OBJECTIVE: This study aims (1) to understand the needs and challenges of the current intensive care unit (ICU) environments in supporting patient well-being from the perspective of healthcare professionals (HCPs) and (2) to explore the new potential of ICU environments enabled by technology. BACKGROUND: Evidence-based design has yielded how the design of environments can advocate for patient well-being, and digital technology offers new possibilities for indoor environments. However, the role of technology in facilitating ICU patient well-being has been unexplored. METHOD: This study was conducted in two phases. First, a mixed-method study was conducted with ICU HCPs from four Dutch hospitals. The study investigated the current environmental support for care activities, as well as the factors that positively and negatively contribute to patient experience. Next, a co-creation session was held involving HCPs and health technology experts to explore opportunities for technology to support ICU patient well-being. RESULTS: The mixed-method study revealed nine negative and eight positive patient experience factors. HCPs perceived patient emotional care as most challenging due to the ICU workload and a lack of environmental support in fulfilling patient emotional needs. The co-creation session yielded nine technology-enabled solutions to address identified challenges. Finally, drawing from insights from both studies, four strategies were introduced that guide toward creating technology to provide holistic and personalized care for patients. CONCLUSION: Patient experience factors are intertwined, necessitating a multifactorial approach to support patient well-being. Viewing the ICU environment as a holistic unit, our findings provide guidance on creating healing environments using technology.
Attitude of Health Personnel , Intensive Care Units , Humans , Netherlands , Male , Female , Health Personnel/psychology , Adult , Interior Design and Furnishings , Middle Aged , Hospital Design and Construction/methods , Emotions , Health Facility Environment
Objective: Loneliness and social isolation are pressing issues that can seriously impact the mental health and well-being of older adults. Interacting with nature can stimulate a feeling of connectedness. However, for older adults, access to nature is often troublesome because of physical limitations and mobility restrictions. Methods: In the present mixed-method study, 37 older adults (62-99 years old) with varying care needs and mobility restrictions watched a video presenting a walkthrough of a simulated digital nature landscape. Results: Quantitative results show a significant increase in social connectedness scores and enhanced peacefulness after experiencing a digital nature. Qualitative results stress the importance of variations in nature scenery and highlight the influence of contextual and person-related factors including nature experiences throughout the life span and mobility constraints that older adults may face. Conclusion: These findings testify to the potential of using digital nature as a complementary strategy when interactions with outdoor nature become increasingly difficult due to old age.
Receiving a dementia diagnosis is a difficult experience for most people and often affects their wellbeing negatively. To support people's wellbeing, in a therapeutic context, life-storytelling, reminiscence and mindfulness are used with people with dementia. In an everyday context, traditional games are used as a resource for stimulating memory, cognition and social activity. While an increasing number of creative strategies are available to support people with dementia, the area of board games design and their effect on wellbeing is underexplored. This paper reports on the evaluation of the This is Me (TIM) mindful life-storytelling board game by the European project MinD. Using a co-design methodology, TIM was developed with and for people with mild to moderate dementia to support their wellbeing by enhancing self-empowerment and social engagement. A focus group methodology was used to evaluate TIM with 50 people with dementia and 19 carers across four countries. TIM was evaluated with regard to the usability and experience of the design as well as people's emotional wellbeing, social engagement and agency. The thematic analysis demonstrated that the combination of life-storytelling and mindfulness allowed players to engage in meaningful social interaction and, as a result, they reported enjoyment, learning, more acceptance of the past and present situation, and that they perceived looking forward into the future together with others as helpful. The study demonstrates that design can be a useful means to support people with dementia in aspects of emotional wellbeing, social engagement and a sense of agency.
Dementia , Mindfulness , Caregivers/psychology , Communication , Dementia/psychology , Humans , Social Participation
BACKGROUND: Delirium prevention is crucial, especially in critically ill patients. Nonpharmacological multicomponent interventions for preventing delirium are increasingly recommended and technology-based interventions have been developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview of these interventions for in-hospital delirium prevention and reduction. OBJECTIVE: This systematic scoping review was carried out to answer the following questions: (1) what are the technologies currently used in nonpharmacological technology-based interventions for preventing and reducing delirium? and (2) what are the strategies underlying these currently used technologies? METHODS: A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were eligible if they contained any type of technology-based interventions and assessed delirium-/risk factor-related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form. RESULTS: A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. Our review revealed 8 different technology types and 14 strategies that were categorized into the following 7 pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, (5) provide a sense of security, (6) provide a sense of control, and (7) provide a sense of being connected. For all technology types, significant positive effects were found on either or both direct and indirect delirium outcomes. Several similarities were found across effective interventions: using a multicomponent approach or including components comforting the psychological needs of patients (eg, familiarity, distraction, soothing elements). CONCLUSIONS: Technology-based interventions have a high potential when multidimensional needs of patients (eg, physical, cognitive, emotional) are incorporated. The 7 pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the intensive care unit into a healing environment as a powerful tool to prevent delirium. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=175874.
