Human Factors in Aging and Special Needs

AHFE International

Accelerating Open Access Science in Human Factors Engineering and Human-Centered Computing

Human Factors in Aging and Special Needs

book-cover

Editors: Jay Kalra

Topics: Aging and Special Needs

Publication Date: 2024

ISBN: 978-1-964867-09-0

DOI: 10.54941/ahfe1004887

Articles

Exploring AI Smart Home Aging-in-Place: Use Cases to Empower Individuals with MCI and Their Carepartners

Mild Cognitive Impairment (MCI) presents a critical juncture between normal cognitive aging and dementia, necessitating tailored interventions for individuals and their informal caregivers (carepartners). As cognitive decline progresses, individuals with Mild Cognitive Impairment (MCI) often require greater assistance with everyday tasks and increased support from their carepartners through prompts and shifting of task responsibility. This evolving dynamic often leads to a heightened burden on caregivers. In order to understand these challenges and how they may be addressed, we employed commercially available smart home technologies with an integrated, AI-powered mobile application as a technology probe in n =13 homes. The dyads consisted of carepartners as spouses, siblings, and adult children with different caregiving arrangements (i.e. cohabitating, adjacent living, remote). Technologies to infer daily activities, such as hygiene, sleep, and meal prep, were installed in homes prior to introducing the smarthome app, providing time for the system to learn. Dyads were then trained on key features of the AI smarthome app and notifications were customized based on individual needs and preferences. Multiple follow-up interviews were conducted at intervals of at least a month to assess app usability, usefulness, user preferences, perceived safety at home and unsupported needs. Results indicated nuanced patterns of app usage based on factors such as caregiver proximity in relation to living arrangements, extent of MCI progression, and individual tech proficiency. The AI smarthome application effectively addressed some concerns for both individuals with MCI and their carepartners around home safety, specifically in relation to exterior doors left open and wandering, as well as medication adherence. The study also demonstrated where AI-driven insights can go wrong, for example, frustrations arose from inaccuracies around the system's inability to distinguish occupants and accurately assess home occupancy. This paper describes use cases underscoring the potential of AI-driven smart home technologies to address the unique challenges faced by individuals with MCI and their carepartners in order to foster independence and enable safe aging-in-place. These use cases were derived from both the analysis of feedback sessions as well as dyad-specific observational data that contextualizes interview findings by providing a deeper understanding of participants’ preferences and concerns.This research contributes to the field by offering practical implications and future considerations for AI-based interventions, including: unique user needs necessitating greater personalization, dyad living arrangements, and seamless integration with existing technologies. Future work will involve codesigning and developing such interventions with dyads.

Adviti Atluri, Brenna Phelps, Yi Qin, Corinne Cutts, Brian Jones

Conference Proceedings

Design for digital ecosystems and telemedicine services to improve the quality of care pathways for frail older adults.

Global population aging is one of the most critical factors in the coming decades (Eurostat, 2019). In Italy, international trends are confirmed: the average age of residents, which was 32 in 1952, increased to 46.2 years at the beginning of 2022 (Istat, 2022). The overall effects of aging on the health and welfare system are considerable. Indeed, with ageing is associated with an increase in chronic pathological conditions, co-morbidities, or the inability to perform basic daily activities independently, and this leads to an increase in the care and assistance needs of the elderly. The European health interview survey (2019) finds that there in Italy there are about 4.6 million elderly people with severe or moderate difficulties in ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living), such that they need help and support to carry them out. However, the need for help is not always fully met: more than 2 million people over 65 with impaired independence do not feel adequately helped (Istat, 2022b).A distinctive factor of the new generation of elders is their approach to technologies, a factor that can greatly expand the possibilities of access to care and assistance, communication and information services (Istat, 2019). To provide, as far as possible, the continuity of care and assistance people need, telemedicine services can ensure safe and efficient care pathways while maintaining a strong patient-physician relationship. For example, in Italy before the health emergency caused by the Covid-19 virus, the use of telemedicine services was very limited. The pandemic emergency accelerated the diffusion of telemedicine applications and services, especially aimed at bridging the difficulties of performing health care services in person and minimizing hospital admissions when unnecessary. Before that time, home-based telemedicine services were used for the management of asthma, hypertension, pulmonary disease, and congestive heart failure (Chan et al., 2003; Benatar et al., 2003; Maiolo et al., 2003; Hersh et al., 2006; Panicacci et al., 2021).Digital technologies are thus a resource to support care and assistance at home. Design, and in particular the Human-Centred Design approach, can have a crucial role both in understanding the elderly population's needs and in translating these needs into digital products that are more suitable and relevant to their purpose.This article presents the first results of the research conducted by the Laboratory of Ergonomics & Design (LED) of the University of Florence as part of Spoke 3 of the project "THE - Tuscany Health Ecosystem" of the PNRR (National Recovery and Resilience Plan), funded by the Italian government with Next Generation EU funds - Mission 4 (Education and Research) - Component 2 "From Research to Enterprise". The THE project involves the participation of 22 partners including universities, research centers and companies in the Tuscany Region, organized in 10 Spokes. The goal is to develop guidelines for the design of interfaces and products for telemedicine services in digital diagnosis and therapy for neurodegenerative diseases.This article will discuss the research questions, applied research methodology, results and future developments.

