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Version 50.1 by Harmen Kroon on 2022/04/05 12:46

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Laura Ottevanger 47.1 1 In this section, we will introduce our experimental test setup and motivate our research questions.
Rohan Sobha 39.1 2
Rohan Sobha 3.1 3 = Problem statement and research questions =
Doreen Mulder 6.1 4
Laura Ottevanger 47.1 5 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 led by a caretaker. However, the staff has limited time available to spend with each individual person. Group activities or caretaker-led 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.
6 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 walks under the 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:
Bart Vastenhouw 1.1 7
Laura Ottevanger 47.1 8 //Does walking with WAF increase the perceived autonomy of people with dementia, compared to walking under the guidance of a caretaker?//
Bart Vastenhouw 1.1 9
Doreen Mulder 13.1 10 To answer this question, we use the following subquestions:
Bart Vastenhouw 1.1 11
Tim Huisman 45.1 12 * Is WAF effective in providing guidance to a person with dementia on a predetermined route?
Doreen Mulder 13.1 13 * Does the increase in perceived autonomy outweigh the possible delayed help when a person with dementia gets in trouble on their walk?
Doreen Mulder 5.1 14
Rohan Sobha 3.2 15 = Method =
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Harmen Kroon 49.1 17 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 performing within-subject experiments. The participants will walk twice randomly ordered: once with a //caretaker// and once with //WAF//. The former will enact the activity of walking in the current setting and the latter will do the equivalent with the robot. Afterward, participants are assessed by means of Likert-scales to measure the changes. The difference in scores between the caretaker and the WAF setting will then be subjected to a Wilcoxon [[(Conover, 1998, p. 250)>>https://www-wiley-com.tudelft.idm.oclc.org/en-nl/Practical+Nonparametric+Statistics%2C+3rd+Edition-p-9780471160687]] test to determine whether the results are statistically significant. If the significance has been demonstrated, then we can reject the null hypothesis: walking with the WAF will not provide an increased feeling of autonomy compared to walking with a caretaker.
Rohan Sobha 3.2 18
Doreen Mulder 6.1 19 == Participants ==
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Tim Huisman 45.1 21 For our study, we would have liked to invite people with dementia to participate. However, user testing with a vulnerable group such as this one is difficult seeing the current circumstances of the COVID-19 pandemic.
Harmen Kroon 49.1 22 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. We will give them one page of the [[persona handout document>>https://xwiki.ewi.tudelft.nl/xwiki/wiki/sce2022group02/download/Test/WebHome/personas-handouts.pdf?rev=1.1]] to aid them in their roleplay and study character traits that might influence acceptance of WAF.
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Doreen Mulder 6.1 24 == Experimental design ==
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Tim Huisman 45.1 26 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. In addition to the questionnaire, notes will be taken during the experiment of the observations of the participant's interactions with WAF.
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Ricardo Vogel 23.1 28 == Ethical Approval ==
Harmen Kroon 31.1 29
Ricardo Vogel 37.1 30 Though the official ethical approval was handled by the course staff, we have also filled in the HREC Risk Assessment and Mitigation Plan form. The form can be found [[here>>https://xwiki.ewi.tudelft.nl/xwiki/wiki/sce2022group02/download/Test/WebHome/HREC-checklist-group-2.pdf]]. Before participating in the study, the participants signed the consent form found [[here>>https://xwiki.ewi.tudelft.nl/xwiki/wiki/sce2022group02/download/Test/WebHome/consent-group-2.pdf]]
Ricardo Vogel 23.1 31
Doreen Mulder 6.1 32 == Tasks ==
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Doreen Mulder 8.1 34 We break up our experiment into the following tasks:
Bart Vastenhouw 1.1 35
Doreen Mulder 9.1 36 * Walking a route
37 * Wandering off during a walk
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Doreen Mulder 10.1 39 Walking a route
Tim Huisman 44.1 40 The person with dementia will walk a route guided by either a caretaker or by WAF.
Doreen Mulder 10.1 41
42 Wandering off during a walk
Tim Huisman 44.1 43 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 WAF will guide the person back to the route.
