Inga-Lill Boman

Using electronic aids to daily living after acquired brain injury: A study of the learning process and the usability

Purpose. The purpose was to study the ability of persons with memory impairments after acquired brain injury to learn how to and use electronic aids to daily living (EADL) and to describe changes in function and quality of life. Method. Eight participants stayed in two apartments equipped with a set of basic and advanced EADL for either 4 or 6 months during an intervention time of 2 years. The teaching and learning method was influenced by certain principles of errorless learning. Ability to learn to use EADL was measured by structured observations. Function and quality of life were assessed with self-rating questionnaires. Results. Results indicate that the participants learned to use EADL in their everyday activities. They perceived that EADL were very useful and easy to learn. Occupational performance and satisfaction with occupational performance and quality of life was improved. Conclusion. The results indicate that EADL may play an important role in facilitating everyday activities and improve satisfaction with occupational performance and quality of life for people with memory impairments. The study indicates the importance of adjusting technology to the users needs and calls for more consideration for human – technology interaction factors.

A training apartment with a set of electronic memory aids for patients with cognitive problems

The aims were to investigate whether patients with memory difficulties after acquired brain injury (ABI) are able to learn how to use a set of electronic memory aids integrated in a training apartment, and to use the same setting for identifying activities that these patients tend to forget among a predefined set of activities. This identification is done by using a computer system to register activities that are not performed, which the system is designed to act upon with reminders or alarms. During a stay of five days in the training apartment, 14 patients received training from an experienced occupational therapist to learn how to use the electronic memory aids. Significant improvements were found at group level in learning how to use the electronic memory aids. Computer registrations showed that the refrigerator and the stove were most challenging to remember. The total number of alarms and reminders as indication/measure of memory difficulties did not correlate with the Rivermead Behavioral Memory Test scores in the individuals. These findings indicate the importance of a stay in a training apartment to examine whether or not patients have difficulties in everyday activities and to try out electronic memory aids that might support these difficulties before they are discharged from the rehabilitation clinic.

Exploring the usability of a videophone mock-up for persons with dementia and their significant others

BackgroundPersons with dementia might have considerable difficulties in using an ordinary telephone. Being able to use the telephone can be very important in order to maintain their social network, getting stimulation and for reaching help when needed. Therefore, persons with dementia might need an easy-to-use videophone to prevent social isolation and to feel safe and independent. This study reports the evaluation of the usability of a touch-screen videophone mock-up for persons with dementia and their significant others.MethodsFour persons with dementia and their significant others tested the videophone mock-up at a living laboratory. In order to gain knowledge of the participants’ with dementia ability to use their own computers and telephones, interviews and observations were conducted.ResultsOverall, the participants had a very positive attitude towards the videophone. The participants with dementia perceived that it was useful, enjoyable and easy to use, although they initially had difficulties in understanding how to handle some functions, thus indicating that the design needs to be further developed to be more intuitive.ConclusionsThe findings suggest that the videophone has the potential to enable telephone calls without assistance and add quality in communication.

Support in everyday activities with a home-based electronic memory aid for persons with memory impairments

Purpose. The purposes of this study was to examine the possibilities of a home-based electronic memory aid with sensors for persons with memory impairments, as support to carry out everyday activities in their own home environments. Method. The method involved a single-subject study with a multiple baseline AB design. Five participants identified three activities each that they usually forget to carry out. An electronic memory aid with individually spoken reminders was installed in the participants home. There were automatic computer registrations of completed activities during the study phase of 12 weeks. Assessments of functioning and quality of life (QoL) were conducted before and after the intervention and at follow-up after 2 months. Results. Four participants improved in completing most of the self-chosen activities when the electronic memory aid was used. Performance and satisfaction with performance and QoL improved, but there was no memory function improvement. There were technical problems with the aid, which had a negative effect for users. Conclusions. Electronic memory aids have a large potential for supporting persons with cognitive impairments. It is important to conduct follow-up afterwards, because the use of an aid and the need of support change over time and put high demands on technical reliability of the electronic memory aid.

