Using the Technology Acceptance Model to explore community dwelling older adults’ perceptions of a 3D interior design application to facilitate pre-discharge home adaptations

Abstract

BackgroundIn the UK occupational therapy pre-discharge home visits are routinely carried out as a means of facilitating safe transfer from the hospital to home. Whilst they are an integral part of practice, there is little evidence to demonstrate they have a positive outcome on the discharge process. Current issues for patients are around the speed of home visits and the lack of shared decision making in the process, resulting in less than 50 % of the specialist equipment installed actually being used by patients on follow-up. To improve practice there is an urgent need to examine other ways of conducting home visits to facilitate safe discharge. We believe that Computerised 3D Interior Design Applications (CIDAs) could be a means to support more efficient, effective and collaborative practice. A previous study explored practitioners perceptions of using CIDAs; however it is important to ascertain older adult’s views about the usability of technology and to compare findings. This study explores the perceptions of community dwelling older adults with regards to adopting and using CIDAs as an assistive tool for the home adaptations process.MethodsTen community dwelling older adults participated in individual interactive task-focused usability sessions with a customised CIDA, utilising the think-aloud protocol and individual semi-structured interviews. Template analysis was used to carry out both deductive and inductive analysis of the think-aloud and interview data. Initially, a deductive stance was adopted, using the three pre-determined high-level themes of the technology acceptance model (TAM): Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Actual Use (AU). Inductive template analysis was then carried out on the data within these themes, from which a number of sub-thmes emerged.ResultsRegarding PU, participants believed CIDAs served as a useful visual tool and saw clear potential to facilitate shared understanding and partnership in care delivery. For PEOU, participants were able to create 3D home environments however a number of usability issues must still be addressed. The AU theme revealed the most likely usage scenario would be collaborative involving both patient and practitioner, as many participants did not feel confident or see sufficient value in using the application autonomously.ConclusionsThis research found that older adults perceived that CIDAs were likely to serve as a valuable tool which facilitates and enhances levels of patient/practitioner collaboration and empowerment. Older adults also suggested a redesign of the interface so that less sophisticated dexterity and motor functions are required. However, older adults were not confident, or did not see sufficient value in using the application autonomously. Future research is needed to further customise the CIDA software, in line with the outcomes of this study, and to explore the potential of collaborative application patient/practitioner-based deployment.

Effects, Barriers and Facilitators in Predischarge Home Assessments to Improve the Transition of Care from the Inpatient Care to Home in Adult Patients: An Integrative Review

“…Ten qualitative studies [3,9,[26][27][28][29][30][31][32][33] with a total of 245 participants (range: n = 4 [31] to n = 60 [26]) were included. All the studies used interview techniques, and one additionally used participant observation [32].…”

“…All the studies used interview techniques, and one additionally used participant observation [32]. Three studies explored perceptions of patients, therapists and older adults in community dwellings with regard to the use of virtual reality (VR) applications in PDHA [9,28,29]. One study explored factors considered by the OTs when deciding about stroke patients' need for a predischarge home assessment visit [33].…”

“…Participants in RCTs were recruited in acute care settings [2,4,21,22,24,25] and rehabilitation units [7,23], and for qualitative studies in the community [9,26], in rehabilitation [30], in acute care [3,27] and in intermediate care [31].…”

“…In recent years, studies on new technologies for PDHA have been published, which were not included in the review by Lockwood et al [8]. These studies focus on 3D visualization that offers computer-generated environments, scenarios and objects [3,4,9] that are used to avoid travelling to a patient's home and to improve the patient's involvement in home modi cation planning. Thus, an update of the evidence synthesis on PDHA is warranted.…”

Leading change: introducing an electronic medical record system to a paramedic service

“…There is evidence from studies that use the TAM or UTAUT (e.g Maillet et al, 2015;Money et al, 2015), as well as from studies that do not (e.g. Boddy et al, 2009;Lapointe and Rivard, 2005), that the introduction of EMR is better accepted when there is a strong perceived usefulness and no loss of clinician autonomy.…”