Managing technology in everyday activities. A study of older adults with dementia, MCI, and no cognitive impairment

The general aim of this thesis was to generate new knowledge of the ability to manage technology in everyday life activities among older adults with or without cognitive impairment, how this ability can be assessed, and how knowledge of this can be translated into healthcare practice. In Study I the psychometric properties of the Management of Everyday Technology Assessment (META) were investigated using a Rasch rating scale model. The META is used to assess the ability to manage everyday technology (ET) in older adults with and without cognitive impairment. In Study II the ability to manage ET, assessed with the META, was compared among three groups of older adults using ANCOVA. The groups included persons with mild Alzheimer’s disease (AD), mild cognitive impairment (MCI), and no known cognitive impairment. Furthermore, in Study III, aspects that could influence the ability to manage ET in a sample of older adults with or without cognitive impairment were investigated using ANOVA. In Study IV, the applicability of a model with the intention to support healthcare professionals to advice and support technology use among older adults with dementia was investigated using a qualitative, constant comparative approach. The model included a one-day course, clinical tools, and interviews (focus group discussions and individual telephone interviews) during and after a period of clinical tryout. The findings in Study I indicated that the META demonstrated acceptable person response validity and ET goodness-of-fit. The META could separate individuals with higher ability from individuals with lower ability to manage ET. Study II showed significant differences in ability to manage ET between all three groups. Persons with mild AD demonstrated the lowest ability, followed by persons with MCI and older adults with no known cognitive impairment. However, there were overlaps between the groups in ability to manage ET. In Study III three aspects that significantly influenced the ability to manage ET were found: variation in the intrapersonal capacities, central tendency in the environmental characteristics, and the diagnostic group. Study IV revealed that the healthcare professionals had had more focus on assistive technology than on ET. The model gave them an eye- opening experience of ET use among persons with dementia. They also described how they had incorporated the knowledge and tools in the model as a new way of thinking to support and inspire new investigations and to support collaboration. The model seemed to be an applicable way to translate knowledge produced in research into utilization in clinical practice. This thesis contributed new knowledge about the ability to manage ET in older adults, particularly those with mild AD or MCI. The thesis also contributed important knowledge about aspects that influence the ability to manage ET, and this may have consequences for assessments and support of the ability to manage ET. Additionally, the findings indicated that the META is an assessment that generates valid measures of the ability to manage ET. The detailed information of the ability to manage ET gained from the META may be applied by researchers and clinicians. The thesis provided an applicable model of how research knowledge about technology use among older adults can be translated into clinical practice, and how this model can be used by healthcare professionals to support the ability to use ET for persons with dementia

The association between perceived and observed ability to use everyday technology in working age people with ABI

Everyday technology (ET), including computers and automated telephone services, is increasingly required for everyday functioning. However, people with acquired brain injury (ABI) may have difficulty with ET use. To design interventions to support ET use, further knowledge of how to assess dimensions of such use is needed. This study investigated the relationship between the perceived difficulty of ET use (self-reported using the Short version of the Everyday Technology Use Questionnaire, S-ETUQ) and observed ability to use ET (observed using the Management of Everyday Technology Assessment, META) in a sample of people with ABI (n=81). Data were analysed using a Rasch measurement model, and person measures of perceived difficulty and observed ability to use ET were identified and correlated. The person measures had a correlation of .49 (p ˂.001). In groups of different severity levels after ABI, significant associations were found in the moderate (.36) and severe (.47) disability groups. In the good recovery group, only a non-significant correlation was found (.21). This indicates that the S-ETUQ and the META measures different but complementary dimensions of ET use. Hence, the assessments are proposed to be used together in clinical practice to more fully understand the ability of people with ABI to use ET.Promobilia FoundationStrategic Research Health Care Programme of Umeå UniversityLuleå University of TechnologyAccepte

The match between everyday technology in public space and the ability of working-aged people with ABI to use it.

