阿尔茨海默病中患者采用数字技术的相关障碍:系统评价
Patient-Related Barriers to Digital Technology Adoption in Alzheimer Disease: Systematic Review.
作者信息
Panzavolta Andrea, Arighi Andrea, Guido Emanuele, Lavorgna Luigi, Di Lorenzo Francesco, Dodich Alessandra, Cerami Chiara
机构信息
IUSS Cognitive Neuroscience ICoN Center, Scuola Universitaria Superiore IUSS, Piazza della Vittoria, 15, Pavia, 27100, Italy, 39 3516237219.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
出版信息
JMIR Aging. 2025 Apr 10;8:e64324. doi: 10.2196/64324.
BACKGROUND
Digital technology in dementia is an area of great development with varying experiences across countries. However, novel digital solutions often lack a patient-oriented perspective, and several relevant barriers prevent their use in clinics.
OBJECTIVE
In this study, we reviewed the existing literature on knowledge, familiarity, and competence in using digital technology and on attitude and experiences with digital tools in Alzheimer disease. The main research question is whether digital competence and attitudes of patients and caregivers may affect the adoption of digital technology.
METHODS
Following the PRISMA guidelines, a literature search was conducted by two researchers in the group. Inter-rater reliability was calculated with Cohen κ statistics. The risk of bias assessment was also recorded.
RESULTS
Of 597 initial records, only 18 papers were considered eligible. Analyses of inter-rater reliability showed good agreement levels. Significant heterogeneity in study design, sample features, and measurement tools emerged across studies. Quality assessment showed a middle-high overall quality of evidence. The main factors affecting the adoption of digital technology in patients and caregivers are severity of cognitive deficits, timing of adoption, and the availability of training and support. Additional factors are age, type of digital device, and ease of use of the digital solution.
CONCLUSIONS
Adoption of digital technology in dementia is hampered by many patient-related barriers. Improving digital competence in patient-caregiver dyads and implementing systematic, patient-oriented strategies for the development and use of digital tools are needed for a successful incorporation of digital technology in memory clinics.
背景
痴呆症领域的数字技术是一个发展迅速的领域,各国的经验各不相同。然而,新型数字解决方案往往缺乏以患者为导向的视角,并且存在一些相关障碍阻碍其在临床中的应用。
目的
在本研究中,我们回顾了关于使用数字技术的知识、熟悉程度和能力,以及关于阿尔茨海默病患者对数字工具的态度和体验的现有文献。主要研究问题是患者和照护者的数字能力及态度是否会影响数字技术的采用。
方法
按照PRISMA指南,由该团队的两名研究人员进行文献检索。使用Cohen κ统计量计算评分者间信度。还记录了偏倚风险评估情况。
结果
在597条初始记录中,仅18篇论文被认为符合要求。评分者间信度分析显示出良好的一致性水平。各项研究在研究设计、样本特征和测量工具方面存在显著异质性。质量评估显示证据的总体质量处于中高水平。影响患者和照护者采用数字技术的主要因素是认知缺陷的严重程度、采用时机以及培训和支持的可获得性。其他因素包括年龄、数字设备类型以及数字解决方案的易用性。
结论
痴呆症患者采用数字技术受到许多与患者相关的障碍的阻碍。为了在记忆诊所成功引入数字技术,需要提高患者 - 照护者二元组的数字能力,并实施系统的、以患者为导向的数字工具开发和使用策略。
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本文引用的文献
J Multidiscip Healthc. 2023-2-14
Eur J Neurol. 2023-1