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患者对预防老年科和综合病房跌倒的新型技术解决方案(环境智能老年管理系统)的可接受性:一项混合方法研究。

Patient Acceptability of a Novel Technological Solution (Ambient Intelligent Geriatric Management System) to Prevent Falls in Geriatric and General Medicine Wards: A Mixed-Methods Study.

机构信息

Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.

出版信息

Gerontology. 2022;68(9):1070-1080. doi: 10.1159/000522657. Epub 2022 Apr 29.

Abstract

INTRODUCTION

As effective interventions to prevent inpatient falls are lacking, a novel technological intervention was trialed. The Ambient Intelligent Geriatric Management (AmbIGeM) system used wearable sensors that detected and alerted staff of patient movements requiring supervision. While the system did not reduce falls rate, it is important to evaluate the acceptability, usability, and safety of the AmbIGeM system, from the perspectives of patients and informal carers.

METHODS

We conducted a mixed-methods study using semistructured interviews, a pre-survey and post-survey. The AmbIGeM clinical trial was conducted in two geriatric evaluation and management units and a general medical ward, in two Australian hospitals, and a subset of participants were recruited. Within 3 days of being admitted to the study wards and enrolling in the trial, 31 participants completed the pre-survey. Prior to discharge (post-intervention), 30 participants completed the post-survey and 27 participants were interviewed. Interview data were thematically analyzed and survey data were descriptively analyzed.

RESULTS

Survey and interview participants had an average age of 83 (SD 9) years, 65% were female, and 41% were admitted with a fall. Participants considered the AmbIGeM system a good idea. Most but not all thought the singlet and sensor component as acceptable and comfortable, with no privacy concerns. Participants felt reassured with extra monitoring, although sometimes misunderstood the purpose of AmbIGeM as detecting patient falls. Participants' acceptability was strongly positive, with median 8+ (0-10 scale) on pre- and post-surveys.

DISCUSSION/CONCLUSION: Patients' acceptability is important to optimize outcomes. Overall older patients considered the AmbIGeM system as acceptable, usable, and improving safety. The findings will be important to guide refinement of this and other similar technology developments.

摘要

介绍

由于缺乏有效的预防住院患者跌倒的干预措施,因此试用了一种新的技术干预措施。Ambient Intelligent Geriatric Management(AmbIGeM)系统使用可穿戴传感器来检测和提醒工作人员注意需要监督的患者活动。尽管该系统并未降低跌倒率,但从患者和非正式照顾者的角度评估 AmbIGeM 系统的可接受性、可用性和安全性非常重要。

方法

我们采用混合方法研究,使用半结构式访谈、预调查和后调查。AmbIGeM 临床试验在澳大利亚的两家医院的两个老年评估和管理病房以及一个普通内科病房进行,部分参与者被招募。在入住研究病房并参加试验后的 3 天内,31 名参与者完成了预调查。在出院前(干预后),30 名参与者完成了后调查,27 名参与者接受了访谈。对访谈数据进行主题分析,对调查数据进行描述性分析。

结果

调查和访谈参与者的平均年龄为 83(SD 9)岁,65%为女性,41%因跌倒而入院。参与者认为 AmbIGeM 系统是一个好主意。大多数参与者(但不是全部)认为背心和传感器组件可以接受且舒适,并且没有隐私问题。尽管有时会误解 AmbIGeM 的目的是检测患者跌倒,但参与者还是感到额外的监测得到了保证。参与者的可接受性非常积极,预调查和后调查的中位数均为 8+(0-10 分)。

讨论/结论:患者的可接受性对于优化结果非常重要。总体而言,老年患者认为 AmbIGeM 系统是可接受、可用和提高安全性的。这些发现对于指导该系统和其他类似技术的改进非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bc7/9501724/c6ada61cd195/ger-0068-1070-g01.jpg

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