Humanoid robots for assisting people with physical disabilities in activities of daily living: a scoping review.

The aim of this scoping review was to gather, summarize, and map the knowledge of peoples' experiences on humanoid robots, capable of assisting people with activities of daily living. The review was guided by the framework of Joanna Briggs Institute and PRISMA-ScR. We found 44 papers describing nine robots that could assist with a variety of tasks listed in the International Classification of Functioning, Disability, and Health. The mixed population experienced little or no anxiety toward the robots, and most accepted the robots' ability to monitor for safety reasons. Some participants disliked the robots' large size and slow movements. Most of the participants found the robots easy to use. They wanted improvements in the robots' functionality and the ability to personalize services. Several of the participants found the services interesting and useful, but not for themselves. The experiences of humanoid robotic assistance showed an insufficient level of technical readiness for assisting in physical assistance, a lack of personalization and readiness for use in home settings. The practical relevance of these findings lies in guiding future research and development toward a more individualized approach focusing on user needs and experiences to enhance the efficacy and integration of humanoid robots in health-care.

Care-receivers with physical disabilities' perceptions on having humanoid assistive robots as assistants: a qualitative study.

BACKGROUND: People with physical disabilities due to disease or injury face barriers to their daily activities and participation in society. Many depend on formal or informal caregivers for assistance to live independently. However, future healthcare challenges due to demographic changes threaten access to home care and assistants. Assistive technologies, such as robots for physical assistance, can support the independence and autonomy of people with physical disabilities. This study explore Norwegian care-receivers' perceptions of using robot assistance in their homes, including preferences for tasks acceptable or unacceptable for robot assistance and the underlying reasons. METHOD: Purposive sampling was employed to recruit 18 participants, aged between 18 and 77 years, with differences in physical function including diagnoses such as stroke, spinal cord injury, amputations, and muscular dystrophy. Qualitative data were gathered through four focus group interviews wherein participants watched videos featuring a humanoid assistive robot, EVEr3. The collected data underwent analysis using reflexive thematic analysis. RESULTS: Three themes with associated sub-themes were constructed: (a) How a robot could assist in daily life, (b) The robot's appearance and functionality, and (c) Concerns about having a robot as an assistant. The participants welcomed the idea of a future robotic assistant in areas that may contribute to an increased feeling of independence and autonomy. CONCLUSION: A robot assisting in activities of daily living would need to be individually customized to meet the needs of each user in terms of which tasks to assist with, how to assist in these defined tasks, and how it is controlled.

Patients' perceptions of use, needs, and preferences related to a telemedicine solution for HIV care in a Norwegian outpatient clinic: a qualitative study.

BACKGROUND: Telemedicine in outpatient services for people living with human immunodeficiency virus (PLHIV) was scaled up during the COVID-19 pandemic as services transitioned to remote care. Many studies have reported on the challenges and advantages of telemedicine care during the pandemic. However, there is limited research on the provision of telemedicine human immunodeficiency virus (HIV) care beyond the COVID-19 pandemic, which entails different telemedicine components and focuses on ways to improve the telemedicine experience for patients. This study aimed to explore PLHIV's perceptions of use, needs, and preferences related to a telemedicine solution for HIV care in an outpatient clinic in Norway. The telemedicine solution included a pre-consultation questionnaire, asynchronous digital messages, and video consultation. METHODS: Qualitative interviews were conducted with 12 PLHIV. The interviews were analysed using thematic analysis. RESULTS: We identified four main themes that covered the participants' perceptions, needs, and preferences: (1) perceived usability, (2) maintaining confidentiality, (3) accommodating personal preferences, and (4) perceived usefulness. Some participants had difficulty logging into the telemedicine solution. Other participants suggested additional functionalities, such as picture sharing and access to test result. Telemedicine care enabled the avoidance of stigmatising clinic experiences, although a few participants reported concerns about confidentiality and data security. Accommodating personal preferences and needs in terms of the type of consultations (in-person or video) and frequency of visits was essential to the participants. With telemedicine care, participants felt more in control of their own lives, perceiving that it increased their perceived quality of life and saved them both time and money for travelling to the clinic. CONCLUSIONS: Our study identified several specific needs and preferences related to the assessed technical solution and the provision of current and future telemedicine care services. Nevertheless, the telemedicine solution was perceived as a usable, flexible, and person-centred approach to HIV care, contributing to accommodating the participants' personal preferences. However, healthcare professionals need to ensure that individual requirements and preferences are consistent with evidence-based follow-up and supported by person-centred care. Thus, the practice of shared decision making is important in telemedicine care.

User evaluation of a therapist-guided internet-delivered treatment program for anxiety disorders: A qualitative study.

