Alexandra Queirós

Usability, accessibility and ambient-assisted living: a systematic literature review

Abstract Ambient-assisted living (AAL) is, nowadays, an important research and development area, foreseen as an important instrument to face the demographic aging. The acceptance of the AAL paradigm is closely related to the quality of the available systems, namely in terms of intelligent functions for the user interaction. In that context, usability and accessibility are crucial issues to consider. This paper presents a systematic literature review of AAL technologies, products and services with the objective of establishing the current position regarding user interaction and how are end users involved in the AAL development and evaluation processes. For this purpose, a systematic review of the literature on AAL was undertaken. A total of 1,048 articles were analyzed, 111 of which were mainly related to user interaction and 132 of which described practical AAL systems applied in a specified context and with a well-defined aim. Those articles classified as user interaction and systems were further characterized in terms of objectives, target users, users’ involvement, usability and accessibility issues, settings to be applied, technologies used and development stages. The results show the need to improve the integration and interoperability of the existing technologies and to promote user-centric developments with a strong involvement of end users, namely in what concerns usability and accessibility issues.

The International Classification of Functioning, Disability and Health as a conceptual model for the evaluation of environmental factors

Abstract The concept of Design for All emphasizes the impact of the surrounding environment in the individuals functionality. The International Classification of Functioning, Disability and Health brought the concepts of functionality and disability into a comprehensive whole of multiple dimensions of human functioning, such as biological, psychological, social and environmental. In order to contribute to a greater overall functionality of the individual, the use of software and complex systems can be decisive to assist the people with special needs in all areas of life. The paradigm introduced with ICF is inclusive and universal, so it favors not only the old people, but all others, whether they have a limitation or not. The characteristics of Ambient Assisted Living (AAL) are appropriate to fulfill elderly needs. However, the current state of development is still mostly oriented to a technological perspective, where the individuals functionality has not been fully addressed. Under the Living Usability Lab project we have defined a methodology and created some evaluation tools for assessment of AAL services according to a Living Lab perspective, based on the ICF. In this paper we intend to describe the base fundamentals of this proposal, as well as present some results concerning a practical implementation of this methodology.

Comparing the content of instruments assessing environmental factors using the International Classification of Functioning, Disability and Health

PURPOSE To describe and compare the content of instruments that assess environmental factors using the International Classification of Functioning, Disability and Health (ICF). METHODS A systematic search of PubMed, CINAHL and PEDro databases was conducted using a pre-determined search strategy. The identified instruments were screened independently by two investigators, and meaningful concepts were linked to the most precise ICF category according to published linking rules. RESULTS Six instruments were included, containing 526 meaningful concepts. Instruments had between 20% and 98% of items linked to categories in Chapter 1. The highest percentage of items from one instrument linked to categories in Chapters 2-5 varied between 9% and 50%. The presence or absence of environmental factors in a specific context is assessed in 3 instruments, while the other 3 assess the intensity of the impact of environmental factors. DISCUSSION Instruments differ in their content, type of assessment, and have several items linked to the same ICF category. Most instruments primarily assess products and technology (Chapter 1), highlighting the need to deepen the discussion on the theory that supports the measurement of environmental factors. This discussion should be thorough and lead to the development of methodologies and new tools that capture the underlying concepts of the ICF. :

European Portuguese Validation of the System Usability Scale (SUS)

Abstract The System Usability Scale (SUS) is a widely used self-administered instrument for the evaluation of usability of a wide range of products and user interfaces. The principal value of the SUS is that it provides a single reference score for participants’ view of the usability of a product or service. This paper presents the translation, cultural adaptation and a contribution to the validation of the European Portuguese version of SUS. The conducted work comprised two phases, the scale translation, and the scale validation. The first phase resulted in a European Portuguese version equivalent to the original in terms of semantic and content. The second phase involved the assessment of the validity and reliability of the scale. The instrument has construct validity as it presents a high and significant correlation with other two usability metrics, the Post-Study System Usability Questionnaire (PSSUQ) (r = 0.70) and a general usability question (r = 0.48). The reliability results show less than satisfactory ICC values (ICC = 0.36), however the percentage of agreement is satisfactory (76.67%). Further studies are needed to investigate the reliability of the Portuguese version.

ICF Inspired Personas to Improve Development for Usability and Accessibility in Ambient Assisted Living

Abstract Ambient Assisted Living (AAL) is an important research and development area. The acceptance of the AAL paradigm is closely related to the quality of the available systems and services, namely in terms of the user interaction. This means that usability and accessibility are crucial issues. The paper presents how the concepts of the International Classification of Functioning, Disability and Health (ICF) can be used to optimize the role of personas and scenarios in the development and evaluation of AAL systems and services, especially in aspects related with human functioning and health conditions.

Adaptation and validation of WHODAS 2.0 in patients with musculoskeletal pain

OBJETIVO Validar la version en portugues del World Health Organisation Disability Assessment Schedule (WHODAS 2.0). METODOS La version original con 36 items del WHODAS 2.0, administrada por entrevista, fue traducida al portugues de acuerdo con orientaciones internacionales, y evaluada en nueve participantes de la poblacion en general. La version en portugues fue aplicada en 204 pacientes con patologia musculoesqueletica. Se colectaron los datos sociodemograficos y de salud de los pacientes, asi como el numero de lugares donde presentaban dolor y su intensidad. El WHODAS 2.0 fue nuevamente aplicado por un segundo entrevistador, uno a tres dias posteriores a la primera entrevista para evaluar la confiabilidad inter-evaluadores. La validez del constructo fue evaluado con relacion a: capacidad del WHODAS 2.0 para diferenciar participantes con diferentes lugares con dolor y asociacion entre el WHODAS 2.0 y la intensidad del dolor. La consistencia interna tambien fue evaluada. RESULTADOS La version en portugues del WHODAS 2.0 fue de facil comprension, presento buena consistencia interna (α= 0,84) y confiabilidad inter evaluadores (CCI=0,95). Mostro ser capaz de detectar diferencias estadisticamente significativas entre individuos con diferente numero de lugares con dolor (p˂0,01) e indicar que mayor incapacidad esta asociada con la mayor intensidad del dolor (r=0,44, p˂0,01), indicando validez del constructo. CONCLUSIONES la version en portugues del WHODAS 2.0 se mostro confiable y valida al ser utilizada en pacientes con dolor asociado a la patologia musculo esqueletica.