Delirium , Critical Illness , Delirium/prevention & control , Hospitals , Humans , Intensive Care Units , Technology
Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.
BACKGROUND: The health internet-of-things (IoT) can potentially provide insights into the present health condition, potential pitfalls, and support of a healthier lifestyle. However, to enjoy these benefits, people need skills to use the IoT. These IoT skills are expected to differ across the general population, thereby causing a new digital divide. OBJECTIVE: This study aims to assess whether a sample of the general Dutch population can use health IoT by focusing on data and strategic IoT skills. Furthermore, we determine the role of gender, age, and education, and traditional internet skills. METHODS: From April 1, 2019, to December 12, 2019, 100 individuals participated in this study. Participants were recruited via digital flyers and door-to-door canvassing. A selective quota sample was divided into equal subsamples of gender, age, and education. Additional inclusion criteria were smartphone possession and no previous experience of using activity trackers. This study was conducted in 3 waves over a period of 2 weeks. In wave 1, a questionnaire was administered to measure the operational, mobile, and information internet skills of the participants, and the participants were introduced to the activity tracker. After 1 week of getting acquainted with the activity tracker, a task-based performance test was conducted in wave 2 to measure the levels of data IoT skills and the strategic IoT skill component-action plan construction. A week after the participants were asked to use the activity tracker more deliberately, a performance test was then conducted in wave 3 to measure the level of the strategic IoT skill component-action plan execution. RESULTS: The participants successfully completed 54% (13.5/25) of the data IoT skill tasks. Regarding strategic IoT tasks, the completion rates were 56% (10.1/18) for action plan construction and 43% (3.9/9) for action plan execution. None of the participants were able to complete all the data IoT skill tasks, and none of the participants were able to complete all the strategic IoT skill tasks regarding action plan construction or its execution. Age and education were important determinants of the IoT skill levels of the participants, except for the ability to execute an action plan strategically. Furthermore, the level of information internet skills of the participants contributed to their level of data IoT skills. CONCLUSIONS: This study found that data and strategic IoT skills of Dutch citizens are underdeveloped with regard to health purposes. In particular, those who could benefit the most from health IoT were those who had the most trouble using it, that is, the older and lower-educated individuals.
Digital nature can provide a substitute for real nature for those who have limited access to green space, or are confined to their homes, for example during the worldwide COVID-19 lockdown. In a large-scale online survey, respondents (N = 1203) watched videos of digital nature, varying in terms of type of nature (wild versus tended nature) and spaciousness. Results show a significant increase of feelings of connectedness to the community after watching digital nature. Furthermore, tended nature scenes elicited more social aspirations than wild nature scenes. A multiple regression model further shows that living further away from nature was a significant predictor for loneliness scores, while number of nature interactions during a week was not. Results of this study confirm the importance of nature interaction for mental and social wellbeing for the general population and stress the potential of digital nature as a complementary strategy. These findings are of particular relevance to those who lack access to nature due to old age and related mobility constraints or a lockdown.
Coronavirus Infections/psychology , Environment , Health Promotion/methods , Loneliness , Nature , Pneumonia, Viral/psychology , Stress, Psychological/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Humans , Internet , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Surveys and Questionnaires
Loneliness and social isolation are increasingly recognized as important challenges of our times. Inspired by research hinting at beneficial effects of interacting with nature on social connectedness and opportunities provided by ambient technology to simulate nature in a rich and engaging manner, this study explored to what extent digital nature projections can stimulate social aspirations and related emotions. To this end, participants (N = 96) were asked to watch, individually or in pairs, digital nature projections consisting of animated scenes which were either dense or spacious and depicting either wild or tended nature. Subsequently, they filled out a questionnaire comprising measures for social aspirations, awe and fascination. Results show that spacious scenes elicited significantly higher social aspiration and awe scores, especially when watching alone. Design implications are discussed for making digital nature accessible for people with limited access to real nature.
