Age-Friendly Healthcare: An Evolutionary Concept Analysis.

AIMS: Aging populations require adapting healthcare systems for older adult's specific needs. Numerous initiatives to improve older-patient care have emerged, but the field lacks a unified framework. The current study aims to provide a systematic concept analysis of 'age-friendly healthcare', examining its characteristics, components and structure. DESIGN: Rodger's evolutionary concept analysis. DATA SOURCES: Searches were conducted in ProQuest, CINAHL, PubMed and Scopus databases between November 2022 and October 2023, utilising the PRISMA 2020 reporting checklist. METHODS: A literature search using specific terms relevant to age-friendly healthcare retrieved 1407 articles. After screening for duplicates and relevance, 140 articles were examined for eligibility based on inclusion criteria for age-friendly care, language and full-text availability. Following full-text screening, 65 articles were included for data extraction by multiple researchers to synthesise theoretical, methodological and design elements. RESULTS: Our findings highlight key attributes of age-friendly healthcare: Respect for older adults' autonomy and needs; leadership and organisational knowledge and support; Proactive policies and processes of care; holistic care environments; and communication and follow-up with awareness of challenges and barriers as well as prioritisation of continuity-of-care. CONCLUSION: The concept of age-friendly healthcare is still developing, with much research focused on development and implementation rather than evaluation of real-world patient and health-system outcomes. Our analysis of the concept may help unify the field and clarify future research directions through identification of areas requiring further study and enable development of improved practices and policies for implementing age-friendly healthcare in a variety of settings. NO PATIENT OR PUBLIC CONTRIBUTION: This concept analysis did not include any patient or public involvement. REPORTING METHOD: This study utilised the PRISMA reporting checklist.

Usability of a touchscreen assessment tool (TATOO) prototype for clinicians and typically developing children.

PURPOSE: Touchscreen devices are widely used in modern life and have quickly become part of daily life for children, including during Occupational Therapy sessions for children with disabilities. Touchscreen Assessment Tool (TATOO) is a prototype application used to evaluate children's performance when using touchscreen devices. The purpose of this study, based on the logical user-centred interaction design framework, was to evaluate TATOO's usability for occupational therapists and typically developing children and to examine the correlations between their usability scores. METHODS: A convenience sample of clinicians (N = 10) and children with typical development (N = 60) was recruited for this study. The usability assessment was conducted using the System Usability Scale (SUS) and semi-structured interviews for the clinicians, and the Short Feedback Questionnaire-Child (SFQ-Child) for the children. RESULTS: The SUS scores (M ± SD = 85.5 ± 8.04, range = 70-97.5) indicated good ratings of TATOO's usability by clinicians; the SFQ-Child results showed children also rated its usability very highly, including all ages (4-10 years) and all tasks. The clinicians all expressed positive attitudes towards using TATOO, and no bias was found between the clinicians' usability scores and the children's usability feedback. CONCLUSION: The TATOO is a user-friendly tool. Researchers and clinicians can benefit from the availability of an objective and low-cost assessment tool to promote their evaluation and intervention by providing more focussed individualized recommendations and adaptations. The study also suggests a model to follow when developing applications and evaluating their usability through a mixed-method approach to deepen understanding of the user's needs.Implications for rehabilitationTouchscreen Assessment Tool (TATOO) shows a user-friendly tool for assessing the different skills required to operate touchscreens interface.TATOO has the potential to become an essential objective and low-cost assessment tool for the clinician, in which the spread of touchscreens constantly increases.Researchers and clinicians can benefit from the availability of such tools to promote their evaluation and intervention by providing more focussed individualized recommendations and adaptations.TATOO will complement the assessment needs, as traditional fine motor assessment tools cannot capture the skills necessary to operate a touchscreen deviceThe study suggests a model to follow when developing applications and evaluating their usability through a mixed-method approach in order to deepen understanding of the user's needs.

Correlation between the Ability to Manipulate a Touchscreen Device and Hand Strength and Manual Dexterity among Community-Living Older Individuals.

Information regarding the relationship between the degree of hand function among the elderly as measured by traditional assessments and the ability to manipulate touchscreens is lacking. This study aimed to examine the correlation between the ability to manipulate a touchscreen device, as assessed using the touchscreen assessment tool (TATOO) (University of Haifa, Israel & Universetiy of Bologna, Italy), and hand strength and manual dexterity among independent community-living older individuals. Thirty-four community-living older adults (average age 79.4 ± 6.7 years) participated in single-session assessments lasting 45 min each. The assessment included hand strength measurement using the manual hand dynamometry and hydraulic pinch gauge, a functional dexterity test (FDT), and TATOO. No significant correlations were observed between most of the TATOO items (22 out of 26) and handgrip strength, pinch strength, and FDT results. Moderately significant correlations were demonstrated between the number of drag attempts in the "Drag to different directions" task and handgrip strength and manual dexterity (r value: -0.39, p value: 0.02; r value: 0.36, p value: 0.04, respectively). In addition, a moderately significant correlation was noted between the number of double taps and manual dexterity (r value: 0.32, p value: 0.07). These results indicate that more complex gestures that require greater accuracy (dragging task) or rapid movements (double tapping) are related to hand strength and manual dexterity. These results suggest that the manual gestures necessary for touchscreen operation entail unique and specific capabilities that are generally not captured by traditional tools. The clinical implication is that the hand function assessment toolbox should be expanded. Tools such as the TATOO should be used to capture skills required for touchscreen manipulation in the context of the modern digital milieu.

