The compatibility of exoskeletons in perioperative environments and workflows: an analysis of surgical team members' perspectives and workflow simulation.

Surgical team members in perioperative environments experience high physical demands. Interventions such as exoskeletons, external wearable devices that support users, have the potential to reduce these work-related physical demands. However, barriers such as workplace environment and task compatibility may limit exoskeleton implementation. This study gathered the perspectives of 33 surgical team members: 12 surgeons, four surgical residents, seven operating room (OR) nurses, seven surgical technicians (STs), two central processing technicians (CPTs), and one infection control nurse to understand their workplace compatibility. Team members were introduced to passive exoskeletons via demonstrations, after which surgical staff (OR nurses, STs, and CPTs) were led through a simulated workflow walkthrough where they completed tasks representative of their workday. Five themes emerged from the interviews (workflow, user needs, hindrances, motivation for intervention, and acceptance) with unique subthemes for each population. Overall, exoskeletons were largely compatible with the duties and workflow of surgical team members.

The goal of this study was to identify exoskeleton compatibility across various surgical team members through a thematic analysis of interviews and a simulated workflow walkthrough. Results revealed five unique themes (workflow, user needs, hinderances, motivation for intervention, acceptance) and that exoskeletons were largely compatible with daily duties.

A year-long case study of multicomponent interventions to promote physical activity in office workers: A randomized control trial.

The purpose of this study was to identify if workplace interventions, (i.e., mindfulness classes and monetary incentives for gym attendance), influenced workers' physical activity. Office-based participants were randomized into one of four intervention assignments: 1) CONTROL (no interventions) (n = 40), 2) MINDFULNESS (n = 33), 3) GYM INCENTIVE (n = 41), or 4) BOTH mindfulness and gym incentive (n = 31). Activity-tracker and self-reported metabolic expenditure and step counts were gathered between January 2020 and December 2020 whereas the eight-week long interventions were provided between January and March 2020, when the impact of COVID-19 pandemic started. While physical activity decreased during the follow-up months, percent changes of physical activity at 1-, 2-, and 9-month follow-ups compared to baseline show no significant differences between or across the four intervention assignments (p > 0.05). These results suggest that the intervention assignments had no effect on physical activity from baseline. The lack of effectiveness of these interventions on participant physical activity could be attributed to the influence of the COVID-19 pandemic, and any effects of the interventions could not outweigh the effects of the pandemic.

Design of Pediatric Outpatient Procedure Environments: A Pilot Study to Understand the Perceptions of Patients and Their Parents.

OBJECTIVE: To understand parent and child perception of spaces experienced during outpatient procedures and to measure their anxiety in these spaces. BACKGROUND: Same-day procedures are becoming prevalent among children in the United States. While studies conducted in different types of healthcare settings show that the physical environment influences healthcare experiences of patients, there is a lack of research on patient and family perceptions of the physical environment of the outpatient centers where such procedures are conducted. METHODS: This study used ecological momentary assessment to collect patient experience and anxiety data at different points during the patient's journey through an ambulatory surgical center where pediatric gastrointestinal (GI) procedures were performed. Objective and subjective measures of anxiety were collected. A Qualtrics survey asked participants' perceptions about four spaces-waiting, preprocedure, procedure, and recovery. RESULTS: Child participants reported liking murals, double chairs, patient beds, wall color, and access to a television. They disliked medical equipment and lack of child-friendly furniture. Most parents liked the murals, access to a television, and nature photos, while disliking the lack of privacy, lack of toys in waiting areas, and lack of child-friendly furniture. On average, both children and parents experienced the highest anxiety levels before and during the procedure and the lowest during recovery. Between the four spaces, no significant differences were observed in the heart rate variability and skin conductance responses for both groups. CONCLUSIONS: Despite the outpatient nature of the procedures, participants experienced anxiety before the GI procedure. Comfortable design features that provide distractions are preferred by children and their parents.

Can pre-visit exposure to virtual tours of healthcare facilities help reduce child and parent anxiety during outpatient surgical procedures?

