Usability of a new digital walking program for older adults: a pilot study.

BACKGROUND: Walking has been emphasized as an important solution for preventing isolation among older adults, especially given the coronavirus disease 2019 (COVID-19) pandemic, and various methods are being proposed to promote walking in this population. In this study, a walking exercise program for the elderly was developed using various latest technologies, and the effectiveness and influencing factors of the program were evaluated. METHOD: The walking program for older adults was designed using mHealth devices, social media application, and gamified elements to prevent isolation. Twelve participants were recruited via an online community of retired individuals. This one-year study involved a one-group repeated measures experimental design; an online questionnaire was conducted four times along with a focus group interview. RESULT: The results showed that the e-health literacy of the 12 participants increased, while Wearable Device App Literacy/Usability, digital health self-efficacy, and walking program evaluation showed a decline. In the focus group interview, participants expressed their appreciation for this program, ways to overcome its limitations, and expectations for the next program. CONCLUSION: This study confirmed the positive effect of the online walking program for retired older adults, indicating that an online-offline convergence program suitable for the "COVID-19 era" will be necessary in the future.

Investigating the Need for Point-of-Care Robots to Support Teleconsultation.

Background: Development of a point-of-care (POC) consultation system based on telepresence robots is needed to enable effective decision-making by medical staff at care sites.Introduction: This study aimed to identify essential features and functional requirements of teleconsultation robot systems and predict potential administrative and clinical issues.Materials and Methods: Surveys were conducted with 90 health care professionals and additional focus group interviews with 4 physicians and 5 nurses. The questionnaire for the surveys was developed by the authors. Survey results were analyzed using descriptive statistics, and content analysis was used to extract themes from the unabridged transcripts of focus group interviews.Results: The most desired functionalities were related to patient evaluation and facilitation of communication, including measuring vital signs, and medical record sharing and delivery. Nurses and physicians reported different needs for human-robot interactions. Nurses valued robotic functions such as voice command, automatic camera movement, voice recognition with contextual perception, and recognition of nonverbal signals. The thematic analysis of the interviews yielded four themes: major functions, usability, expected effects, and potential issues. The results indicated that robots should primarily be employed to support communication between medical professionals. The major expected effects included prevention of treatment delays and decision-making assistance. Participants believed that teleconsultation robots would be helpful, but had concerns, including anxiety about the robots and judgment errors.Conclusions: Using robots in health care institutions may support effective communication among medical staff, thus contributing to health care improvement. In the future, an actual POC robot system will be developed and its effectiveness evaluated.

Development of a Metaverse Online Learning System for Undergraduate Nursing Students: A Pilot Study.

BACKGROUND: An active online learning environment enables 2-way communication wherein students can engage in problem-based learning and projects, unlike fragmented lecture-style classes. PURPOSE: This pilot study aimed to develop a metaverse-based online learning system and evaluate its usability. METHODS: A rapid prototyping model and Gather.town was used to design and develop a metaverse classroom. Participants were 10 nursing students from a college in South Korea. To evaluate usability, 10 tasks were configured and 2 pilot tests were conducted. The degree of difficulty, time required to perform tasks, and students' experience were investigated. RESULTS: The Metaverse for Education of Nursing Students was successfully completed, incorporating student feedback and addressing identified areas for improvement. CONCLUSION: This study reflects a learner-centered educational environment through the direct participation in the development process of the instructors who conducted the lectures. The metaverse space can be widely applied in creative nursing education in the future.

Lessons from a multicenter clinical trial with an approved wearable electrocardiogram: issues and practical considerations.

