RESUMO
BACKGROUND: The electronic patient record (EPR) has been introduced into nursing homes in order to facilitate documentation practices such as assessment and care planning, which play an integral role in the provision of dementia care. However, little is known about how the EPR facilitates or hinders these practices from the end-user's perspective. Therefore, the objective of this qualitative study was to explore the usability issues associated with the EPR for assessment and care planning for people with dementia in nursing homes from a staff perspective. METHODS: An exploratory, qualitative research design with a multiple case study approach was used. Contextual Inquiry was carried out with a variety of staff members (n = 21) who used the EPR in three nursing homes situated in Belgium, Czech Republic and Spain. Thematic analysis was used to code interview data, with codes then sorted into a priori components of the Health Information Technology Evaluation Framework: device, software functionality, organisational support. Two additional themes, structure and content, were also added. RESULTS: Staff provided numerous examples of the ways in which EPR systems are facilitating and hindering assessment and care planning under each component, particularly for people with dementia, who may have more complex needs in comparison to other residents. The way in which EPR systems were not customisable was a common theme across all three homes. A comparison of organisational policies and practices revealed the importance of training, system support, and access, which may be linked with the successful adoption of the EPR system in nursing homes. CONCLUSIONS: EPR systems introduced into the nursing home environment should be customisable and reflect best practice guidelines for dementia care, which may lead to improved outcomes and quality of life for people with dementia living in nursing homes. All levels of nursing home staff should be consulted during the development, implementation and evaluation of EPR systems as part of an iterative, user-centred design process.
Assuntos
Demência , Registros Eletrônicos de Saúde , Humanos , Casas de Saúde , Qualidade de VidaRESUMO
INTRODUCTION: Incorporating technology in cognitive interventions represents an innovation, making them more accessible, flexible, and cost-effective. This will not be feasible without adequate user-technology fit. Bearing in mind the importance of developing cognitive interventions whose technology is appropriate for elderly people with cognitive impairment, the objective of this systematic review was to find evidence about usability and user experience (UX) measurements and features of stimulation, training, and cognitive rehabilitation technologies for older adults with mild cognitive impairment (MCI) or dementia. METHOD: The Medline, PubMed, Scopus, ScienceDirect, and PsycINFO databases were searched for literature published in the last 10 years (2009-2019), and three researchers independently reviewed potentially eligible studies, following specific inclusion criteria. A systematic review of the studies was conducted, presenting a qualitative synthesis of usability and UX measures with their outcomes, study characteristics and features of the cognitive intervention technologies. RESULTS: Ten studies were selected: five were cognitive stimulation and five were cognitive training. Most of them (60%) were computer-based programs with a serious game format. Efficiency and effectiveness were the most frequent measurements used for collecting objective usability data, showing that elderly people with cognitive impairment require more time (45%) and help (40%) but can complete tasks (60%). Regarding UX or subjective usability data, questionnaires and scales were the most used methods, reporting positive experience despite certain difficulties with the interface in five studies. CONCLUSION: Measuring usability and UX in cognitive intervention technologies for older adults with MCI or dementia provides an integrated view that can contribute to their development according to the needs and characteristics of the target population. More research is required to include this population group in usability and UX studies, as well as standardized tools and consensus on the relationship of these terms to guarantee the future effectiveness of cognitive intervention technologies. REVIEW REGISTRATION: This review was registered in the PROSPERO (CRD42020158147) International Register of Systematic Review Protocols.
RESUMO
Resumen El consumo de sustancias psicoactivas es un problema de salud pública que afecta cada vez más a la población adolescente. La presente investigación tuvo como objetivo registrar la actividad eléctrica cerebral (EEG) en tareas de atención (sostenida y selectiva) en un grupo de adolescentes policonsumidores. Se empleó un diseño ex post-facto retrospectivo con grupo cuasi control, en 46 adolescentes con edades entre los 12 los 17 años: 23 policonsumidores y 23 cuasi-controles. Para el registro de la actividad eléctrica cerebral se utilizó un equipo de BCI (Brain Control Interface) Emotiv EPOC research grade 14 Channel Mobile EEG y se aplicó el Programa virtual de entrenamiento cerebral Brain HQ con el módulo "enfoco mi atención" para la evaluación de la atención. Los resultados mostraron un incremento de ondas cerebrales beta-β (13-30 Hz), theta-θ (4-7 Hz) y delta-δ (3-4 Hz) en áreas frontales y prefrontales en los adolescentes policonsumidores en tareas de atención en comparación con el grupo cuasi-control. Se identificó una diferencia significativa con respecto al tiempo de respuesta entre los adolescentes consumidores de sustancias psicoactivas frente al grupo cuasi-control en ambos tipos de tareas atencionales.
Resumo O consumo de substâncias psicoativas é um problema de saúde pública que afeta cada vez mais a população adolescente. Esta pesquisa teve como objetivo registrar a atividade elétrica cerebral (EEG) em tarefas de atenção (sustentada e alternada) num grupo de adolescentes policonsumidores. Foi empregado um desenho ex post-facto retrospectivo com grupo quasecontrole, em en 46 adolescentes entre 12 e 17 anos de idade: 23 policonsumidores e 23 quase-controles. Para o registro da atividade elétrica cerebral, foi utilizado um equipamento de Brain Control Interface (BCI) Emotiv EPOC research grade 14 Channel Mobile EEG e foi aplicado o Programa Virtual de Treinamento Cerebral Brain HQ, com o módulo "foco minha atenção" para a avaliar a atenção. Os resultados mostraram um aumento de ondas cerebrais beta-β (13-30 Hz), theta-θ (4-7 Hz) e delta-δ (3-4 Hz) em áreas frontais e pré-frontais nos adolescentes policonsumidores em tarefas de atenção em comparação com o grupo quase-controle. Foi identificada uma diferença significativa a respeito do tempo de resposta entre os adolescentes consumidores de substâncias psicoativas ante o grupo quase-controle em ambos os tipos de tarefas de atenção.
Abstract The consumption of psychoactive substances is a public health problem that increasingly affects the adolescent population. This investigation had the objective of record the brain electrical activity (EEG) in attention tasks (sustained and selective) in a group of polyconsumers. Employment a retrospective ex post-facto design with a quasi-control group with 46 adolescents between 12-17 years old: 23 polyconsumers and 23 quasi-controls. For the recording of brain electrical activity, it was used a equipment BCI (Brain Control Interface) research grade 14 Channel Mobile EEG and applied the Brain Training Virtual Program "Brain HQ" module "focus my attention" to evaluate the attention. The results showed an increase in beta-β (1330 Hz), theta-θ (4-7 Hz) and delta-δ (3-4 Hz) brain waves in frontal and prefrontal areas in adolescent polyonsumers versus the quasi-control group in attention tasks. Likewise, identified a significant difference with respect to the response time between adolescents consuming psychoactive substances in relation to the quasi-control group in both types of attentional tasks.