AIM: The study aims to evaluate the impact of exposure to a highly realistic virtual facility tour prior to the on-site visit on patients and their parent/care partner's self-reported anxiety and physiological measures on the day of the procedure. BACKGROUND: Preoperative anxiety impacts pediatric surgical outcomes; therefore, it is important for healthcare providers to address and manage preoperative anxiety in pediatric patients to promote better outcomes and overall wellbeing. Providing patients with a preview of the care setting before the actual procedure can be highly beneficial in mitigating preoperative anxiety. METHODOLOGY: In this pilot randomized experimental study, sixteen patient-care partner dyads scheduled to undergo a gastrointestinal procedure either received a virtual tour identical to the places experienced on the day of the procedure (experimental group) or received no virtual tour (control group). Self-reported measures of anxiety were collected from participants before and on the day of the procedure. Physiological measures of heart rate variability and skin conductance were collected on the day of the procedure from both groups. RESULTS: There were no significant differences between the self-reported and physiological measures of anxiety between the child groups. However, parents in the control group reported lower levels of anxiety and demonstrated lower levels of stress based on their physiological measures. CONCLUSION: Exposure to virtual facility tours days before the surgery was not helpful in positively impacting the psychological measures related to preoperative anxiety levels for the participants.

Manufacturing Industry Stakeholder Perspectives on Occupational Exoskeletons: Changes after a Brief Exposure to Exoskeletons.

OCCUPATIONAL APPLICATIONSMultiple occupational exoskeletons have been developed recently with potential to reduce physical demands, muscle fatigue, and risk of over-exertion injuries in manufacturing, yet there are currently challenges in practical, large-scale deployment. We explored how stakeholder perceptions of exoskeletons were affected by exposure to passive arm- and back-support exoskeletons. Our outcomes indicate that even brief exposure to exoskeletons can positively influence worker and stakeholder perceptions on the usefulness and safety of exoskeletons. However, worker concerns about device usability and acceptability in the field were not mitigated by such brief exposure. This work may help manufacturing industry stakeholders understand what technology-adoption factors need further consideration when planning for exoskeleton deployment.

Background: Despite evidence from several laboratory studies on the effectiveness of passive exoskeletons to support specific industrial jobs, barriers to adoption still exist. Contextual factors underlying exoskeleton adoption need further understanding. Purpose: We aimed to document how stakeholder perceptions of exoskeleton technologies could be affected by physical exposure to a wide variety of exoskeletons, by providing an opportunity to wear them and perform standardized tasks. Methods: We recorded the opinions of 22 participants from different manufacturing industries, both before and after trying seven different passive arm-support and back-support occupational EXOs. EXO expectations, adoption factors/barriers in their work settings, and perceived next steps for implementing such technologies were captured. Participants also completed usability questionnaires after each EXO trial. Results: Even brief exposure to EXOs positively influenced both worker and stakeholder perceptions on exoskeleton usefulness and safety; in contrast, worker concerns about usability and acceptability remained unchanged. Participants indicated stronger preferences for some specific EXO technologies, in terms of ease of use, performance improvements, and applicability. Conclusions: Actual exposure to occupational exoskeletons, even if brief, was found to alter worker and stakeholder perceptions of exoskeleton usefulness and safety. Future work on technology perceptions and intention to use exoskeletons may need to consider physical exposure to devices before soliciting perceptions, especially for novel technologies like exoskeletons.

Physical activity changes among office workers during the COVID-19 pandemic lockdown and the agreement between objective and subjective physical activity metrics.

After the onset of the COVID-19 pandemic, many office workers transitioned to working-from-home (WFH) which altered routine physical activity (PA). To understand how these workers' PA were affected throughout the pandemic, PA data collected in January, April, June, and December 2020 with an activity tracker and a validated survey were analyzed. Between January and December, it was found that step counts during the weekday decreased (p < 0.01), weekday heart rate was higher than weekends (p < 0.01), activity-tracker and self-reported PA decreased (p < 0.01), and sitting time increased (p < 0.01). To understand the agreement between the objective and subjective METs, Bland-Altman analyses were completed and demonstrated an acceptable level of agreement. Findings show decreased level of PA amongst WFH office workers and that the activity tracker and survey are reliable methods of recording WFH PA.