The usability of an AAC pain description system for patients with acquired expressive communication disorders.

Augmentative and alternative communication (AAC) has been used by patients with acquired expressive communication disorders as an alternative to natural speech. The use of symbols to express pain, which is intangible, is challenging because designing a series of comprehensible symbols to represent personal experiences such as pain is not straightforward. This study describes (a) the development of symbols to express pain that were derived from Chinese pain-related similes and metaphors for an AAC mobile application developed specifically for this study known as PainDiary and (b) an assessment of the appropriateness of the app compared to conventional methods of collecting pain information. The symbols depicted headache pain and discomfort, which is prevalent among neurosurgical patients. The participants were 31 patients diagnosed with acquired expressive communication disorders who were receiving treatment in a neurosurgery general ward of Chang Gung Memorial Hospital in Taiwan and 14 nurses who worked on the ward. Pain information was collected by nurses using conventional methods and the PainDiary app. Assessment data, including the accuracy and efficiency of and user satisfaction with PainDiary, are compared. The results show that use of the app was effective in reporting pain and that patients required less time to report a pain event. The results further indicate that the PainDiary app was better received by younger individuals than by their older counterparts.

Technology anxiety and resistance to change behavioral study of a wearable cardiac warming system using an extended TAM for older adults.

With advances in technology, wireless and sensor technologies represent a method for continuously recording people's biomedical signals, which may enhance the diagnosis and treatment of users' everyday health conditions. These technologies mostly target older adults. In this study, we examine a smart clothing system targeting clinically high-risk patients, including older adults with cardiovascular disease (31 outpatients) and older adults in general (81 participants), to obtain an understanding of the patients' perception of using wearable healthcare technologies. Given that technology anxiety has been shown to affect users' resistance to using new technology and that perceived ubiquity is considered a characteristic of wearable devices and other mobile wireless technologies, we included three external variables: i.e., technology anxiety, perceived ubiquity, and resistance to change, in addition to the traditional components of the technology acceptance model (TAM). The results of the hypothesized model showed that among older adults in general, technology anxiety had a negative effect on the perceived ease of use and perceived ubiquity. The perceived ubiquity construct affects both user groups' perceived ease of use and perceived usefulness of wearing smart clothes. Most relationships among the original constructs of the TAM were validated in older adults in general. Interestingly, we found that perceived usefulness had an indirect effect on behavioral intention through attitude. These results further confirm the validity of the extended TAM in determining older users' technology acceptance behavior.

A study exploring the usability of an exergaming platform for senior fitness testing.

This study proposes a structural usability model to identify the relationship between the user interface design and the usability of an exergame system that includes a software system and a separate hardware device. The model consisted of two dimensions: the interface design, which was evaluated using Nielsen's heuristic evaluation method, and the usability, as defined by ISO 9241-11. An empirical study used the iFit exergame system to test the physical fitness of 101 seniors in order to evaluate the model's validity. The results showed a strong correlation between the interface design and the usability of the exergame system. An improved interface enabled users to interact with the system better, and the usability of the whole system was enhanced, including the device and the system itself. The results show that the proposed usability model can be used to evaluate other exergame systems.

Realization and Technology Acceptance Test of a Wearable Cardiac Health Monitoring and Early Warning System with Multi-Channel MCGs and ECG.

In this work, a wearable smart clothing system for cardiac health monitoring with a multi-channel mechanocardiogram (MCG) has been developed to predict the myo-cardiac left ventricular ejection fraction (LVEF) function and to provide early risk warnings to the subjects. In this paper, the realization of the core of this system, i.e., the Cardiac Health Assessment and Monitoring Platform (CHAMP), with respect to its hardware, firmware, and wireless design features, is presented. The feature values from the CHAMP system have been correlated with myo-cardiac functions obtained from actual heart failure (HF) patients. The usability of this MCG-based cardiac health monitoring smart clothing system has also been evaluated with technology acceptance model (TAM) analysis and the results indicate that the subject shows a positive attitude toward using this wearable MCG-based cardiac health monitoring and early warning system.

Acceptance of different design exergames in elders.

