Berridge Clara, Demiris George, Kaye Jeffrey
School of Social Work, University of Washington, Seattle, WA, USA.
School of Nursing and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Sci Eng Ethics. 2021 Feb 18;27(1):14. doi: 10.1007/s11948-021-00286-w.
There is an urgent need to learn how to appropriately integrate technologies into dementia care. The aims of this Delphi study were to project which technologies will be most prevalent in dementia care in five years, articulate potential benefits and risks, and identify specific options to mitigate risks. Participants were also asked to identify technologies that are most likely to cause value tensions and thus most warrant a conversation with an older person with mild dementia when families are deciding about their use. Twenty-one interdisciplinary domain experts from academia and industry in aging and technology in the U.S. and Canada participated in a two-round online survey using the Delphi approach with an 84% response rate and no attrition between rounds. Rankings were analyzed using frequency counts and written-in responses were thematically analyzed. Twelve technology categories were identified along with a detailed list of risks and benefits for each. Suggestions to mitigate the most commonly raised risks are categorized as follows: intervene during design, make specific technical choices, build in choice and control, require data transparency, place restrictions on data use and ensure security, enable informed consent, and proactively educate users. This study provides information that is needed to navigate person-centered technology use in dementia care. The specific recommendations participants offered are relevant to designers, clinicians, researchers, ethicists, and policy makers and require proactive engagement from design through implementation.
迫切需要了解如何将技术适当地融入痴呆症护理中。这项德尔菲研究的目的是预测哪些技术将在五年内最普遍地应用于痴呆症护理，阐明潜在的益处和风险，并确定减轻风险的具体方案。参与者还被要求确定那些最有可能引发价值冲突的技术，因此在家庭决定是否使用这些技术时，最需要与患有轻度痴呆症的老年人进行沟通。来自美国和加拿大的21位老年学和技术领域的跨学科专家，包括学术界和业界人士，参与了两轮在线调查，采用德尔菲法，回复率为84%，两轮调查之间没有人员流失。使用频次计数分析排名，并对书面回复进行主题分析。确定了12个技术类别，并列出了每个类别的详细风险和益处清单。减轻最常提出的风险的建议分类如下：在设计过程中进行干预、做出特定的技术选择、内置选择和控制权、要求数据透明、对数据使用加以限制并确保安全、实现知情同意以及积极对用户进行教育。本研究提供了在痴呆症护理中以患者为中心使用技术所需的信息。参与者提出的具体建议对设计师、临床医生、研究人员、伦理学家和政策制定者都具有参考价值，并且从设计到实施都需要各方积极参与。
