, SE =.334, p < .05). In depression model no significant direct effects of EF were found in the depression model, however they were found in the anxiety model (β = 1.335 SE =.566, p < .05). Somatic symptoms of depression were a total mediator, and anxiety a partial mediator. The results suggest that EF increased the probability of emotional symptoms, which led to a higher consumption of SBBs.

[Factors influencing the intention of caregivers to use digital technologies in outpatient care - A case study examining the introduction of a textile sensor mat]

Durch die steigende Arbeitsbelastung in der Pflegebranche werden Arbeitsprozesse zunehmend digitalisiert. Die Folge eines unzureichenden Einbezugs von Pflegekräften in diesen Digitalisierungsprozess zeigt sich in schlecht integrierten technologischen Entwicklungen mit ausbleibender Technikakzeptanz. Um eine Basis für eine erfolgreiche Technikentwicklung in der ambulanten Pflege legen zu können, gilt es zunächst die Nutzungsabsicht ambulanter Pflegekräfte besser zu verstehen. Zur Untersuchung der Nutzungsabsicht wird in dieser Arbeit ein Modell entwickelt, das Einflussfaktoren auf die Nutzungsintention von digitalen Technologien in der ambulanten Pflege anhand einer Fallstudie zur Einführung einer textilen Sensormatte aufzeigt. Im entwickelten Modell wird erstmals neben der Technikakzeptanz auch die Pflegesituation als Einflussfaktor auf die Nutzungsintention betrachtet und untersucht. Neben der Herleitung der Faktoren des Modells und der Untersuchung der Stärke ihrer Einflüsse wird die praktische Relevanz für Technikentwickler*innen auch in anderen Pflegekontexten abgeleitet.

Praktische Relevanz: Der demographische Wandel in der deutschen Bevölkerung führt zu großen Herausforderungen in unterschiedlichen Branchen. In der ohnehin bereits stark vom Fachkräftemangel betroffenen Pflegebranche macht sich dieser Wandel besonders in einer Zunahme pflegebedürftiger Menschen in der ambulanten Pflege und einer hohen Arbeitsbelastung der Beschäftigten bemerkbar. Zur Reduktion dieser Arbeitsbelastung werden daher vermehrt digitale Technologien verwendet, die den Arbeitsalltag von Pflegekräften hinsichtlich physischer und psychischer Faktoren erleichtern sollen. Das in dieser Studie entwickelte Modell beschreibt – auf Basis eines Fallbeispiels zur Einführung einer Sensormatte – förderliche und hinderliche Faktoren für die Technikeinführung in der ambulanten Pflege und trägt so zu einer gelingenden Digitalisierung in diesem Berufsbereich bei.

A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: Formative Evaluation Study

Background

Care personalization is key to the well-being of people with dementia according to person-centered care. With the development of the internet of things, a large quantity of personal data can be collected securely and reliably, which has the potential to facilitate care personalization for people with dementia. Yet, there are limited assistive technologies developed for this purpose, and the user acceptance of assistive technologies is low in nursing homes. Therefore, through a data-enabled design approach, a digital platform was developed for helping the care team in a nursing home to personalize dementia care, specifically in the management of behavioral and psychological dementia symptoms.

Objective

This study aimed to evaluate the digital platform in a real-life context with potential users from the following two aspects: (1) to explore if the digital platform could help with generating insights on the current state of each person with dementia and (2) to gather feedback on the digital platform from the care team.

Methods

The digital platform was deployed in the nursing home for 7 weeks and the data collected were visualized and presented to the care team via the digital platform. The visualizations were analyzed by the researchers for pattern detection. Meanwhile, the care team was asked to examine the visualizations and were interviewed for the following: (1) if any insights and actions were generated from the examination, (2) the usefulness of the digital platform, and (3) the improvements they would like to see.

