Dina Battisto

Advice from Rural Elders: What It Takes to Age in Place.

Older adults prefer to age in place (AIP), and there are psychological, physiological, and economic benefits in doing so. However, it is especially challenging to AIP in rural communities. AIP models have been tested in urban settings and age-segregated communities, but they are not appropriate for rural communities. This paper presents rural AIP variables identified in the literature as well as those described by 39 older adults in five focus groups.

The Effects of Nature Images on Pain in a Simulated Hospital Patient Room

Background: Views of nature have been reported to relieve stress and pain, making nature an ideal medium for use in healthcare settings. In hospitals whose design does not allow for a view of nature, virtual and surrogate views of nature may be viable therapeutic options. Objective: This study tests the effects of specific nature images, as defined by Appletons prospect refuge theory of landscape preference, on participants experiencing pain. The hypotheses were: (1) Nature views are variable in their impact on specific psychological and physiological health status indicators; and (2) Prospect and refuge nature scenes are more therapeutic than hazard nature scenes. The research question was (1) Which nature image categories are most therapeutic as evidenced by reduced pain and positive mood? Methods: An experiment using mixed methods assessed the effects of four different nature scenes on physiological (blood pressure, heart rate) and psychological (mood) responses when a person was subjected to a pain stressor. Four groups were subjected to a specific nature image category of prospect, refuge, hazard, or mixed prospect and refuge; the fifth group viewed no image. The Short-Form McGill Pain Questionnaire and the Profile of Mood States survey instruments were used to assess pain and mood, respectively. Continuous physiological readings of heart rate and blood pressure were collected. Pain was induced through a cold pressor task, which required participants to immerse their nondominant hand in ice water for up to 120 seconds. Results: The mixed prospect and refuge image treatment showed significantly lower sensory pain responses, and the no-image treatment indicated significantly higher affective pain perception responses. The hazard image treatment had significantly lower diastolic blood pressure readings during the pain treatment, but it also had significantly high total mood disturbance. Conclusions: Although there was no clear “most” therapeutic image, the mixed prospect and refuge image showed significant potential to reduce sensory pain. The hazard image was the most effective at distracting participants from pain, but it should not be considered a positive distraction because it also received the highest mood disturbance scores of all groups.

Match-moving for area-based analysis of eye movements in natural tasks

Analysis of recordings made by a wearable eye tracker is complicated by video stream synchronization, pupil coordinate mapping, eye movement analysis, and tracking of dynamic Areas Of Interest (AOIs) within the scene. In this paper a semi-automatic system is developed to help automate these processes. Synchronization is accomplished via side by side video playback control. A deformable eye template and calibration dot marker allow reliable initialization via simple drag and drop as well as a user-friendly way to correct the algorithm when it fails. Specifically, drift may be corrected by nudging the detected pupil center to the appropriate coordinates. In a case study, the impact of surrogate nature views on physiological health and perceived well-being is examined via analysis of gaze over images of nature. A match-moving methodology was developed to track AOIs for this particular application but is applicable toward similar future studies.

The effects of presence and influence in nature images in a simulated hospital patient room.

Background: Nature images are frequently used for therapeutic purposes in hospital settings. Nature images may distract people from pain and promote psychological and physiological well-being, yet limited research is available to guide the selection process of nature images. Objective: The hypothesis is that higher degrees of presence and/or influence in the still photograph make it more effective at holding the viewers attention, which therefore may distract the viewer from pain, and therefore be considered therapeutic. Research questions include: (1) Is there a significant difference in the level of perceived presence among the selected images? (2) Is there a significant difference in the level of perceived influence among the selected images? (3) Is there a correlation between levels of presence and levels of influence? Methods: 109 college students were randomly assigned to one of four different image categories defined by Appletons prospect refuge theory of landscape preference. Categories included prospect, refuge, hazard, and mixed prospect and refuge. A control group was also included. Each investigation was divided into five periods: prereporting, rest, a pain stressor (hand in ice water for up to 120 seconds), recovery, and postreporting. Physiological readings (vital signs) were measured repeatedly using a Dinamap automatic vital sign tracking machine. Psychological responses (mood) to the image were collected using a reliable instrument, the Profile of Mood States. Results: No significant statistical difference in levels of presence was found among the four image categories. However, levels of influence differed and the hazard nature image category had significantly higher influence ratings and lower diastolic blood pressure readings during the pain treatment. A correlation (r = .62) between presence and influence was identified; as one rose, so did the other. Mood state was significantly low for the hazard nature image after the pain stressor experience. Conclusions: Though the hazard image caused distraction from pain, it is nontherapeutic because of the low mood ratings it received. These preliminary findings contribute methodology to the research field and stimulate interest for additional research into the visual effects of nature images on pain.

