Comfort and Attitudes Towards Robots Among Young, Middle-Aged, and Older Adults: A Cross-Sectional Study.

PURPOSE: To explore the social impact of, comfort with, and negative attitudes towards robots among young, middle-aged, and older adults in the United States. DESIGN: Descriptive, cross-sectional. Conducted in 2014-2015 in an urban area of the western United States using a purposive sample of adults 18 years of age or older. METHODS: Respondents completed a survey that included the Negative Attitudes Toward Robots Scale (NARS) and two questions taken or modified from the European Commission's Autonomous System 2015 Report. Analyses were conducted to compare perceptions and demographic factors by age groups (young adults:18-44, middle-aged adults: 45-64, and older adults: >65 years old). FINDINGS: Sample included 499 individuals (n = 322 age 18-44 years, n = 50 age 45-64 years, and n = 102 age 65-98 years). There were no significant differences between age groups for 9 of the 11 items regarding social impact of robots and comfort with robots. There were no significant differences by age groups for 9 of the 14 items in the NARS. Among those items with statistically significant differences, the mean scores indicate similar sentiments for each group. CONCLUSIONS: Older, middle-aged, and younger adults had similar attitudes regarding the social impact of and comfort with robots; they also had similar negative attitudes towards robots. Findings dispel current perceptions that older adults are not as receptive to robots as other adults. This has implications for nurses who integrate supportive robots in their practice. CLINICAL RELEVANCE: Nurses working in clinical and community roles can use these findings when developing and implementing robotic solutions. Understanding attitudes towards robots can support how, where, and with whom robots can be used in nursing practice.

Using scenarios and personas to enhance the effectiveness of heuristic usability evaluations for older adults and their care team.

OBJECTIVE: Using heuristics to evaluate user experience is a common methodology for human-computer interaction studies. One challenge of this method is the inability to tailor results towards specific end-user needs. This manuscript reports on a method that uses validated scenarios and personas of older adults and care team members to enhance heuristics evaluations of the usability of commercially available personal health records for homebound older adults. MATERIALS AND METHODS: Our work extends the Chisnell and Redish heuristic evaluation methodology by using a protocol that relies on multiple expert reviews of each system. It further standardizes the heuristic evaluation process through the incorporation of task-based scenarios. RESULTS: We were able to use the modified version of the Chisnell and Redish heuristic evaluation methodology to identify potential usability challenges of two commercially available personal health record systems. This allowed us to: (1) identify potential usability challenges for specific types of users, (2) describe improvements that would be valuable to all end-users of the system, and (3) better understand how the interactions of different users may vary within a single personal health record. CONCLUSIONS: The methodology described in this paper may help designers of consumer health information technology tools, such as personal health records, understand the needs of diverse end-user populations. Such methods may be particularly helpful when designing systems for populations that are difficult to recruit for end-user evaluations through traditional methods.

How patient-generated health data and patient-reported outcomes affect patient-clinician relationships: A systematic review.

INTRODUCTION: Many patients use mobile devices to track health conditions by recording patient-generated health data. However, patients and clinicians may disagree how to use these data. OBJECTIVE: To systematically review the literature to identify how patient-generated health data and patient-reported outcomes collected outside of clinical settings can affect patient-clinician relationships within surgery and primary care. METHODS: Six research databases were queried for publications documenting the effect of patient-generated health data or patient-reported outcomes on patient-clinician relationships. We conducted thematic synthesis of the results of the included publications. RESULTS: Thirteen of the 3204 identified publications were included for synthesis. Three main themes were identified: patient-generated health data supported patient-clinician communication and health awareness, patients desired for their clinicians to be involved with their patient-generated health data, which clinicians had difficulty accommodating, and patient-generated health data platform features may support or hinder patient-clinician collaboration. CONCLUSION: Patient-generated health data and patient-reported outcomes may improve patient health awareness and communication with clinicians but may negatively affect patient-clinician relationships.

The Experience of Home Care Providers and Beneficiaries With Enhanced Training Requirements in Washington State.

Objective: Our objective was to understand the perceived impact of Washington State's upgraded training and certification requirements of long-term care workers providing personal care services from the perspectives of consumers and home care aides. Methods: We applied conventional qualitative content analysis to semi-structured interviews with 17 consumers and 10 certified home care aides. Results: We found that consumers in this study put a high premium on directing many aspects of their personal care services. We also found that while home care aides supported what consumers desired for their own care, some were unsure how to reconcile providing individualized services with the State's standardized, competency-based training and certification program. Discussion: State-based efforts, such as the one in Washington State, serve as an important starting point for building a broader effort toward the identification of competencies and associated training standards for the home care workforce.

Lack of Diversity in Personal Health Record Evaluations with Older Adult Participants: A Systematic Review of Literature.

BACKGROUND: Older adults are not adopting personal health records (PHRs) at the same rates as other adult populations. Disparities in adoption rates are also reported in older adult subgroups. The variability in adoption may be because PHRs are not designed to meet older adult users. OBJECTIVE: We analyzed PHR evaluation studies to examine the characteristics and perspectives of older adult study participants to identify their self-reported needs. METHOD: We searched Medline, CINAHL, PsycINFO, and Embase for PHR evaluation studies that involved older adult participants. RESULTS: 1017 abstracts were identified, and 179 publications went through full text review. 10 publications met inclusion criteria. These publications described studies conducted in 3 countries, and evaluated 7 PHRs. Homogeneity was found in the study populations and participant opinions of the systems. DISCUSSION: Many PHR evaluations do not include diverse older adult participants. This may lead to consistency in outcomes, but it also may create gaps in identifying user needs. Additional studies, specifically targeting diverse older adult participants, are needed to gain a more comprehensive understanding of the opinions of older adults on PHRs and how these systems could benefit older adult healthcare consumers. CONCLUSION: The body of research shows that older adults are highly satisfied using PHRs. These outcomes may be generalizable because most PHR evaluation studies do not include diverse older adult participants. This lack of participant diversity may be contributing to the disparities observed in PHR adoption rates.

Older Adults' Perceptions of Fall Detection Devices.

A third of adults over the age of 65 are estimated to fall at least once a year. Perhaps as dangerous as the fall itself is the time spent after a fall if the person is unable to move. Although there are many devices available to detect when a person has fallen, little is known about the opinions of older adults regarding these fall detection devices (FDDs). We conducted five focus groups with 27 older adults. Transcripts from sessions were coded to generate themes that captured participants' perceptions. Themes were identified that related to two topics of interest: (a) personal influences on the participants' desire to have a FDD, including perceived need, participant values, and cost, and (b) participant recommendations regarding specific features and functionalities of these devices such as automation, wearable versus non-wearable devices, and device customization. Together, these themes suggest ways in which FDDs may be improved so that they are suitable for their intended population.

Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

BACKGROUND: Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. OBJECTIVES: To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. METHODS: Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. RESULTS: Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. CONCLUSIONS: The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.