Aspirations, Psychological , Loneliness , Nature , Social Isolation , Emotions , Humans , Surveys and Questionnaires
Dementia is generally considered to be one of the most pressing societal issues now and in the years to come. Although insights from different disciplines have contributed to a better understanding of dementia and the development of interventions targeting dementia symptoms, there is a lack of integration of insights from these different perspectives for the purposes of design for dementia. The aim of this paper is to show how insights from environmental psychology and advances in technology can inform a user-centred multidisciplinary design approach. To this end, first a brief meta-review of (systematic) reviews from the fields of assistive technology for dementia care and healing environments research is presented, after which gaps and opportunities for a multidisciplinary design approach are identified. To illustrate what such an approach could look like, two exploratory case studies are presented in which technology-enhanced prototypes of an experience handrail (aimed at facilitating wayfinding by providing meaningful sensory experiences) and a virtual nature installation (aimed at providing relaxation and stimulating social engagement) were implemented at a Dutch care centre for people with dementia. Preliminary evaluations indicate that these designs contribute to the wellbeing of people with dementia and confirm the fruitfulness of the design approach presented in this paper. Furthermore, this approach may not only provide a means to optimize existing environments and enhance ease of living, but may also lead to novel solutions to the challenges people with dementia face on a day-to-day basis, and improve their quality of life.
Dementia/therapy , Environment Design , Nursing Homes , Quality of Life , Self-Help Devices , Dementia/psychology , Humans
Based on the embodied cognition framework and research addressing transfer effects between visual perception and taste, the point of departure for this study is the widespread association between vertical orientation and connotations related to luxury and (economic) power. Specifically, this study tests whether vertical orientation not only affects impressions of product luxury, but also influences actual taste evaluations, including perceptions of taste strength (intensity) and taste liking. Results confirm these predictions by showing that participants in a Dutch coffee house gave higher ratings on these constructs when they were exposed to an ad display depicting vertically-oriented rather than horizontally-oriented visual cues during a coffee sample test. Findings furthermore stress the influence of design cues as opposed to more traditional product claims. Implications for marketing and design practice are discussed.
Coffee , Consumer Behavior , Cues , Marketing , Orientation , Taste , Visual Perception , Adult , Attitude , Communication , Emotions , Female , Food Industry , Humans , Male , Netherlands , Young Adult
Introduction: This study is aimed at gaining more insight into the effects of camera-surveillance on behavior. It investigates the effects of three different ways of "framing" camera presence on cheating behavior and pro-social behavior. First, we explore the effect of presenting the camera as the medium through which an intimidating authority watches the participant. Second, we test the effect of presenting the camera as being a neutral, non-intimidating viewer. Third, we investigate the effect of watching oneself via a camera. In contrast to most studies on camera surveillance, we will conduct our experiments in an indoor setting. We also explore possible interaction effects of personality traits; we measured Locus of Control, Need for Approval, Self-Monitoring and Social Value Orientation. Methods: In this experiment participated 86 students, randomly distributed over four conditions: three different ways of framing the camera presence, plus a control condition. Our main dependent variables were various kinds of cheating and pro-social behavior. We established the participant's relevant personality traits using a classification tree. Results: For cheating behavior, findings showed that in the "authorative" way of framing camera presence and in the situation in which participants viewed themselves, participants cheated significantly less compared to a situation without camera-surveillance. We did not find significant effects of camera surveillance on pro-social behavior. Looking at personality traits, we found an indication that people with an internal locus of control are more inclined to cheat when there is no camera present compared to people with an external locus of control. However, the effects of our manipulations were stronger. Conclusion: Our findings support the idea that the framing of a camera's presence does indeed influence cheating behavior, adding to the preventive effects of camera-surveillance. Additionally, this study provides some valuable insights into the influence of camera presence on behavior in general.
Nowadays, technology is increasingly used to increase people's well-being. For example, many mobile and Web-based apps have been developed that can support people to become mentally fit or to manage their daily diet. However, analyses of current Web-based interventions show that many systems are only used by a specific group of users (eg, women, highly educated), and that even they often do not persist and drop out as the intervention unfolds. In this paper, we assess the impact of design features of Web-based interventions on reach and adherence and conclude that the power that design can have has not been used to its full potential. We propose looking at design research as a source of inspiration for new (to the field) design approaches. The paper goes on to specify and discuss three of these approaches: personalization, ambient information, and use of metaphors. Central to our viewpoint is the role of positive affect triggered by well-designed persuasive features to boost adherence and well-being. Finally, we discuss the future of persuasive eHealth interventions and suggest avenues for follow-up research.
Guideline Adherence/standards , Internet/statistics & numerical data , Research Design/standards , Female , Health Promotion/methods , Humans , Male , Precision Medicine
