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面向香港社区居住老年人的个性化健康监测系统:设计、实施和评估研究。

A Personalized Health Monitoring System for Community-Dwelling Elderly People in Hong Kong: Design, Implementation, and Evaluation Study.

机构信息

Centre for Systems Informatics Engineering, City University of Hong Kong, Hong Kong, China.

School of Design, The Hong Kong Polytechnic University, Hong Kong, China.

出版信息

J Med Internet Res. 2020 Sep 30;22(9):e19223. doi: 10.2196/19223.

Abstract

BACKGROUND

Telehealth is an effective means to assist existing health care systems, particularly for the current aging society. However, most extant telehealth systems employ individual data sources by offline data processing, which may not recognize health deterioration in a timely way.

OBJECTIVE

Our study objective was two-fold: to design and implement an integrated, personalized telehealth system on a community-based level; and to evaluate the system from the perspective of user acceptance.

METHODS

The system was designed to capture and record older adults' health-related information (eg, daily activities, continuous vital signs, and gait behaviors) through multiple measuring tools. State-of-the-art data mining techniques can be integrated to detect statistically significant changes in daily records, based on which a decision support system could emit warnings to older adults, their family members, and their caregivers for appropriate interventions to prevent further health deterioration. A total of 45 older adults recruited from 3 elderly care centers in Hong Kong were instructed to use the system for 3 months. Exploratory data analysis was conducted to summarize the collected datasets. For system evaluation, we used a customized acceptance questionnaire to examine users' attitudes, self-efficacy, perceived usefulness, perceived ease of use, and behavioral intention on the system.

RESULTS

A total of 179 follow-up sessions were conducted in the 3 elderly care centers. The results of exploratory data analysis showed some significant differences in the participants' daily records and vital signs (eg, steps, body temperature, and systolic blood pressure) among the 3 centers. The participants perceived that using the system is a good idea (ie, attitude: mean 5.67, SD 1.06), comfortable (ie, self-efficacy: mean 4.92, SD 1.11), useful to improve their health (ie, perceived usefulness: mean 4.99, SD 0.91), and easy to use (ie, perceived ease of use: mean 4.99, SD 1.00). In general, the participants showed a positive intention to use the first version of our personalized telehealth system in their future health management (ie, behavioral intention: mean 4.45, SD 1.78).

CONCLUSIONS

The proposed health monitoring system provides an example design for monitoring older adults' health status based on multiple data sources, which can help develop reliable and accurate predictive analytics. The results can serve as a guideline for researchers and stakeholders (eg, policymakers, elderly care centers, and health care providers) who provide care for older adults through such a telehealth system.

摘要

背景

远程医疗是辅助现有医疗体系的有效手段,尤其适用于当前的老龄化社会。然而,大多数现有的远程医疗系统通过离线数据处理使用个体数据源,这可能无法及时识别健康恶化情况。

目的

我们的研究目的有两个:一是设计并实现基于社区的综合个性化远程医疗系统;二是从用户接受度的角度评估该系统。

方法

该系统旨在通过多种测量工具采集和记录老年人的健康相关信息(如日常活动、连续生命体征和步态行为)。可集成最先进的数据挖掘技术,根据日常记录中检测到的显著变化,通过决策支持系统向老年人、其家庭成员和护理人员发出警报,以便采取适当的干预措施,防止健康状况进一步恶化。我们从香港的 3 家养老院招募了 45 名老年人,指导他们使用该系统 3 个月。采用探索性数据分析方法对收集到的数据集进行总结。为了进行系统评估,我们使用定制的接受度问卷来评估用户对系统的态度、自我效能感、感知有用性、感知易用性和行为意向。

结果

在 3 家养老院共进行了 179 次随访。探索性数据分析的结果表明,参与者在 3 家养老院的日常记录和生命体征(如步数、体温和收缩压)方面存在一些显著差异。参与者认为使用该系统是一个好主意(即态度:平均 5.67,标准差 1.06),使用起来舒适(即自我效能感:平均 4.92,标准差 1.11),有助于改善他们的健康(即感知有用性:平均 4.99,标准差 0.91),并且易于使用(即感知易用性:平均 4.99,标准差 1.00)。总体而言,参与者对在未来的健康管理中使用我们个性化远程医疗系统的第一版表现出积极的意向(即行为意向:平均 4.45,标准差 1.78)。

结论

所提出的健康监测系统为基于多数据源监测老年人健康状况提供了一个范例设计,可以帮助开发可靠和准确的预测分析。研究结果可为通过远程医疗系统为老年人提供护理的研究人员和利益相关者(如政策制定者、养老院和医疗保健提供者)提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/954e/7557449/b090e1e82727/jmir_v22i9e19223_fig1.jpg

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