Although wearable electrocardiograms (ECGs) are being increasingly applied in clinical settings, validation methods have not been standardized. As an exploratory evaluation, we performed a multicenter clinical trial implementing an approved wearable patch ECG. Healthy male adults were enrolled in 2 study centers. The approved ECGs were deployed for 6 hours, and pulse rates were measured independently with conventional pulse oximetry at selected time points for correlation analyses. The transmission status of the data was evaluated by heart rates and classified into valid, invalid, and missing. A total of 55 subjects (40 in center 1 and 15 in center 2) completed the study. Overall, 77.40% of heart rates were within the valid range. Invalid and missing data accounted for 1.42% and 21.23%, respectively. There were significant differences in valid and missing data between centers. The proportion of missing data in center 1 (24.77%) was more than twice center 2 (11.77%). Heart rates measured by the wearable ECG and conventional pulse oximetry showed a poor correlation (intraclass correlation coefficient = 0.0454). In conclusion, we evaluated the multicenter feasibility of implementing wearable ECGs. The results suggest that systems to mitigate multicenter discrepancies and remove artifacts should be implemented prior to performing a clinical trial. Trial Registration: ClinicalTrials.gov Identifier: NCT05182684.

Companion robots for older adults: Rodgers' evolutionary concept analysis approach.

This study aims to analyze the concept of companion robots for older adults from the perspective of nursing. This study employed a concept analysis. The literature from July 2011 to June 2021 was sought from databases using specific keywords. Any quantitative or qualitative study published in English or Korean focusing on companion robots for older adults was included in the study. Rodgers' evolutionary concept analysis was used to clarify the antecedents, attributes, and consequences. Seventy-five eligible articles were studied. The findings were categorized into antecedents, attributes, and consequences. Companion robot antecedents were classified into individual factors, attitude toward robots, and caregiver and social factors. The defining attributes included human-robot interaction, function, features, structure, cost, and management of the robot being a companion. Consequences were categorized into user, caregiver, and health related. Companion robots are designed to enhance well-being, quality of life, and independence by providing service and companionship and assisting daily life. This mainly includes cognitive and social support, mobility support, relaxation, health monitoring, and self-care support through human-robot interaction. The attributes, antecedents, and consequences of companion robots identified in this study can inform future decision making and interventions by caregivers for aging in place.

Development and Usability Evaluation of a Healthy Lifestyle Coaching Chatbot Using a Habit Formation Model.

OBJECTIVES: It is crucial to find ways to fit regular exercise into the daily lives of office workers. Non-exercise activity thermogenesis has been introduced as an effective form of daily exercise. This study aimed to develop a healthy lifestyle coaching program for office workers, to be delivered using a messenger application. METHODS: The interface was developed using KakaoTalk and Plus Friend. Performance feedback was developed using the IBM Watson conversation program. Twenty office workers used the application for three weeks. Afterward, a survey was conducted to assess the usability of and participants' satisfaction with the application. RESULTS: The application delivered customized push alarms, provided information related to habit formation, allowed for one-on-one chats, and delivered rewards. The satisfaction measurement results for the application showed that extrinsic reward factors contributed the most to the performance of the activity, followed by reminders and intrinsic rewards. Regarding the usability test, the perceived usefulness of the Healthy Lifestyle Coaching Chatbot was highest, followed by the usage intent and the perceived ease of use. CONCLUSIONS: This study found that coaching programs using chatbots can improve the effectiveness of performing simple, repetitive exercises.

Use of the Healthy Lifestyle Coaching Chatbot App to Promote Stair-Climbing Habits Among Office Workers: Exploratory Randomized Controlled Trial.