For promoting the successful aging of elderly residents of Chang Gung Silver Village in Taiwan, five interactive exergames were developed to promote the well-being of the elderly. The exergames included both physical games and cognitive games, and were implemented using various computer-based technologies in the Chang Gung Silver Village. The exergames were trialed by 39 elderly residents (15 male, 24 female; mean age 79.5 ± 17.5 years) of Chang Gung Silver Village. Following the trials, the participants were requested to complete a Technology Acceptance Model 2 (TAM2) questionnaire. The results showed that the perceived playfulness and perceived usefulness of the exergames were significantly related to the users' usage behavior and intention to use for both the physical games and the cognitive games. However, a relationship between the output quality of the game and the usage behavior was apparent only in the case of the cognitive exergames. Finally, the impact of social influence on the intention to use and the usage behavior was more pronounced for the physical exergames. Overall, the results revealed that the acceptance of exergames by the elderly depends not so much on the awareness of fun in using the game, but the perceived usefulness of the related physical and cognitive abilities.

Identification of Location Specific Feature Points in a Cardiac Cycle Using a Novel Seismocardiogram Spectrum System.

Seismocardiogram (SCG) or mechanocardiography is a noninvasive cardiac diagnostic method; however, previous studies used only a single sensor to detect cardiac mechanical activities that will not be able to identify location-specific feature points in a cardiac cycle corresponding to the four valvular auscultation locations. In this study, a multichannel SCG spectrum measurement system was proposed and examined for cardiac activity monitoring to overcome problems like, position dependency, time delay, and signal attenuation, occurring in traditional single-channel SCG systems. ECG and multichannel SCG signals were simultaneously recorded in 25 healthy subjects. Cardiac echocardiography was conducted at the same time. SCG traces were analyzed and compared with echocardiographic images for feature point identification. Fifteen feature points were identified in the corresponding SCG traces. Among them, six feature points, including left ventricular lateral wall contraction peak velocity, septal wall contraction peak velocity, transaortic peak flow, transpulmonary peak flow, transmitral ventricular relaxation flow, and transmitral atrial contraction flow were identified. These new feature points were not observed in previous studies because the single-channel SCG could not detect the location-specific signals from other locations due to time delay and signal attenuation. As the results, the multichannel SCG spectrum measurement system can record the corresponding cardiac mechanical activities with location-specific SCG signals and six new feature points were identified with the system. This new modality may help clinical diagnoses of valvular heart diseases and heart failure in the future.

Determinants of user acceptance of a specific social platform for older adults: An empirical examination of user interface characteristics and behavioral intention.

The use of the Internet and social applications has many benefits for the elderly, but numerous investigations have shown that the elderly do not perceive online social networks as a friendly social environment. Therefore, TreeIt, a social application specifically designed for the elderly, was developed for this study. In the TreeIt application, seven mechanisms promoting social interaction were designed to allow older adults to use social networking sites (SNSs) to increase social connection, maintain the intensity of social connections and strengthen social experience. This study's main objective was to investigate how user interface design affects older people's intention and attitude related to using SNSs. Fourteen user interface evaluation heuristics proposed by Zhang et al. were adopted as the criteria to assess user interface usability and further grouped into three categories: system support, user interface design and navigation. The technology acceptance model was adopted to assess older people's intention and attitude related to using SNSs. One hundred and one elderly persons were enrolled in this study as subjects, and the results showed that all of the hypotheses proposed in this study were valid: system support and perceived usefulness had a significant effect on behavioral intention; user interface design and perceived ease of use were positively correlated with perceived usefulness; and navigation exerted an influence on perceived ease of use. The results of this study are valuable for the future development of social applications for the elderly.

Development of a Wearable Instrumented Vest for Posture Monitoring and System Usability Verification Based on the Technology Acceptance Model.

Body posture and activity are important indices for assessing health and quality of life, especially for elderly people. Therefore, an easily wearable device or instrumented garment would be valuable for monitoring elderly people's postures and activities to facilitate healthy aging. In particular, such devices should be accepted by elderly people so that they are willing to wear it all the time. This paper presents the design and development of a novel, textile-based, intelligent wearable vest for real-time posture monitoring and emergency warnings. The vest provides a highly portable and low-cost solution that can be used both indoors and outdoors in order to provide long-term care at home, including health promotion, healthy aging assessments, and health abnormality alerts. The usability of the system was verified using a technology acceptance model-based study of 50 elderly people. The results indicated that although elderly people are anxious about some newly developed wearable technologies, they look forward to wearing this instrumented posture-monitoring vest in the future.