Developing a Usability Evaluation Tool to Assess the Patient Room Bathroom

Objective: The goal of this project was to create an easy-to-administer and inexpensive tool that can help identify usability issues in a patient room bathroom during the design process so improvements can be made before the final product is constructed and put into operation. Background: The bathroom is an essential part of any hospital patient room, yet it is associated with nurse dissatisfaction and patient falls. Minimal literature has examined whether the physical structure of various elements within the bathroom are efficient, safe, and satisfactory for the majority of users. Furthermore, there is a paucity of human factor guidelines for architects and designers to follow to ensure the usability of bathroom space for a wide variety of users. Methods: The authors adapted a common technique used in software usability: the heuristic evaluation. A heuristic evaluation is a “discount” evaluation method used to quickly and efficiently evaluate the usability flaws of user interfaces. Three methods were used to provide input for the heuristic evaluation: (1) Review of existing heuristic evaluations, reported hospital bathroom problems, and safety checklists; (2) Interviews with nurses and nursing assistants; and (3) Focus groups with nurses. Analysis of the interview and focus group transcripts enabled the categorization of the types of problems nurses encounter in the patient room bathroom. These categories served as the basis for the heuristics in the heuristic evaluation tool. Results: Eleven major heuristics (or categories of problems in the bathroom) were identified initially. The authors then went through several iterations of designing and refining the heuristic evaluation to form parsimonious categories and subcategories. Each of the eventual six major heuristic categories contains a general description as well as specific exemplar questions. These detailed subcategories enable an evaluator to easily gauge whether a bathroom adheres to the guideline, to write any comments about a particular issue, and to rate the severity of any problems. Conclusions: The bathroom heuristic evaluation was designed to be a discount usability evaluation tool. It can be used to assess a hospital bathroom during the design process for major usability issues, enabling necessary alterations before a final product is developed.

A Survey of Nurses Self-Reported Prospective Memory Tasks: What Must they Remember and What do they Forget?:

Although a nurses job is inundated with prospective memory (PM) demands, and studies show that PM failures are a key component of adverse medical events, only one study has examined prospective memory in nursing (Grundgeiger, Sanderson, MacDougall, & Venkatesh, 2009). The purpose of the current study was to complement existing research with self-reports from 25 nurses on the PM tasks they must remember and those they forget. Results revealed that nurses most frequently perform episodic tasks, and these tasks can be further classified to better explain when nursing PM demands arise and what the demands consist of. A more specific categorization of nursing PM tasks enables researchers to focus on specific design solutions. We provide examples of such re-design recommendations intended to alleviate PM demands.

Prospective memory in the nursing environment: Effects of type of prospective task and prospective load

A nurses working environment may place high demands on both event-based and time-based prospective memory (PM), leading to forgetting. In the field of nursing, forgetting can have serious consequences and put a patients life in danger. To better understand the role of prospective load (quantity of PM tasks in memory) in nursing, the current study will examine the effects of type of PM task being performed (event-based or time-based) and quantity of PM tasks (n = 1 or 4) on performance of an ongoing task and PM task(s). A novel paradigm will be used to capture naturalistic elements of the nursing environment. Forty registered nurses will complete a representative documentation task in a full-scale mock-up patient room, while also remembering to perform 1 or 4, event-based or time-based PM task(s). Results from this study can be used to further the literature on prospective load, explain possible causes of nursing error, and inform the design of memory technology aides.