How age and health status impact attitudes towards aging and technologies in care: a quantitative analysis.

BACKGROUND: Increasing proportions of geriatric patients pose tremendous challenges for our society. Developments in assistive technologies have the potential to support older and frail people in aging and care. To reach a sustainable adoption of these technologies, the perceptions and wishes of future users must be understood. In particular, the relationships between individual health-related factors, and the perceptions of aging and using assistive technologies in severe health situations must be empirically examined. METHODS: Addressing this research gap, our quantitative study (N = 570) investigates the impact of diverse future users' age and health status on their a) perceptions of aging, b) perceptions and acceptance of using assistive technologies in aging and care, as well as c) end-of-life decisions regarding technology usage. For this, four groups were segmented for the comparison of younger (< 50 years) healthy, younger chronically ill, older (50 + years) healthy, and older chronically ill participants. RESULTS: The results revealed that health status is more decisive for age-related perceptions compared to age. The technology-related perceptions were slightly impacted by either chronological age or health status. The end-of-life decisions showed the most striking differences in the willingness to use assistive technologies, revealing older chronically ill participants to have more restrained attitudes towards technology usage than older healthy as well as all younger participants. CONCLUSIONS: The findings suggest that the benefits of assistive technologies in private or professional care contexts should be communicated and implemented tailored to the respective user group's needs. Moreover, the results allow us to derive practical implications within the geriatric care context.

Telemedicine in nursing homes: Insights on the social acceptance and ethical acceptability of telemedical consultations.

Introduction: The increasing number of older adults in need of care, the resulting rise in demand for care services and the shortage of nursing staff are major challenges for society. In these situations, the use of telemedicine seems promising - especially in nursing homes when the focus is on rapid support in acute medical cases. However, in addition to the medical and technical potential, the acceptability and usability of the use of telemedical consultations are crucial for a sustainable implementation and acceptance. Our research aims at a holistic identification of socially and ethically relevant parameters for the evaluation of telemedical consultations in nursing homes. Methods: Presentation of the empirical approach of an interdisciplinary cooperation that combines social and ethical research perspectives during an entire research project. Qualitative analysis of social and ethical aspects based on an interview study with care personnel (N = 14) who have experiences with telemedical consultations in nursing homes, as an example of this interdisciplinary collaboration and to show first insights. Results: The results of the interview study show a slightly positive evaluation of the use of telemedical consultations in nursing homes. Six main categories were identified to capture and differentiate ethically and socially relevant perceived benefits and barriers (contact with physicians, general, personnel-related, residents-related, technical, and organizational aspects). Conclusion: The study results allow initial recommendations for the implementation of telemedicine consultations in nursing homes considering socially and ethically relevant aspects. These recommendations can be used to inform medical and technical experts in the field of telemedicine. In addition, the presentation of the interdisciplinary collaboration shows that the close integration of social and ethical aspects in research enables a holistic dimension of the use of telemedicine.

Everybody hurts sometimes: perceptions of benefits and barriers in telemedical consultations.

Introduction: Shifts in the age structure, rising needs of care and support, and a lack of (in)formal caregivers require innovative solutions to relieve the whole healthcare system. Applying digital approaches, such as telemedicine, has the potential to support people in need of care, to relieve caregivers in families and professional environments, and to assist medical professionals in their working everyday life: e.g., using telemedicine for acute consultations could contribute to avoid hospitalizations of older people, whereas consultations with the general practitioner could reduce efforts and relive medical personnel. Beyond technical opportunities and potential, the acceptance of future users represents a prerequisite for a sustainable adoption of such innovative approaches, especially in sensitive contexts such as life in older age in nursing homes. Methods: This study aimed at collecting users' perceptions and evaluations of telemedicine in nursing homes. Two scenarios of telemedical consultations were applied which were either carried out by an emergency physician in acute situations or by the attending general practitioner. In a first approach, advantages and disadvantages of telemedicine were collected with the help of a qualitative interview study (N = 12) with laypersons and medical staff. The identified acceptance-relevant factors were then quantified in a second study using an online questionnaire (N = 204). Results: Outcomes revealed that both types of telemedicial consultations would be gladly used. However, for telemedical consultations in acute situations, the perceived disadvantages outweighed the advantages; for telemedical consultations with the general practitioner, the advantages outweighed the disadvantages. A prominent barrier in both scenarios was perceived impersonality, which limited the willingness to use. Nevertheless, participants indicated that telemedical consultations can be a support for nursing staff. Discussion: Outcomes may help to derive specific implications and recommendations to develop and realize digital technologies tailored to the requirements, needs, and wishes of diverse stakeholders (i.e., patients, medical professionals) as potential future users.

