Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
Disabil Rehabil Assist Technol. 2023 Nov;18(8):1555-1576. doi: 10.1080/17483107.2022.2116114. Epub 2022 Sep 6.
PURPOSE: This two-phased study aimed to collate, summarize and characterize - through the lens of an occupation-based, person-centred framework - ongoing research and practice featuring activity participation-supportive digital health technology (DHT) for direct use by older persons with mild cognitive impairment or Alzheimer's disease and related dementias (PwMCI/ADRD). MATERIALS AND METHODS: Phase 1: Using scoping review procedures, PubMed, MEDLINE and PsycInfo were searched to identify primary research studies. Phase 2: Semi-structured interviews were completed with MCI/ADRD expert stakeholders identified through publicly available biographies and snowball referral. Thematic analysis was used to identify, synthesize and cross-compare emergent themes from both data sources that were subsequently organized into core facets of the Human Activity Assistive Technology (HAAT) model. RESULTS: The scoping review resulted in 28 studies, which were primarily feasibility work with small sample sizes. Interviewed experts ( = 17) had 4+ years of MCI/ADRD experience, came from a variety of settings, and held myriad roles. Real world and research-based use of DHTs held some commonalities, particularly around support for social participation and instrumental activities of daily engagement. No DHT for sleep or work/volunteerism were noted in either phase. People with milder MCI/ADRD conditions were most often targeted users. Soft technology strategies facilitating implementation centred on product design (e.g., prompting software, customisability, multimedia/multisensory experiences), instructional methods and technology partner involvement. CONCLUSIONS: This study demonstrates that although DHT supportive of activity participation is being studied and integrated into the lives of PwMCI/ADRD, there are still key opportunities for growth to meet the needs of diverse MCI/ADRD end users.Implications for rehabilitationMainstream digital health technologies (DHTs) are being utilized by persons with mild cognitive impairment and Alzheimer's disease and related dementias (PwMCI/ADRD) in everyday life, in limited capacities, to support social participation, leisure, health management and instrumental activities of daily living (IADL).Innovative research-based technologies to be used directly by PwMCI/ADRD are under development, particularly to facilitate management of ADL, social participation and IADL in persons with mild-to-moderate forms of cognitive impairment.Soft technology strategies to support technology implementation with MCI/ADRD target users include close attention to design of the technology (e.g., customisability, sensory stimulators and prompting features), instructional strategies that promote learning and motivation and involvement of technology partners to facilitate engagement with the technology.Future studies will require more robust research designs with transparent reports of participant characteristics and facilitative instructional methods to expand DHT's potential to account for and better meet the needs of diverse MCI/ADRD communities in real-world contexts.
目的:本研究分为两个阶段,旨在通过以职业为基础、以人为中心的框架,对正在进行的研究和实践进行整理、总结和描述,这些研究和实践的重点是支持轻度认知障碍或阿尔茨海默病及相关痴呆症(PwMCI/ADRD)患者活动参与的基于活动的数字健康技术(DHT)。
材料与方法:第一阶段:采用系统综述程序,在 PubMed、MEDLINE 和 PsycInfo 上搜索确定初级研究。第二阶段:通过公开传记和滚雪球推荐,确定 MCI/ADRD 专家利益相关者进行半结构式访谈。使用主题分析方法从两个数据源中识别、综合和交叉比较新兴主题,然后将其组织到人类活动辅助技术(HAAT)模型的核心方面中。
结果:系统综述共纳入 28 项研究,主要是小样本量的可行性研究。接受访谈的专家( = 17)具有 4 年以上的 MCI/ADRD 经验,来自不同的环境,担任各种角色。DHT 在现实世界和研究中的实际应用有一些共同之处,特别是在支持社会参与和日常生活活动方面。在这两个阶段都没有注意到与睡眠或工作/志愿服务相关的 DHT。轻度 MCI/ADRD 患者是最常被针对的使用者。以产品设计为中心的软技术策略(例如,提示软件、可定制性、多媒体/多感官体验)、教学方法和技术合作伙伴的参与,促进了 DHT 的实施。
结论:本研究表明,尽管支持活动参与的 DHT 正在被研究并整合到 PwMCI/ADRD 的生活中,但仍有很大的发展机会来满足不同 MCI/ADRD 最终用户的需求。
康复意义:主流数字健康技术(DHT)正在被轻度认知障碍和阿尔茨海默病及相关痴呆症(PwMCI/ADRD)患者在日常生活中有限地使用,以支持社会参与、休闲、健康管理和日常生活活动(IADL)。为了便于轻度至中度认知障碍患者管理日常生活活动、促进社会参与和 IADL,正在开发直接供 PwMCI/ADRD 使用的创新研究型技术。为了支持与 MCI/ADRD 目标使用者的技术实施,软技术策略包括密切关注技术设计(例如,可定制性、感官刺激和提示功能)、促进学习和动机的教学策略以及技术合作伙伴的参与,以促进他们与技术的互动。未来的研究将需要更强大的研究设计,并透明地报告参与者的特征和促进性教学方法,以扩大 DHT 的潜力,以适应和更好地满足现实世界背景下不同 MCI/ADRD 群体的需求。
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