Results

The data collected on the digital platform demonstrated its potential for pattern detection. Insights were generated by the care team and categorized into “client level,” “ward level,” and “team level.” The corresponding actions taken by the care team were classified into “investigation” and “implementation.” User acceptance varied across the care team, and three aspects of improvement for the digital platform were identified.

Conclusions

By evaluating the digital platform, this study gained insights on applying data-enabled design for personalizing dementia care; besides, it offers future researchers some recommendations on how to integrate assistive technologies in the nursing home context.

Perceptions About Technologies That Help Community-Dwelling Older Adults Remain at Home: Qualitative Study

Background

The population of Europe is aging rapidly. Most community-dwelling older adults (CDOAs) want to remain in their homes, particularly those experiencing functional decline. Politicians and academics repeatedly praise technological instruments for being the preferred solution for helping older adults with deteriorating health to remain at home.

Objective

This study aimed to understand the perceptions of CDOAs and their informal caregivers (ICs) and professional caregivers (PCs) about technologies that can help keep older adults at home.

Methods

This qualitative study used personal interviews, focus groups, and photo-elicitation interviews to better understand the perceptions of a convenience sample of 68 CDOAs, 21 ICs, and 32 PCs.

Results

A fraction of CDOAs did not perceive technological instruments to be a very useful means of helping them remain at home. However, the ICs and PCs were more positive. The CDOAs preferred and were more willing to adopt technologies related to their mobility and safety and those that would help slow down their cognitive decline. The ICs preferred technological aids that assist in the activities of daily living as well as safety-related technologies for detecting falls and helping to locate disoriented older adults. The PCs preferred integrated communication and information systems to improve collaboration between all stakeholders, housing equipped with technologies to manage complex care, high-performance ancillary equipment to transfer people with reduced mobility, and surveillance systems to ensure safety at home.

Conclusions

Although our study reports that CDOAs have limited interest in innovative technologies to help them remain at home, their technological skills will undoubtedly improve in the future, as will those of ICs and PCs. Technological tools will play an increasingly important role in home health care.

Nothing Else Matters! Trade-Offs Between Perceived Benefits and Barriers of AAL Technology Usage

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.

Bare necessities? How the need for care modulates the acceptance of ambient assisted living technologies

BACKGROUND

Steadily increasing numbers of older people and people in need of care represent critical challenges for today's society. In the last years, diverse (health-related) technologies have been developed to facilitate living at home for older people but also to support (professional) care personnel in their daily care efforts. Ambient Assisted Living (AAL) technologies have the potential to enhance safety, support medical therapy, or facilitate everyday chores and social life. With the huge range and variety of technical opportunities, the question arises what influences (potential) users' decisions for the right technology in their individual conditions and situations. In particular with regard to the fragility of the care situation, it is unknown which technologies are desired for different care needs and diverse situations.

OBJECTIVES

The present study investigates (1) personal care needs as a potential influencing parameter for technology acceptance and (2) the selection of specific technologies.

METHOD

In an online questionnaire (including n = 162 people of all ages), technology acceptance and the selection of specific technologies was assessed, using two scenarios differing in their personal care needs (low care needs vs. moderate care needs) in two situational contexts (emergency detection vs. medical reminders).

RESULTS

Personal care needs influence the perception of benefits, barriers, and general acceptance of assisting technologies, independent from situational context. Higher needs for care lead to higher acknowledgements of the technology's benefits, lower agreements or, in parts, higher rejections of potential barriers and higher acceptance. The two care situations differ regarding the participants' preferences for technologies: For emergency detection, smart watches and emergency buttons are clearly accepted. In contrast, cameras are consistently rejected. For situations in which medical reminders are used, smartphone and smartwatches are most wanted, whereas audio assistants and smart TV were rather rejected.

CONCLUSIONS

The results provide insights into users' preferences for specific technologies for the purpose of emergency detection and medical reminders as well as for the important influence of personal care needs. These insights can be used to derive user-tailored solutions of technology configurations for specific care needs and situations.