Usabilidad y experiencia de usuario de intervenciones psicosociales basadas en la TIC dirigidas a personas mayores con deterioro cognitivo: ehcoBUTLER y GRADIOR

Tesis por compendio de publicaciones.[ES] El incremento a nivel mundial de personas mayores y el riesgo de que desarrollen deterioro cognitivo leve (DCL) y luego demencia, requieren de intervenciones que prevengan la enfermedad y dependencia, o que les permitan permanecer activos a pesar de sus enfermedades o discapacidades. Los tratamientos no farmacológicos se destacan por no tener efectos secundarios y reducir la inversión en medicamentos e institucionalización. Dentro de estos, se encuentran las intervenciones psicosociales a las que se han incorporado las Tecnologías de la Información y la Comunicación (TIC) por promover su accesibilidad, eficacia, rentabilidad e innovación. En ese sentido, ehcoBUTLER y GRADIOR son dos intervenciones psicosociales basadas en las TIC, que se enfrentan al reto de estar adecuadamente adaptados a las personas mayores con deterioro cognitivo. Por lo que en esta tesis se propuso evaluar y explorar su usabilidad y experiencia de usuario (UX) en dicha población. Se comenzó por realizar una revisión sistemática con el fin de identificar las medidas e instrumentos para evaluar en adultos mayores con DCL o demencia la usabilidad y UX de intervenciones cognitivas basadas en las TIC, así como determinar las características y funciones de estas. De los 10 estudios seleccionados, se encontró que la eficiencia y eficacia fueron las medidas más utilizadas para recopilar datos objetivos de la usabilidad, mientras que los cuestionarios y escalas lo fueron para recabar la UX o datos subjetivos de la usabilidad. La mayoría eran programas de ordenador con ejercicios o juegos serios no solo cognitivos, sino también de otras áreas. Algunos estudios aclaraban que la pantalla era táctil. Se prosiguió con evaluar la usabilidad y UX de ehcoBUTLER mediante dos estudios. En el primero, se realizó una encuesta a 313 personas (35 usuarios finales, 80 cuidadores informales, 149 cuidadores formales y 49 personal de administración/gestión). Los participantes consideraron ehcoBUTLER principalmente interesante y útil. Además, tenían disposición a pagar por él, pero una tarifa baja o que fuera gratuito para los usuarios. En el segundo estudio, se llevaron a cabo grupos focales a 49 sujetos (13 con DCL, 13 con demencia leve, 12 cuidadores informales y 11 profesionales de la salud). Los participantes mostraron aceptabilidad hacia su apariencia y uso. No obstante, desearían recibir una formación previa, aplicaciones más intuitivas y personalizadas, contenidos offline/USB, añadir otras actividades y que fuera de bajo precio o gratuito para los usuarios. Los estudios anteriores también permitieron recabar información sobre GRADIOR, porque este conforma el módulo cognitivo de ehcoBUTLER. En ambas publicaciones los participantes mostraron aceptabilidad hacia GRADIOR por parecerles útil, pero por ser pensionistas no estaban dispuestas a pagar por él o lo harían si tuviera un costo pequeño. Por otro lado, dieron mayores puntuaciones positivas a otros módulos de ehcoBUTLER. Para continuar ampliando el conocimiento sobre la usabilidad y UX de GRADIOR, se comparó la percepción de 41 adultos mayores con DCL/demencia leve con la de 41 personas con esquizofrenia, porque estos también son un grupo significativo de usuarios con deterioro cognitivo y problemas de dependencia. Se utilizó el Cuestionario de Experiencia de Usuario para dicho fin. Los participantes valoraron positivamente GRADIOR en su impresión general, usabilidad y UX. Los adultos mayores con DCL/demencia presentaron mayores puntuaciones positivas que las personas con esquizofrenia. Ambos grupos coincidieron en dar puntuaciones más bajas en Controlabilidad. En conclusión, los resultados indican que ehcoBUTLER y GRADIOR están adecuadamente desarrollados y adaptados a las capacidades, necesidades y preferencias de los usuarios, aunque se necesita mejorar su usabilidad y UX. Aspectos clave para lograrlo son herramientas más intuitivas, multidominio y personalizadas según el tipo de usuario. Además, para implementarlos eficazmente se requiere superar la brecha de inversión. También se necesitan más estudios que incluyan a adultos mayores con DCL/demencia y a partes interesadas en la evaluación de la usabilidad y UX de intervenciones psicosociales basadas en las TIC, para adaptarlas apropiadamente en beneficio de todos. Los hallazgos encontrados pueden contribuir al desarrollo y mejora de otras intervenciones psicosociales basadas en las TIC para personas con deterioro cognitivo. Una adecuada usabilidad y positiva UX en dichas intervenciones promueve su aceptabilidad, adherencia y efectividad del tratamiento

