JMIR Publications

ABSTRACT

Background:

The non-randomized and exploratory intervention and feasibility study examines how a digital assistive technology (DAT), the Dfree ultrasound sensor, impacts nursing care in continence support. Additionally, the project asks about the willingness of caregivers to incorporate DAT into planning and the practical implementation of care processes as a direct effect of a positive assessed intention to use and usability.

Objective:

It is unclear whether the Dfree is a relief in clinical care settings and to what extent the Dfree supports caregiving in the field of activity of daily living (ADL) “micturition” by means of the extent of work load reduction in continence support. The aim is to design a human-technology interaction that ensures a high level of usability for all test subjects, i.e. the nursing care stuff and to increase user acceptance during the study period for at least one level of the SUS (e.g. from average to slightly above average). Therefore, the goal is to design a process with a level of acceptance as high as possible for all test subjects involved.

Methods:

Around 45 nurses from the clinics and polyclinics of Neurology, Neurosurgery and Geriatrics at the University Medicine Halle are included in the 90-day (3-month) intervention. The intervention takes place on site at the respective wards. After the wards have been equipped with the digital technologies, participating nurses will be trained for use and to be able to select the Dfree as a possible resource for continence care, if patients anamnesis describes a bladder dysfunction. The trial only takes place if the patient is willing to participate. The study is conducted as a mixed-method-design. The willingness of health and nursing care stuff to use the Dfree while planning their care process is going to be assessed by using the Technology Usage Inventory (TUI) at three measurement points. The primary target values are the results of this multidimensional TUI assessment. Data are processed in the sense of descriptive statistics (quantitative part). In addition, ten of the participating nurses are invited to extensive guided interviews, which are intended to provide information about usefulness, feasibility in the special field of continence care and possible improvements regarding the device (qualitative part).

Results:

It is expected that the intention to use is going to be confirmed by the nurses and the number of nursing problems such as bedwetting induced by the presence of bladder dysfunction will be reduced. Furthermore usability should be rated as high.

Conclusions:

The Dfree ultrasound device is a technical artefact for predicting micturition needs that helps patients with bladder dysfunction to take control of their micturition behavior. As studies show its potential in outpatient care (Hofstetter et al., 2022) it is still unclear, whether the Dfree can be a relief in the clinical care setting and to what extent caregivers actually are willing to use the Dfree as a care supporting technology. Therefore, this study protocol fosters a study project to show if user acceptance of Dfree is high among participating clinical health care and nursing stuff. We expect the Dfree to reduce the workload in continence care by health and nursing care professionals as well as cost for continence care materials. The present study protocoll suggests to have a deeper look into how digital and assistive technologies (DAT), by using the example of Dfree Professional, facilitate continence care in clinical settings and how health and nursing care professionals assess the "usability" of this DAT. Usability in this sense means not just attributes of a technology, but more a quality feature of using a technology by means of human-technology interaction. Usability in this sense depends "on the significance, transparency and physical access to socio-technical constellations“ (Janda 2019), as meaningfulness and effectiveness must be particularly accessible to the users (Venkatesh and Davis 1996; Janda 2019). The assessed intention of nursing professionals to use (ITU) Dfree Professional in their daily nursing process planning corresponds to what is called "usability" of a DAT. Clinical Trial: Deutsches Register Klinische Studien DRKS00031483