Harmen Kroon 50.1 44
Doreen Mulder 6.1 45 == Measures ==
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Laura Ottevanger 47.1 47 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 led by an interviewer [[(Neerincx et al., to appear)>>]]. A caretaker may also be present to help the person with dementia accurately express themselves.
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Doreen Mulder 6.1 49 == Procedure ==
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Harmen Kroon 48.1 51 The procedure is that the person with dementia walks with WAF. The PwD is given WAF and the accompanying proximity bracelet. WAF has a pre-programmed route to walk and the PwD is asked to walk with the dog. While they are walking the dog, they are observed by a separate observer, carefully noting down any remarkable events. The emotional state of the PwD is actively monitored by looking at facial expressions. Furthermore, the researchers will actively check how easily the PwD interacts with WAF to check the familiarity. When the PwD is done walking, some small questions will be asked to check the satisfaction, autonomy, and familiarity.
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Tim Huisman 44.1 53 Functions like when an elderly person falls or when they walk in 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.
Laura Ottevanger 4.1 54
Doreen Mulder 6.1 55 == Material ==
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Laura Ottevanger 4.1 57 The items necessary for the tests are the following
Doreen Mulder 6.1 58
Tim Huisman 44.1 59 * A MiRo + bracelet
60 * Caretaker
Harmen Kroon 50.1 61 * Questionnaire
62 * Consent forms
63 * Persona handouts
64 * Controlling device
Bart Vastenhouw 1.1 65
Doreen Mulder 6.1 66 = Results =
Bart Vastenhouw 1.1 67
Laura Ottevanger 47.1 68 We asked participants about their sense of being in charge, happiness, safety, and trust when walking with WAF and with the caretaker. In the graphs below we show each sense compared between the two guiding agents.
Harmen Kroon 34.1 69
70 {{html}}
71 <table width='80%'>
72 <tr>
73 <td width='60%'>
74 <img src="https://xwiki.ewi.tudelft.nl/xwiki/wiki/sce2022group02/download/Test/WebHome/In_charge_graph_comparison.jpg" width="500" height="398">
75 </td>
76 <td align="left">
Tim Huisman 45.1 77 <p align="left">This comparison shows that when walking with a caretaker the participants felt mostly in charge, whereas when walking with WAF the participants felt this less frequently.</p>
Harmen Kroon 34.1 78 </td>
79 </tr>
80 <tr>
81 <td>
82 <img src="https://xwiki.ewi.tudelft.nl/xwiki/wiki/sce2022group02/download/Test/WebHome/Happy_graph_comparison.jpg" alt="Feeling of being in charge" width="500" height="398" align="left">
83 </td>
84 <td>
Tim Huisman 45.1 85 This comparison shows that both a caretaker or WAF accompanied positive emotions.
Harmen Kroon 34.1 86 </td>
87 </tr>
88 <tr>
89 <td>
90 <img src="https://xwiki.ewi.tudelft.nl/xwiki/wiki/sce2022group02/download/Test/WebHome/Safe_graph_comparison.jpg" alt="Feeling of being in charge" width="500" height="398" align="left">
91 </td>
92 <td>
Tim Huisman 45.1 93 This comparison shows a significant difference between walking with a caretaker and WAF. A caretaker made the participants feel safe most of the time or prevented any unsafe feelings. WAF conveyed only minimal feelings of safety with participants answering 'at times' most frequently.
Harmen Kroon 34.1 94 </td>
95 </tr>
96 <tr>
97 <td>
98 <img src="https://xwiki.ewi.tudelft.nl/xwiki/wiki/sce2022group02/download/Test/WebHome/Trustworthy_graph_comparison.jpg" alt="Feeling of trust" width="500" height="398" align="left">
99 </td>
100 <td>
Tim Huisman 45.1 101 This comparison shows similar results to the safety comparison. A caretaker is reported to be mostly or completely trustworthy, while WAF is trusted less as participants trusted it 'a little' or 'mostly'.
