Development trajectory of a fall detection device involving community-dwelling older people

Abstract

<p><strong>Purpose: </strong>The aim of the study was to explore and consider the needs, requirements, feasibility and usability aspects of daily life from the perspective of community-dwelling older people, by involving them interactively in the development of a wearable fall detection sensor, including its smartphone application.</p> <p><strong>Methods: </strong>A qualitative descriptive study was chosen. Community-dwelling older people, 75 years and older, were involved in two stages of device development using the theoretical framework of Shah et al. (2009). They were involved in the device design and mock-up evaluation stage and in the real field prototype testing stage of the fall detection device. In the first stage, the needs and requirements of the participants regarding the mock-up (not functional prototype) were explored using focus group interviews. Based on those findings the fall detection prototype was developed. One year later, participants tested its feasibility and usability for nine days in daily life, and participated in a focus group interview. Data was analysed using content analysis with the application of deductive coding.</p> <p><strong>Results: </strong>22 participants took part in the device design and mock-up evaluation, and 15 participants tested the fall detection prototype for nine days in their daily life. The average age was 80.7 years.</p> <p>The 24 hour wearing comfort of the lightweight, waterproof, body-worn sensor was high. The automatic alerting process in case of a fall met the needs of the participants. The manual alerting option was useful, as other emergency situations might occur. It was recommended that blinking lights be added in order to locate the sensor more easily.&nbsp;However, the smartphone did not adequately meet the needs of the participants due to: high battery consumption; difficulties using the touch-screen; and limited range between smartphone and sensor of eight to ten meters which was considered as limiting activities in daily life. In general, the smartphone application satisfied the requirements of participants as it was easy to manipulate, false alerts could be manually stopped and the design and acoustics were pleasant.</p> <p>Having several contact persons in case of an alert was required by the participants. It was emphasized that at least one health professional should be included in order to verify a reply in case of an alert, which would increase the feeling of security. Utilizing relatives, friends or neighbours as contacts may lead to the feeling of being a bother, which may be a barrier for use of a fall detection device. Additionally, the participants highlighted that they would prefer more coaching and training in using this fall detection device.</p> <p>The added value of user involvement was amongst others that it enabled the focus to remain on the most needed aspects from the perspective of users, instead of focusing solely on the technological aspects. The challenges of user involvement were the establishment of a shared language with engineers and financial and time resources.</p> <p><strong>Conclusion: </strong>The study demonstrated that older people contribute in a &laquo;needs-driven&raquo; way, to the development of a fall detection device. Involving users is valuable because it enables researchers to go beyond factors related to the technology itself, by identifying barriers and facilitators in the daily use of fall detection devices. It is important that nurses are aware of and familiar with new technologies, since they have a key role in instructing and supporting patients in their use.</p>