Technologies for Cognitive Training and Cognitive Rehabilitation for People With Mild Cognitive Impairment and Dementia. A Systematic Review

[EN]Due to the growing number of older adults with cognitive impairment, it is essential to delay the onset and progression of cognitive decline and promote a healthy lifestyle. The rapid growth of technology has considerably advanced the field of computerized cognitive interventions. Consequently, traditional cognitive interventions are being adapted and new multimedia systems are being developed to encourage health and independent living in old age. The primary objective of this review was to identify cognitive stimulation, training and rehabilitation programs aimed at older people with mild cognitive impairment (MCI) and dementia. PsycINFO, Medline, CINAHL,Web of Science, PubMed, and CORDIS databases were searched from January 2008 to August 2018. Two researchers reviewed the potential studies individually for eligibility. Studies of computerized cognitive interventions for people with dementia and cognitive impairment were included if they clearly described objectives, users and functioning. A systematic review of the studies was carried out, providing a qualitative synthesis of the features and study characteristics of each software. Nineteen studies met the inclusion criteria, and 11 different cognitive stimulation, training, and rehabilitation programs were identified. The studies found on cognitive intervention software indicate the existence of various technological programs for people with MCI and dementia. On the overall, the programs were aimed at people with different clinical conditions, able to create specific treatments and personalized training, optimized for portable devices, and user-friendly. However, the selected programs differ from each other in terms of objectives, usage mode and characteristics, even if they were used for the same purposes. Therefore, the information obtained in the review may be relevant to distinguish between programs and select the one that best suits each user. Thus, more information about the features and context of use is needed as well as more clinical studies to be able to compare among computerized cognitive programs

A Qualitative Study of the Cognitive Rehabilitation Program GRADIOR for People with Cognitive Impairment: Outcomes of the Focus Group Methodology

[EN]In recent years, technology has been implemented in the field of interventions for older adults. GRADIOR 4.5 is a cognitive software within the wide variety of available multimedia programs that support healthcare professionals in cognitive assessment and neuropsychological rehabilitation. The study aimed to evaluate the new version of GRADIOR (v4.5) based on the experience of people with mild cognitive impairment (MCI), people with dementia (PWD), and healthcare professionals. A qualitative study using the focus group methodology was carried out involving 13 people with MCI, 13 PWD, and 11 healthcare professionals. An analysis of the content and the level of feedback was performed. The study showed that GRADIOR 4.5 might be sufficiently adapted to PWD and people with MCI. Participants were motivated to use GRADIOR 4.5, showed high acceptability of the software, and a positive attitude towards technology. However, healthcare professionals suggested significant improvements to the software. GRADIOR 4.5 appeared to be a promising intervention that, because of its positive experience and acceptability, could be systematically implemented to complement cognitive rehabilitation interventions for older adults with MCI and dementia. Finally, it is advisable to consider the suggestions gathered in this study for future developments

Study on the Acceptability of an ICT Platform for Older Adults with Mild Cognitive Impairment

