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      Patient Preference and Adherence (submit here)

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      Involvement of the end user: exploration of older people’s needs and preferences for a wearable fall detection device – a qualitative descriptive study

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          Abstract

          Purpose

          To explore the needs and preferences of community-dwelling older people, by involving them in the device design and mock-up development stage of a fall detection device, consisting of a body-worn sensor linked to a smartphone application.

          Patients and methods

          A total of 22 community-dwelling persons 75 years of age and older were involved in the development of a fall detection device. Three semistructured focus group interviews were conducted. The interview data were analyzed using qualitative descriptive analysis with deductive coding.

          Results

          The mock-up of a waterproof, body-worn, automatic and manual alerting device, which served both as a day-time wearable sensor and a night-time wearable sensor, was welcomed. Changes should be considered regarding shape, color and size along with alternate ways of integrating the sensor with items already in use in daily life, such as jewelry and personal watches. The reliability of the sensor is key for the participants. Issues important to the alerting process were discussed, for instance, who should be contacted and why. Several participants were concerned with the mandatory use of the smartphone and assumed that it would be difficult to use. They criticized the limited distance between the sensor and the smartphone for reliable fall detection, as it might restrict activity and negatively influence their degree of independence in daily life.

          Conclusion

          This study supports that involving end users in the design and mock-up development stage is welcomed by older people and allows their needs and preferences concerning the fall detection device to be explored. Based on these findings, the development of a “need-driven” prototype is possible. As participants are doubtful regarding smartphone usage, careful training and support of community-dwelling older people during real field testing will be crucial.

          Most cited references55

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          User involvement: A review of the benefits and challenges

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            Challenges, issues and trends in fall detection systems

            Since falls are a major public health problem among older people, the number of systems aimed at detecting them has increased dramatically over recent years. This work presents an extensive literature review of fall detection systems, including comparisons among various kinds of studies. It aims to serve as a reference for both clinicians and biomedical engineers planning or conducting field investigations. Challenges, issues and trends in fall detection have been identified after the reviewing work. The number of studies using context-aware techniques is still increasing but there is a new trend towards the integration of fall detection into smartphones as well as the use of machine learning methods in the detection algorithm. We have also identified challenges regarding performance under real-life conditions, usability, and user acceptance as well as issues related to power consumption, real-time operations, sensing limitations, privacy and record of real-life falls.
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              Patients' perspectives in health technology assessment: a route to robust evidence and fair deliberation.

              There is increasing emphasis on providing patient-focused health care and ensuring patient involvement in the design of health services. As health technology assessment (HTA) is meant to be a multidisciplinary, wide-ranging policy analysis that informs decision making, it would be expected that patients' views should be incorporated into the assessment. However, HTA is still driven by collection of quantitative evidence to determine the clinical and cost effectiveness of a health technology. Patients' perspectives about their illness and the technology are rarely included, perhaps because they are seen as anecdotal, biased views. There are two distinct but complementary ways in which HTAs can be strengthened by: (i) gathering robust evidence about the patients' perspectives, and (ii) ensuring effective engagement of patients in the HTA process from scoping, through evidence gathering, assessment of value, development of recommendations and dissemination of findings. Robust evidence eliciting patients' perspectives can be obtained through social science research that is well conducted, critically appraised and carefully reported, either through meta-synthesis of existing studies or new primary research. Engagement with patients can occur at several levels and we propose that HTA should seek to support effective patient participation to create a fair deliberative process. This should allow two-way flow of information, so that the views of patients are obtained in a supportive way and fed into decision-making processes in a transparent manner.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient Preference and Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2017
                20 December 2016
                : 11
                : 11-22
                Affiliations
                [1 ]Applied Research and Development in Nursing, Health Division, Bern University of Applied Sciences, Bern, Switzerland
                [2 ]Department of Health Services Research
                [3 ]Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, the Netherlands
                Author notes
                Correspondence: Friederike JS Thilo, Applied Research and Development in Nursing, Health Division, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland, Tel +41 31 848 4564, Fax +41 31 848 3501, Email friederike.thilo@ 123456bfh.ch
                Article
                ppa-11-011
                10.2147/PPA.S119177
                5189694
                28053509
                f1ae7bc4-9c4e-41b8-a5ea-6c52db1f75b5
                © 2017 Thilo et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

                Medicine
                focus group interview,coding,wearable device,sensor,mock-up,smartphone
                Medicine
                focus group interview, coding, wearable device, sensor, mock-up, smartphone

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