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3Physical activity monitoring with wearable technology has the potential to support stroke rehabilitation. Little is known about how physical therapists use and value the use of wearable activity monitors. This cross-sectional study explores the use, perspectives, and barriers to wearable activity monitoring in day-to-day stroke care routines amongst physical therapists. Over 300 physical therapists in primary and geriatric care and rehabilitation centers in the Netherlands were invited to fill in an online survey that was developed based on previous studies and interviews with experts. In total, 103 complete surveys were analyzed. Out of the 103 surveys, 27% of the respondents were already using activity monitoring. Of the suggested treatment purposes of activity monitoring, 86% were perceived as useful by more than 55% of the therapists. The most recognized barriers to clinical implementation were lack of skills and knowledge of patients (65%) and not knowing what brand and type of monitor to choose (54%). Of the non-users, 79% were willing to use it in the future. In conclusion, although the concept of remote activity monitoring was perceived as useful, it was not widely adopted by physical therapists involved in stroke care. To date, skills, beliefs, and attitudes of individual therapists determine the current use of wearable technology.
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Background: To experience external objects in such a way that they are perceived as an integral part of one's own body is called embodiment. Wearable technology is a category of objects, which, due to its intrinsic properties (eg, close to the body, inviting frequent interaction, and access to personal information), is likely to be embodied. This phenomenon, which is referred to in this paper as wearable technology embodiment, has led to extensive conceptual considerations in various research fields. These considerations and further possibilities with regard to quantifying wearable technology embodiment are of particular value to the mobile health (mHealth) field. For example, the ability to predict the effectiveness of mHealth interventions and knowing the extent to which people embody the technology might be crucial for improving mHealth adherence. To facilitate examining wearable technology embodiment, we developed a measurement scale for this construct.
Objective: This study aimed to conceptualize wearable technology embodiment, create an instrument to measure it, and test the predictive validity of the scale using well-known constructs related to technology adoption. The introduced instrument has 3 dimensions and includes 9 measurement items. The items are distributed evenly between the 3 dimensions, which include body extension, cognitive extension, and self-extension.
Methods: Data were collected through a vignette-based survey (n=182). Each respondent was given 3 different vignettes, describing a hypothetical situation using a different type of wearable technology (a smart phone, a smart wristband, or a smart watch) with the purpose of tracking daily activities. Scale dimensions and item reliability were tested for their validity and Goodness of Fit Index (GFI).
Results: Convergent validity of the 3 dimensions and their reliability were established as confirmatory factor analysis factor loadings45 (>0.70), average variance extracted values40 (>0.50), and minimum item to total correlations50 (>0.40) exceeded established threshold values. The reliability of the dimensions was also confirmed as Cronbach alpha and composite reliability exceeded 0.70. GFI testing confirmed that the 3 dimensions function as intercorrelated first-order factors. Predictive validity testing showed that these dimensions significantly add to multiple constructs associated with predicting the adoption of new technologies (ie, trust, perceived usefulness, involvement, attitude, and continuous intention).
Conclusions: The wearable technology embodiment measurement instrument has shown promise as a tool to measure the extension of an individual's body, cognition, and self, as well as predict certain aspects of technology adoption. This 3-dimensional instrument can be applied to mixed method research and used by wearable technology developers to improve future versions through such things as fit, improved accuracy of biofeedback data, and customizable features or fashion to connect to the users' personal identity. Further research is recommended to apply this measurement instrument to multiple scenarios and technologies, and more diverse user groups.
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Despite assumptions that wearable self-care technologies such as smart wristbands and smart watches help users to monitor and self-manage health in daily life, adherence rates are often quite low. In an effort to better understand what determines adherence to wearable self-care technologies, researchers have started to consider the extent to which a technology is perceived as being part of the user (i.e., technology embodiment) and the extent to which users feel they can influence reaching their health goals (i.e., empowerment). Although both concepts are assumed to determine adherence, few studies have empirically validated their influence. Furthermore, the relationships between technology embodiment, empowerment, and adherence to wearable self-care technology have also not been addressed. Drawing upon embodied theory and embodiment cognition theory, this research paper introduces and empirically validates ‘embodied empowerment’ as a predictor of adherence to wearable self-care technology. Using partial least squares structural equation modeling and multigroup analysis on a dataset of 317 wearable self-care technology users, we find empirical evidence of the validity of embodied empowerment as a determinant of adherence. We also discuss the implications for research and practice.
