Experienced usability of assistive technology for cognitive support with respect to user goals.

BACKGROUND: Studies have shown that Assistive Technology (AT) for cognitive support can support users in everyday activities. However, whether the AT actually supports the user to achieve their individual goals must further be examined. OBJECTIVE: The study objective was to examine the experienced usability of features in AT for cognitive support for users with cognitive impairment. METHODS: A content analysis was applied on data from interviews and field notes collected during two six-month interventions in which persons with cognitive impairment tested AT for cognitive support. RESULTS: Features, included in the AT support that enhanced the user's sense of control, were identified as promotional for the achievement of user goals, and some features, such as reminders, were more sensitive to the specific user's perceptions and motives. Also, features related to how the AT was maintained and communicated with other technology were very influential. CONCLUSIONS: The results show that easily maintained AT that fits in to the context of use increases the user's sense of control of the AT and thereby promotes the goal achievement and usability of the AT. Further, the usability of the AT is very influenced by contextual factors such as the ordinary mobile network, the Internet, and the operators.

A walker used as a lifting device.

PURPOSE: To develop assistive technology that would help an older person to arise from a kneeling position to a standing one. METHODS: Developing a prototype, based on an inclusive design and then testing the prototype to verify the approach. The prototype was subsequently tested by a panel of 20 elderly users. These tests were observed and filmed. Participants' experiences of being lifted with the elevation seat were registered with the VIDAR ergonomic assessment system. RESULT: None of the 20 participants used a walker at that time. In response to a question of whether, assuming they might have to use a walker in the future, they thought that a walker with an elevating seat would be helpful, 18 said that it would. Two of the participants did not believe that they would ever have to use a walker. CONCLUSION: A simple assistive technology such as a walker equipped with an elevating seat would in many of these cases simplify matters and reduce the distress of people who fall often. In addition, such a device can allow people who fall often to live in their homes longer. For caregivers dealing frequently with people who fall, this assistive device can contribute to decreasing occupational injuries. IMPLICATIONS FOR REHABILITATION: Development of a lifting device that can help people raise themselves up entirely on their own, or with minimal assistance, would be a revolutionary step for the individual. Lifting devices in use today requires much more extensive assistance from home helpers or others and due to the risk of injuries it is a great value for the helpers that easy to use devices develops. A walker equipped with an elevating seat could even provide a potential for people to stay in their homes longer.

The effect of working position on trunk posture and exertion for routine nursing tasks: an experimental study.

OBJECTIVES: To examine the influence of the two following factors on the proportion of time that nurses spend in a forward-bending trunk posture: (i) the bed height during basic care activities at the bedside and (ii) the work method during basic care activities in the bathroom. A further aim was to examine the connection between the proportion of time spent in a forward-bending posture and the perceived exertion. METHODS: Twelve nurses in a geriatric nursing home each performed a standardized care routine at the bedside and in the bathroom. The CUELA (German abbreviation for 'computer-assisted recording and long-term analysis of musculoskeletal loads') measuring system was used to record all trunk inclinations. Each participant conducted three tests with the bed at different heights (knee height, thigh height, and hip height) and in the bathroom, three tests were performed with different work methods (standing, kneeling, and sitting). After each test, participants rated their perceived exertion on the 15-point Borg scale (6 = no exertion at all and 20 = exhaustion). RESULTS: If the bed was raised from knee to thigh level, the proportion of time spent in an upright position increased by 8.2% points. However, the effect was not significant (P = 0.193). Only when the bed was raised to hip height, there was a significant increase of 19.8% points (reference: thigh level; P = 0.003) and 28.0% points (reference: knee height; P < 0.001). Bathroom tests: compared with the standing work method, the kneeling and sitting work methods led to a significant increase in the proportion of time spent in an upright posture, by 19.4% points (P = 0.003) and 25.7% points (P < 0.001), respectively. The greater the proportion of time spent in an upright position, the lower the Borg rating (P < 0.001) awarded. CONCLUSIONS: The higher the proportion of time that nursing personnel work in an upright position, the less strenuous they perceive the work to be. Raising the bed to hip height and using a stool in the bathroom significantly increase the proportion of time that nursing personnel work in an upright position. Nursing staff can spend a considerably greater proportion of their time in an ergonomic posture if stools and height-adjustable beds are provided in healthcare institutions.