Users’ and professionals’ contributions in the process of designing an easy-to-use videophone for people with dementia

Abstract Purpose: To develop a design concept for an easy-to-use videophone for people with dementia and to evaluate the design and need of such a product. Method: In this project, we have used an inclusive design approach that includes the target users in the design process. In an earlier study, the need of a videophone was examined and a requirement specification was developed. In this study, a preliminary design concept was developed. Five focus groups of people with dementia, significant others and occupational therapists working with people with dementia were formed to capture their experiences, expectations and thoughts concerning the videophone and the design concept. Data were analysed using a grounded theory approach. Findings: The participants pointed out that the design of the videophone should be flexible in order to meet the needs of people with dementia, be easy-to-use and not look like assistive technology. In order to facilitate learning, the videophone should be introduced in an early stage of the disease. Conclusions: A videophone has potentials to enable videophone calls without assistance, add quality in communication and provide possibilities for monitoring. Further work will focus on developing a prototype to be empirically tested by people with dementia and significant others. Implications for Rehabilitation An easy-to-use videophone was viewed as an important device that could support people with dementia in making videophone calls without assistance. It was also viewed as a product that significant others could use for monitoring the person with dementia, for example to judge the well-being of the person. But monitoring should be used with caution and not without the consent of the person with dementia. It was viewed as important that the videophone be introduced in an early stage of the disease in order to facilitate learning, so that the person can get used to the new way of making telephone calls and incorporate the new habit in his/her routines. In order to motivate people with dementia to start using a videophone, it was recommended that the videophone should be introduced as a product which is a pleasure to use, and not as a compensation for impairment or to solve a problem.

First steps in designing a videophone for people with dementia: identification of users’ potentials and the requirements of communication technology

Purpose: To identify, based on the literature, people with dementia’s potentials to manage an easy-to-use videophone, and to develop a videophone requirement specification for people with dementia. Method: The study is based on the Inclusive Design method, utilising the first two of four phases. Content analyses of literature reviews were used to identify users’ potentials for managing a videophone and to gather recommendations regarding communication technology design for the target group. Existing videophones in Sweden were examined regarding potential fit to users with dementia. Findings: This led to detailed identification of cognitive, physical and psychosocial challenges that people with dementia will probably have when using an ordinary telephone or videophone. A requirement specification for videophone design to fit users with dementia was formulated, with the seven principles of Universal Design as a framework. Conclusions: The requirement specification presented here is aimed at designing a videophone but might also facilitate design of other products for people with dementia, particularly in the field of communication technology. Based on this, further work will focus on developing a design concept and a prototype to be empirically tested by people with dementia and their significant others, i.e. the final two design process phases. Implications for Rehabilitation Before recommending the use of assistive technology or new products such as a videophone it is important to examine in detail how well the product can meet the person’s abilities and needs. If people with dementia and their significant others receive information about new products or assistive technology that could be useful for them in an early stage of the disease process they might be willing to use it. In order to facilitate acceptance and use of new products such as a videophone, the design should aim at resembling other well known similar products and people with dementia should be introduced to using it at an early stage of the disease.

The first step in using a robot in brain injury rehabilitation: patients’ and health-care professionals’ perspective