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The use of in-body wearable devices is increasing in the healthcare sector, given their capacity to diagnose diseases and monitor health conditions. At the same time, some of these devices have entered the market and are being researched for use in workplace settings to enhance workers’ health and safety. However, neither specific EU legislation nor national law currently regulates the use of in-body wearables in employment, raising questions about the safeguarding of workers’ fundamental rights to privacy and data protection. Addressing the challenges posed by this regulatory gap, this article explores whether the European legislative framework employed in the healthcare sector for medical devices could be applied to the use of in-body wearables in employment settings. It also discusses the application of a key principle of the General Data Protection Regulation when in-body wearables are used in the workplace: lawfulness.
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Background:
Current technology innovations, such as wearables, have caused surprising reactions and feelings of deep connection to devices. Some researchers are calling mobile and wearable technologies cognitive prostheses, which are intrinsically connected to individuals as if they are part of the body, similar to a physical prosthesis. Additionally, while several studies have been performed on the phenomenology of receiving and wearing a physical prosthesis, it is unknown whether similar subjective experiences arise with technology.
Objective:
In one of the first qualitative studies to track wearables in a longitudinal investigation, we explore whether a wearable can be embodied similar to a physical prosthesis. We hoped to gain insights and compare the phases of embodiment (ie, initial adjustment to the prosthesis) and the psychological responses (ie, accept the prosthesis as part of their body) between wearables and limb prostheses. This approach allowed us to find out whether this pattern was part of a cyclical (ie, period of different usage intensity) or asymptotic (ie, abandonment of the technology) pattern.
Methods:
We adapted a limb prosthesis methodological framework to be applied to wearables and conducted semistructured interviews over a span of several months to assess if, how, and to what extent individuals come to embody wearables similar to prosthetic devices. Twelve individuals wore fitness trackers for 9 months, during which time interviews were conducted in the following three phases: after 3 months, after 6 months, and at the end of the study after 9 months. A deductive thematic analysis based on Murray’s work was combined with an inductive approach in which new themes were discovered.
Results:
Overall, the individuals experienced technology embodiment similar to limb embodiment in terms of adjustment, wearability, awareness, and body extension. Furthermore, we discovered two additional themes of engagement/reengagement and comparison to another device or person. Interestingly, many participants experienced a rarely reported phenomenon in longitudinal studies where the feedback from the device was counterintuitive to their own beliefs. This created a blurring of self-perception and a dilemma of “whom” to believe, the machine or one’s self.
Conclusions:
There are many similarities between the embodiment of a limb prosthesis and a wearable. The large overlap between limb and wearable embodiment would suggest that insights from physical prostheses can be applied to wearables and vice versa. This is especially interesting as we are seeing the traditionally “dumb” body prosthesis becoming smarter and thus a natural merging of technology and body. Future longitudinal studies could focus on the dilemma people might experience of whether to believe the information of the device over their own thoughts and feelings. These studies might take into account constructs, such as technology reliance, autonomy, and levels of self-awareness.
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The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitch during football-specific exercises (F-EX) and games (F-GAME). Knee joint moments were collected in the laboratory and grouped using hierarchical agglomerative clustering. The clusters were used to investigate the kinematics collected on field through wearable sensors. Three clusters emerged: Cluster 1 presented the lowest knee moments; Cluster 2 presented high knee extension but low knee abduction and rotation moments; Cluster 3 presented the highest knee abduction, extension, and external rotation moments. In F-EX, greater knee abduction angles were found in Cluster 2 and 3 compared to Cluster 1 (p = 0.007). Cluster 2 showed the lowest knee and hip flexion angles (p < 0.013). Cluster 3 showed the greatest hip external rotation angles (p = 0.006). In F-GAME, Cluster 3 presented the greatest knee external rotation and lowest knee flexion angles (p = 0.003). Clinically relevant differences towards ACL injury identified in the laboratory reflected at-risk patterns only in part when cutting on the field: in the field, low-risk players exhibited similar kinematic patterns as the high-risk players. Therefore, in-lab injury risk screening may lack ecological validity.