Therapist-guided internet-based cognitive behaviour therapy (ICBT) has been proposed as a potential means to increase individuals' access to quality mental health care and effective treatment. Guided ICBT aims to increase a patient's knowledge and competence to better cope with their disorder. Despite the growing evidence supporting the effects of guided ICBT, there is remarkably little research on the different factors that are important for patients to achieve effects from using such digital treatment interventions. Thus, the aim of this study was to conduct a user evaluation of a therapist-guided ICBT program using the updated DeLone and McLean (D&M) model for measuring information systems (IS) success or effectiveness. This model includes the following six dimensions: system quality, information quality, service quality, intention to use and use, user satisfaction, and net benefits (impacts or effect). Ten users of a Norwegian therapist-guided ICBT program for treating anxiety disorders named 'Assisted Self-Help' (Assistert Selvhjelp) participated in phone-based individual interviews. Data were analysed using directed content analysis. Results showed that the participants were quite satisfied with the program's system quality and information quality. However, participants suggested improvements, including in-program instruction, improved visibility of system status, more flexibility regarding automated measurement surveys, and the inclusion of more videos with patient stories. Further, the results indicated a need for improvement in the service quality of guided ICBT introduction, instruction, follow-up, guidance, and support from therapists. The results showed that user friendliness and high educational content might not be sufficient for a therapist-guided ICBT program to be perceived as effective. It might also be necessary for therapists to provide follow-up, guidance, and support that are more in line with individual patient needs. Thus, the results suggest that guided ICBT requires active participation from all involved in the process, including the therapist.

Nursing students' perceptions of combining hands-on simulation with simulated patients and a serious game in preparing for clinical placement in home healthcare: A qualitative study.

BACKGROUND: There is a growing demand to provide complex healthcare services in patients' own homes. However, high quality home healthcare clinical placements are often difficult to obtain, and arranging laboratory-based simulations to provide relevant clinical-practical learning experiences for all students is resource intensive. OBJECTIVES: The aim of this study was to explore nursing students' perceptions of using a blended simulation approach, including hands-on simulation with simulated patients and a video-based serious game, in preparation for their home healthcare clinical placements. DESIGN: An exploratory qualitative design using focus group interviews was utilized. SETTING AND PARTICIPANTS: Second- and third-year nursing students in home healthcare courses in Norway participated in this study. METHODS: Five focus group interviews were conducted with a total of 26 nursing students. Data were collected over two semesters in three home healthcare courses. The data were analyzed using thematic content analysis. RESULTS: The study identified four main themes that influenced students' perceptions of combining the two simulations. These included personal engagement, contextual and environmental factors, a safe and structured learning environment, as well as organizational and technical factors. In relation to the different themes, students expressed that disadvantages in one simulation were counteracted in the other. CONCLUSIONS: The blended simulation approach was perceived to address curricular objectives in different but complementary ways. The blended simulation approach was perceived to facilitate personal engagement and reflections and to provide relevant clinical-practical learning experiences. However, results also indicated that the organization of such a blended simulation approach (i.e., group compositions and size), facilitation from teachers, and technical issues (i.e., with medical equipment and the serious game) may influence students' perceptions and satisfaction directly. The results should provide useful information for designing future teaching strategies in Bachelor of Nursing programs.

Nursing students' perceptions of a video-based serious game's educational value: A pilot study.

BACKGROUND: Despite an increasing number of serious games (SGs) in nursing education, few evaluation studies specifically address their educational value in terms of face, content, and construct validity. OBJECTIVES: To assess nursing students' perceptions of a video-based SG in terms of face, content, and construct validity. In addition, the study assessed perceptions of usability, individual factors, and preferences regarding future use. DESIGN: A pilot study was conducted. SETTING AND PARTICIPANTS: An SG prototype was implemented as part of two simulation courses in nursing education: one for home health care and one for hospital medical-surgical wards. The SG aimed to teach clinical reasoning and decision-making skills to nursing students caring for patients with chronic obstructive pulmonary disease. A total of 249second-year nursing students participated in pilot testing of the SG. METHOD: A paper-based survey was used to assess students' perceptions of the SG's educational value. RESULTS: Overall, students from both simulation courses perceived the SG as educationally valuable and easy to use. No significant differences were found in perceptions of educational value between nursing students with previous healthcare experience versus those with none. However, significantly more students in the home healthcare simulation course indicated that the SG tested their clinical reasoning and decision-making skills. Students from both the medical-surgical and home healthcare simulation courses suggested that more video-based SGs should be developed and used in nursing education. CONCLUSIONS: Overall, the survey results indicate that the participants perceived the SG as educationally valuable, and that the SG has potential as an educational tool in nursing education, especially in caring for patients with chronic diseases and in home healthcare simulation. Showing a SG's educational value and user acceptance among nursing students may justify the development and application of more SGs in nursing education.

Developing a Serious Game for Nurse Education.

Future nursing education is challenged to develop innovative and effective programs that align with current changes in health care and to educate nurses with a high level of clinical reasoning skills, evidence-based knowledge, and professional autonomy. Serious games (SGs) are computer-based simulations that combine knowledge and skills development with video game-playing aspects to enable active, experiential, situated, and problem-based learning. In a PhD project, a video-based SG was developed to teach nursing students nursing care for patients with chronic obstructive pulmonary disease in home health care and hospital settings. The current article summarizes the process of the SG development and evaluation. [Journal of Gerontological Nursing, 44(1), 15-19.].

Teaching clinical reasoning and decision-making skills to nursing students: Design, development, and usability evaluation of a serious game.

