Abstract
BackgroundA clinical algorithm (Algo) in paper form is used in Quebec, Canada, to allow health care workers other than occupational therapists (OTs) to make bathroom adaptation recommendations for older adults. An integrated knowledge transfer process around Algo suggested an electronic version of this decision support system (electronic decision support system [e-DSS]) to be used by older adults and their caregivers in search of information and solutions for their autonomy and safety in the bathroom.ObjectiveThis study aims to (1) create an e-DSS for the self-selection of bathroom-assistive technology by community-dwelling older adults and their caregivers and (2) assess usability with lay users and experts to improve the design accordingly.MethodsOn the basis of a user-centered design approach, the process started with content identification for the prototype through 7 semistructured interviews with key informants of various backgrounds (health care providers, assistive technology providers, and community services) and 4 focus groups (2 with older adults and 2 with caregivers). A thematic content transcript analysis was carried out and used during the creation of the prototype. The prototype was refined iteratively using think-aloud and observation methods with a clinical expert (n=1), researchers (n=3), OTs (n=3), older adults (n=3), and caregivers (n=3), who provided information on the usability of the e-DSS.ResultsOverall, 4 themes served as the criteria for the prototype of the electronic Algo (Hygiene 2.0 [H2.0]): focus (safety, confidentiality, well-being, and autonomy), engage, facilitate (simplify, clarify, and illustrate), and access. For example, users first pay attention to the images (engage and illustrate) that can be used to depict safe postures (safety), illustrate questions embedded in the decision support tool (clarify and illustrate), and demonstrate the context of the use of assistive technology (safety and clarify).ConclusionsThe user-centered design of H2.0 allowed the cocreation of an e-DSS in the form of a website, in line with the needs of community-dwelling older adults and their caregivers seeking bathroom-assistive technology that enables personal hygiene. Each iteration improved usability and brought more insight into the users’ realities, tailoring the e-DSS to the implementation context.
Highlights
BackgroundPerforming personal hygiene is an essential daily activity for health and dignity that commonly becomes difficult with aging
The user-centered design of H2.0 allowed the cocreation of an electronic decision support system (e-DSS) in the form of a website, in line with the needs of community-dwelling older adults and their caregivers seeking bathroom-assistive technology that enables personal https://www.jmir.org/2020/8/e16175
It is important not to exclude those who do not use technologies; the importance of caregivers being involved in the development of H2.0 and the e-DSS giving an option to answer on behalf of someone else
Summary
BackgroundPerforming personal hygiene is an essential daily activity for health and dignity that commonly becomes difficult with aging. At 90 years of age, 21% of Canadians reported requiring assistance to wash themselves [1] In such cases, adapting the bathroom environment with assistive technologies, such as bath seats, grab bars, or nonslip mats, is a common recommendation to promote autonomy and safety [2,3]. To address this issue in Quebec, a mainly French-speaking province of Canada, the clinical algorithm Algo [4] has been proposed allowing occupational therapists (OTs) to collaborate with non-OTs: health care workers other than OTs, such as home health aides, social workers, and nurse assistants. An integrated knowledge transfer process around Algo suggested an electronic version of this decision support system (electronic decision support system [e-DSS]) to be used by older adults and their caregivers in search of information and solutions for their autonomy and safety in the bathroom
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