Cristiano Alessia, Musteata Stela, De Silvestri Sara, Bellandi Valerio, Ceravolo Paolo, Cesari Matteo, Azzolino Domenico, Sanna Alberto, Trojaniello Diana
Center for Advanced Technology in Health and Wellbeing, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy.
Department of Computer Science, Università Degli Studi di Milano, Milan, Italy.
JMIR Aging. 2022 Feb 28;5(1):e29623. doi: 10.2196/29623.
Over recent years, interest in the development of smart health technologies aimed at supporting independent living for older populations has increased. The integration of innovative technologies, such as the Internet of Things, wearable technologies, artificial intelligence, and ambient-assisted living applications, represents a valuable solution for this scope. Designing such an integrated system requires addressing several aspects (eg, equipment selection, data management, analytics, costs, and users' needs) and involving different areas of expertise (eg, medical science, service design, biomedical and computer engineering).
The objective of this study is 2-fold; we aimed to design the functionalities of a smart health platform addressing 5 chronic conditions prevalent in the older population (ie, hearing loss, cardiovascular diseases, cognitive impairments, mental health problems, and balance disorders) by considering both older adults' and clinicians' perspectives and to evaluate the identified smart health platform functionalities with a small group of older adults.
Overall, 24 older adults (aged >65 years) and 118 clinicians were interviewed through focus group activities and web-based questionnaires to elicit the smart health platform requirements. Considering the elicited requirements, the main functionalities of smart health platform were designed. Then, a focus group involving 6 older adults was conducted to evaluate the proposed solution in terms of usefulness, credibility, desirability, and learnability.
Eight main functionalities were identified and assessed-cognitive training and hearing training (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 6/6, 100%; learnability: 6/6, 100%), monitoring of physiological parameters (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 6/6, 100%; learnability: 5/6, 83%), physical training (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 5/6, 83%; learnability: 2/6, 33%), psychoeducational intervention (usefulness: 6/6, 100%; credibility: 6/6, 100%; desirability: 4/6, 67%; learnability: 2/6, 33%), mood monitoring (usefulness: 4/6, 67%; credibility: 4/6, 67%; desirability: 3/6, 50%; learnability: 5/6, 50%), diet plan (usefulness: 5/6, 83%; credibility: 4/6, 67%; desirability: 1/6, 17%; learnability: 2/6, 33%), and environment monitoring and adjustment (usefulness: 1/6, 17%; credibility: 1/6, 17%; desirability: 0/6, 0%; learnability: 0/6, 0%). Most of them were highly appreciated by older participants, with the only exception being environment monitoring and adjustment. The results showed that the proposed functionalities met the needs and expectations of users (eg, improved self-management of patients' disease and enhanced patient safety). However, some aspects need to be addressed (eg, technical and privacy issues).
The presented smart health platform functionalities seem to be able to meet older adults' needs and desires to enhance their self-awareness and self-management of their medical condition, encourage healthy and independent living, and provide evidence-based support for clinicians' decision-making. Further research with a larger and more heterogeneous pool of stakeholders in terms of demographics and clinical conditions is needed to assess system acceptability and overall user experience in free-living conditions.
近年来,人们对开发旨在支持老年人群体独立生活的智能健康技术的兴趣日益浓厚。物联网、可穿戴技术、人工智能和环境辅助生活应用等创新技术的整合,是实现这一目标的宝贵解决方案。设计这样一个集成系统需要考虑几个方面(如设备选择、数据管理、分析、成本和用户需求),并涉及不同的专业领域(如医学、服务设计、生物医学和计算机工程)。
本研究有两个目标;我们旨在通过考虑老年人和临床医生的观点,设计一个智能健康平台的功能,以解决老年人群体中普遍存在的5种慢性病(即听力损失、心血管疾病、认知障碍、心理健康问题和平衡障碍),并与一小群老年人一起评估所确定的智能健康平台功能。
总体而言,通过焦点小组活动和网络问卷对24名老年人(年龄>65岁)和118名临床医生进行了访谈,以获取智能健康平台的需求。根据获取的需求,设计了智能健康平台的主要功能。然后,进行了一个由6名老年人组成的焦点小组,以评估所提出的解决方案在有用性、可信度、可取性和易学性方面的情况。
确定并评估了八项主要功能——认知训练和听力训练(有用性:6/6,100%;可信度:6/6,100%;可取性:6/6,100%;易学性:6/6,100%)、生理参数监测(有用性:6/6,100%;可信度:6/6,100%;可取性:6/6,100%;易学性:5/6,83%)、体育锻炼(有用性:6/6,100%;可信度:6/6,100%;可取性:5/6,83%;易学性:2/6,33%)、心理教育干预(有用性:6/6,100%;可信度:6/6,100%;可取性:4/6,67%;易学性:2/6,33%)、情绪监测(有用性:4/6,67%;可信度:4/6,67%;可取性:3/6,50%;易学性:5/6,50%)、饮食计划(有用性:5/6,83%;可信度:4/6,67%;可取性:1/6,17%;易学性:2/6,33%)以及环境监测与调整(有用性:1/6,17%;可信度:1/6,17%;可取性:0/6,0%;易学性:0/6,0%)。除了环境监测与调整外,大多数功能都得到了老年参与者的高度评价。结果表明,所提出的功能满足了用户的需求和期望(如改善患者疾病的自我管理和提高患者安全性)。然而,一些方面需要解决(如技术和隐私问题)。
所提出的智能健康平台功能似乎能够满足老年人增强自我意识和医疗状况自我管理的需求和愿望,鼓励健康和独立生活,并为临床医生的决策提供循证支持。需要对更多样化的利益相关者群体(在人口统计学和临床状况方面)进行进一步研究,以评估在自由生活条件下系统的可接受性和总体用户体验。