Francesca Tosi, Claudia Becchimanzi, Mattia Pistolesi

Conference Proceedings

Evaluation of an Interactive Solution for Reminiscence and Communication

Communication with older adults and/or people with cognitive impairments could be supported by gathered information about the person’s history or his/her preferences (Rehn, 2015). By using information about the persons preferences and wishes, the sense of belonging and the persons social identity could be strengthened (Turner, 1999). Digital tools addressing this area often consist of static information about the older adult, and they do not consider that we as human beings constantly are changing (Sjölinder et al., 2023). Further, most of these tools have the focus on providing information to the care giving staff instead of being a tool that can be used together and create an experience.In an ongoing project an interactive solution that supports reminiscence and communication with older adults was developed. The solution consists of hardware units in terms of a tablet, interactive devices and a charging station that is combined with a removable tray. The tablet is used for interaction and communication with the system. By using the tablet, general collections of discussion topics can be accessed. The system also has the possibility to gather information and create personal profiles. The information for the personal profiles is gathered by using the tablet to play simple mini games. For example, the older adults can play a mini game where they are presented to items and give these items thumb up or thumb down. Based on the answers a personal profile is built up. The interactive devices are physical devices resembling stones in the size of approximately 15 cm. The devices (“the stones”) have a screen were text or images can be presented. They also have light emitting diodes for conveying different moods and the possibility to play sounds. From the tablet, collections of content can be sent to the stones that presents the items on the screen to provide topics for the conversation. The charging station consists of a part that can be removed (the tray). The aim of this is to make it possible to carry around several stones at the same time. This paper will present a study examining the usage of the solution described above. The study was conducted in collaboration with older adults and staff at a nursing home in Sweden. In one part of the study, the researchers used the solution in the interaction with the older adults. In the other part of the study the staff at the nursing home used the solution in the interaction with the older adults. In both cases two sessions were held with each older adult, one to gather information (playing the mini games), and one session where the gathered content was used in a conversation. After each session with the older adults, questions were asked about the usage of the solution and about aspects related to how they have perceived the solution and the situation. After the sessions that was held between older adults and care giving staff similar questions were given, but in these interviews questions about the care givers perspective were added.ReferencesRehn, A. (2015). Life stories as a method for developing daily activities. FoU-report 77:2015.Sjölinder, M., Hollström, E., Rönntoft, H. (2023). Life Stories – Developing an Interactive Solution for Reminiscence and Communication. In: Jay Kalra (eds) Human Factors in Aging and Special Needs. AHFE (2023) International Conference. AHFE Open Access, vol 88. AHFE International, USA.http://doi.org/10.54941/ahfe1003660Turner, J. C. (1999). Some current issues in research on social identity and self-categorization theories. In: Ellemers, N.; Spears, R.; Doosje, B. (Eds.).Social Identity: 6–34.

Marie Sjölinder, Elin Hollström, Hanna Rönntoft, Olov Ståhl, Anders Helin, Victor Marklund

Conference Proceedings

Enhancing Quality of Care for Older Adults: A Participatory Design Approach for Assistive Devices in Caregiving

As the proportion of the older adult population is increasing worldwide, so is the prevalence of disabilities such as dementia. Older adults living with dementia often need the help of a caregiver, and caregivers tend to have a higher prevalence of burnout.This research aims to address the pressing need to improve the quality of care for older adults by focusing on the development of assistive devices tailored to alleviate caregiver burnout. The objective is to propose a participatory design process, engaging caregivers as potential users, to create technology-based devices that fulfill the ideal design requirements. By mitigating symptoms of burnout among caregivers of older adults, this study seeks to elevate the standard of care provided to the elderly population.Three distinct design approaches, namely User-Centered Design, Total Design, and Participatory Design, are proposed as integral components of a comprehensive framework. Recognizing the inherent limitations of these methodologies when employed individually, this research advocates for their collective integration, harnessing their combined potential to yield an effective, functional, and valuable product. The workflow for merging these design approaches forms a crucial aspect of the findings, delineating a structured pathway toward the realization of the study's objectives. By combining the strengths of User-Centered Design, Total Design, and Participatory Design, this approach offers a holistic strategy to optimize the effectiveness of the proposed technology-based devices. Such an integration facilitates the creation of solutions that not only meet user needs but also address the complexities and challenges inherent in caregiving for older adults, particularly those with conditions such as dementia.This research contributes to a paradigm shift in the development of assistive devices, offering a novel framework that prioritizes the needs and experiences of caregivers. By advocating for a collaborative design process that transcends individual methodologies, this approach has the potential to herald a new era in caregiving practices for the aging population, fostering a culture of empathy, innovation, and improved quality of life for both caregivers and older adults.

Pilar Hernández Grageda, Ramiro Velázquez, Andrew Johnson

Conference Proceedings

Facilitating Social Engagement for Middle-Aged and Older Individuals: Examining the Role of Idle Goods and Product-Service Design

This article is grounded in the context of middle-aged and older individuals (aged 55 and above) in China living separately from their families due to population aging and shifts in traditional family structures. It delves into their requirements for social engagement and the potential of idle goods to foster connections among this demographic, thereby stimulating economic growth and influencing consumer behaviour. Drawing from a literature review and a survey of 212 participants, the article suggests that innovative approaches are essential to address social isolation and promote meaningful interaction among older individuals. It offers recommendations for future research and practical intervention strategies, emphasizing the importance of product-service design frameworks and community-based initiatives. In sum, this article enhances our comprehension of the challenges and opportunities associated with population aging in China and highlights the critical role of social cohesion and inclusive community development in supporting the well-being of older people.

Jie Meng

Conference Proceedings

Elderly and digital health technologies: the relationship between Gerontechnology and Design for active and healthy ageing.

The rise of new interactive, digital and connected objects is bringing about significant transformations in our world, generating new ways of living and new channels of access to communication. The healthcare sector is one of the sectors most affected by this digital revolution.Gerontechnology, a relatively recent field of research, studies the interaction between increasing longevity combined with a decreasing birth rate and the development of emerging healthcare technologies (Bouma et al., 2007; Chen, 2020).Therefore, from a theoretical point of view, digital health technologies (wearable devices, social media, robotics, smart devices, virtual technologies, etc.) can support successful ageing (van Bronswijk et al., 2009; Lee et al., 2020), but in practice, the results achieved do not live up to the expectations of elderly users, as the elderly population is less able to access new technologies as they are less open to innovation (Loges & Jung; 2001; van Dijk & Hacker, 2003; Manchester & Jarke, 2022).The EU's 2022 report (European Commission, 2022) on the Digital Economy and Society Index (DESI) places Italy 18th among the 27 EU Member States, which can be attributed to the relative lack of literacy of the Italian elderly population, although, compared to 2021, Italy gained two points (20th place). In order to limit the Grey Digital Divide, gerontechnology design in recent years has been influenced by the anthropocentric approach, a design approach that places the elderly within the design process (Baker et al., 2019; Vines et al., 2015; Wallace et al., 2020) considering them as a social resource and not as frail, sick and dependent. Design, and in particular the Human-Centred Design approach, can play a crucial role both in understanding the needs of the elderly population and in translating these needs into digital products that are more suitable and relevant to their purpose. For these reasons, in this article we introduce the first results of the research carried out by the Ergonomics and Design Lab. (LED) of the University of Florence within the research programme "Age-It Ageing well in an ageing society", an extended partnership financed within the PNRR (National Recovery and Resilience Plan, Funded by the Italian Government with the European funds Next Generation Eu Mission 4 "Education and Research" Component 2 "From Research to Enterprise"). The Age-It programme, in which 25 partners, including Universities and Research Centres, participate, is led by the University of Florence and consists of 10 spokes. LED researchers are involved in spoke 9, which aims to study advanced gerontechnologies for active and healthy ageing. The objective is therefore to reduce the digital divide between generations through the development of design guidelines that can help the elderly to use digital health technologies consciously and safely.The article will discuss the research questions, method, results and future developments.

