@article{TeipelHeineHeinetal.2017, author = {Teipel, Stefan and Heine, Christina and Hein, Albert and Kr{\"u}ger, Frank and Kutschke, Andreas and Kernebeck, Sven and Halek, Margareta and Bader, Sebastian and Kirste, Thomas}, title = {Multidimensional assessment of challenging behaviors in advanced stages of dementia in nursing homes—The insideDEM framework}, series = {Alzheimer's \& Dementia: Diagnosis, Assessment \& Disease Monitoring}, volume = {8}, journal = {Alzheimer's \& Dementia: Diagnosis, Assessment \& Disease Monitoring}, issn = {2352-8729}, doi = {10.25974/fhms-17330}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173308}, pages = {36 -- 44}, year = {2017}, abstract = {IntroductionAssessment of challenging behaviors in dementia is important for intervention selection. Here, we describe the technical and experimental setup and the feasibility of long-term multidimensional behavior assessment of people with dementia living in nursing homes.MethodsWe conducted 4 weeks of multimodal sensor assessment together with real-time observation of 17 residents with moderate to very severe dementia in two nursing care units. Nursing staff received extensive training on device handling and measurement procedures. Behavior of a subsample of eight participants was further recorded by videotaping during 4 weeks during day hours. Sensors were mounted on the participants' wrist and ankle and measured motion, rotation, as well as surrounding loudness level, light level, and air pressure.ResultsParticipants were in moderate to severe stages of dementia. Almost 100\% of participants exhibited relevant levels of challenging behaviors. Automated quality control detected 155 potential issues. But only 11\% of the recordings have been influenced by noncompliance of the participants. Qualitative debriefing of staff members suggested that implementation of the technology and observation platform in the routine procedures of the nursing home units was feasible and identified a range of user- and hardware-related implementation and handling challenges.DiscussionOur results indicate that high-quality behavior data from real-world environments can be made available for the development of intelligent assistive systems and that the problem of noncompliance seems to be manageable. Currently, we train machine-learning algorithms to detect episodes of challenging behaviors in the recorded sensor data.}, language = {en} } @article{KernebeckHollePogschebaetal.2019, author = {Kernebeck, Sven and Holle, Daniela and Pogscheba, Patrick and Jordan, Felix and Mertl, Fabian and Huldtgren, Alina and Bader, Sebastian and Kirste, Thomas and Teipel, Stefan and Holle, Bernhard and Halek, Margareta}, title = {A Tablet App- and Sensor-Based Assistive Technology Intervention for Informal Caregivers to Manage the Challenging Behavior of People With Dementia (the insideDEM Study): Protocol for a Feasibility Study (Preprint)}, series = {JMIR Res Protoc}, volume = {8}, journal = {JMIR Res Protoc}, number = {2}, doi = {10.25974/fhms-17306}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173061}, year = {2019}, abstract = {BACKGROUND Despite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers. OBJECTIVE The main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home. METHODS In this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis. RESULTS The newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018. CONCLUSIONS This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11630}, language = {de} } @article{KernebeckHollePogschebaetal.2019, author = {Kernebeck, Sven and Holle, Daniela and Pogscheba, Patrick and Jordan, Felix and Mertl, Fabian and Huldtgren, Alina and Bader, Sebastian and Kirste, Thomas and Teipel, Stefan and Holle, Bernhard and Halek, Margareta}, title = {A Tablet App- and Sensor-Based Assistive Technology Intervention for Informal Caregivers to Manage the Challenging Behavior of People With Dementia (the insideDEM Study): Protocol for a Feasibility Study}, series = {JMIR Research Protocols}, volume = {8}, journal = {JMIR Research Protocols}, issn = {1929-0748}, doi = {10.25974/fhms-17327}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173274}, pages = {e11630}, year = {2019}, abstract = {Despite the enormous number of assistive technologies (ATs) in dementia care, the management of challenging behavior (CB) of persons with dementia (PwD) by informal caregivers in home care is widely disregarded. The first-line strategy to manage CB is to support the understanding of the underlying causes of CB to formulate individualized nonpharmacological interventions. App- and sensor-based approaches combining multimodal sensors (actimetry and other modalities) and caregiver information are innovative ways to support the understanding of CB for family caregivers. The main aim of this study is to describe the design of a feasibility study consisting of an outcome and a process evaluation of a newly developed app- and sensor-based intervention to manage CB of PwD for family caregivers at home. In this feasibility study, we perform an outcome and a process evaluation with a pre-post descriptive design over an 8-week intervention period. The Medical Research Council framework guides the design of this feasibility study. The data on 20 dyads (primary caregiver and PwD) are gathered through standardized questionnaires, protocols, and log files as well as semistructured qualitative interviews. The outcome measures (neuropsychiatric inventory and Cohen-Mansfield agitation inventory) are analyzed by using descriptive statistics and statistical tests relevant to the individual assessments (eg, chi-square test and Wilcoxon signed-rank test). For the analysis of the process data, the Unified Theory of Acceptance and Use of Technology is used. Log files are analyzed by using descriptive statistics, protocols are analyzed by using documentary analysis, and semistructured interviews are analyzed deductively using content analysis. The newly developed app- and sensor-based AT has been developed and was evaluated until July in 2018. The recruitment of dyads started in September 2017 and was concluded in March 2018. The data collection was completed at the end of July 2018. This study presents the protocol of the first feasibility study to encompass an outcome and process evaluation to assess a complex app- and sensor-based AT combining multimodal actimetry sensors for informal caregivers to manage CB. The feasibility study will provide in-depth information about the study procedure and on how to optimize the design of the intervention and its delivery. DERR1-10.2196/11630}, language = {en} } @article{BusseJuxKernebecketal.2021, author = {Busse, Theresa Sophie and Jux, Chantal and Kernebeck, Sven and Meister, Sven and Ehlers, Jan P.}, title = {Steigerung der Versorgungsqualit{\"a}t in der Palliativversorgung durch elektronische Gesundheitsakten}, series = {Monitor Versorgungsforschung}, volume = {14}, journal = {Monitor Versorgungsforschung}, issn = {1866-0533}, doi = {10.25974/fhms-17303}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173035}, pages = {45 -- 50}, year = {2021}, language = {de} } @article{BusseKernebeckNefetal.2021, author = {Busse, Theresa Sophie and Kernebeck, Sven and Nef, Larissa and Rebacz, Patrick and Kickbusch, Ilona and Ehlers, Jan Peter}, title = {Views on Using Social Robots in Professional Caregiving: Content Analysis of a Scenario Method Workshop (Preprint)}, series = {J Med Internet Res}, volume = {23}, journal = {J Med Internet Res}, number = {11}, doi = {10.25974/fhms-17307}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173072}, year = {2021}, abstract = {BACKGROUND Interest in digital technologies in the health care sector is growing and can be a way to reduce the burden on professional caregivers while helping people to become more independent. Social robots are regarded as a special form of technology that can be usefully applied in professional caregiving with the potential to focus on interpersonal contact. While implementation is progressing slowly, a debate on the concepts and applications of social robots in future care is necessary. OBJECTIVE In addition to existing studies with a focus on societal attitudes toward social robots, there is a need to understand the views of professional caregivers and patients. This study used desired future scenarios to collate the perspectives of experts and analyze the significance for developing the place of social robots in care. METHODS In February 2020, an expert workshop was held with 88 participants (health professionals and educators; [PhD] students of medicine, health care, professional care, and technology; patient advocates; software developers; government representatives; and research fellows) from Austria, Germany, and Switzerland. Using the scenario methodology, the possibilities of analog professional care (Analog Care), fully robotic professional care (Robotic Care), teams of robots and professional caregivers (Deep Care), and professional caregivers supported by robots (Smart Care) were discussed. The scenarios were used as a stimulus for the development of ideas about future professional caregiving. The discussion was evaluated using qualitative content analysis. RESULTS The majority of the experts were in favor of care in which people are supported by