Shin Marlena H, McLaren Jaye, Ramsey Alvin, Sullivan Jennifer L, Moo Lauren
Center for Healthcare Organization and Implementation Research, Veterans Affairs Boston Healthcare System, Boston, MA, United States.
New England Geriatric Research Education and Clinical Center, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States.
JMIR Aging. 2022 May 3;5(2):e32322. doi: 10.2196/32322.
By 2050, nearly 13 million Americans will have Alzheimer disease and related dementias (ADRD), with most of those with ADRD or mild cognitive impairment (MCI) receiving home care. Mobile telepresence robots may allow persons with MCI or ADRD to remain living independently at home and ease the burden of caregiving. The goal of this study was to identify how an existing mobile telepresence robot can be enhanced to support at-home care of people with MCI or ADRD through key stakeholder input.
The specific aims were to assess what applications should be integrated into the robot to further support the independence of individuals with MCI or ADRD and understand stakeholders' overall opinions about the robot.
We conducted in-person interviews with 21 stakeholders, including 6 people aged >50 years with MCI or ADRD living in the community, 9 family caregivers of people with MCI or ADRD, and 6 clinicians who work with the ADRD population. Interview questions about the robot focused on technology use, design and functionality, future applications to incorporate, and overall opinions. We conducted a thematic analysis of the data obtained and assessed the patterns within and across stakeholder groups using a matrix analysis technique.
Overall, most stakeholders across groups felt positively about the robot's ability to support individuals with MCI or ADRD and decrease caregiver burden. Most ADRD stakeholders felt that the greatest benefits would be receiving help in emergency cases and having fewer in-person visits to the doctor's office. Caregivers and clinicians also noted that remote video communication with their family members using the robot was valuable. Adding voice commands and 1-touch lifesaving or help buttons to the robot were the top suggestions offered by the stakeholders. The 4 types of applications that were suggested included health-related alerts; reminders; smart-home-related applications; and social, entertainment, or well-being applications. Stakeholders across groups liked the robot's mobility, size, interactive connection, and communication abilities. However, stakeholders raised concerns about their physical stability and size for individuals living in smaller, cluttered spaces; screen quality for those with visual impairments; and privacy or data security.
Although stakeholders generally expressed positive opinions about the robot, additional adaptations were suggested to strengthen functionality. Adding applications and making improvements to the design may help mitigate concerns and better support individuals with ADRD to live independently in the community. As the number of individuals living with ADRD in the United States increases, mobile telepresence robots are a promising way to support them and their caregivers. Engaging all 3 stakeholder groups in the development of these robots is a critical first step in ensuring that the technology matches their needs. Integrating the feedback obtained from our stakeholders and evaluating their effectiveness will be important next steps in adapting telepresence robots.
到2050年,近1300万美国人将患有阿尔茨海默病及相关痴呆症(ADRD),其中大多数患有ADRD或轻度认知障碍(MCI)的人将接受家庭护理。移动远程临场感机器人可能使患有MCI或ADRD的人能够继续独立生活在家中,并减轻护理负担。本研究的目的是通过关键利益相关者的意见,确定如何改进现有的移动远程临场感机器人,以支持对患有MCI或ADRD的人的家庭护理。
具体目标是评估应将哪些应用程序集成到机器人中,以进一步支持患有MCI或ADRD的人的独立性,并了解利益相关者对该机器人的总体看法。
我们对21名利益相关者进行了面对面访谈,其中包括6名年龄超过50岁、患有MCI或ADRD且居住在社区的人、9名患有MCI或ADRD的人的家庭护理人员以及6名与ADRD患者群体打交道的临床医生。关于机器人的访谈问题集中在技术使用、设计和功能、未来要纳入的应用程序以及总体看法上。我们对获得的数据进行了主题分析,并使用矩阵分析技术评估了利益相关者群体内部和之间的模式。
总体而言,各群体中的大多数利益相关者对机器人支持患有MCI或ADRD的人以及减轻护理负担的能力持积极态度。大多数ADRD利益相关者认为,最大的好处将是在紧急情况下获得帮助以及减少去医生办公室的当面就诊次数。护理人员和临床医生还指出,使用机器人与家人进行远程视频通信很有价值。利益相关者提出的首要建议是为机器人添加语音命令和一键式救生或求助按钮。建议的4种应用类型包括与健康相关的警报;提醒;与智能家居相关的应用程序;以及社交、娱乐或健康应用程序。各群体的利益相关者都喜欢机器人的移动性、尺寸、交互连接和通信能力。然而,利益相关者对机器人在较小、杂乱空间中的物理稳定性和尺寸、视力障碍者的屏幕质量以及隐私或数据安全表示担忧。
尽管利益相关者普遍对机器人表达了积极意见,但仍建议进行额外的改进以增强功能。添加应用程序并改进设计可能有助于减轻担忧,并更好地支持患有ADRD的人在社区中独立生活。随着美国患有ADRD的人数增加,移动远程临场感机器人是支持他们及其护理人员的一种有前途的方式。让所有三个利益相关者群体参与这些机器人的开发是确保技术符合他们需求的关键第一步。整合从我们的利益相关者那里获得的反馈并评估其有效性将是改进远程临场感机器人的重要后续步骤。