Francesca Tosi, Mattia Pistolesi, Claudia Becchimanzi

Conference Proceedings

Self-service Health Screening Devices Based on Community Health Management Services

The development of primary public health services in China is facing great challenges. A shortage of family doctor resources, inadequate health awareness of residents, and low health screening coverage of residents are still the current dilemmas that primary health services face. Gradually, community health services that include a type of self-service health screening device are starting to emerge. In this context, a community is defined as a collection of individuals living in a particular geographical area with public facilities for their daily life use.In light of today's aging trends, self-service devices may be adopted by senior residents, who are the primary users of community services. Enabling seniors to manage their health more proactively can effectively prevent primary health care services from stagnating.This study aimed to explore how design can help older adults better adopt self-help sign detection devices in the community in the context of technological development. A value sensitivity research approach was used in this thesis. First, through a desktop survey and conceptual literature review, the current health care dilemma and development trends were understood, and values appreciated by each stakeholder for self-help physical sign testing in a community setting were defined. The combination of multiple interview methods was used by users to analyze information on existing self-services used to integrate the value claims of health screening devices in Shanghai to gain a more realistic view and explore potential design opportunities. Finally, the value claims were further transformed into a solution that was designed. This includes suggestions for the design of devices that can be used in the near future, for the human‒machine interaction process, for the overall service process, and for future functional expansion. The industrial design was also produced through sketches and 3D model iterations.The findings and outcomes can be used as a reference for the development and design of current or near-future self-service sign detection devices.

Shimeng Xiao, Xiaohan Tu, Long Liu

Conference Proceedings

Retired independent women adjusting to co-living

With present financial concern and the increase of aging populations the French government has seen a way to support women in co-housing within buildings with moderate rents (HLM).This represents a significant saving, both for the women and the government as these women support one another with no medicalized need to the end of their lives. We investigated the charateristics, attributes and qualities for such successful co-housing as the model Babayagas House in Montreuil. It is extremely important to get a good grasp of the way people fit together. Many groups have tried similar endeavours in order to live more economically, yet few have lasted 12 years like the model housing in Montreuil. This is especially true in Canada. Friends have decided to share a house, and after three to five years it all falls apart. In all parts of the world similar attempts are being made. In Korea and China, it is usually wealthier people who get together. Retirement housing is expensive in Canada and often women who lost their spouse also lost additional income while finding themselves alone and struggling.This study is of a qualitative nature (Creswell & Poth, 2018). The outcome is an inventory questionnaire to be used for the selection of members of similar co-living arrangements. First we researched well-being questionnaires to identify a format that would best suit the targeted population.We then analyzed personal journals to uncover desirable characteristics. We also analyzed documents from the public domain pertaining to the housing arrangements as well as the House Charter, each member has to sign upon joining the Babayagas House.All categories were examined and emerging themes were used as items for the identification of relevant questions from an already existing well-being questionnaire.Questions were slightly modified for the convenience of an aging population.These questionnaires are further reviewed by people presently in retirement homes for annotations as regards their content and appropriateness.Findings show a number of characteristics that emerged from the data analysis which are deemed necessary for on-going harmonious co-living. It comprises 33 sections, from autonomy and responsibility to adherence to rules in an attempt to identify personal traits based on aspects that emerged from existing data, namely the participants journals and other documents through which these traits were deemed to be conducive to better co-living.Examples will be given. The results will be discussed in light of the findings of the analysis and also as they pertain to the annotated questionnaires from present residents in retirement homes.

Marie J Myers

Conference Proceedings

Smart Relax Armchair - a solution for active and safe ageing at home

The fact that people are living longer is a social and economic challenge for developed countries in the 21st century. An ageing society leads to an increase in the number of people living with multiple chronic conditions, facing the loss of independence and autonomy in daily activities and suffering social isolation caused by the pandemic or by the necessity of long-term care at home. The increasing incidence of sedentarism as well as prolonged immobility caused by long-stay settings (care home) is also a growing health concern. Indeed, spending too much time sitting daily could increase the incidence of postural changes and pressure ulcer formation, further reducing the physical, social, and emotional well-being of older adults.These problems are countable as significant contributors among many threats to elderly health and well-being leading to morbidity, disability, and premature death. In this view, Ambient Assisted Living solutions to monitor house routines of elderly patients and offer simple and healthy exercises daily are essential.This paper reports the results of the research activity conducted by the authors in collaboration with a well-known Italian sofa and armchair producer and health experts to develop an innovative solution for promoting active and safe ageing at home using a Smart Relax Armchair. The goal of the study was to introduce new smart functions to a Relax Armchair to help maintain a correct posture as well as to reduce the formation of bedsores by inducing frequent repositioning.To reach the goal, firstly the authors conducted a benchmarking analysis to identify the smart functions dedicated to health and wellbeing purposes already available on the market in the home furniture sector. A user-centred design methodology has been implemented to identify the Smart Relax Armchair functionalities, by involving industry experts, researchers in active ageing, biomedical engineers, and potential users since the early design stage. A dedicated design thinking tool has been used for users’ needs identification and translation into metrics (i.e. technical features). The Quality Function Deployment (QFD) method and tool have been used to rank such metrics and drive the design of the final product to meet users’ needs at best.3D virtual manikins, technical standards, ergonomic manuals, and the know-how of biomedical engineers and experts in Functional Recovery and Rehabilitation have been used to identify postural misbehaviour in daily life and potential intervention areas on a commercial Relax Armchair. Several active and passive solutions have been identified and tested to help maintain the correct posture and reduce the formation of bedsores. A sensorised mat has been used to assess changes in pressure distribution with respect to different layers of cushioning materials and to help select the specific pressure relief mattresses for bedsore prevention to be integrated into the final design.At the same time, an innovative protocol (anti-decubitus function) has been developed and implemented via ARDUINO to automatically induce a repositioning of the Smart Relax Armchair and thus changing the pressure distribution on the body, if the APP detects prolonged sitting.The protocol of the anti-decubitus function has been validated on a preliminary prototype thanks to a sensorised mat which demonstrated the effectiveness on pressure distribution variation, thus allowing the patenting of the idea.In order to promote active ageing at home, a set of simple rehabilitation exercises to be performed with the help of the Smart Relax Armchair has been designed and implemented in the APP specifically developed to control the product via a Smartphone or a vocal assistant.A final prototype including all the selected and developed solutions has been produced and a clinical trial will be conducted in the next months for the final validation of the product.The solutions developed and implemented on the Smart Relax Armchair have the potential to be applied to any model of Armchair or Sofa by the producer, thus changing the conventional paradigm of expensive products for active ageing only available for residential care facilities which cannot be afforded by those willing to age in place.