Effect of Age on the Touchscreen Manipulation Ability of Community-Dwelling Adults.

Assessment of touchscreen manipulation skills is essential for determining the abilities of older individuals and the extent to which they may benefit from this technology as a means to enhance participation, self-esteem, and quality of life. The aim of this study was to compare the touchscreen manipulation ability between community-dwelling older adults and middle-aged adults using a newly developed Touchscreen Assessment Tool (TATOO) and to determine the usability of this instrument. Convenience samples of two age groups were considered, one including 28 independent community-living older adults aged 81.9 ± 4.2 years with intact or corrected vision and with the abilities to walk independently with or without a walking aid and to understand and follow simple commands, and the other including 25 healthy middle-age adults aged 53.4 ± 5.9 years. The usability assessment was conducted during a single session using the System Usability Scale (SUS). Older adults demonstrated poorer touchscreen skills compared to middle-aged adults. Previous experience in manipulating a smartphone by the older adults did not affect their performance. The SUS results indicated good usability of the TATOO by both age groups. The TATOO shows promise as a user-friendly tool for assessing the specific skills needed to operate touchscreens. The outcomes of this study support the suitability of touchscreen devices and applications as well as the need for adapted accessibility for older adults. Researchers and clinicians will benefit from the availability of a rapid, low-cost, and objective tool to assess the skills required for touchscreen use.

A multidisciplinary approach for developing an assessment tool for touch screen devices.

AIM: The aim of this study was to describe the processes of reaching consensus regarding the assessment of the user's skills required to operate various touch screen devices. A five-step procedure was used to collect and validate the required skills by a multidisciplinary team of 52 experts. Content validity was calculated to determine the agreement levels between the experts. A comparison was made between the discipline groups in order to test correlation between each group and their choice of specific clusters of tasks. METHODS: The final consensus set by the experts' recommendations included 15 domains and 50 skills/measurements. The result of Cronbach's α test for the final assessment questionnaire (50 skills/measurements) was 0.94, which indicates a high degree of internal consistency. The results of Kruskal-Wallis's test showed the lack of any significant difference between agreements of the clinicians and the technicians groups, but significant differences were found between the educators and the clinicians groups. CONCLUSION: The assessment questionnaire, in its current form, can be used by clinicians and it is expected to help in developing an objective assessment tool to quantify the performance and touch characteristics of individuals with varying abilities and disabilities, in order to enhance accessibility of touch screen technology. Implications for Rehabilitation Collecting and creating the required knowledge needed for assessing the user's skills for operating touch screen devices. The created knowledge helps clinicians to focus on the essential skills and measurements needed for a comprehensive assessment of the individual's abilities and disabilities while operating touch screen devices. The results of the assessment can be used as recommendations for enhancing accessibility of touch screen devices for various disabilities. This knowledge is expected to help in developing an application that provides an objective assessment tool. The study emphasizes the importance of close collaboration with multidisciplinary teams for creating a valid assessment tool.

Developing an Assessment (Tool) for Touch Screen Devices.

Touch screen devices have become prevalent in our lives. Assistive technology experts working with people with disabilities face difficulty in understanding and assessing the problems experienced by individuals with disabilities in operating touch screen devices. This paper presents the processes of collecting and creating the required knowledge needed for assessing the user's skills for operating various touch screen devices, in order to develop an application for assessing the user's abilities and limitations. A six step procedure was used to collect and validate the required knowledge for the assessment from a multidisciplinary team. To determine the agreement levels between the experts, content validity was calculated. To test correlation between the experts from the different disciplines, a comparison was made between the discipline groups and their choice of specific skills/measurements. The final number of domains and skills/measurements was 15 domains and 50 skills/measurements. The result of Cronbach's α test for the final assessment questionnaire (50 skills/measurements) was 0.94, which indicates a high degree of reliability. The results of Kruskal-Wallis test showed the lack of any significant difference between agreements of the clinicians and the technicians groups, but significant differences were found between the educators and the clinicians groups. Each of the skills appearing in the final questionnaire was illustrated in a flowchart in preparation for developing the assessment (tool) for using touch screen devices.

Usability of clinical decision support system as a facilitator for learning the assistive technology adaptation process.