Fall scenarios In causing older women's hip fractures.

OBJECTIVE: Falls and fall-related injuries among older women constitute a major public health problem with huge costs for the society and personal suffering. The aim of this study was to describe and illustrate how a number of circumstances, conceptualized as a scenario, that were related to the individual, the environment, and the ongoing occupation contributed to a fall that led to a hip fracture among women. The sample included 48 women over 55 years old. METHODS: Interviews were conducted during home visits and the analysis provided a descriptive picture of circumstances in the shape of a scenario related to the risk of falling. A number of scenarios were developed based on the data and named to provide an understanding of the interplay between the individual, the environment, and the ongoing occupation at the time of the fall. RESULTS: By applying the concept of a scenario, occupational therapists can increase the awareness of fall risks among older people, and are relevant also for interior designers, architects, and town planners to consider when designing the local environment as well as furniture and other objects.

Frequent bending--an underestimated burden in nursing professions.

OBJECTIVES: The aim of the present study was to quantify the total duration per shift in which nurses work in a forward bending position over 20°. Furthermore, the influence of several factors on the occurrence of sagittal trunk inclinations in nurses was investigated. METHODS: Trunk postures were recorded for nine nursing home nurses from four German nursing homes and 18 hospital nurses from seven hospitals using the CUELA measurement system. A total of 79 shifts, 27 in nursing homes and 52 in hospitals, were analysed. All measurements were supported by video recordings. Specially developed software (WIDAAN 2.75) was used to synchronize the measurement data and video footage. RESULTS: The total duration of inclinations per shift was significantly affected by the working area (nursing home or hospital) with an increase of 25.3 min in nursing homes (95% confidence interval 2.4-48.2; P = 0.032). Another factor was the extent of personal basic care tasks performed by the nurses (P < 0.001). Nursing home nurses worked about twice as long per shift in a forward bending position compared with hospital nurses (112 versus 63 min; P < 0.001) and they assumed almost one-third more inclinations per shift (1541 versus 1170; P = 0.005). CONCLUSIONS: Nursing staff perform a large number of inclinations. The amount of time spent by nurses working in a forward bending position was highly dependent on the working area and the extent to which patients were in need of help. It is very likely that future preventive measures, focussing on reducing the huge amount of inclination, would reduce the physical stress in everyday nursing work substantially.

Measurement of stressful postures during daily activities: An observational study with older people.

This study measured the postures of older people during cooking and laundry. A sample of men and women aged 75+ years (n=27) was recruited and observed in a home-like environment. Postures were recorded with a measurement system in an objective and detailed manner. The participants were videotaped to be able to see where 'critical' postures occurred, as defined by a trunk inclination of ≥60°. Analysis of data was facilitated by specially developed software. Critical postures accounted for 3% of cooking and 10% of laundry, occurring primarily during retrieving from and putting in lower cabinets, the refrigerator, laundry basket or washing machine as well as disposing into the waste bin. These tasks involve a great variation in postural changes and pose a particular risk to older people. The results suggest that the use of stressful postures may decrease efficiency and increase fatigue, eventually leading to difficulties with daily activities. The specific tasks identified during which critical postures occurred should be targeted by designers in order to improve the activities. A few examples are given of how better design can reduce or eliminate some of the postural constraints.

Forklift safety, traffic engineering and intelligent transport systems: a case study.

This paper details a forklift safety demonstration project undertaken at two manufacturing sites in Victoria, Australia. The purpose of the work was both to help improve safety at the two sites, and, more broadly, to develop, help implement and evaluate a series of human-centred design interventions involving vehicles and pedestrian workers. The 'before' and 'after' case study presented here summarises the background to the research and introduces the test sites. Thereafter, it describes the overall nature of the safety interventions proposed and introduces the methods developed to assess safety. For the traffic engineering interventions, positive safety results were found in terms of reductions in the number of potentially hazardous interactions involving forklifts. Similarly, for the vehicle interventions, the research found that forklift drivers and managers considered the newly developed and installed Intelligent Transport Systems to be broadly acceptable in operational conditions, and the systems' intended safety benefits were well understood. The results are discussed and conclusions are drawn regarding human factors aspects of forklift safety.