Perceptions of a Specific Family Communication Application among Grandparents and Grandchildren: An Extension of the Technology Acceptance Model.

Many studies have noted that the use of social networks sites (SNSs) can enhance social interaction among the elderly and that the motivation for the elderly to use SNSs is to keep in contact with remote friends and family or the younger generation. Memotree is designed to promote intergenerational family communication. The system incorporates the Family Tree design concept and provides family communication mechanisms based on the Family Communication Scale. In addition, the system optimizes hardware and interface use to conform to the specific needs of older and substantially younger individuals. Regarding the impact of variables on SNS with respect to the interaction of usability variables in the construction of a cross-generational communication platform, we adopted the TAM model and Chung et al.'s suggestions to promote user acceptance of the proposed Memotree system. A total of 39 grandchildren and 39 grandparents met the criteria and were included in the study. The elderly and young respondents revealed substantial willingness to use and/or satisfaction with using the Memotree system. Empirical results indicate that technology affordances and perceived ease of use have a positive impact on perceived usefulness, while perceived ease of use is affected by technology affordances. Internet self-efficacy and perceived usefulness have a positive impact on the user's behavioral intention toward the system. In addition, this study investigated age as a moderating variable in the model. The results indicate that grandchildren have a larger significant effect on the path between perceived usefulness and behavioral intention than grandparents. This study proposes a more complete framework for investigating the user's behavioral intention and provides a more appropriate explanation of related services for cross-generational interaction with SNS services.

Development of Home-Based Frailty Detection Device Using Wireless Sensor Networks.

This study develops a home-based frailty detection device that uses embedded systems and wireless sensing technology. This system helps monitor the impact of aging among the elderly through wireless automatic detection. The detection system consists of four devices. The first device, called eScale, simulates the traditional falling ruler test to measure reaction time. Another device, called eChair, measures the pressure exerted by a test subject through a pressure sensor. It is used to test three symptoms of frailty, namely slowness of movement, physical weakness, and body weight. The third device, called ePad, consists of a soft membrane switch placed on the ground to detect footsteps and is used to test balance. The fourth device, called eReach, measures displacement through ultrasound sensors. It is used to carry out the functional reach test. The sampling rate of each device is the main factor that determines system performance. When the test distance was set to 5 m for Home-Gateway, a 1-Hz sampling rate showed the best performance (98 %). Up to eight devices can be connected simultaneously to the gateway. The proposed system was compared with conventional approaches through testing with test subjects (n = 8). The results of the five tests were as follows: standing forward bend (r = 0.929), balance (r = 0.996), slowness of movement (r = 0.976), and physical weakness (r = 0.991), with p < 0.01. In the reaction time test, r = 0.871, with p < 0.1. All results suggest high correlations. Tests of aging symptoms were performed on 309 people aged over 65 years. Among males, degradation of over 20 % was found in the areas of physical weakness, slowness of movement, and functional reach. Among females, a degradation of 75 % was found in the balance test.

Research on a community-based platform for promoting health and physical fitness in the elderly community.

This study aims to assess the acceptability of a fitness testing platform (iFit) for installation in an assisted living community with the aim of promoting fitness and slowing the onset of frailty. The iFit platform develops a means of testing Bureau of Health Promotion mandated health assessment items for the elderly (including flexibility tests, grip strength tests, balance tests, and reaction time tests) and integrates wireless remote sensors in a game-like environment to capture and store subject response data, thus providing individuals in elderly care contexts with a greater awareness of their own physical condition. In this study, we specifically evaluated the users' intention of using the iFit using a technology acceptance model (TAM). A total of 101 elderly subjects (27 males and 74 females) were recruited. A survey was conducted to measure technology acceptance, to verify that the platform could be used as intended to promote fitness among the elderly. Results indicate that perceived usefulness, perceived ease of use and usage attitude positively impact behavioral intention to use the platform. The iFit platform can offer user-friendly solutions for a community-based fitness care and monitoring of elderly subjects. In summary, iFit was determined by three key drivers and discussed as follows: risk factors among the frail elderly, mechanism for slowing the advance frailty, and technology acceptance and support for promoting physical fitness.

eFurniture for home-based frailty detection using artificial neural networks and wireless sensors.