Sarah De Cristofaro, Luca Rizzi, Dario Cardone, Lisa Berti, Ubaldo Spina

Conference Proceedings

An approximate metaverse virtual store designed for reducing cybersickness in middle-aged consumers

With the rapid growth of online shopping, the business model of online stores has also shown diversified development. In the case of product display, when customers cannot experience the actual product in person, merchants will work hard to promote the products to gain the favor of customers on the display platform and then to purchase their products. However, traditional product catalogs in 2D images to present products cannot satisfy consumers' recognition. With the advancement of technology, online stores constructed with 3D virtual reality will significantly enhance consumers' attraction. Previous research in Taiwan found that the percentage of people over 40 engaged, especial in middle-aged, in online activities has increased significantly since 2011. If the virtual store added the metaverse concept, middle-aged people could interact with relatives and friends like in real life. It is convinced that this online store consumption model will profoundly affect middle-aged people to be happy to invite relatives and friends to participate in online shop shopping. However, the resulting problems, such as spatial orientation and spatial perception conflicts, need to be addressed as soon as possible so as not to affect the participation of middle-aged people. This study applied the concept of cross-zone navigation and the method of static clarity-reducing design in peripheral vision to reduce cybersickness infection and obtain a safe shopping environment. The results showed that cross-zone navigation developed in this study can assist middle-aged subjects in reaching the target location quickly, reducing disorientation problems.

Cheng-li Liu, Shiaw-tsyr Uang

Conference Proceedings

The Other Aspect of Ergonomics: Job Crafting In A Sample of Older Adults Still in Employment

Problem Statement: Job crafting" refers to the psychological and physiological adaptations an employee makes while adhering to the requirements and relationships of his employment. Improving the level of fit between the employee and their job is the aim of these changes. Employees may also self-initiate changes to the job requirements and resources, whether they be increased or decreased, in order to achieve their personal and professional goals and to strike a balance between the job requirements and resources and their unique needs and abilities (Wrzesniewski & Dutton, 2001). Employees generally don't stay at their jobs for the years they spend doing nothing with them; instead, they make small adjustments to improve their happiness at work, even when their professional circumstances prevent them from doing so. Worker modifications typically take place in one or more of the following three domains: social, cognitive, and skill. In terms of Algeria's work environment, do employees engage in job crafting within their respective fields, and are they content with their current jobs? Can job crafting be classified as an ergonomic practice? This is the subject of the research paper.Objective/ Question: This study is centered on the following objectives:1. Assess the level of job crafting by senior staff members.2. Examine the relationship between job crafting and the mental health of senior employees.3. Consider the possibility that job crafting is the antithesis of ergonomics.Additionally, this research aims to respond to the following queries:1. To what extent do senior employees in their different fields practice job crafting?2. How do senior staff members who are implementing job crafting feel about their mental health?3. Can job crafting be categorized as an additional type of ergonomics?Methodology: Researchers employed both survey and correlational methods of the descriptive approach to carry out this investigation. A questionnaire created especially for the study was used to gather research data. Forty-two teachers of elementary schools made up the research sample. There were 21 educators from the first cycle (primary grades 1-3) and 21 educators from the second cycle (primary grades 4-6). The sample's average age was 55.76 years, with a standard deviation of 03.69 years.Results: To what extent do senior employees in their different fields practice job crafting? The findings demonstrated that most people in the general sample said they frequently crafted their work. They stated that they have made the changes they feel are required to advance educational work. Task components, the cognitive components, and the social components were the three areas of adjustment that they concentrated on.How are the senior staff members who are using job crafting doing in terms of mental health? The findings also demonstrated the high degree of mental health among employees who do craft their work. It is noteworthy, to mention that first-cycle educators have been found to have better mental health than second-cycle educators. Does job crafting fall under the category of another type of ergonomics? Ergonomics has been defined as the study and practice of fitting work to people for over fifty years, with the goal of enabling people to work happily and enjoy what they do. This is still the definition that is currently used to describe ergonomics. However, who makes the work human-readable? In this case, the person who adapts the work would likely be an ergonomist or engineer with ergonomic training (Grandjean & Kroemer, 1997). This was the state of affairs for many years. However, the concept of "job crafting", has been aiming to achieve a similar objective as ergonomics: that is tailoring work to the needs of the individual so they can be happy doing it. Ergonomics and job crafting therefore have the same end goal, but different methods to get there. In other words, they disagree on the question of who handles the adaptation process. When it comes to job crafting, the employee customizes the task to fit his or her skills and capabilities (Demerouti, 2014).Discussion: The fact that employees are granted freedom within reasonable bounds is among the most significant developments in the twenty-first century workplace. Because an employee with autonomy can be creative and imaginative. In this particular context, it has been observed that employees in the education sector implement any adjustments they think are necessary to ensure they are as comfortable and happy as possible while working. Teachers' excellent psychological health is one outcome of this change at work. Job crafting is a type of ergonomics since it aims to adjust work to workers.Conclusion:According to this study, senior teachers often craft their jobs to make them more appropriate for them. It also demonstrated the high degree of psychological well-being of teachers who engage in job crafting.