BACKGROUND: Serious games (SGs) are a type of simulation technology that may provide nursing students with the opportunity to practice their clinical reasoning and decision-making skills in a safe and authentic environment. Despite the growing number of SGs developed for healthcare professionals, few SGs are video based or address the domain of home health care. AIMS: This paper aims to describe the design, development, and usability evaluation of a video based SG for teaching clinical reasoning and decision-making skills to nursing students who care for patients with chronic obstructive pulmonary disease (COPD) in home healthcare settings. METHODS: A prototype SG was developed. A unified framework of usability called TURF (Task, User, Representation, and Function) and SG theory were employed to ensure a user-centered design. The educational content was based on the clinical decision-making model, Bloom's taxonomy, and a Bachelor of Nursing curriculum. A purposeful sample of six participants evaluated the SG prototype in a usability laboratory. Cognitive walkthrough evaluations, a questionnaire, and individual interviews were used for the usability evaluation. The data were analyzed using qualitative deductive content analysis based on the TURF framework elements and related usability heuristics. RESULTS: The SG was perceived as being realistic, clinically relevant, and at an adequate level of complexity for the intended users. Usability issues regarding functionality and the user-computer interface design were identified. However, the SG was perceived as being easy to learn, and participants suggested that the SG could serve as a supplement to traditional training in laboratory and clinical settings. CONCLUSIONS: Using video based scenarios with an authentic COPD patient and a home healthcare registered nurse as actors contributed to increased realism. Using different theoretical approaches in the SG design was considered an advantage of the design process. The SG was perceived as being useful, usable, and satisfying. The achievement of the desired functionality and the minimization of user-computer interface issues emphasize the importance of conducting a usability evaluation during the SG development process.

A Serious Game for Teaching Nursing Students Clinical Reasoning and Decision-Making Skills.

The aim of this study was to design and pilot-test a serious game for teaching nursing students clinical reasoning and decision-making skills in caring for patients with chronic obstructive pulmonary disease. A video-based serious game prototype was developed. A purposeful sample of six participants tested and evaluated the prototype. Usability issues were identified regarding functionality and user-computer interface. However, overall the serious game was perceived to be useful, usable and likable to use.

Registered nurses' clinical reasoning in home healthcare clinical practice: A think-aloud study with protocol analysis.

BACKGROUND: The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. OBJECTIVES: The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. DESIGN: An exploratory qualitative think-aloud design with protocol analysis was used. SETTINGS: Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. PARTICIPANTS: A purposeful sample of eight registered nurses with one year of experience. METHODS: Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. RESULTS: Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. CONCLUSIONS: Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes.

Patient Satisfaction after Thoracoscopic Sympathectomy for Palmar Hyperhidrosis: Do Method and Level Matter?

CONTEXT: Although surgery is widely recognized as the best treatment for palmar hyperhidrosis (PH), the decision to perform a sympathicotomy, sympathectomy, or clipping of the thoracic sympathetic chain is based on surgeon preference. OBJECTIVE: We investigated the outcomes of patients who underwent surgical intervention for PH with regard to method used and level of sympathetic chain interrupted. DESIGN: This was a retrospective medical chart review. Patients who underwent thoracoscopic intervention for PH were mailed questionnaires regarding their presenting and postoperative symptoms and satisfaction 6 months to 15 years after their procedure. Analyses were performed to investigate whether the surgical method applied affected these outcomes. RESULTS: A total of 635 patients underwent bilateral thoracoscopic procedures for PH between April 1995 and February 2010, and 210 (33%) responded to the questionnaires. Sixteen surgeons performed 108 sympathicotomies, 83 sympathectomies, and 19 ligations with titanium clips for PH. Mean follow-up was 5.5 years. Overall palmar success was 85.4% and was not affected by the surgical method. The rate of compensatory hyperhidrosis was significantly lower if the operative level did not include the R2 ganglion (66.7% vs 80.6%, p = 0.028). Nevertheless, 76.2% of patients were satisfied with the results, and 85.7% would repeat the procedure if given the option to do it again. CONCLUSION: Most patients reported relief of their PH and were satisfied with surgical intervention, regardless of method used. Although postoperative compensatory hyperhidrosis was common, this did not appear to affect overall patient satisfaction. The inclusion of rib level 2 ganglion resulted in a significantly increased incidence of compensatory hyperhidrosis.

Cytomegalovirus enterocolitis presenting as abdominal compartment syndrome in a premature neonate.

BACKGROUND: Cytomegalovirus (CMV) enterocolitis is an uncommon intestinal disorder of newborns that is often initially misdiagnosed as necrotizing enterocolitis. METHODS: We treated a premature twin boy with CMV enterocolitis who presented with abdominal compartment syndrome requiring urgent decompression. All patients with neonatal CMV enterocolitis reported were reviewed. RESULTS: Nine previously reported patients with neonatal CMV enterocolitis presented with abdominal distention and signs of sepsis. At the time of surgery, either perforation or stricture was identified. The current report is the first to present with clinical signs of abdominal compartment syndrome. CONCLUSION: CMV is a rare cause of neonatal enterocolitis. Surgical intervention is required for bowel perforation, stricture, or abdominal compartment syndrome.