technology (Deep Care) and developed similar scenarios with a focus on dignity-centeredness. The discussions then focused on the steps necessary for its implementation, highlighting a strong need for the development of eHealth competence in society, a change in the training of professional caregivers, and cross-sectoral concepts. The experts also saw user acceptance as crucial to the use of robotics. This involves the acceptance of both professional caregivers and care recipients. CONCLUSIONS The literature review and subsequent workshop revealed how decision-making about the value of social robots depends on personal characteristics related to experience and values. There is therefore a strong need to recognize individual perspectives of care before social robots become an integrated part of care in the future.}, language = {de} } @article{NitscheSmetanaKochaneketal.2021, author = {Nitsche, Julia and Smetana, Jan and Kochanek, Tonja and Busse, Theresa Sophie and Kernebeck, Sven and Taetz-Harrer, Angelika and Zupanic, Michaela and Eulitz, Mona and Ehlers, Jan P.}, title = {Needs must when the devil drives - Migration of an entire university to digital teaching}, series = {Zeitschrift f{\"u}r Hochschulentwicklung}, volume = {16}, journal = {Zeitschrift f{\"u}r Hochschulentwicklung}, number = {3}, doi = {10.25974/fhms-17316}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173168}, year = {2021}, language = {en} } @article{KernebeckBusseEhlersetal.2021, author = {Kernebeck, Sven and Busse, Theresa Sophie and Ehlers, Jan Peter and Vollmar, Horst Christian}, title = {Adh{\"a}renz digitaler Interventionen im Gesundheitswesen: Definitionen, Methoden und offene Fragen}, series = {Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz}, volume = {64}, journal = {Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz}, issn = {1436-9990}, doi = {10.25974/fhms-17318}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173188}, pages = {1278 -- 1284}, year = {2021}, abstract = {AbstractMany digital interventions rely on the participation of their users to have a positive impact. In various areas it can be observed that the use of digital interventions is often reduced or fully discontinued by the users after a short period of time. This is seen as one of the main factors that can limit the effectiveness of digital interventions. In this context, the concept of adherence to digital interventions is becoming increasingly important. Adherence to digital interventions is roughly defined as "the degree to which the user followed the program as it was designed," which can also be paraphrased as "intended use" or "use as it is designed." However, both the theoretical-conceptual and practical discussions regarding adherence to digital interventions still receive too little attention.The aim of this narrative review article is to shed more light on the concept of adherence to digital interventions and to distinguish it from related concepts. It also discusses the methods and metrics that can be used to operationalize adherence and the predictors that positively influence adherence. Finally, needs for action to better address adherence are considered critically.}, language = {en} } @article{BusseJuxKernebecketal.2021, author = {Busse, Theresa Sophie and Jux, Chantal and Kernebeck, Sven and Dreier, Larissa Alice and Meyer, Dorothee and Zenz, Daniel and Zernikow, Boris and Ehlers, Jan Peter}, title = {Participatory Design of an Electronic Cross-Facility Health Record (ECHR) System for Pediatric Palliative Care: A Think-Aloud Study}, series = {Children}, volume = {8}, journal = {Children}, issn = {2227-9067}, doi = {10.25974/fhms-17319}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173191}, pages = {839}, year = {2021}, abstract = {Background: Pediatric palliative care (PPC) patients experience years of multisectoral and professional care. An electronic cross-facility health record (ECHR) system can support the immediate exchange of information among PPC professionals. Based on a needs assessment, a prototype ECHR system was developed. Methods: To evaluate potential users' perspective regarding the system, a qualitative observational study was conducted consisting of a concurrent think-aloud session and a semi-structured qualitative interview. Results: Twenty PPC professionals (nurses, physicians) from specialized outpatient PPC teams, a PPC unit, and medical offices rated the ECHR system as a helpful tool to improve the exchange and collection of information, communication between PPC professionals, and treatment planning. From the user's point of view, the basic logic of the ECHR system should be further adapted to improve the interaction of data remirrored from patient records of outpatient and inpatient care with those entered via the system. The users wished for further functions (text search) and content (information on therapies). Some content, such as the treatment process, needs to be further adapted. Conclusion: The developed ECHR system needs to be more specific in some features by offering all available information; while for other features, be less specific to offer a quick overview. The ability to share information promptly and automatically was seen as a tremendous improvement to the quality of care for PPC patients.