Mohamed Mokdad, Bouhafs Mebarki, Sami Al-mahjoub

Conference Proceedings

Chinese nursing home design studies based on changes in design formal language

1 BackgroundBased on the current structural shortage of labor force and serious shortage of caregivers in China's elderly and medical services [1], the future demand for elderly care services for the elderly population is also increasingly strong [2]. At present, the proportion of Chinese elderly people living in elderly care institutions is 0.73%, which reflects that there are still some obstacles to the general acceptance of elderly care institutions by Chinese elderly people. Combined with the theory of environmental psychology, it can be seen that the environment can have an impact on behavior, psychology and other aspects, so the scientific shaping of space is inextricably linked to the enhancement of the user's spatial acceptance. Based on this, this study discusses the development history, development status and future development trend of nursing home design in China, and explores the innovative development path of nursing home design in the future. It aims to improve the acceptance and willingness to use nursing homes by the elderly and their families through optimization at the design level, so as to alleviate the current aging problem in China and the world.2 MethodDesign form language, is a kind of abstract language that can cover the design concept, design strategy, is a logical combination of structure, color, material and other figurative language in design. The change of design form language is often closely related to the change of user needs, the development of the industry now, etc. Citespace can present the structure of knowledge, the situation of information in the form of graphical distribution [3], and combined with the resulting graphs to analyze the disciplinary structure of the field of study related to the discipline structure, the hot frontier and other laws [4]. In view of the fact that the keyword maps that can be directly generated by importing literature data in Citespace cannot accurately represent the design form language explored in this study, this study organizes the design form language of each piece of literature in the valid title data for the titles, keywords, and abstracts of the 253 pieces of literature in the CNKI database, respectively.3 ResultThis study combines the data processing results of the design form language to produce three results related to the development of nursing home design in China. First, the development history of nursing home design in China is divided into three stages: the "starting period", the "high speed development period" and the "innovation enlightenment period", and there is still much room for development. Secondly, from the current development status of Chinese nursing home design, the concentration of current research is high, which also proves that the innovation of Chinese nursing home design is low at this stage. In addition, the research hotspots are mainly "people-oriented" and "integration of medical and nursing care", which reflects the current Chinese nursing home design's emphasis on the physiological and psychological needs of the elderly, and conforms to the current Chinese government's guidelines for nursing homes. Thirdly, "multi-dimensional consideration of user needs", "optimization of nursing home living mode through spatial design", and "exploration of cutting-edge fields" are proposed, The four suggestions on the direction of future development of nursing home design in China are "multi-dimensional consideration of users' needs", "optimization of living mode through spatial design", "exploration of frontier fields", and "in-depth combination of theory and practice".4 ConclusionThis study applies Citespace to analyze the literature about design form language visualization mapping in the field of Chinese nursing home design in the past 15 years, and according to the changing law of design form language, we have launched a study on the development history, development status, and future development trend of China's nursing home design, and obtained four directions of the future of China's nursing home design that are worth developing and studying in depth, which provides a directional guideline for the research of China's nursing home design.References[1] Zuo Meiyun. Meaning and mode of smart aging[J]. China Social Work,2018(32):26-27.[2]Wang Min. Research on nursing home design based on geriatric psychology[D]. Southwest Jiaotong University,2016.[3]Chen Yue,Chen Chaomei,Liu Zeyuan et al. Methodological functions of CiteSpace knowledge graph[J]. Science Research,2015,33(02):242-253.DOI:10.16192/j.cnki.1003-2053.2015.02.009.[4] Du Shuxing,Peng Liping,Lian Lilin. Current status of foreign industrial design research based on CiteSpace econometric analysis[J]. Journal of Graphics,2017,38(06):876-880.

Jiaxin Liu, Changming Tang

Conference Proceedings

Importance of handgrip strength and endurance time for predicting COVID-19 mortality in older adult patients: K-Nearest Neighbors (k-NN) algorithm

The study aimed to investigate the role of handgrip strength (HGS) and muscular endurance time (ET), as assessment measures for physical frailty and muscle function, in predicting the COVID-19 mortality of elderly patients admitted to the intensive care unit (ICU). This prospective observational cross-sectional study was conducted on 872 COVID-19 patients (415 females and 457 Males) aged 65-90 years admitted to ICU. Demographic data, underlying comorbidities, COVID-19-related symptoms, as well as laboratory and computed tomography (CT) findings were obtained from the patient's medical records. Using a JAMAR® hydraulic dynamometer, the average HGS (kg) after three measurements on the dominant side was recorded as the outcome for analysis. The threshold of the Low grip strength was defined as less than 26 kg and 14 kg for males and females, respectively. This is based on the consideration that low grip is two standard deviations below the gender-specific peak mean value. Muscular ET was also calculated after an additional trial, in which patients were asked to maintain the grip, and the value was measured in seconds when strength dropped to 50% of its maximum level. Subsequently, all thirty-one features were entered into the k-Nearest Neighbors (k-NN) algorithm to investigate the possible relationship between HGS and ET with COVID-19 mortality in elderly patients admitted to ICU. The results showed that chronic obstructive pulmonary disease (COPD), low grip strength, C-reactive protein (CRP), SaO2, and ET were found to be the most relevant components for possible COVID-19 mortality prediction, respectively. Further, the k-NN classifier achieved the highest classification accuracy of 95.21% to predict COVID-19 mortality, under the 10-fold data division protocol. Along with the well-known clinical risk factors, HGS and ET can be quick and low-cost prognostic tools in the mortality rate of elderly patients with COVID-19.