Abstract Purpose: To evaluate the usability of a mobile telepresence robot (MTR) in a hospital training apartment (HTA). The MTR was manoeuvred remotely and was used for communication when assessing independent living skills, and for security monitoring of cognitively impaired patients. Method: Occupational therapists (OTs) and nurses received training in how to use the MTR. The nurses completed a questionnaire regarding their expectations of using the MTR. OTs and patients staying in the HTA were interviewed about their experiences of the MTR. Interviews and questionnaires were analysed qualitatively. Results: The HTA patients were very satisfied with the MTR. The OTs and nurses reported generally positive experiences. The OT’s found that assessment via the MTR was more neutral than being physically present. However, the use of the MTR implied considerable difficulties for health-care professionals. The main obstacle for the nurses was the need for fast and easy access in emergency situations while protecting the patients’ integrity. Conclusions: The results indicate that the MTR could be a useful tool to support daily living skills and safety monitoring of HTA patients. However, when designing technology for multiple users, such as health-care professionals, the needs of all users, their routines and support services involved, should also be considered. Implications for Rehabilitation A mobile telepresence robot (MTR) can be a useful tool for assessments and communication in rehabilitation. The design of the robot has to allow easy use by remote users, particularly in emergency situations. When designing MTRs the needs of ALL users have to be taken into consideration.

A Multi-disciplinary Approach in the Development of a Stroke Rehabilitation Tool

This work describes a method used in the development of a stroke rehabilitation tool. The method was based on three key elements. The first key element was iterations between the use of broad groups with different professionals/stakeholders and small hands-on working groups with users from the same profession. The second key element was movement between understanding differences between different organizations and professionals and understanding of specific needs within the different organizations. The final key element was including implementation aspects from the very start of the work.

An interactive distance solution for stroke rehabilitation in the home setting - A feasibility study.

ABSTRACT Background: In this study an interactive distance solution (called the DISKO tool) was developed to enable home-based motor training after stroke. Objectives: The overall aim was to explore the feasibility and safety of using the DISKO-tool, customized for interactive stroke rehabilitation in the home setting, in different rehabilitation phases after stroke. Methods: Fifteen patients in three different stages in the continuum of rehabilitation after stroke participated in a home-based training program using the DISKO-tool. The program included 15 training sessions with recurrent follow-ups by the integrated application for video communication with a physiotherapist. Safety and feasibility were assessed from patients, physiotherapists, and a technician using logbooks, interviews, and a questionnaire. Qualitative content analysis and descriptive statistics were used in the analysis. Results: Fourteen out of 15 patients finalized the training period with a mean of 19.5 minutes spent on training at each session. The DISKO-tool was found to be useful and safe by patients and physiotherapists. Conclusions: This study demonstrates the feasibility and safety of the DISKO-tool and provides guidance in further development and testing of interactive distance technology for home rehabilitation, to be used by health care professionals and patients in different phases of rehabilitation after stroke.

First steps in designing an all-in-one ICT-based device for persons with cognitive impairment: evaluation of the first mock-up

BackgroundThis project Smart Assisted Living involving Informal careGivers++ (SALIG) intends to develop an ICT-based device for persons with cognitive impairment combined with remote support possibilities for significant others and formal caregivers. This paper presents the identification of the target groups’ needs and requirements of such device and the evaluation of the first mock-up, demonstrated in a tablet.MethodsThe inclusive design method that includes end-users in the design process was chosen. First, a scoping review was conducted in order to examine the target group’s need of an ICT-based device, and to gather recommendations regarding its design and functionalities. In order to capture the users’ requirements of the design and functionalities of the device three targeted focus groups were conducted. Based on the findings from the publications and the focus groups a user requirement specification was developed. After that a design concept and a first mock-up was developed in an iterative process. The mock-up was evaluated through interviews with persons with cognitive impairment, health care professionals and significant others. Data were analysed using content analysis.ResultsSeveral useful recommendations of the design and functionalities of the SALIG device for persons with cognitive impairment were identified. The main benefit of the mock-up was that it was a single device with a set of functionalities installed on a tablet and designed for persons with cognitive impairment. An additional benefit was that it could be used remotely by significant others and formal caregivers.ConclusionThe SALIG device has the potentials to facilitate everyday life for persons with cognitive impairment, their significant others and the work situation for formal caregivers. The results may provide guidance in the development of different types of technologies for the target population and for people with diverse disabilities. Further work will focus on developing a prototype to be empirically tested by persons with cognitive impairment, their significant others and formal caregivers.