Eyes on privacy: acceptance of video-based AAL impacted by activities being filmed.

Introduction: The use of video-based ambient assisted living (AAL) technologies represents an innovative approach to supporting older adults living as independently and autonomously as possible in their homes. These visual devices have the potential to increase security, perceived safety, and relief for families and caregivers by detecting, among others, emergencies or serious health situations. Despite these potentials and advantages, using video-based technologies for monitoring different activities in everyday life evokes concerns about privacy intrusion and data security. For a sustainable design and adoption of such technical innovations, a detailed analysis of future users' acceptance, including perceived benefits and barriers is required and possible effects and privacy needs of different activities being filmed should be taken into account. Methods: Therefore, the present study investigated the acceptance and benefit-barrier-perception of using video-based AAL technologies for different activities of daily living based on a scenario-based online survey (N = 146). Results: In the first step, the results identified distinct evaluation patterns for 25 activities of daily living with very high (e.g., changing clothes, showering) and very low privacy needs (e.g., gardening, eating, and drinking). In a second step, three exemplary activity types were compared regarding acceptance, perceived benefits, and barriers. The acceptance and the perceived benefits of using video-based AAL technologies revealed to be higher in household and social activities compared to intimate activities. The strongest barrier perception was found for intimate activities and mainly regarded privacy concerns. Discussion: The results can be used to derive design and information recommendations for the conception, development, and communication of video-based AAL technologies in order to meet the requirements and needs of future users.

Emotions of scepticism, trust, and security within the acceptance of telemedical applications.

BACKGROUND: Addressing demands and shortages in healthcare supply, especially care in nursing homes, applying telemedicine represents a promising approach. However, the patients' acceptance and willingness to use telemedicine are necessary prerequisites for a sustainable integration within the medical supply structure. METHOD: Therefore, this online survey study empirically (N = 203) investigates potential patients' attitudes towards telemedicine and their impact on the acceptance and perception of telemedical consultations being applied in nursing homes. Beyond that, using telemedicine in acute situations and for regular consultations is compared. RESULTS: The results show three different patterns of attitudes towards telemedicine affecting the evaluation of telemedical consultations in both, acute and regular consultations. CONCLUSION: The insights enable concrete recommendations for the integration of telemedicine in healthcare supply adressing the individual needs of potential patients.

Shapes of You? Investigating the Acceptance of Video-Based AAL Technologies Applying Different Visualization Modes.

An aged population, increasing care needs, and a lack of (in)formal caregivers represent major challenges for our society today. Addressing these challenges fuels efforts and developments in innovative technologies leading to various existing AAL applications aiming at improving autonomy, independence, and security in older age. Here, the usage of video-based AAL technologies is promising as detailed information can be obtained and analyzed. Simultaneously, this type of technology is strongly connected with privacy concerns due to fears of unauthorized data access or inappropriate use of recorded data potentially resulting in rejection and non-use of the applications. As privacy-preserving visualizations of video data can diminish those concerns, this empirical study examines the acceptance and privacy perceptions of video-based AAL technology applying different visualization modes for privacy preservation (n = 161). These visualization modes differed in their degrees of visibility and identifiability, covering different levels of privacy preservation (low level: "Blurred" mode; medium level: "Pixel" and "Grey" modes; high level: "Avatar" mode) and are specifically evaluated based on realistic video sequences. The results of our study indicate a rather low acceptance of video-based AAL technology in general. From the diverse visualization modes, the "Avatar" mode is most preferred as it is perceived as best suitable to protect and preserve the users' privacy. Beyond that, distinct clusters of future users were identified differing in their technology evaluation as well as in individual characteristics (i.e., privacy perception, technology commitment). The findings support the understanding of potential users' needs for a successful future design, development, and implementation of video-based, but still privacy-preserving AAL technology.

