Escuela de Terapia Ocupacional, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Metropolitana, Chile.
Departamento de Terapia Ocupacional y Ciencia de la Ocupación, Facultad de Medicina, Universidad de Chile, Santiago, Metropolitana, Chile.
Age Ageing. 2020 Feb 27;49(2):239-245. doi: 10.1093/ageing/afz166.
non-pharmacological interventions to prevent delirium are useful in hospitalised older adults. However, they are poorly implemented in clinical practice. We aimed to develop a software for bedside use by hospitalised older adults and to improve their access to these interventions.
a transdisciplinary team composed of healthcare professionals, designers, engineers and older adults participated in the development of the software. Scrum methodology was used to coordinate the work of the team, and the software was evaluated in a feasibility study.
a software for touchscreen mobile devices that supports Android 5.0 or later was produced, including modules for time-spatial re-orientation, cognitive stimulation, early mobilisation, sensorial support use promotion, sleep hygiene and pain management optimisation. Horizontal disposition, use of colour contrast and large interaction areas were used to improve accessibility. The software's usability and accessibility were evaluated in 34 older adults (average age 73.2 ± 9.1 years) showing that 91.1% of them got access to all the software functions without previous instructions. The clinical feasibility assessment showed that 83.3% of the 30 enrolled hospitalised patients (76 ± 8 years) completed the 5-day protocol of software usage during hospitalisation. Software use was associated with a decreased trend in delirium incidence of 5 of 32 (15.6%) at baseline to 2 of 30 (6.6%) after its implementation.
a highly accessible and implementable software, designed to improve access to non-pharmacological interventions to prevent delirium in hospitalised older adults, was developed. The effectiveness of the software will be evaluated in a randomised clinical trial.
非药物干预措施可预防住院老年患者发生谵妄,但在临床实践中实施效果不佳。本研究旨在开发一种适用于住院老年患者的床边使用软件,以提高其对这些干预措施的可及性。
由医护人员、设计师、工程师和老年人组成的跨学科团队参与了该软件的开发。采用 Scrum 方法协调团队工作,并在可行性研究中对该软件进行了评估。
开发了一款适用于支持 Android 5.0 或更高版本的触摸屏移动设备的软件,包括时空定向、认知刺激、早期活动、感官支持使用促进、睡眠卫生和疼痛管理优化等模块。采用水平布局、颜色对比度和大交互区域来提高软件的可及性。对 34 名(平均年龄 73.2±9.1 岁)老年人进行了软件可用性和可及性评估,结果表明 91.1%的老年人无需指导即可使用所有软件功能。临床可行性评估显示,30 名住院患者(76±8 岁)中有 83.3%完成了住院期间 5 天的软件使用方案。软件使用与谵妄发生率的下降趋势相关,基线时有 32 例(15.6%)患者发生谵妄,实施后降至 30 例中的 2 例(6.6%)。
开发了一种高度可及且易于实施的软件,旨在提高住院老年患者预防谵妄的非药物干预措施的可及性。将在一项随机临床试验中评估该软件的有效性。