Department of Neurosurgery, Medical University of Vienna, Wien, Austria.
BMC Neurol. 2012 Feb 13;12:4. doi: 10.1186/1471-2377-12-4.
Technical devices are becoming more prevalent in society and also in medical care. Older adults need more support to learn new technologies than younger subjects. So far, no research has been done on the usability of patient controllers in deep brain stimulation in an elderly population. The aim of the study was to investigate the factors influencing the performance of elderly DBS patients with respect to usability aspects of Medtronic Access therapy controllers.
Time, mistakes and frequency of use of the controller were compared in 41 elderly DBS patients who prior to the study had already owned a therapy controller for more than six years. One group (n = 20, mean age = 66.4 years) was watching an instructional video and then completed practical assignments on a model implantable pulse generator (IPG). The other group (n = 21, mean age = 65.9 years) completed the tasks without having seen the video before. Any errors that patients made were documented and also corrected so that all of them received hands-on training. After six months all patients were re-evaluated on the dummy IPG in order to compare the effects of hands-on alone vs. video-based training combined with hands-on.
The group that had seen the video before significantly outperformed the control group at both assessments with respect to number of errors. Both groups performed faster after six months compared to baseline and tend to use the controller more often than at baseline.
Our results indicate that elderly DBS patients who have been using the controller for several years still have various difficulties in operating the device. However, we also showed that age-specific training may improve the performance in older adults. In general, the design of DBS patient controllers should focus on the specific needs of the end-users. But as changes to medical devices take a long time to be implemented, video instructions with age-specific content plus hands-on training may improve learning for older adults.
技术设备在社会中越来越普及，在医疗保健领域也是如此。老年人学习新技术所需的支持比年轻受试者更多。迄今为止，尚未针对老年人在深部脑刺激中使用患者控制器的可用性进行研究。本研究的目的是调查影响老年 DBS 患者表现的因素，这些因素涉及美敦力 Access 治疗控制器的可用性方面。
将 41 名老年 DBS 患者的控制器使用时间、错误和频率与已经拥有治疗控制器超过六年的患者进行比较。一组（n = 20，平均年龄= 66.4 岁）观看教学视频，然后在模型可植入脉冲发生器（IPG）上完成实际作业。另一组（n = 21，平均年龄= 65.9 岁）在没有观看视频的情况下完成任务。记录患者所犯的任何错误，并进行纠正，以便他们所有人都接受实践培训。六个月后，所有患者均在虚拟 IPG 上重新进行评估，以比较单独实践与视频结合实践的效果。
观看视频的组在两次评估中均比对照组的错误数量明显更少。两组在六个月后与基线相比，操作速度都有所提高，并且比基线更倾向于经常使用控制器。
我们的结果表明，使用该控制器多年的老年 DBS 患者在操作设备方面仍存在各种困难。但是，我们也表明，特定于年龄的培训可以提高老年人的表现。通常，深部脑刺激患者控制器的设计应侧重于最终用户的特定需求。但是，由于医疗器械的更改需要很长时间才能实施，因此具有特定于年龄的内容的视频说明加上实践培训可以改善老年人的学习效果。