BACKGROUND: Lack of time for exercise is common among office workers given their busy lives. Because of occupational restrictions and difficulty in taking time off, it is necessary to suggest effective ways for workers to exercise regularly. Sustaining lifestyle habits that increase nonexercise activity in daily life can solve the issue of lack of exercise time. Healthy Lifestyle Coaching Chatbot is a messenger app based on the habit formation model that can be used as a tool to provide a health behavior intervention that emphasizes the importance of sustainability and involvement. OBJECTIVE: This study aimed to assess the efficacy of the Healthy Lifestyle Coaching Chatbot intervention presented via a messenger app aimed at stair-climbing habit formation for office workers. METHODS: From February 1, 2018, to April 30, 2018, a total of 106 people participated in the trial after online recruitment. Participants were randomly assigned to the intervention group (n=57) or the control group (n=49). The intervention group received cues and intrinsic and extrinsic rewards for the entire 12 weeks. However, the control group did not receive intrinsic rewards for the first 4 weeks and only received all rewards as in the intervention group from the fifth to twelfth week. The Self-Report Habit Index (SRHI) of participants was evaluated every week, and the level of physical activity was measured at the beginning and end of the trial. SPSS Statistics version 21 (IBM Corp) was used for statistical analysis. RESULTS: After 4 weeks of intervention without providing the intrinsic rewards in the control group, the change in SRHI scores was 13.54 (SD 14.99) in the intervention group and 6.42 (SD 9.42) in the control group, indicating a significant difference between the groups (P=.04). When all rewards were given to both groups, from the fifth to twelfth week, the change in SRHI scores of the intervention and control groups was comparable at 12.08 (SD 10.87) and 15.88 (SD 13.29), respectively (P=.21). However, the level of physical activity showed a significant difference between the groups after 12 weeks of intervention (P=.045). CONCLUSIONS: This study provides evidence that intrinsic rewards are important to enhance the sustainability and effectiveness of an intervention. The Healthy Lifestyle Coaching Chatbot program can be a cost-effective method for healthy habit formation. TRIAL REGISTRATION: Clinical Research Information Service KCT0004009; https://tinyurl.com/w4oo7md.

Usability Evaluation of User Requirement-Based Teleconsultation Robots: A Preliminary Report from South Korea.

BACKGROUND: Telepresence robots used to deliver a point-of-care (POC) consultation system that may provide value to enable effective decision making by healthcare providers at care sites. OBJECTIVES: This study aimed to evaluate usability of teleconsultation robots, based on endusers' needs, that can improve acceptance in future robot applications. METHODS: This is a single group postdesign study using mixed methods to assess the usability of teleconsultation robots using scenarios. To collect opinions from various departments, 15 nurses or physicians currently working at medical institutions in Korea were selected using purposive sampling. The usability evaluation was conducted on healthcare providers twice at the simulation center; the think-aloud method was used and surveys and interviews were conducted to identify problems or improvements that may arise from the use of robots in hospital settings. RESULTS: The results showed that perceived usefulness, perceived ease of use, and satisfaction level each scored 4 points or higher out of 7 points, showing usability of midhigh level. Camera angle control and robot driving functions were the most difficult. Other basic robot user interface was shown to be relatively easy. There was no difference in usability depending on the characteristics of the evaluator. Some functions including user interface were modified based on the usability test. CONCLUSION: Using robots in health care institutions may support effective communication among healthcare providers, thus contributing to health care improvement.

Evaluation of User Experience of New Defense Medical Information System.

OBJECTIVES: This study aimed to investigate the user experience (UX) of the New Defense Medical Information System (N-DEMIS), which was introduced in 2012 as part of an effort to improve the old system of armed forces hospitals and ultimately bring their standards up to those of civilian hospitals. METHODS: In this study, the dependent variable was the UX of N-DEMIS and was composed of usability, affect, and user value. The questionnaire comprised 41 questions: nine on general characteristics, 20 on usability, four on affect, and eight on user value. The data collection period was from April 15 to April 30, 2018. Overall, 85 responses were received; of these, three insincere responses were excluded, and the remaining 82 responses were used in the analysis. RESULTS: The overall value of Cronbach's alpha was 0.917, indicating an overall high-reliability. There was a significant difference between user value and usability, but there was no significant differences between the other pairs. We observed a significant effect on UX for length of time working in an armed forces hospital and employment type. CONCLUSIONS: The results of our survey showed an even distribution of scores across the three elements of UX, showing that no particular aspect of N-DEMIS is superior to the others in terms of user satisfaction. However, the overall UX score of around 60% indicates the need for future improvements. Rather than focusing improvements on a specific area, improvements should be spread across usability, affect, and user value.