Test
Problem statement and research questions
People with dementia face challenges that were not present in their life before being affected by their condition. This is also influenced by their living situation, since they may live in care homes or dementia centers. To ensure that people with dementia stay safe, activities are usually lead by a caretaker. However, staff has limited time available to spend with each individual person. Group activities or caretaker-lead activities may affect the feeling of autonomy of the person with dementia. Autonomy is one of the key psychological needs described in self-determination theory, which describes how feeling fulfilled is influenced by how much a person feels in control of their own actions. It is important to the mental well-being of people with dementia to keep a sense of autonomy.
With our research, we aim to provide support to Patients with Dementia (PwD) who currently are dependent on their caretakers and significant other to go for walks. This is outlined in more detail in the Objectives section. The presumed baseline is that PwD walk under supervision of their loved ones or caretakers. To reach our objective and support our claims, we would like to put forward the following research question:
Does walking with the MiRo increase the perceived autonomy of people with dementia, compared to walking under guidance of a caretaker?
To answer this question, we use the following subquestions:
- Is the MiRo effective in providing guidance to a person with dementia on a predetermined route?
- Does the increase in perceived autonomy outweigh the possible delayed help when a person with dementia gets in trouble on their walk?
Method
To this effect, we would like to invite users to participate in a usability study. In the study, we will assess our research question by dividing the participants into two groups: one with a caretaker and one with a MiRo. The former group will enact the activity of walking in the current setting and the latter group will do the equivalent with the robot. Afterwards, both groups are assessed by means of Likert-scales to measure the increase.
Participants
For our study, we would have liked to invite people with dementia to participate. However, user testing with a vulnerable group as this one is difficult seeing the current circumstances with the COVID-19 pandemic.
For this reason, we decided to design an experiment to be conducted on our fellow students. Students will be briefed on dementia. Then they take on the role of one of the personas, and roleplay a person with dementia. Through this roleplay, we aim to simulate a study with people with dementia as accurately as possible in the given situation.
Experimental design
The main research question can be answered using a within-subject design in order to be able to measure the increase per subject. The learning effect will be mitigated, because the two juxtaposed settings are vastly different. So, there is no advantage for the participant to be subjected to two conditions serially.
The experiment will be recorded in the form of audio recording which are to be transcribed afterwards. Naturally, the recordings will be deleted subsequently to comply with GDPR.
Tasks
We break up our experiment into the following tasks:
- Walking a route
- Wandering off during a walk
- Falling and alerting a caretaker
Walking a route
The person with dementia will walk a route guided by either a caretaker or by the MiRo.
Wandering off during a walk
A person with dementia may become lost in their current surroundings. They might wander off from the predetermined route. Depending on the study group, either the caretaker or the MiRo will guide the person back to the route.
Falling and alerting a caretaker
When a person with dementia gets in trouble when walking around, it is very important that they receive immediate attention.
Measures
To measure the effectiveness of our solution, we use a questionnaire. Since people with dementia may experience difficulties with expressing themselves in a conversation, this questionnaire is lead by an interviewer (Neerincx et al., to appear). A caretaker may also be present to help the person with dementia accurately express themselves.
Procedure
There are two different situations that need to be tested.
The first situation is walking with the Miro. The PwD is given the MiRo and the bracelet/leash, the MiRo has a pre-programmed route to walk. The PwD is asked to walk with the dog. While they are walking the dog, they are observed, preferably by cameras as to simulate the situation how the MiRo should be used. The emotional state of the PwD is actively monitored by looking at facial expressions. Furthermore, the researchers will actively check how easily the PwD interact with the MiRo to check the familiarity. When the PwD is done walking, some small questions will be asked to check the satisfaction, autonomy and familiarity.
The second situation is Snoezelen. The PwD will sit at a table, the MiRo will be put on the table. The researcher will either stay in the room or put up cameras to observe the PwD. The PwD will be encouraged to pet and play with the MiRo. During the Snoezelen, the emotional state of the PwD will be observed. The researchers will also observe how easily the PwD handles the MiRo. After the snoezelen, the PwD will be asked how they felt during the Snoezelen.
Functions like when an elderly person falls or when they walk the wrong direction will not forcibly be tested with PwD as this might create a dangerous situation. These functions will be tested in advance with the use of "Dogfeeding". Other people from the development-team will test these functions.
Material
The items necessary for the tests are the following
- MiRo + bracelet/leash
- Camera to observe
- Caretaker in a nearby room in case of emergency
Results
Discussion
Is het erg om om een rank te vragen aan PwD's? Iets tussen 1-5 of very bad en very good. Zo nee, lijkt het me beter om vraag 3 in die vorm te stellen
3. Do you consider the guiding agent to be helpful in the following aspects?
- Wat wordt er bedoeld met "was the guiding agent helpful in paying attention to its user"
-> Hiermee wordt er bedoeld of de guiding agent behuplzaam is geweest d.m.v. aandacht geven. Bijvoorbeeld, de MiRo kijkt regelmatig naar PwD of loopt niet te ver weg. Deze factoren kunnen worden geïntepreteerd als aandachtsvol.
-> ik denk dat dit eerder iets als "Did the guiding agent succeed remaining near its user" of iets in de trend van erbij blijven> Dat is dus één aspect ervan. Wellicht dat we de vragen kunnen opdelen in meerdere onderdelen.
- Ik denk niet dat we uit een wizard of oz experiment een goed antwoord gaan krijgen uit Getting the attention of healthcare workers, tenzij we een experiment hebben waarmee we kunnen testen of MiRo/de armband een val kan herkennen.> Goed punt, dat gaat uit de evaluation en nemen we mee in de discussion omtrent future work.
- Misschien kunnen we nog een 'Getting attention' vraag stellen om te testen hoe goed het aandacht trekken als de patient van het pad afwijkt werkt.> Door middel van rank/Likert-scale of open vraag?
4. De scale hier is heel nice. In charge, happy, afraid lijken me goed. Tired kan er misschien uit blijven want dat zou meer afhangen van de lengte van de walk en daar evalueren we nog niet op.
-> Tired duidt op een moeizaam verloop, dus of de PwD vermoeid is geraakt door met de hond te lopen. Daar valt inderdaad de fysieke inspanning onder, maar ook hoe de MiRo en de PwD samenwerken. Mijn hypothese is namelijk dat de gebruiker minder vermoeid is als de MiRo beter inspeelt op de wensen van de gebruiker, maar vermoeider is als de gebruiker de MiRo 'in toom' moet houden.
Laatste remark: misschien nog een vraag over hoe het lopen met een hond-achtige robot was - zorgt het voor de nostalgie zoals wij verwachten?
-> Wellicht een combinatie van ja/nee met een uitleg van welke herinneringen het lopen opriep of niet opriep. Wel lastiger met gebruikers die nooit een huisdier (specifieker gezegd: een hond) hebben gehad.