Sajjad Rostamzadeh Kalkhoran, Alireza Abouhossein, Atabak Allafasghari, Amin Allafasghari

Conference Proceedings

Overcoming Obstacles: Examining User Resistance to Home-based Health Monitoring Systems among Older Adults

Home-based Health Monitoring Systems (HHMSs) have rapidly emerged as a promising tool for health management among older adults. By providing real-time, easily accessible health information, HHMSs can facilitate proactive health management and potentially improve health outcomes for older adults. However, despite the potential benefits of this technology, its adoption by older adults remains a complex challenge. Older adults’ unique perceptions and attitudes toward technology often create barriers to effectively using these systems. While numerous studies have explored the factors affecting technology acceptance among older adults, there is a relative lack of research into the factors contributing to resistance towards health monitoring technologies. The present study aims to fill this gap by investigating the factors influencing older adults’ resistance to HHMSs. To this end, the study integrates two key theoretical frameworks: status quo bias theory and task-technology fit theory. We conducted an empirical study investigating factors influencing older adults’ resistance to HHMSs. Data was collected from 483 seniors aged 55 and above through an online survey. Based on this data, a structural model of user resistance was proposed and tested using the partial least squares structural equation modeling (PLS-SEM) method. The results revealed that inertia and technology anxiety accounted for 43.5% of the variance in user resistance. Among these factors, technology anxiety was found to strongly impact user resistance (p < 0.01), suggesting that fears or apprehensions about using the technology can significantly deter older adults from adopting HHMSs. The study also found that inertia, switching costs, and switching benefits significantly influenced technology anxiety (all p values < 0.01). When older adults perceive higher benefits and lower costs of switching to a new technology, they may experience lower anxiety. Furthermore, if the required task and technology are fit, they are more willing to switch to the new technology. It’s worth noting that the study found that task-technology fit did not significantly affect technology anxiety and user resistance (p > 0.05), suggesting that even if a technology perfectly aligns with an older adult’s tasks, it may not necessarily reduce their anxiety or resistance towards it. This study dedicated that the development of HHMS should consider the relationship between task characteristics and technology capabilities, identify tasks in specific contexts, and gain insight into older adults’ emotional and psychological anxieties. It also provides valuable insights into designing effective, user-friendly, and easy-to-use systems for older adults.

Zhen Zhao, Qian Mao, Yun Hei Chak, Trudy Cheung, Hailiang Wang

Conference Proceedings

Design a Rehabilitation Platform to Improve Mild Cognitive Impairment by Integrating Cognitive Training Games with Moderate-intensity Cycling Exercise

Most studies recognized motor-cognitive dual-task training as an effective treatment to enhance neurological disorders in patients with improved motor and cognitive performance. However, the practical treatment strategy of motor-cognitive dual-task training still need to be confirmed with the clinical evidence-based support. The purpose of this study aimed to propose the optimal strategy of dual-task training using moderate-intensity stationary cycling and multidomain cognitive training for patients with MCI, and compare the post-training performance between motor, cognitive and motor-cognitive dual-task training.Materials and MethodsNineteen patients were recruited from the local rehabilitation centers in Hong Kong and were diagnosed with mild cognitive impairment (MCI). The following inclusion criteria were used: (a) total scores of Montreal Cognitive Assessment, Hong Kong version (HK-MoCA) ranging from 7th to 16th percentile stratified by age and education, (b) be able to follow the instructions and perform cycling independently, (c) free of any other neuromuscular that affect the motor performance, (d) free of any cardiovascular diseases that may have a potential risk of life during cycling. All participants were randomly allocated to the treatments of motor (N=7), cognitive (N=7) and motor-cognitive dual-task training (N=5). In this study, we proposed the rehabilitation platform integrating the stationary cycling (Monark 928E, Monark Sport & Medical, Sweden) with cognitive training games (RehaCom, HASOMED GmbH, Germany). The rehabilitation platform was equipped with optical encoder (HN3806-AB -400N, Electronic Katrangi Trading, Syria), power meter sensors (Vector™, Garmin Ltd, Taiwan) and heart rate sensor (Polar H10, Polar Electro, Finland) for real-time cycling parameters display (i.e., elapsed time, heart rate, RPM, power output, and power ratio between left and right pedals) and cardiovascular intensity monitoring. Last, performing stationary cycling concurrent with multidomain cognitive training operated by the touchscreen is the way of the treatment of motor-cognitive dual-task training. Before training, all subjects were asked to perform the Graded Exercise Test modified from YMCA Sub-Maximal Cycle Ergometer Test to determine the upper and lower boundary of workloads for maintaining the moderate-intensity cycling at pedaling rate of 50 RPM during motor and dual-task training. In this study, the definition of HRmax was calculated: 208-(0.7*age), and the moderate-intensity cycling was defined as the range from 55% to 75% HRmax. After finishing the Graded Exercise Test, all patients received 30 training sessions in the frequency of four sessions weekly. The assessments of MoCA, Trail Making Tests (TMTs), 5-Times Sit to Stand Test (5TSTS), 10-Meter Walk Test (10MWT) and 6-Minute Walk Test (6MWT) were used for evaluation. In addition, the record of grading level of the cognitive training using RehaCom software were also used to quantify the multidomain cognitive performance. Paired t-test and Kruskal-Wallis test were used to examine the outcome differences in cognitive function and functional motor performance within groups between baseline and post-assessments, and the comparisons between groups, respectively. After the Kruskal-Wallis test, the Bonferroni correction was used for post-hoc pairwise comparisons. All comparisons were performed using SPSS 22.0 software (SPSS, IBM, Armonk, New York, U.S.A.), and the statistical significance was set at α = 0.05.ResultsFor cognitive function, significant improvements in MoCA were found in cognitive and dual-task groups, and the significant differences in TMTs – part A and part B were found in cognitive group. For functional motor performance, both motor and dual-task groups showed significant improvements in 5TSTS, 10MWT and 6MWT. The greater improvement of grading level in sustain attention and logical reasoning were found in the typical subjects after receiving dual-task training than cognitive treatment. The greater slopes of grading level in sustain attention and logical reasoning were found in the typical subjects after receiving dual-task training than cognitive treatment.ConclusionsThe treatment strategy of simultaneous dual-task using moderate-intensity stationary cycling and computer-based multidomain cognitive training was proposed. The current results encouraged this treatment to be applied as the routine training in a population of MCI for restriction of cognitive decline or delayed progression to related dementia.