The aim of this study was to evaluate the usability of Ontology Supported Computerized Assistive Technology Recommender (OSCAR), a Clinical Decision Support System (CDSS) for the assistive technology adaptation process, its impact on learning the matching process, and to determine the relationship between its usability and learnability. Two groups of expert and novice clinicians (total, n = 26) took part in this study. Each group filled out system usability scale (SUS) to evaluate OSCAR's usability. The novice group completed a learning questionnaire to assess OSCAR's effect on their ability to learn the matching process. Both groups rated OSCAR's usability as "very good", (M [SUS] = 80.7, SD = 11.6, median = 83.7) by the novices, and (M [SUS] = 81.2, SD = 6.8, median = 81.2) by the experts. The Mann-Whitney results indicated that no significant differences were found between the expert and novice groups in terms of OSCAR's usability. A significant positive correlation existed between the usability of OSCAR and the ability to learn the adaptation process (rs = 0.46, p = 0.04). Usability is an important factor in the acceptance of a system. The successful application of user-centered design principles during the development of OSCAR may serve as a case study that models the significant elements to be considered, theoretically and practically in developing other systems. Implications for Rehabilitation Creating a CDSS with a focus on its usability is an important factor for its acceptance by its users. Successful usability outcomes can impact the learning process of the subject matter in general, and the AT prescription process in particular. The successful application of User-Centered Design principles during the development of OSCAR may serve as a case study that models the significant elements to be considered, theoretically and practically. The study emphasizes the importance of close collaboration between the developers and the end users.

Building an effective ontology for assistive technology.

The aim of this paper was to develop and validate an ontology for one class of assistive technology (AT), namely physically controllable pointing devices, using the Delphi method. Six occupational therapists with AT expertise identified important items and categories to the pointing device prescription through a three-round, structured process consisting of responses to a series of questionnaires. The intraclass correlation coefficient (ICC) was used to assess the interrater reliability of items included in categories related to the pointing devices and to the user profile. During the first round, the ICC ranged from 0.19 to 0.97; this improved to ICCs ranging from 0.72 to 1.0 during the second round. A full consensus was reached by the experts during the final round which included 218 items, divided into five categories, for the pointing device list, and 168 items, divided into six categories, for the user profile list. This ontology is expected to help achieve a more systematic regulation of the AT field, leading to greater standardization and increased knowledge sharing.

Effectiveness of a Clinical Decision Support System for Pointing Device Prescription.

OBJECTIVE: We present a novel, knowledge-driven approach to prescription of pointing devices that uses the Ontology-Supported Computerized Assistive Technology Recommender (OSCAR), a clinical decision support system (CDSS). METHOD: Fifty-five occupational therapists were divided into four groups: two assistive technology (AT) expert groups and two novice groups. Novice Group 1 used the OSCAR CDSS for the prescription process, and Novice Group 2 used the conventional method. OSCAR's effectiveness and its impact on users were evaluated. RESULTS: The ability of Novice Group 1 to make suitable pointing device prescriptions was similar to that of the two expert groups and was significantly better than that of Novice Group 2. The system positively affected Novice Group 1's learning of the prescription process. CONCLUSION: The structure and organized framework for clinical reasoning of the OSCAR CDSS appear to enable occupational therapy practitioners inexperienced in AT to achieve performance levels comparable to those of experts.

Building an ontology for assistive technology using the Delphi method.

The aim of this study was to use the Delphi method to develop and validate an ontology for one class of assistive technology (AT), namely physically controllable pointing devices. A three-round, structured process consisting of responses to a series of questionnaires was used to identify items and categories of importance to pointing device prescription from six occupational therapists with AT expertise. The intraclass correlation coefficient (ICC) was used to assess the interrater reliability of items included in categories related to the pointing devices and to the user profile by the six experts during each Delphi round. During the first round, the ICC ranged from 0.19 to 0.97; this improved to ICCs ranging from 0.72 to 1.0 during the second round. A full consensus was reached by the experts during the final round which included 218 items, divided into five categories, for the pointing device list, and 168 items, divided into six categories, for the user profile list. This ontology is expected to help achieve a more systematic regulation of the AT field, leading to greater standardization and increased knowledge sharing, which may help novice clinicians to achieve a level of competence in matching AT to a person with special needs.

Assessment of computer task performance (ACTP) of children and youth with intellectual and developmental disability.

The aims of this study were to assess the reliability and validity of the Arabic translation of the Assessment of Computer Task Performance (ACTP) when used for children with Intellectual and Developmental Disabilities (IDD) and to determine the relationship between participants' performance when using an adapted pointing device and the teacher's satisfaction of their performance. Thirty boys and girls, Arabic speakers, 6- 21 years old, who had moderate IDD, participated in the study. Two expert occupational therapists used the ACTP to evaluate the performance of five standardized timed computer tasks. The Quebec User Evaluation of Satisfaction with Assistive Technology was used to evaluate the teachers' satisfaction with the prescribed pointing device. The sample in the current study performed slower than typically developing children and youth, and slower than participants with motor impairments, examined in previous studies. Differences were found in performance time between girls and boys, and between three diagnostic subgroups. The participants' success scores of computer performance correlated significantly with the teacher's satisfaction with the prescribed pointing device. Demonstration of the validity and reliability of the Arabic version of the ACTP-Child enables wider use of this tool which is now available in four languages and diverse cultural settings and disability populations, including children and youth with significant IDD.