The traditional paternalistic approach in health care is increasingly developing towards a patient-centered care (PCC) approach. However, not all patients are able to take advantage of the positive effects of PCC. Inadequate health literacy (HL) is an important limiting factor in the ability of patients to take on an active role and exchange information with their health care provider effectively. A provenly effective approach to improvement of provider-patient interaction and health outcomes is the use of health-related questionnaires. The aim of the research project described within this thesis was to adapt the most frequently-used questionnaire in Dutch physical therapy practice and add information and communication technology to it. A Dutch and Turkish version of the tool called Talking Touch Screen Questionnaire (TTSQ) was developed and evaluated on both usability and validity aspects. The current prototype of the tool does not yet fully solve the problems native and minority patients with low (health) literacy have with completing the adapted questionnaire. Big challenges in future development and testing the TTSQ are the recruitment of vulnerable members of the hard-to-reach native and minority target populations and finding research methods that suit the abilities and needs of these participants. This is expected to be a very challenging, labor- and time-consuming process. On the other hand, having a usable, valid and reliable TTSQ may well save a lot of time and money in both research and clinical practice in the future.
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Background: The Turkish translation of the Dutch Talking Touch Screen Questionnaire (TTSQ) has been developed to help physical therapy patients with a Turkish background in the Netherlands to autonomously elucidate their health problems and impairments and set treatment goals, regardless of their level of health literacy. Objective: The aim of this study was to evaluate the usability of the Turkish TTSQ for physical therapy patients with a Turkish background with diverse levels of health literacy and experience in using mobile technology. Methods: The qualitative Three-Step Test-Interview method was carried out to gain insight into the usability of the Turkish TTSQ. A total of 10 physical therapy patients participated. The interview data were analyzed using a thematic content analysis approach aimed at determining the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating, which was used to provide a rough estimate of the need for additional usability improvements. Results: No participant in this study was able to complete the questionnaire without encountering at least one usability problem. A total of 17 different kinds of problems were found. On the basis of their severity score, 3 problems that should be addressed during future development of the tool were “Not using the navigation function of the photo gallery in Question 4 causing the participant to not see all presented response items;” “Touching the text underneath a photo in Question 4 to select an activity instead of touching the photo itself, causing the activity not to be selected;” and “Pushing too hard or tapping too softly on the touch screen causing the touch screen to not respond.” The data on efficiency within this study were not valid and are, therefore, not reported in this study. No participant was completely satisfied or dissatisfied with the overall ease of use of the Turkish TTSQ. Two participants with no prior experience of using tablet computers felt that, regardless of what kinds of improvement might be made, it would just be too difficult for them to learn to work with the device. Conclusions: As with the Dutch TTSQ, the Turkish TTSQ needs improvement before it can be released. The results of this study confirm the conclusion of the Dutch TTSQ study that participants with low levels of education and little experience in using mobile technology are less able to operate the TTSQ effectively. Using a Dutch speaking interviewer and Turkish interpreter has had a negative effect on data collection in this study.
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We demonstrate a method that allows two users to communicate remotely using their sense of touch by dynamically applying vibrotactile feedback to one user's forearm using two different input methods. User input on a standard mobile touch-screen device or a purpose-built touch-sensitive wearable is analyzed in real time, and used to control intensity, location, and motion parameters of the vibrotactile output to synthesize the stroke on a second users arm. Our method demonstrates that different input methods can be used for generating similar vibrotactile sensations.
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Het project in Touch heeft geleid tot veel kennisontwikkeling en -verspreiding. Er is een iPad cover ontwikkeld en in productie genomen. Ook is er kennis ontwikkeld over de effecten van het spelen van spelletjes op de iPad door mensen met dementie. Uit het onderzoek van Kenniscentrum Zorginnovatie is gebleken dat ouderen met dementie zelf aangeven dat het doen van spellen op de iPad hun zelfwaardering verhoogt, omdat ze een hoge score kunnen behalen, hun identiteit wordt versterkt doordat ze spellen spelen die ze vroeger ook deden, en omdat ze zich verbazen over de mooie beelden van het spel (Groenewoud et al. 2014). Een indeling maakt het gemakkelijker om vooraf een spel te kiezen dat goed aansluit bij de individuele wensen en behoeften van een persoon met dementie. De criteria voor indeling zijn niet eenduidig en zijn onderwerp van nadere precisering. Naar aanleiding van de ervaringen tijdens het In Touch onderzoek is er een indeling gekozen (Cordia,2014) die voor de context van belang is en die door nader onderzoek verfijnd kan worden. De Top-up biedt de mogelijkheid om vooral het element beoordeling en selectie van games voor mensen met dementie verder uit te werken. Hierdoor zal de toepassing in het onderwijs en praktijk vergemakkelijkt en vergroot worden. Het biedt bovendien de kans om het onderzoek wat door de UK-partner (Sheffield University) van In Touch is gedaan met dit vervolg te vergelijken en de samenwerking internationaal te versterken. Het doel van het project is het verder ontwikkelen van een instrument om een goede match tussen wensen, behoeften en mogelijkheden van mensen met dementie en eigenschappen van een spel te vergemakkelijken en de verwerking hiervan in handreikingen en een internationale conferentie. Belangrijk mijlpalen van het project zijn: een instrument dat getest kan worden in de praktijk (fase 1), Inhoudelijke en praktische kennis over wat wel en niet werkt in praktijk (fase 2), digitaal instrument bruikbaar voor onderwijs en praktijk waarvan de ervaringen gedissemineerd kunnen worden ism met Sheffield University.