Hsuan-yu Lu, Zhongping Ye, Chun Hang Ti, Cathy Lau, Chengpeng Hu, Xiangqian Shi, Kai-yu Tong

Conference Proceedings

Assessment of Elderly oriented assistive devices

With the advancement of technology and the improvement of medical conditions, people around the world are living longer. Meanwhile, low fertility rates have reduced the proportion of young workers. These two factors together are driving the global trend of rapid population aging. The United Nations announced that the world's population has reached 8 billion on November 15, 2022, with 761 million people aged 65 and over, and this number will increase to 1.6 billion by 2050, with the population aged 80 and over growing faster. The global pension crisis is gradually entering the outbreak period, and the aging population makes countries all over the world face severe challenges of pension. In this context, countries around the world are trying to find strategies to cope with aging. China's 14th Five-Year Plan proposes to develop the silver economy and promote the vigorous development of the elderly products industry. At present, China's pension industry is still in its infancy, lack of perfect industry standards, market norms, evaluation systems and industry regulators, on the market for pension products and functions of many, fast update speed, some enterprises emphasis on publicity light research, products in the practical and safety aspects of the greater hidden dangers. Therefore, it is of great significance to actively carry out elderly-oriented assessment of elderly products. Based on the safety, usability and comfort of the products, this paper mainly focuses on the "elderly", concentrate on studying the physiological and psychological characteristics of the elderly, such as their perceptual ability, operational ability and cognitive ability, and establishes an elderly-oriented evaluation index system for assistive devices. This paper mainly focuses on the "elderly", revolves around the physical, physiological and psychological characteristics of the elderly such as the perception, operation and cognitive ability, and takes the safety, usability, comfort and affectivity as the purpose, and constructs a comprehensive, multi-level and multi-dimensional evaluation index system for the assistive devices for the elderly. The rollator was studied as a typical category of assistive devices for the elderly, and 6 corresponding products were randomly selected for the elderly-oriented assessment. By analyzing the functional characteristics and specific use situation of these rollators, the interaction process between the elderly and the rollators was analyzed, the typical task profile was extracted and the experimental task was designed. By screening 10 target elderly users for the usability test and user experience of the rollators, the interactive behavior and subjective experience results of the elderly in the process of using the product were collected and analyzed, based on which the elderly-oriented assessment of the product was studied effectively. Meanwhile the typical problems during the interaction were recorded and analyzed, based on which the optimization suggestions for the ergonomic design of the rollator category were suggested. The current research plays an important role in promoting the improvement of the quality of pension products and the optimization of service standards, which can effectively protect the personal health and safety of the elderly using pension products.

Xiaoli Fan, Hua Guo, Feng Wu

Conference Proceedings

Cool Guy's Adventure: A Sensory Integration Game Designed for Children with Attention Deficit Hyperactivity Disorder (ADHD)

This paper offers an interactive scenario of Cool Guy's Adventure for children with Attention Deficit Hyperactivity Disorder (ADHD) based on sensory integration (SIT). We present a design framework that allows occupational therapists to arrange and combine game units and difficulty levels. ADHD is one of the most common neurodevelopmental disorders of childhood. Many studies have utilized HCI technology to assist and treat patients with various mental conditions, helping them lead healthier lives. However, there has been limited attention given to the development of HCI technologies to support children with ADHD. The game was developed using the Unity3D game engine and Microsoft Kinect®, each game design focuses on sensory integration training and enhances the child's intrinsic motivation: Throw the perfect ball, Play hopscotch, and Capture treasure. We present assessments and results after testing a sample of children (n=4), aged 8, with or without ADHD.■ References[1]Fage C., Pommereau L., Consel C., Balland E. and Sauzéon H. 2014. The 16th International ACM SIGACCESS Conference on Computers and Accessibility Tablet-based Activity Schedule for Children with Autism in Mainstream Environment. Rochester, USA, 145-152. DOI: https://doi.org/10.1145/2858036.2858245[2]Sonne T. and Jensen M. M. 2016. Evaluating the ChillFish Biofeedback Game with Children with ADHD. In Proceedings of the 2016 ACM Interaction Design and Children (IDC), Manchester, United Kingdom, 529-534. DOI: https://doi.org/10.1145/2930674.2935981[3]American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders. Fifth edition: DSM-5, Washington, p.991.[4]Liao M.-N. 2016. Co-creation - Exploration and Research on The Joint Decision-making Mode of Interdisciplinary Cooperation. Master’s thesis. National Yunlin University of Science and Technology.

Yi Sin Wu, Chun Yen Chen, Chang Teng-, Yee Pay Wuang

Conference Proceedings

Design Strategies of Outdoor Fitness Equipment for Elderly Community Based on KJ Method and KANO

The global aging phenomenon is becoming increasingly serious, as is the case in China. In order to enable the elderly to have better physical fitness, daily outdoor fitness activities are essential. However, the current outdoor fitness equipment in the communities has some problems, which cannot provide support for the fitness of the elderly and may even pose potential safety hazards. The subjects of this study are elderly people with outdoor activities abilities. Older adults often turn to fitness equipment within their closer community as their first choice for fitness. The specific research process is as follows: firstly, information on outdoor fitness behaviors and the environment of the elderly in the community were collected through non-structured observations, user interviews, and questionnaires. The researchers used the KJ method to sum up and summarize the behavioral habits of outdoor community elderly fitness equipment, personalized needs and opinions on existing products, and sorted out the data on users' cognition, tendencies, behavioral styles and needs. They also segment the raw demand data into five types: appearance demand, functional demand, ease-of-use demand, psychological demand, and safety demand. Secondly, encode and integrate the raw demand categories and product functions according to each original category. Next, design a questionnaire using the KANO model to survey the 2nd Level functional indicators based on the original requirements and product features. The satisfaction levels were categorized as Expectation, supposed to be so, dispensable, reluctant acceptance, and dissatisfaction. The main target of the questionnaire survey was the elderly group over 60 years old who use outdoor fitness equipment for exercise in the community, and the sample size was 120. We conduct a questionnaire survey of the target users, collate the data information obtained from the research, and the original demand data of the target users for both positive and negative aspects of the level 2 functional indicators. After obtaining the user demand degree data, the raw data needs to be processed using the KANO model to obtain the demand type of each function and calculate its demand degree index. User evaluation can be classified into six functional attributes based on the KANO model: Must-have demand indicator (M), Expected demand indicator (O), Excited demand indicator (A), Undifferentiated demand indicator (I), Reversed demand indicator (R), and Questionable demand indicator (Q). After obtaining the basic functional priorities, and then the satisfaction index formula is used to calculate the satisfaction and dissatisfaction coefficients for each demand indicator. The formula is: Satisfaction coefficient = (A+O)/(A+O+M+I),Dissatisfaction coefficient = [(O+M)/(A+O+M+I)] × -1.Finally, the results of the calculation are introduced into the design of community outdoor fitness equipment, and the function modules with higher demand values are given priority in the design to obtain community outdoor fitness equipment that meets the use of the elderly.This study aimed to assess the needs of the elderly community and their satisfaction with outdoor fitness equipment. Based on the findings, suitable equipment was designed to improve their physical fitness.