Harmen Kroon 34.1 102 </td>
103 </tr>
104 </table>
105 {{/html}}
Bart Vastenhouw 1.1 106
Laura Ottevanger 47.1 107 We performed the Wilcoxon test on the questions that were asked to the participants where both WAF and the caretaker were evaluated. With the Wilcoxon test, we are able to determine if there is any significant difference between WAF and the caretaker. Unfortunately, due to the low amount of participants, there is no possibility to create a normal distribution and thus causing the p-value to be less reliable.
Doreen Mulder 40.2 108
Laura Ottevanger 47.1 109 The first question is whether the PwD feels in charge while walking with the caretaker or WAF. The resulting z-value was -0.3145. The value of W is 9. The critical value for W at N = 6 (p < .05) is 2. The test concluded that the result for this question is not significant at p < .05. Thus there is no significant difference between either walking with the caretaker or walking with WAF.
Doreen Mulder 40.2 110
Laura Ottevanger 47.1 111 The second question is whether the PwD feels happy while walking with the caretaker or with WAF. 5 out of the 8 test answers showed no difference in either WAF or the caretaker, they gave exactly the same answers. This caused the test answers to be reduced to 3 which is too small to perform the Wilcoxon test on.
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113 The third question is whether the PwD feels safe while walking with the caretaker or with WAF. This test had a z-value of -2.3664 and a W-value of 0. The result is significant with p < .05. There was a strong preference for walking with the caretaker in regards to feeling safe.
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115 The final question is whether the PwD trusts the WAF or the caretaker while walking. The z-value resulted in -2.3664 which resulted in the same W-value as the third question: 0. The result was again significant with p < .05. Again there was a strong preference for walking with the caretaker. The caretaker was considered more trustworthy than the WAF.
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Doreen Mulder 40.2 117 = Discussion =
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Laura Ottevanger 47.1 119 Through this test, we aim to answer the question: "Does walking with WAF increase the perceived autonomy of people with dementia, compared to walking under the guidance of a caretaker?"
120 We see that in the current state of our prototype, this is not the case. The caretaker is preferred when asked if the user feels in charge, feels safe, and feels trustworthy. However, we note that WAF does slightly outperform the caretaker in regard to happiness. We think that further development is needed to accurately gauge if walking with WAF will eventually score equal or better compared to walking with a caretaker.
Tim Huisman 45.1 121 We see flaws in the limited testing setup that was available to us. With only eight participants, it is nearly impossible to draw conclusions from the experiment. Additionally, these participants were actors and not real people with dementia, which may have caused bias in our results. Finally, while we intended to have the participants walk through a hallway accompanied by WAF, we only had a meeting room available to conduct the experiment in.
Doreen Mulder 40.2 122
Harmen Kroon 50.1 123 === Inclusivity ===
Doreen Mulder 40.5 124
Doreen Mulder 26.1 125 In addition to the questionnaire, we conducted a short interview with our participant who is hard-of-hearing. Their study was conducted without them wearing their hearing aids.
Tim Huisman 45.1 126 We asked them if they thought their experience would differ if they were wearing their hearing aids. Their answer was that the biggest thing was that in a real scenario, the wristband doesn't give you enough information about what to do. It only tells you that you are something wrong. They commented that if they were 83, they would not have enough direction from this, compared to someone who could hear sounds: WAF could direct them back by barking at the user, for example. However, they mention that if you are severely hearing impaired, there is probably nothing you can do other than vibrating the wristband.
127 We asked them how we could make it more inclusive. They mention that the robot is small and not very visible, which might cause problems for people with a sight impairment. People who are not familiar with walking dogs would also not naturally keep looking at WAF. They recommended using a larger robot.
Bart Vastenhouw 1.1 128
Doreen Mulder 6.1 129 = Conclusions =
Doreen Mulder 41.1 130 In conclusion, the prototype as-is is not capable of outperforming the benefits of a traditional walk with a caretaker. Additional work is needed to bring the prototype to a state of usability where users walking with MiRo can feel trust, happiness, safety, and being in charge. We would like to conduct a similar experiment with real people with dementia, in a setting that is familiar to them, to properly simulate a realistic use case. In the future, we would increase the number of participants to gain better insights into the usability of our prototype.
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