More Like this

1. Advance Planning for Technology Use in Dementia Care: Development, Design, and Feasibility of a Novel Self-administered Decision-Making Tool

   https://doi.org/10.2196/39335  

   Berridge, Clara ; Turner, Natalie R ; Liu, Liu ; Karras, Sierramatice W ; Chen, Amy ; Fredriksen-Goldsen, Karen ; Demiris, George ( January 2022 , JMIR Aging)

   Monitoring technologies are used to collect a range of information, such as one’s location out of the home or movement within the home, and transmit that information to caregivers to support aging in place. Their surveilling nature, however, poses ethical dilemmas and can be experienced as intrusive to people living with Alzheimer disease (AD) and AD-related dementias. These challenges are compounded when older adults are not engaged in decision-making about how they are monitored. Dissemination of these technologies is outpacing our understanding of how to communicate their functions, risks, and benefits to families and older adults. To date, there are no tools to help families understand the functions of monitoring technologies or guide them in balancing their perceived need for ongoing surveillance and the older adult’s dignity and wishes.

   We designed, developed, and piloted a communication and education tool in the form of a web application called Let’s Talk Tech to support family decision-making about diverse technologies used in dementia home care. The knowledge base about how to design online interventions for people living with mild dementia is still in development, and dyadic interventions used in dementia care remain rare. We describe the intervention’s motivation and development process, and the feasibility of using this self-administered web application intervention in a pilot sample of people living with mild AD and their family care partners.

   We surveyed 29 mild AD dementia care dyads living together before and after they completed the web application intervention and interviewed each dyad about their experiences with it. We report postintervention measures of feasibility (recruitment, enrollment, and retention) and acceptability (satisfaction, quality, and usability). Descriptive statistics were calculated for survey items, and thematic analysis was used with interview transcripts to illuminate participants’ experiences and recommendations to improve the intervention.

   The study enrolled 33 people living with AD and their care partners, and 29 (88%) dyads completed the study (all but one were spousal dyads). Participants were asked to complete 4 technology modules, and all completed them. The majority of participants rated the tool as having the right length (>90%), having the right amount of information (>84%), being very clearly worded (>74%), and presenting information in a balanced way (>90%). Most felt the tool was easy to use and helpful, and would likely recommend it to others.

   This study demonstrated that our intervention to educate and facilitate conversation and documentation of preferences is preliminarily feasible and acceptable to mild AD care dyads. Effectively involving older adults in these decisions and informing care partners of their preferences could enable families to avoid conflicts or risks associated with uninformed or disempowered use and to personalize use so both members of the dyad can experience benefits.

    

   more » « less
2. Empowering Dementia Caregivers: Incorporating Caregiving Training Resources Into Current Procedural Technology Codes

   https://doi.org/10.1097/NUR.0000000000000803  

   Ko, Eunjung ; Rose, Karen M. ; Wright, Kathy D. ( January 2024 , Clinical Nurse Specialist)

   We aim to explore Current Procedural Terminology (CPT) codes for caregiving training services and their potential impacts on caregivers of people living with dementia.

   In response to the growing need for support for caregivers of people living with physical and mental health issues, CPT codes for caregiving training services will be activated for the calendar year 2024. These codes cover (1) family group behavior management and modification training services and (2) caregiver training for techniques to help patients maintain their quality of life. Caregivers will access such training support through the CPT codes provided by treating practitioners. The duration of training will vary by code.

   Implementing CPT codes for caregiver training services highlights the vital role of caregivers in patient care. This support may improve their skills and communication with healthcare providers. However, timing and accessibility in care delivery need clarification, especially for caregivers of people living with dementia. Regular skill assessment and culturally competent care are essential. Before providing the service, provider training may also promote person-centered care, benefiting patients and their caregivers.

   Activating CPT codes for caregiving training services may enhance caregivers' support and skills, including dementia care.

    

   more » « less
3. Conceptualizing caregiver workload: an exploratory study guided by NASA TLX

   https://doi.org/10.1177/1071181319631245  

   Rutkowski, R.A. ; Ponnala, S. ; Gonzalez-Vargas, J. ; Gilmore-Bykovskyi, A. ; Block, L. ; Kind, A.J. ; Werner, N.E. ( November 2019 , Proceedings of the Human Factors and Ergonomics Society Annual Meeting)

   Persons with dementia (PwD) are heavily dependent on the support of informal, dementia caregivers to fulfill their day-to-day care needs. Dementia caregivers, often friends and family members of the PwD, are unpaid, non-professional individuals who take on many of the care responsibilities. Due to the lack of formal training, social support, and information resources, among other factors, dementia caregivers are often at risk for negative outcomes such as stress and burden. There have not been any comprehensive assessment tools to predict these negative outcomes. Therefore, we employ the NASA TLX dimensions to conceptualize caregiver workload. This study operationalizes the NASA TLX dimensions in the context of dementia caregiving and illustrates examples for each of the dimensions. The results indicate that the NASA TLX does not include all of the factors necessary to conceptualize caregiver workload and prescribe a need for developing a robust caregiver workload assessment tool. 

   more » « less
4. Diversified caregiver input to upgrade the Young Children’s Participation and Environment Measure for equitable pediatric re/habilitation practice

   https://doi.org/10.1186/s41687-023-00627-2  

   Villegas, Vivian C. ; Bosak, Dianna L. ; Salgado, Zurisadai ; Phoenix, Michelle ; Parde, Natalie ; Teplicky, Rachel ; Khetani, Mary A. ; High Value Early Intervention Research Group ; Kuznicki, L. ; Pedrow, A. ; et al ( August 2023 , Journal of Patient-Reported Outcomes)

   Practitioner and family experiences of pediatric re/habilitation can be inequitable. The Young Children’s Participation and Environment Measure (YC-PEM) is an evidence-based and promising electronic patient-reported outcome measure that was designed with and for caregivers for research and practice. This study examined historically minoritized caregivers’ responses to revised YC-PEM content modifications and their perspectives on core intelligent virtual agent functionality needed to improve its reach for equitable service design.