Li Xu, Ao Yu, Yuquan Zhou, Xiaoxuan Jiang

Conference Proceedings

Unveiling the Future Design of Health Management Systems: An Exploratory Study on Older Adults’ Perceived Usefulness of Functional Modules

Degradation of physical functions with aging contributes to multiple chronic diseases among older adults. In the era of global aging, older adults’ health management has brought considerable challenges to the economy, health system, and society due to the giant care burden and complex care requirements. Advanced technology (e.g., sensors, computing) prompted diverse digital health management systems, allowing stakeholders to monitor, evaluate, treat, and manage older adults’ health status. Despite these systems’ great efficiency and convenience, older adults’ attitudes toward the usefulness of functional modules in expanding health knowledge and enhancing health management remain uncertain. This study explored older adults’ perceived usefulness of five functional modules in health management systems: education, evaluation, tailored profiles, monitoring, and telemedicine modules. The results will provide valuable insights for designing future health management products. Participants were recruited through a convenience sampling method on a professional Web-based survey platform. The questionnaire included demographic information and participants’ perceived usefulness of the five functional modules in expanding health knowledge and enhancing health management. Friedman’s tests were conducted to compare older adults’ perceptions of the five functional modules, and ordinal logistic regressions were performed to assess the effects of demographics on perceived usefulness. A total of 109 valid responses were included in the data analysis (76 males and 33 females; mean age = 64.5±4.5 years). The results showed significant differences in older adults’ perceptions of the usefulness of five functional modules in enhancing health management (𝝌2 = 21.646, p < 0.001). Older adults believed the evaluation module was significantly more useful than the monitoring module in enhancing health management (p = 0.036); however, no significant differences existed in the perceived usefulness of expanded health knowledge (𝝌2 = 4.966, p = 0.291) among five modules. The results of ordinal logistic regressions showed that individuals living in care institutions were more likely to believe that the evaluation module was useful in enhancing health management than those living with relatives (OR= 333.33, 𝝌2 = 7.31, p = 0.01). Older adults without a fall history were more convinced that a monitoring module could contribute to health management than those with a fall history (OR= 4.92, 𝝌2 = 4.00, p = 0.04). Older adults had positive attitudes toward the usefulness of functional modules in expanding health knowledge and enhancing health management. The adoption of age-friendly design strategies in health management systems is recommended to promote individuals’ use of healthcare products and improve their well-being in the long term.

Qian Mao, Zhen Zhao, Lisha Yu, Hailiang Wang

Conference Proceedings

Analysis of environmental and human factors of attention deficit in special-needs students using eye-tracking technology.

The visual and auditory attention of students with disabilities is fundamental to their progress at school. However, intellectual disability and neurodevelopmental disorders can lead to deficits in visual and auditory attention, and thus hinder the acquisition of new skills. As a result, the pupils concerned may find it difficult to inhibit certain information, to process others, or to make the link between information received and a response to be given. Assessing students' attention is therefore a key issue for specialist teachers. There are many factors that can affect attention, including motivation, fatigue and executive control deficits, as well as sensory factors arising from the external environment and teacher support. However, it can be complex to observe and assess environmental distractors in a specialized classroom setting. Indeed, traditional observation methods can be subjective and observer-biased. In response, eye-tracking is an infrared measurement of the participant's gaze. This allows us to capture eye trajectories, saccades and visual fixation times. However, the most commonly used eye-tracking techniques tend to assess gaze towards a fixed screen. As a result, they are unable to track gaze in a moving environment. Dynamic eye-tracking, using an on-board eyewear device, can track users' eye trajectories and visual hold. In this way, it can take into account the user's evolution in a given environment, in relation to a group of individuals. Method - The study presented consisted in assessing the ocular patterns (maintains and pursuits) of 17 students with disabilities, using an eye-tracking goggle device. With two 10-minute sessions of learning context, the eye-tracking data collected were viewed and analyzed with the teachers. An evaluation grid was drawn up based on the following criteria: Elements observed, eye-hold time by type of element, number of occurrences of eye contact, number of eye saccades, length of eye saccades, student and teacher behaviors during the session. After using a psychometric tool to assess participants' visual and auditory attention levels (cognitive inhibition, information processing time, working memory), observation and analysis of visual patterns enabled us to assess the factors that can facilitate or disrupt visual attention. Results - First and foremost, the results highlighted the decisive influence of the physical organization of spaces. Indeed, while small spaces grouping individuals together encourage interaction between them, for some students they appear to be detrimental to maintaining attention. On the other hand, they can generate regulatory strategies in other students, through positive peer imitation. Secondly, teachers' attitudes play a decisive role in students' visual attention. Indeed, the teacher's distance from and presence with the pupil is a factor in maintaining attention. Verbal prompts and visual aids also play a decisive role in the teacher's pedagogy. Finally, the support of a digital medium constitutes an attentional attractor that can isolate the student and make him inattentive to his social environment, thus interfering with the processing of information from the teacher. Discussion - The present study fulfils two objectives. Firstly, it enables us to assess the benefits of eye-tracking with on-board goggles in analyzing the behavior and abilities of special-needs pupils. Its use could then be extended to other educational systems. Secondly, the study reveals the influence of the physical layout of the environment and the teacher on the regulation of visual attention in special-needs pupils. It would be useful to use eye-tracking to better evaluate teaching methods, the layout of materials and pedagogical support. It would therefore be necessary to replicate this study on larger samples.

Armand Manukyan, Jérôme Dinet

Conference Proceedings