EhcoBUTLER is an Information and Communication Technology (ICT) solution funded by the EuropeanUnion (H2020; ID: 643566)and intended especially for elderly people with mild cognitive impairment (MCI) to improve their health, independence and quality oflife, particularly at the social level. The purpose of this study is to assess the acceptability of ehcoBUTLER based on a survey deliveredto potential users and actors involved in their care, exploring theirexpectations and preferences, while anticipating the system'sfunctional requirements. The survey was delivered online to 313participants (11% end users, 25% informal caregivers, 48% formalcaregivers and 16% administration/management staff) from eight countries. Participants rated the different functionalities ofehcoBUTLER positively, 86.1% perceiving it as an interesting and useful system. Likewise, they assessed it as a commerciallyattractive product (75.1%). End users expressed a stronger preference for the social module. Nevertheless, they would be ready topay a low monthly price for ehcoBUTLER. Professionals would be willing to pay choosing its functionalities modularly, but theywould also expect it to be funded by the National Health System, centres or businesses. The conclusion is that all participants foundehcoBUTLER interesting, useful and ergonomic. However, to effectively implement it, it is necessary to bridge the digital gap andaddress the issue of insufficient investment in products aimed atolder adults with cognitive impairment. To supplement cognitivetraining systems with social, emotional or entertainment functionalities could improve adherence to their use

Perceptions of Older People with Cognitive Impairment, Caregivers, and Professionals about ehcoBUTLER (Tablet Health Care Platform): A Qualitative Focus Group Study

EhcoBUTLER is a tablet platform mainly aimed at the elderly with mild cognitive impairment (MCI) to promote their well-being and health. The main objective of this study was to explore the perceptions and feedback level of the ehcoBUTLER potential users and stakeholders to improve its development. Through this exploration, the secondary objective was to contribute to the development of software/apps that promote their integral health. Focus groups were conducted (13 elderly with MCI, 13 with dementia, 12 caregivers, 11 professionals). The content and feedback level were analyzed. Participants liked the appearance of ehcoBUTLER, would like to use it, and were mainly interested in the emotional, healthy lifestyle, cognitive, and ergonomic tools. It is necessary to have prior training, more intuitive/customizable apps, low-price/free, offline/USB content, and add other activities/features. EhcoBUTLER is well-oriented to meet the needs and preferences of potential users. However, improvements in its usability, accessibility, and sustainability are needed. The participants’ perspectives provided a comprehensive view to improve ehcoBUTLER, so that in the future, it can benefit the elderly to be active agents in their health; support caregivers in their role and to have a respite; and professionals to have a multi-intervention platform. The present findings can contribute to the development of tablet software/apps that promote the integral well-being of this population

A Qualitative Study of the Cognitive Rehabilitation Program GRADIOR for People with Cognitive Impairment: Outcomes of the Focus Group Methodology

In recent years, technology has been implemented in the field of interventions for older adults. GRADIOR 4.5 is a cognitive software within the wide variety of available multimedia programs that support healthcare professionals in cognitive assessment and neuropsychological rehabilitation. The study aimed to evaluate the new version of GRADIOR (v4.5) based on the experience of people with mild cognitive impairment (MCI), people with dementia (PWD), and healthcare professionals. A qualitative study using the focus group methodology was carried out involving 13 people with MCI, 13 PWD, and 11 healthcare professionals. An analysis of the content and the level of feedback was performed. The study showed that GRADIOR 4.5 might be sufficiently adapted to PWD and people with MCI. Participants were motivated to use GRADIOR 4.5, showed high acceptability of the software, and a positive attitude towards technology. However, healthcare professionals suggested significant improvements to the software. GRADIOR 4.5 appeared to be a promising intervention that, because of its positive experience and acceptability, could be systematically implemented to complement cognitive rehabilitation interventions for older adults with MCI and dementia. Finally, it is advisable to consider the suggestions gathered in this study for future developments