Introduction: In today’s society, the access to and use of everyday technology (ET), such as cell phones and Internet-based services, can be claimed as conditions for participation in many tasks in everyday life. This study aims to determine and compare levels of perceived access to and perceived difficulties in the use of common ETs in the public space among people with acquired brain injury (ABI) compared with controls. Methods: The perceived access to and difficulty in the use of 14 ETs were investigated in a sample with ABI (n=59, returned to work (RTW, n=28)/not returned to work (NRTW, n =31) and matched controls (n=52) using the Everyday Technology Use Questionnaire. Findings: Perceived access to the ETs was generally high. The potential to use each of the ETs independently or with minor difficulties significantly differed between controls and persons with ABI in eight of the fourteen ETs. Particularly, difficulties were found among those with ABI-NRTW. Conclusion: People with ABI perceive access to ETs commonly used in public space, but the ET difficulty is not always satisfactory matched to their ability to use ET. To enable participation in society, it is important to consider both the accessibility and usability of ET.Luleå University of TechnologyPromobilia FoundationStrategic Research Health Care Programme of Umeå UniversityManuscrip

Using a screening tool to evaluate potential use of e-health services for older people with and without cognitive impairment

Objectives: E-health services are increasingly offered to provide clients with information and a link to healthcare services. The aim of this study is to investigate the perceived access to and the potential to use technologies important for e-health services among older adults with MCI or mild AD and controls. Method: The perceived access to and perception of difficulty in the use of everyday technology (such as cell phones, coffee machines, computers) was investigated in a sample of older adults (n=118) comprising three subsamples: adults with mild cognitive impairment (MCI) (n=37), with mild Alzheimer’s disease (AD) (n=37) and controls (n=44) using the Everyday Technology Use Questionnaire (ETUQ). The use of seven technologies important for e-health services was specifically examined for each subsample and compared between the subsamples. Results: The findings demonstrated that the older adults in all subsamples both perceive access to e-health technologies and potentially would use them competently in several e-health services. However, among persons with AD a lower proportion of perceived access to the technology was described, as well as for persons with MCI. Conclusion: To make the benefits of e-health services available and used by all clients, it is important to consider access to the technology required in e-health services and also to support the clients’ capabilities to understand and use the technologies. Also, the potential use of the ETUQ to explore the perceived access to and competence in using e-health technologies is a vital issue in the use of e-health services.Swedish Brain PowerThe regional agreement on medical training and clinical research between the Stockholm County Council and the Karolinska InstitutetStrategic Research Programme in Care SciencesAccepte

Psychometric evaluation of a new assessment of the ability to manage technology in everyday life

Technology increasingly influences the everyday lives of most people, and the ability to manage technology can be seen as a prerequisite for participation in everyday occupations. However, knowledge about ability and skills required for management of technology is sparse. This study aimed to validate a new observation-based assessment, the Management of Everyday Technology Assessment (META). The META is developed to assess the ability to manage technology in everyday life. A sample of 116 older adults with and without cognitive impairment were observed and interviewed by the use of the META when managing their everyday technology at home. The results indicate that the META demonstrates acceptable person response validity and technology goodness-of-fit. Additionally, the META can separate individuals with higher ability from individuals with lower ability to manage everyday technology. The META can be seen as a complement to existing ADL assessment techniques and is planned to be used both in research and practice.NoneAccepte

An approach to facilitate healthcare professionals' readiness to support technology use in everyday life for persons with dementia

Everyday technologies (ETs) like microwave ovens and automatic telephone services as well as assistive technologies (ATs) are often used in the performance of everyday activities. As a consequence, the ability to manage technology is important. This pilot study aimed to clarify the applicability of a model for knowledge translation to support healthcare professionals, to support technology use among older adults with dementia and their significant others. An additional aim was to explore the process of translating the model into practice. The applicability of the model (comprising a one-day course, including introduction and provision of tools, followed by interviews during and after a period of practice) was clarified for 11 healthcare professionals using a constant comparative approach. The content of the model gave the participants an eye-opening experience of technology use among persons with dementia. They also described how they had incorporated the model as a new way of thinking which supported and inspired new investigations and collaborations with colleagues and significant others. This study provided an applicable model of how research knowledge about technology use can be translated into clinical practice and be used by healthcare professionals to support the use of technology for persons with dementia.Health Care Sciences Postgraduate SchoolSwedish Institute of Assistive TechnologySwedish BrainpowerThe Swedish Council for Working Life and Social Research (FAS)The regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska InstitutetAccepte

Ability to manage everyday technology : a comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment

Purpose: The ability to manage technology is important for performance and participation in everyday activities. This study compares the management of technology in everyday activities among people with mild-stage dementia or MCI with older adults without known cognitive impairment (OA). Method: Persons with mild-stage dementia (n=38), MCI (n=34) and OA (n=45) were observed and interviewed when managing their everyday technology at home by using the Management of Everyday Technology Assessment (META). A computer application of a Rasch measurement model was used to generate measures of participants’ ability to manage technology. These measures were compared group-wise with ANCOVA. Results: The management of everyday technology was significantly more challenging for the samples with mild-stage AD or MCI compared to the OA sample (AD – OA, p<0.001; d=1.87, MCI – OA, p<0.001; d=0.66 ). The sample with MCI demonstrated a significantly higher ability to manage technology than the sample with mild-stage AD (AD – MCI, p<0.001; d=1.23). However, there were overlaps between the groups and decreased ability appeared in all groups. Conclusions: Persons with cognitive impairment are likely to have decreased ability to manage everyday technology. Since their decreased ability can have disabling consequences, ability to manage technology is important to consider when assessing ability to perform everyday activities.Health Care Sciences Postgraduate SchoolBotkyrka communitySwedish BrainpowerThe regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and the Karolinska Institutet.Accepte

Everyday technologies' levels of difficulty when used by older adults with and without cognitive impairment : comparison of self-perceived versus observed difficulty estimates

BACKGROUND: Older adults may have difficulties in using everyday technologies, ET, e.g. micros, computers, particularly those with cognitive impairment. To guide supportive interventions, more knowledge of how to best assess ET use is needed. OBJECTIVE: To provide new knowledge of perceived and observed levels of difficulty of ETs in older adults with and without cognitive impairment. METHODS: Two samples of older adults (n=118 and 116) with and without cognitive impairment were assessed. One was interviewed with the Everyday Technology Use Questionnaire (ETUQ) about perceived difficulties in ET use. The other sample’s observed ability to manage ET was assessed with the Management of Everyday Technology (META). Data was analyzed using a Rasch measurement model and rank-ordered hierarchies of perceived and observed levels of ET difficulty were identified, correlated and examined. RESULTS: Findings demonstrated a correlation of 0.63 (p ˂.001). The upper range of both hierarchies contained more complex ETs like cell phones and computers while the lower comprised more home maintenance ETs. CONCLUSIONS: Perceived and observed levels of ET difficulty appear as similar, yet not identical constructs. In self-reports, though, ETUQ to a great extent seems to capture levels of ET difficulty. However, in clinical practice observations of actions may guide interventions, as they can identify why an ET is difficultSwedish Research CouncilSwedish Brain PowerBotkyrka CommunityThe regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska InstitutetAccepte

Comparação de metodologias na determinação da flexibilidade em jovens do sexo feminino

Orientador: Sérgio Gregório da SilvaMonografia (licenciatura) - Universidade Federal do Paraná. Setor de Ciências Biológicas. Curso de Educação Físic

Individual variability and environmental characteristics influence older adults’ abilities to manage everyday technology

Background: The ability to manage everyday technology (ET) such as computers and microwave ovens is increasingly required in the performance of everyday activities and participation in society. This study aimed to identify aspects that influence the ability to manage ET among older adults with and without cognitive impairment. Methods: Older adults with mild Alzheimer’s disease and mild cognitive impairment and without known cognitive impairment were assessed as they managed their ET at home. Data was collected with the Management of Everyday Technology Assessment (META). Rasch-based measures of the person’s ability to manage ET were analyzed. These measures were used as dependent variables in backward procedure ANOVA analyses. Different pre-defined aspects that could influence the ability to manage ET were used as independent variables. Results: Three aspects had a significant effect upon the ability to manage ET. These were: (1) variability in intrapersonal capacities (such as “the capacity to pay attention and focus”, (2) environmental characteristics (such as “the impact of the design”) and (3) diagnostic group. Conclusions: Variability in intrapersonal capacities seems to be of more importance than the actual level of intrapersonal capacity in relation to the ability to manage ET for this sample. This implies that investigations of ability to manage ET should also include intra-person variability. Additionally, adaptations in environmental characteristics could simplify the management of ET to support older adults as technology users.Health Care Sciences Postgraduate SchoolSwedish BrainpowerBotkyrka municipalityThe Swedish Council for Working Life and Social Research (FAS)The regional agreement on medical training and clinical research (ALF) between the Stockholm County Council and Karolinska InstitutetAccepte