The purpose of this study is to integrate wireless sensor technologies and artificial neural networks to develop a system to manage personal frailty information automatically. The system consists of five parts: (1) an eScale to measure the subject's reaction time; (2) an eChair to detect slowness in movement, weakness and weight loss; (3) an ePad to measure the subject's balancing ability; (4) an eReach to measure body extension; and (5) a Home-based Information Gateway, which collects all the data and predicts the subject's frailty. Using a furniture-based measuring device to provide home-based measurement means that health checks are not confined to health institutions. We designed two experiments to obtain optimum frailty prediction model and test overall system performance: (1) We developed a three-step process to adjust different parameters to obtain an optimized neural identification network whose parameters include initialization, L.R. dec and L.R. inc. The post-process identification rate increased from 77.85% to 83.22%. (2) We used 149 cases to evaluate the sensitivity and specificity of our frailty prediction algorithm. The sensitivity and specificity of this system are 79.71% and 86.25% respectively. These results show that our system is a high specificity prediction tool that can be used to assess frailty.

The iFit: an integrated physical fitness testing system to evaluate the degree of physical fitness of the elderly.

This paper presents an integrated physical fitness testing system (iFit) that evaluates the physical fitness of older adults. The intent of the test is to help them manage and promote their health and mitigate the effects of aging. National protocols of physical fitness were implemented to support the assessment. The proposed system encompasses four modules of physical fitness assessment for both users and medical professionals. The test information will be recorded and managed through a wireless sensor network that will enable a better understanding of users' fitness states. Furthermore, the iFit has been validated by a test session attended by elderly participants. The results show that there is a significant correlation between iFit use in the test of flexibility, grip strength, and balance, compared to conventional methods.

Technology acceptance for an Intelligent Comprehensive Interactive Care (ICIC) system for care of the elderly: a survey-questionnaire study.

The key components of caring for the elderly are diet, living, transportation, education, and safety issues, and telemedical systems can offer great assistance. Through the integration of personal to community information technology platforms, we have developed a new Intelligent Comprehensive Interactive Care (ICIC) system to provide comprehensive services for elderly care. The ICIC system consists of six items, including medical care (physiological measuring system, Medication Reminder, and Dr. Ubiquitous), diet, living, transportation, education (Intelligent Watch), entertainment (Sharetouch), and safety (Fall Detection). In this study, we specifically evaluated the users' intention of using the Medication Reminder, Dr. Ubiquitous, Sharetouch, and Intelligent Watch using a modified technological acceptance model (TAM). A total of 121 elderly subjects (48 males and 73 females) were recruited. The modified TAM questionnaires were collected after they had used these products. For most of the ICIC units, the elderly subjects revealed great willingness and/or satisfaction in using this system. The elderly users of the Intelligent Watch showed the greatest willingness and satisfaction, while the elderly users of Dr. Ubiquitous revealed fair willingness in the dimension of perceived ease of use. The old-old age group revealed greater satisfaction in the dimension of result demonstrability for the users of the Medication Reminder as compared to the young-old and oldest-old age groups. The women revealed greater satisfaction in the dimension of perceived ease of use for the users of Dr. Ubiquitous as compared to the men. There were no statistically significant differences in terms of gender, age, and education level in the other dimensions. The modified TAM showed its effectiveness in evaluating the acceptance and characteristics of technologic products for the elderly user. The ICIC system offers a user-friendly solution in telemedical care and improves the quality of care for the elderly.

A five-layer users' need hierarchy of computer input device selection: a contextual observation survey of computer users with cervical spinal injuries (CSI).

This article presents how the researcher goes about answering the research question, 'how assistive technology impacts computer use among individuals with cervical spinal cord injury?' through an in-depth investigation into the real-life situations among computer operators with cervical spinal cord injuries (CSI). An in-depth survey was carried out to provide an insight into the function abilities and limitation, habitual practice and preference, choices and utilisation of input devices, personal and/or technical assistance, environmental set-up and arrangements and special requirements among 20 experienced computer users with cervical spinal cord injuries. Following the survey findings, a five-layer CSI users' needs hierarchy of input device selection and use was proposed. These needs were ranked in order: beginning with the most basic criterion at the bottom of the pyramid; lower-level criteria must be met before one moves onto the higher level. The users' needs hierarchy for CSI computer users, which had not been applied by previous research work and which has established a rationale for the development of alternative input devices. If an input device achieves the criteria set up in the needs hierarchy, then a good match of person and technology will be achieved.