Ntsweng Oteng, Kodyš Martin, Ong Zhi Quan, Zhou Fang, Marassé-Enouf Antoine de, Sadek Ibrahim, Aloulou Hamdi, Tan Sharon Swee-Lin, Mokhtari Mounir
W.P Carey School of Business, Arizona State University, Tempe, AZ, United States.
Institut Mines-Télécom, Paris, France.
JMIR Rehabil Assist Technol. 2025 Jun 11;12:e57989. doi: 10.2196/57989.
COVID-19 has given impetus to an already growing trend around the use of ambient assisted living (AAL) technologies to support frail older adults who live alone. However, the challenge is that systematic research on the long-term use of AAL technologies remains in its nascent stages, leaving gaps in the understanding of the predictors that contribute to the routine embedding of AAL technologies in older adults' care.
This paper aims to share key lessons from a longitudinal study on the routine embedding of AAL technologies in older adults' care within a hitherto under-studied Southeast Asian context. Our objective was to design and deploy an AAL system termed Ubiquitous Service Management and Reasoning Architecture (Ubismart), evaluate its impact on older adults' quality of life (QOL), and distill lessons to inform the sustainable and culturally sensitive adoption of AAL technologies in similar settings.
We conducted an in-depth case study using a mixed methods design. First, we designed and deployed Ubismart to unobtrusively monitor and visualize older adults' activities of daily living. To assess changes in QOL, we administered a simplified, gamified version of the validated Older People's Quality of Life Questionnaire. Finally, we conducted semistructured interviews with older adults and their caregivers to triangulate the quantitative findings and explore evolving perceptions of the technology and its integration into daily routines.
Quantitative analysis revealed significant improvements in (1) psychological and emotional well-being (P=.01) and (2) leisure and social activities (P=.03) following the AAL intervention. Other QOL dimensions showed no statistically significant change. Qualitative findings reinforced the improvement in psychological and emotional well-being, with many participants describing a heightened sense of safety and peace of mind, often likening the technology to "insurance" or a silent companion. However, the impact on social relationships was paradoxical; some older adults felt more cared for, while others perceived a decline in in-person visits. This paradox highlighted the complexities of technology's role in caregiving, as it might simultaneously enhance feelings of safety while unintentionally diminishing social connection for some older adults.
AAL technologies such as Ubismart enhance older adults' psychological and emotional well-being and sense of safety but may inadvertently reduce social interaction. Sustainable integration requires balancing these benefits with efforts to maintain meaningful caregiver connections, supporting both safety and social engagement for older adults.
ClinicalTrials.gov NCT06486935; https://clinicaltrials.gov/study/NCT06486935.
新冠疫情推动了围绕使用环境辅助生活（AAL）技术来支持独居体弱老年人这一已然不断增长的趋势。然而，挑战在于对AAL技术长期使用的系统性研究仍处于初始阶段，在理解有助于AAL技术常规融入老年人护理的预测因素方面存在空白。
本文旨在分享一项纵向研究的关键经验教训，该研究是关于在一个此前研究不足的东南亚背景下AAL技术在老年人护理中的常规融入情况。我们的目标是设计并部署一个名为泛在服务管理与推理架构（Ubismart）的AAL系统，评估其对老年人生活质量（QOL）的影响，并提炼经验教训，为在类似环境中可持续且符合文化敏感性地采用AAL技术提供参考。
我们采用混合方法设计进行了一项深入的案例研究。首先，我们设计并部署了Ubismart，以不引人注意的方式监测和可视化老年人的日常生活活动。为评估生活质量的变化，我们使用了经过验证的老年人生活质量问卷的简化、游戏化版本。最后，我们对老年人及其照顾者进行了半结构化访谈，以对定量研究结果进行三角验证，并探索他们对该技术及其融入日常生活的不断变化的看法。
定量分析显示，在AAL干预后，（1）心理和情绪幸福感（P = 0.01）以及（2）休闲和社交活动（P = 0.03）有显著改善。生活质量的其他维度没有显示出统计学上的显著变化。定性研究结果强化了心理和情绪幸福感的改善，许多参与者描述了安全感和安心感增强，经常将该技术比作“保险”或无声的陪伴者。然而，对社会关系的影响是矛盾的；一些老年人感觉得到了更多照顾，而另一些人则感觉到面对面探访减少了。这种矛盾突出了技术在护理中作用的复杂性，因为它可能在增强一些老年人安全感的同时，无意中减少了他们的社会联系。
诸如Ubismart这样的AAL技术可提高老年人的心理和情绪幸福感以及安全感，但可能会无意中减少社会互动。可持续的整合需要在这些益处与维持有意义的照顾者联系的努力之间取得平衡，以支持老年人的安全和社会参与。
ClinicalTrials.gov NCT06486935；https://clinicaltrials.gov/study/NCT06486935 。