Interdisciplinary perspectives on privacy awareness in lifelogging technology development.

Population aging resulting from demographic changes requires some challenging decisions and necessary steps to be taken by different stakeholders to manage current and future demand for assistance and support. The consequences of population aging can be mitigated to some extent by assisting technologies that can support the autonomous living of older individuals and persons in need of care in their private environments as long as possible. A variety of technical solutions are already available on the market, but privacy protection is a serious, often neglected, issue when using such (assisting) technology. Thus, privacy needs to be thoroughly taken under consideration in this context. In a three-year project PAAL ('Privacy-Aware and Acceptable Lifelogging Services for Older and Frail People'), researchers from different disciplines, such as law, rehabilitation, human-computer interaction, and computer science, investigated the phenomenon of privacy when using assistive lifelogging technologies. In concrete terms, the concept of Privacy by Design was realized using two exemplary lifelogging applications in private and professional environments. A user-centered empirical approach was applied to the lifelogging technologies, investigating the perceptions and attitudes of (older) users with different health-related and biographical profiles. The knowledge gained through the interdisciplinary collaboration can improve the implementation and optimization of assistive applications. In this paper, partners of the PAAL project present insights gained from their cross-national, interdisciplinary work regarding privacy-aware and acceptable lifelogging technologies.

Analyzing technology acceptance and perception of privacy in ambient assisted living for using sensor-based technologies.

People increasingly use various technologies that enable them to ease their everyday lives in different areas. Not only wearable devices are gaining ground, but also sensor-based ambient devices and systems are increasingly perceived as beneficial in supporting users. Especially older and/or frail persons can benefit from the so-called lifelogging technologies assisting the users in different activities and supporting their mobility and autonomy. This paper empirically investigates users' technology acceptance and privacy perceptions related to sensor-based applications implemented in private environments (i.e., passive infrared sensors for presence detection, humidity and temperature sensors for ambient monitoring, magnetic sensors for user-furniture interaction). For this purpose, we designed an online survey entitled "Acceptance and privacy perceptions of sensor-based lifelogging technologies" and collected data from N = 312 German adults. In terms of user acceptance, statistical analyses revealed that participants strongly agree on the benefits of such sensor-based ambient technologies, also perceiving these as useful and easy to use. Nevertheless, their intention to use the sensor-based applications was still rather limited. The evaluation of privacy perceptions showed that participants highly value their privacy and hence require a high degree of protection for their personal data. The potential users assessed the collection of data especially in the most intimate spaces of domestic environments, such as bathrooms and bedrooms, as critical. On the other hand, participants were also willing to provide complete data transparency in case of an acute risk to their health. Our results suggest that users' perceptions of personal privacy largely affect the acceptance and successful adoption of sensor-based lifelogging in home environments.

Acceptance and Preferences of Using Ambient Sensor-Based Lifelogging Technologies in Home Environments.

Diverse sensor-based technologies can be used to track (older and frail) people's movements and behaviors in order to detect anomalies and emergencies. Using several ambient sensors and integrating them into an assisting ambient system allows for the early identification of emergency situations and health-related changes. Typical examples are passive infrared sensors (PIR), humidity and temperature sensors (H&T) as well as magnetic sensors (MAG). So far, it is not known whether and to what extent these three specific sensor types are perceived and accepted differently by future users. Therefore, the present study analyzed the perception of benefits and barriers as well as acceptance of these specific sensor-based technologies using an online survey (reaching N=312 German participants). The results show technology-related differences, especially regarding the perception of benefits. Furthermore, the participants estimated the costs of these sensors to be higher than they are, but at the same time showed a relatively high willingness to pay for the implementation of sensor-based technologies in their home environment. The results enable the derivation of guidelines for both the technical development and the communication and information of assisting sensor-based technologies and systems.