The right to assistive technology

Digital health interventions for healthy ageing: a qualitative user evaluation and ethical assessment

Background

Digital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies.

Aim

The aim of this study was to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing.

Method

Face-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis.

Results

Three main themes and twelve sub-themes addressing our study aim resulted from the data obtained. The main themes revolved around favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations.

Conclusions

Our study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact were also addressed by participants as key considerations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02338-z.

Weak Signal-Oriented Investigation of Ethical Dissonance Applied to Unsuccessful Mobility Experiences Linked to Human-Machine Interactions

Ethical dissonance arises from conflicts between beliefs or behaviors and affects ethical factors such as normality or conformity. This paper proposes a weak signal-oriented framework to investigate ethical dissonance from experiences linked to human-machine interactions. It is based on a systems engineering principle called human-systems inclusion, which considers any experience feedback of weak signals as beneficial to learn. The framework studies weak signal-based scenarios from testimonies of individual experiences and these scenarios are assessed by other people. For this purpose, the framework proposes several databases as sources of weak signals, formalization tools of experience feedback of weak signals, models of references of conformity, ethical factors, and a list of examples of ethical dissonance. It also includes sequential steps to make the latter credible regarding the results from the experimental protocols. The framework was used to investigate ethical dissonance by analyzing experiences pertaining to achieving inclusive mobility. The first example focuses on ethical dissonance in terms of hindrance that goes against autonomous mobility due to a misunderstanding of how the system functions in terms of negative and positive emotions. Two other examples present possible ethical dissonance when the use of safety systems such as car driver-assistance systems, may create danger. Investigating ethical dissonance can then help system-inclusive design or evaluation processes by taking into account scenarios from weak signal-based experiences and making them credible.