   Caregivers were recruited during a routine early intervention (EI) service visit and met five inclusion criteria: (1) were 18 + years old; (2) identified as the parent or legal guardian of a child 0–3 years old enrolled in EI services for 3 + months; (3) read, wrote, and spoke English; (4) had Internet and telephone access; and (5) identified as a parent or legal guardian of a Black, non-Hispanic child or as publicly insured. Three rounds of semi-structured cognitive interviews (55–90 min each) used videoconferencing to gather caregiver feedback on their responses to select content modifications while completing YC-PEM, and their ideas for core intelligent virtual agent functionality. Interviews were transcribed verbatim, cross-checked for accuracy, and deductively and inductively content analyzed by multiple staff in three rounds.

   Eight Black, non-Hispanic caregivers from a single urban EI catchment and with diverse income levels (Mdn = $15,001–20,000) were enrolled, with children (M = 21.2 months,SD = 7.73) enrolled in EI. Caregivers proposed three ways to improve comprehension (clarify item wording, remove or simplify terms, add item examples). Environmental item edits prompted caregivers to share how they relate and respond to experiences with interpersonal and institutional discrimination impacting participation. Caregivers characterized three core functions of a virtual agent to strengthen YC-PEM navigation (read question aloud, visual and verbal prompts, more examples and/or definitions).

   Results indicate four ways that YC-PEM content will be modified to strengthen how providers screen for unmet participation needs and determinants to design pediatric re/habilitation services that are responsive to family priorities. Results also motivate the need for user-centered design of an intelligent virtual agent to strengthen user navigation, prior to undertaking a community-based pragmatic trial of its implementation for equitable practice.

    

   more » « less
5. Acceptability of Using a Robotic Nursing Assistant in Health Care Environments: Experimental Pilot Study

   https://doi.org/10.2196/17509  

   Saadatzi, Mohammad Nasser ; Logsdon, M Cynthia ; Abubakar, Shamsudeen ; Das, Sumit ; Jankoski, Penelope ; Mitchell, Heather ; Chlebowy, Diane ; Popa, Dan O ( January 2020 , Journal of Medical Internet Research)

   null (Ed.)

   Background According to the US Bureau of Labor Statistics, nurses will be the largest labor pool in the United States by 2022, and more than 1.1 million nursing positions have to be filled by then in order to avoid a nursing shortage. In addition, the incidence rate of musculoskeletal disorders in nurses is above average in comparison with other occupations. Robot-assisted health care has the potential to alleviate the nursing shortage by automating mundane and routine nursing tasks. Furthermore, robots in health care environments may assist with safe patient mobility and handling and may thereby reduce the likelihood of musculoskeletal disorders. Objective This pilot study investigates the perceived ease of use and perceived usefulness (acceptability) of a customized service robot as determined by nursing students (as proxies for nursing staff in health care environments). This service robot, referred to as the Adaptive Robotic Nurse Assistant (ARNA), was developed to enhance the productivity of nurses through cooperation during physical tasks (eg, patient walking, item fetching, object delivery) as well as nonphysical tasks (eg, patient observation and feedback). This pilot study evaluated the acceptability of ARNA to provide ambulatory assistance to patients. Methods We conducted a trial with 24 participants to collect data and address the following research question: Is the use of ARNA as an ambulatory assistive device for patients acceptable to nurses? The experiments were conducted in a simulated hospital environment. Nursing students (as proxies for nursing staff) were grouped in dyads, with one participant serving as a nurse and the other acting as a patient. Two questionnaires were developed and administrated to the participants based on the Technology Acceptance Model with respect to the two subscales of perceived usefulness and perceived ease of use metrics. In order to evaluate the internal consistency/reliability of the questionnaires, we calculated Cronbach alpha coefficients. Furthermore, statistical analyses were conducted to evaluate the relation of each variable in the questionnaires with the overall perceived usefulness and perceived ease of use metrics. Results Both Cronbach alpha values were acceptably high (.93 and .82 for perceived usefulness and perceived ease of use questionnaires, respectively), indicating high internal consistency of the questionnaires. The correlation between the variables and the overall perceived usefulness and perceived ease of use metrics was moderate. The average perceived usefulness and perceived ease of use metrics among the participants were 4.13 and 5.42, respectively, out of possible score of 7, indicating a higher-than-average acceptability of this service robot. Conclusions The results served to identify factors that could affect nurses’ acceptance of ARNA and aspects needing improvement (eg, flexibility, ease of operation, and autonomy level). 

   more » « less