Mills Jodie, Duffy Orla, Pedlow Katy, Kernohan George
School of Health Sciences, Faculty of Life and Health Sciences, University of Ulster, Belfast, United Kingdom.
School of Nursing, Faculty of Life and Health Sciences, University of Ulster, Belfast, United Kingdom.
JMIR Rehabil Assist Technol. 2025 Jul 16;12:e75316. doi: 10.2196/75316.
People with Parkinson disease (PD) often report low volume and reduced intelligibility of speech. Common household devices that use voice-assisted technology (VAT) require users to speak slowly, clearly, and loudly for the technology to function. For people with PD, this can be challenging, but this also suggests that VAT may have potential as a therapeutic tool. While VAT is an emerging health care technology, it is important to better understand the thoughts and experiences of people with PD who are already using it despite having speech and voice difficulties.
This study aimed to explore experiences of using VAT to address hypokinetic dysarthria secondary to PD, based on the perspectives of people with PD and family carers.
People with PD experiencing mild to moderate speech changes who were smart speaker users, and their carers, were invited to participate in 1 of 4 in-person focus groups. Between September and December 2024, focus groups were audiovisually recorded. A semistructured topic guide informed by published evidence was used to guide discussions. Results were transcribed and analyzed through a framework analysis approach (managed using NVivo software).
A total of 15 participants, including 8 (53%) people with PD and 7 (47%) carers, participated in 4 in-person focus groups. Findings revealed shared experiences with VAT that were marked by its therapeutic potential and practical challenges. Five main themes were identified: (1) therapeutic potential for speech and voice, with subthemes of changes in volume, intelligibility, and clarity of speech; the role of VAT feedback; and VAT as an everyday device; (2) distrust of technology, with concerns surrounding data privacy, the listening nature of devices, and measures users take to protect themselves; (3) frustrations with devices, including devices not understanding, devices timing out, and the lack of conversation; (4) support needs, including the impact of a lack of knowledge and the need for education and guidance; and (5) design considerations for a future VAT tool in speech and language therapy (SLT).
This study extends on previous research findings, demonstrating that VAT may be acceptable to people with PD to create changes in volume, clarity, and intelligibility. However, attention must be given to users' privacy concerns and frustrations with devices before VAT can used as a tool in SLT. Future research should design solutions to address current usability challenges with people with PD and professionals in three ways: (1) co-designing education and guidelines for people with PD, describing the use of VAT for speech and voice difficulties; (2) refining commercial VAT for use in SLT; and (3) establishing the feasibility of a therapeutic VAT intervention for people with PD with speech and voice difficulties.
帕金森病（PD）患者常常报告语音音量低且清晰度下降。使用语音辅助技术（VAT）的普通家用设备要求用户缓慢、清晰且大声地说话，技术才能正常运行。对于帕金森病患者而言，这可能具有挑战性，但这也表明语音辅助技术可能具有作为治疗工具的潜力。虽然语音辅助技术是一种新兴的医疗保健技术，但更好地了解尽管存在言语和语音困难却已在使用该技术的帕金森病患者的想法和经历非常重要。
本研究旨在基于帕金森病患者及其家庭护理人员的视角，探索使用语音辅助技术来解决帕金森病继发的运动减少型构音障碍的体验。
邀请正在使用智能音箱且存在轻度至中度言语变化的帕金森病患者及其护理人员参加4个面对面焦点小组中的1个。在2024年9月至12月期间，对焦点小组进行了视听记录。采用基于已发表证据的半结构化主题指南来指导讨论。通过框架分析方法（使用NVivo软件进行管理）对结果进行转录和分析。
共有15名参与者，包括8名（53%）帕金森病患者和7名（47%）护理人员，参加了4个面对面焦点小组。研究结果揭示了与语音辅助技术相关的共同体验，其特点是具有治疗潜力和实际挑战。确定了五个主要主题：（1）语音和嗓音的治疗潜力，子主题包括语音音量、清晰度和可懂度的变化；语音辅助技术反馈的作用；以及语音辅助技术作为日常设备；（2）对技术的不信任，涉及数据隐私、设备的监听性质以及用户采取的自我保护措施；（3）对设备的不满，包括设备不理解、设备超时以及缺乏对话；（4）支持需求，包括知识缺乏的影响以及对教育和指导的需求；（5）语音语言治疗（SLT）中未来语音辅助技术工具的设计考虑因素。
本研究扩展了先前的研究结果，表明帕金森病患者可能接受语音辅助技术以实现音量、清晰度和可懂度的改变。然而，在语音辅助技术能够用作语音语言治疗工具之前，必须关注用户对隐私的担忧以及对设备的不满。未来的研究应以三种方式设计解决方案，以应对当前帕金森病患者和专业人员面临的可用性挑战：（1）共同为帕金森病患者设计教育和指南，描述如何使用语音辅助技术解决言语和语音困难；（2）改进商业语音辅助技术以用于语音语言治疗；（3）确定针对存在言语和语音困难的帕金森病患者进行治疗性语音辅助技术干预的可行性。