Self-Reported Disability: Association With Lower Extremity Performance and Other Determinants in Older Adults Attending Primary Care

Background Measurement of function usually involves the use of both performance-based and self-report instruments. However, the relationship between both types of measures is not yet completely understood, in particular for older adults attending primary care. Objective The main objective of the study was to investigate the association between the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Short Physical Performance Battery (SPPB) for older adults at primary care. A secondary objective was to determine the influence of sociodemographic and health-related variables on this relationship. Design This was a cross-sectional study. Methods A total of 504 participants aged 60 years and older from 18 different primary care centers underwent a one-session assessment including: sociodemographic variables, comorbidities, performance, self-reported disability, pain, depressive symptoms, and physical activity. Performance was assessed using the SPPB, and self-reported disability was assessed using the WHODAS 2.0. Results The correlation between WHODAS 2.0 and SPPB scores was strong (r=.65). Regression analysis showed that the SPPB total score explained 41.7% of the variance in WHODAS 2.0 scores (adjusted R2=41.6%). A second model including the SPPB subtests (balance, gait, and sit-to-stand), depressive symptoms, number of pain sites, pain intensity, and level of physical activity explained 61.7% of the variance in WHODAS 2.0 scores (adjusted R2=60.4%). No model improvement was found when considering the 6 WHODAS 2.0 individual domains. Limitations The cross-sectional nature of the study does not allow inferences on causal relationships. Conclusions This studys findings confirm that self-report and performance-based measures relate to different aspects of functioning. Further study is needed to determine if primary care interventions targeting lower extremity performance and depressive symptoms improve self-reported disability.

Definition and Validation of the ICF – Usability Scale☆

Abstract Usability assessment is an important issue of the development of products and services based on information technologies. Questionnaires and scales are valuable instruments to collect large amounts of subjective data from users and their application is a reliable technique to assess usability. Furthermore, when considering products and services for older adults, the International Classification of Functioning, Disability and Health (ICF) might be used as a conceptual model for usability assessment. This paper presents the development and validation of the ICF-Usability Scale (ICF-US), an instrument supported by concepts and terminologies related to ICF and that is part of a comprehensive framework for the design, development and evaluation of ambient assisted living products and services for older adults. The methodology that has been followed in the study reported by this paper comprises two phases: the development and the validation phases. The last phase consisted in an observational study performed in a nursing home involving 32 adults and its results suggest acceptable reliability and validity values for the ICF-US.

Adaptacao e validacao do WHODAS 2.0 em utentes com dor musculoesqueletica

OBJETIVO Validar la version en portugues del World Health Organisation Disability Assessment Schedule (WHODAS 2.0). METODOS La version original con 36 items del WHODAS 2.0, administrada por entrevista, fue traducida al portugues de acuerdo con orientaciones internacionales, y evaluada en nueve participantes de la poblacion en general. La version en portugues fue aplicada en 204 pacientes con patologia musculoesqueletica. Se colectaron los datos sociodemograficos y de salud de los pacientes, asi como el numero de lugares donde presentaban dolor y su intensidad. El WHODAS 2.0 fue nuevamente aplicado por un segundo entrevistador, uno a tres dias posteriores a la primera entrevista para evaluar la confiabilidad inter-evaluadores. La validez del constructo fue evaluado con relacion a: capacidad del WHODAS 2.0 para diferenciar participantes con diferentes lugares con dolor y asociacion entre el WHODAS 2.0 y la intensidad del dolor. La consistencia interna tambien fue evaluada. RESULTADOS La version en portugues del WHODAS 2.0 fue de facil comprension, presento buena consistencia interna (α= 0,84) y confiabilidad inter evaluadores (CCI=0,95). Mostro ser capaz de detectar diferencias estadisticamente significativas entre individuos con diferente numero de lugares con dolor (p˂0,01) e indicar que mayor incapacidad esta asociada con la mayor intensidad del dolor (r=0,44, p˂0,01), indicando validez del constructo. CONCLUSIONES la version en portugues del WHODAS 2.0 se mostro confiable y valida al ser utilizada en pacientes con dolor asociado a la patologia musculo esqueletica.

Technologies for Ageing in Place to Support Home Monitoring of Patients with Chronic Diseases.

Objectives This study aims to identify: i) the most relevant chronic diseases in terms of the use of technologies for ageing in place to support home monitoring; and ii) types, outcomes and impacts of technologies for ageing in place being used to support home monitoring. Methods A systematic review of reviews and meta-analysis was performed based on a search of the literature. Results A total of 35 reviews and meta-analysis across 4 chronic diseases, diabetes, congestive heart failure, chronic obstructive pulmonary disease, and hypertension, were retrieved. These studies compare home monitoring supported by different technologies with usual care. Conclusion Home monitoring has positive effects in various health related outcomes, but further research is required to allow its incorporation in the clinical practice.