}, language = {en} } @article{KernebeckBusseJuxetal.2021, author = {Kernebeck, Sven and Busse, Theresa Sophie and Jux, Chantal and Meyer, Dorothee and Dreier, Larissa Alice and Zenz, Daniel and Zernikow, Boris and Ehlers, Jan Peter}, title = {Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians}, series = {Children}, volume = {8}, journal = {Children}, issn = {2227-9067}, doi = {10.25974/fhms-17321}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173219}, pages = {695}, year = {2021}, abstract = {Background: Electronic medical records (EMRs) offer a promising approach to mapping and documenting the complex information gathered in paediatric palliative care (PPC). However, if they are not well developed, poorly implemented EMRs have unintended consequences that may cause harm to patients. One approach to preventing such harm is the involvement of users in the participatory design to ensure user acceptance and patient safety. Therefore, the aim of this study is to evaluate the acceptance of a novel patient chart module (PCM) as part of an EMR from the perspective of potential users in PPC and to involve these professionals in the design process. Methods: A qualitative observational study with N = 16 PPC professionals (n = 10 nurses, n = 6 physicians) was conducted, including concurrent think aloud (CTA) and semi-structured interviews. A structured content analysis based on the Unified Theory of Acceptance and Use of Technology was applied. Results: The results can be summarized in terms of general observations, performance expectancy, effort expectancy and facilitating conditions, all of which are likely to have a positive influence on acceptance of the PCM from the user perspective in the context of PPC. Conclusions: The involvement of users in the development of EMRs is important for meeting the requirements in PPC. Further software adaptations are necessary to implement these requirements.}, language = {en} } @article{BusseJuxKernebecketal.2021, author = {Busse, Theresa Sophie and Jux, Chantal and Kernebeck, Sven and Dreier, Larissa Alice and Meyer, Dorothee and Zenz, Daniel and Zernikow, Boris and Ehlers, Jan Peter}, title = {Needs Assessment for the Development of an Electronic Cross-Facility Health Record (ECHR) for Pediatric Palliative Care: A Design Thinking Approach}, series = {Children}, volume = {8}, journal = {Children}, issn = {2227-9067}, doi = {10.25974/fhms-17324}, url = {http://nbn-resolving.de/urn:nbn:de:hbz:836-opus-173245}, pages = {602}, year = {2021}, abstract = {Background: Pediatric palliative care (PPC) is characterized by years of multisectoral and multi-professional care. Sharing information between PPC professionals is, therefore, essential for quality care. The evidence shows that electronic cross-facility health records (ECHRs) provide useful support in this context. To our knowledge, no ECHRs have been developed through a user-centered approach for this specific setting in Germany. Methods: Guided by design thinking, first, qualitative interviews were conducted to assess the needs of PPC professionals. Second, the elicited needs were specified in focus groups (FGs). Based on the needs stated in the interviews, prototypes of the ECHR were developed and discussed in the FGs. The indicated needs were supplemented and specified in an iterative process. The prototypes were further adapted according to these results. The unified theory of acceptance and use of technology was the basic model in the evaluation of needs. Results: Across seven main categories, past and current medication, emergency view, and messaging functions were identified as the participants' desired core components of an ECHR. Utilizing design thinking facilitated the explicit articulation of user needs. Conclusions: Developing an ECHR with the content identified would allow for real-time data during emergencies, tracking what other PPC professionals have done, and making the applied treatments visible to others. This would offer a broader picture of the complex conditions common to PPC.}, language = {en} }