Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
KITE, Toronto Rehabilitation Institute, Toronto, ON, Canada.
J Med Internet Res. 2023 Oct 12;25:e46188. doi: 10.2196/46188.
BACKGROUND: Studies have shown that mobile apps have the potential to serve as nonpharmacological interventions for dementia care, improving the quality of life of people living with dementia and their informal caregivers. However, little is known about the needs for and privacy aspects of these mobile apps in dementia care. OBJECTIVE: This review seeks to understand the landscape of existing mobile apps in dementia care for people living with dementia and their caregivers with respect to app features, usability testing, privacy, and security. METHODS: ACM Digital Library, Cochrane Central Register of Controlled Trials, Compendex, Embase, Inspec, Ovid MEDLINE, PsycINFO, and Scopus were searched. Studies were included if they included people with dementia living in the community, their informal caregivers, or both; focused on apps in dementia care using smartphones or tablet computers; and covered usability evaluation of the app. Records were independently screened, and 2 reviewers extracted the data. The Centre for Evidence-Based Medicine critical appraisal tool and Mixed Methods Appraisal Tool were used to assess the risk of bias in the included studies. Thematic synthesis was used, and the findings were summarized and tabulated based on each research aim. RESULTS: Overall, 44 studies were included in this review, with 39 (89%) published after 2015. In total, 50 apps were included in the study, with more apps developed for people living with dementia as end users compared with caregivers. Most studies (27/44, 61%) used tablet computers. The most common app feature was cognitive stimulation. This review presented 9 app usability themes: user interface, physical considerations, screen size, interaction challenges, meeting user needs, lack of self-awareness of app needs, stigma, technological inexperience, and technical support. In total, 5 methods (questionnaires, interviews, observations, logging, and focus groups) were used to evaluate usability. There was little focus on the privacy and security aspects, including data transfer and protection, of mobile apps for people living with dementia. CONCLUSIONS: The limitations of this review include 1 reviewer conducting the full-text screening, its restriction to studies published in English, and the exclusion of apps that lacked empirical usability testing. As a result, there may be an incomplete representation of the available apps in the field of dementia care. However, this review highlights significant concerns related to the usability, privacy, and security of existing mobile apps for people living with dementia and their caregivers. The findings of this review provide a valuable framework to guide app developers and researchers in the areas of privacy policy development, app development strategies, and the importance of conducting thorough usability testing for their apps. By considering these factors, future work in this field can be advanced to enhance the quality and effectiveness of dementia care apps. TRIAL REGISTRATION: PROSPERO CRD42020216141; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216141. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1159/000514838.
背景:研究表明,移动应用程序有可能成为痴呆症护理的非药物干预措施,可以提高痴呆症患者及其非专业照护者的生活质量。然而,对于这些在痴呆症护理中使用的移动应用程序的需求和隐私方面,我们知之甚少。
目的:本综述旨在了解针对痴呆症患者及其照护者的现有移动应用程序在痴呆症护理方面的应用情况,包括应用程序的功能、可用性测试、隐私和安全。
方法:我们在 ACM 数字图书馆、考科蓝对照试验中心注册库、Compendex、Embase、Inspec、Ovid MEDLINE、PsycINFO 和 Scopus 中进行了搜索。纳入的研究必须符合以下标准:研究对象为居住在社区中的痴呆症患者、他们的非专业照护者,或同时包括上述两者;研究聚焦于使用智能手机或平板电脑的痴呆症护理应用程序;并涵盖应用程序的可用性评估。记录由 2 名独立审查员进行筛选,然后由他们提取数据。我们使用循证医学中心的批判性评估工具和混合方法评估工具来评估纳入研究的偏倚风险。我们采用主题合成法,根据每个研究目的总结和制表呈现研究结果。
结果:共有 44 项研究被纳入本综述,其中 39 项(89%)是在 2015 年以后发表的。总共纳入了 50 个应用程序,其中针对痴呆症患者的应用程序比针对照护者的应用程序更多。大多数研究(27/44,61%)使用平板电脑。最常见的应用程序功能是认知刺激。本综述提出了 9 个应用程序可用性主题:用户界面、物理因素、屏幕尺寸、交互挑战、满足用户需求、缺乏对应用程序需求的自我意识、污名化、技术经验不足和技术支持。总共使用了 5 种方法(问卷调查、访谈、观察、记录和焦点小组)来评估可用性。对于痴呆症患者使用的移动应用程序的隐私和安全方面,包括数据传输和保护,关注较少。
结论:本综述的局限性包括 1 位审查员进行了全文筛选、研究仅限于发表在英语期刊上,以及排除了缺乏实证可用性测试的应用程序。因此,在痴呆症护理领域可能存在对现有应用程序的不完整描述。然而,本综述突出了与痴呆症患者及其照护者使用的现有移动应用程序的可用性、隐私和安全相关的重大问题。本综述的研究结果为应用程序开发人员和研究人员提供了一个有价值的框架,用于指导隐私政策制定、应用程序开发策略,以及对其应用程序进行彻底的可用性测试。考虑到这些因素,该领域的未来工作可以得到推进,以提高痴呆症护理应用程序的质量和效果。
试验注册:PROSPERO CRD42020216141;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216141.
国际注册报告标识符(IRRID):RR2-10.1159/000514838.
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