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Purpose: Recent advancements in wearable computing offer opportunities for art galleries to provide a unique experience. However, to ensure successful implementation of this new technology in the visitor industry, it is essential to understand user requirements from a visitor’s point of view. Therefore, the aim of this paper is to investigate visitors’ requirements for the development of a wearable smart glasses augmented reality (AR) application in the museum and art gallery context. Design/methodology/approach: Interviews with 28 art gallery visitors were conducted and an affinity diagram technique was used to analyze the interviews. Findings: The findings reveal that wearable AR is in its infancy and that technical and design issues have to be overcome for a full adoption. It reveals that content requirement, functional requirement, comfort, experience and resistance are important when developing and implementing the wearable AR application in the museum and art gallery contexts. Originality/value: Mapping user requirements in the wearable smart glasses AR context using an affinity diagram is a new approach and therefore contributes to the creation of knowledge in the tourism domain. Practically, the area of wearable technologies and AR within the tourism and visitor industry context is still relatively unexplored, and the present paper provides a first foundation for the implementation of wearable smart glasses AR applications in the museum and art gallery context.
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Background: Continuous monitoring of vital signs (CMVS) using wearable wireless sensors is increasingly available to patients in general wards and can improve outcomes and reduce nurse workload. To assess the potential impact of such systems, successful implementation is important. We developed a CMVS intervention and implementation strategy and evaluated its success in 2 general wards. Conclusions: We successfully implemented a system for CMVS at scale in 2 hospital wards, but our results show that intervention fidelity decreased over time, more in the internal medicine ward than in the surgical ward. This decrease appeared to depend on multiple ward-specific factors. Nurses’ perceptions regarding the value and benefits of the intervention varied. Implications for optimal implementation of CMVS include engaging nurses early, seamless integration into electronic health records, and sophisticated decision support tools for vital sign trend interpretation.
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The paper explores how a post-cognitive approach to human perception can help the design of wearable technologies that augment sense-making. This approach relies on the notion of pure experience to understand how we can make sense of the world without interpreting it, for example through our body, as claimed by phenomenology. In order to understand how to design wearable technologies for pure experience, we first held interviews with experts from different domains, all investigating how to express and recognise pure experience. Subsequently, we had a focus group with professional dancers: given their heightened sense of bodily cognition in their experience, we wanted to verify the extent to which the experts’ practice could be claimed back into the dancers’ experience. In this paper, we will present our preliminary findings.
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Patients on general wards are at risk of complications, often associated with deviations in vital signs. Unfortunately, the currently used manual method of intermittently measuring vital signs is not optimal, potentially leading to late recognition and treatment of complications, and sometimes with serious consequences such as intensive care admissions and even death. A possible solution may be wearable, wireless sensors that can continuously monitor vital signs (CMVS), but large-scale evaluation and successful implementation have not yet been described. This thesis aimed to gain a deeper understanding of the essential elements of CMVS, the crucial aspects of the implementation process, and the potential benefits of such systems for patient care, all with an emphasis on the nurse's perspective, as a prelude to further development and future implementations. The findings highlight the complexity of implementing CMVS on general wards and underline the need for further development and studies to assess actual clinical value and cost-effectiveness. Due to the current early stage of technology development, implementation remains a serious challenge. Nurses have an essential role in the successful deployment of CMVF on regular wards and are key to their success. Wearable continuous vital signs monitoring technology is expected to mature further in the coming years, enabling continuous monitoring of all relevant vital signs, enabling software to integrate seamlessly with hospital IT systems and providing personalised clinical decision support. If properly implemented, such evolving systems promise to significantly improve the future quality, safety and efficiency of patient care, both inside and also outside the hospital. Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof.dr. H.R.B.M. Kummeling, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op maandag 25 september 2023 des middags te 2.15 uur door Jobbe Pierre Lucien Leene.
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