Rochon Elizabeth A, Thacker Ayush, Phillips Mirelle, Ritchie Christine, Vranceanu Ana-Maria, Plys Evan
Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.
JMIR Aging. 2025 May 21;8:e66212. doi: 10.2196/66212.
BACKGROUND: Persons living with dementia and their caregivers experience frequent emotional health challenges. Across the illness spectrum, engaging in shared pleasant activities is an important feature of well-being for persons living with dementia-caregiver dyads. Under the umbrella of virtual reality, immersive virtual environment technology (IVET) offers artificial sensory experiences and shows promise in this population. IVET development benefits from a user-centered design approach, and as an emerging field, preliminary testing of safety, usability, and engagement for person living with dementia-caregiver dyads is required. OBJECTIVE: We aimed to develop a preliminary IVET intervention for psychosocial health among person living with dementia-caregiver dyads. In doing so, we highlight design considerations and user preferences to ensure the safety and usability of technology-based interventions in the context of dementia. METHODS: We engaged 10 clinicians, 8 caregivers, and 3 persons living with dementia in 5 rounds of focus groups to evaluate the safety and usability of preliminary intervention features. Following prototype development, we engaged caregivers and persons living with dementia (n=9 dyads) in beta testing workshops to observe real-time user interaction with the intervention and guide refinements. Rapid data analysis was used to extract themes relevant to intervention development. RESULTS: The following themes emerged from focus groups to inform prototype development: (1) designing flexibly to allow users to tailor the intervention experience to their own environmental context and circumstance, (2) designing with the dyad's clinical and relational needs in mind, and (3) accounting for illness and aging-related challenges in design. The following themes emerged from workshops to inform prototype refinements: (1) increasing user support through more feedback and (2) increasing variety of visual and auditory feedback. CONCLUSIONS: Using user feedback throughout the development process, we developed a prototype of an IVET intervention, Toolkit for Experiential Well-Being in Dementia (the Isle of TEND), tailored to the needs of persons living with dementia and their caregivers. Our prototype uses specific design features to promote safety, usability, and engagement in the context of dementia. Future feasibility testing of the intervention is warranted. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/52799.
背景：痴呆症患者及其照护者经常面临情绪健康方面的挑战。在整个疾病范围内，参与共同的愉悦活动是痴呆症患者与照护者二元组幸福感的一个重要特征。在虚拟现实的框架下，沉浸式虚拟环境技术（IVET）提供了人工感官体验，并在这一人群中显示出前景。IVET的开发受益于以用户为中心的设计方法，作为一个新兴领域，需要对痴呆症患者与照护者二元组进行安全性、可用性和参与度的初步测试。 目的：我们旨在为痴呆症患者与照护者二元组开发一种用于心理社会健康的初步IVET干预措施。在此过程中，我们强调设计考量和用户偏好，以确保基于技术的干预措施在痴呆症背景下的安全性和可用性。 方法：我们邀请了10名临床医生、8名照护者和3名痴呆症患者参加5轮焦点小组讨论，以评估初步干预特征的安全性和可用性。在原型开发之后，我们邀请照护者和痴呆症患者（9个二元组）参加测试版测试工作坊，以观察用户与干预措施的实时互动并指导改进。采用快速数据分析来提取与干预开发相关的主题。 结果：焦点小组讨论中出现了以下主题，为原型开发提供了参考：（1）灵活设计，允许用户根据自身环境背景和情况调整干预体验；（2）设计时考虑二元组的临床和关系需求；（3）在设计中考虑与疾病和衰老相关的挑战。测试版测试工作坊中出现了以下主题，为原型改进提供了参考：（1）通过更多反馈增加用户支持；（2）增加视觉和听觉反馈的多样性。 结论：在整个开发过程中利用用户反馈，我们开发了一种IVET干预措施的原型，即痴呆症体验式幸福感工具包（TEND岛），以满足痴呆症患者及其照护者的需求。我们的原型使用特定设计特征，以促进痴呆症背景下的安全性、可用性和参与度。未来有必要对该干预措施进行可行性测试。 国际注册报告识别码（IRRID）：RR2-10.2196/52799。
JMIR Aging. 2024-7-3
BMC Med Inform Decis Mak. 2023-12-20
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