Human Factors and Healthcare: The older patient & nurse

I‘ve recently published two papers on the topic of human factors and healthcare. Each paper covers a different “stakeholder”: the older patient and the nurse.  The first paper is available for free but the second paper (a collaboration with my architect colleague Dina Battisto) is available at your local library (or you can request a PDF reprint from me).

Pak, R., Price, M. M., & Thatcher, J. (2009). Age-sensitive design of online health information. Journal of Medical Internet Research.

ABSTRACT
Background:
Older adults’ health maintenance may be enhanced by having access to online health information. However, usability issues may prevent older adults from easily accessing such information. Prior research has shown that aging is associated with a unique pattern of cognitive changes, and knowledge of these changes may be used in the design of health websites for older adults. Objective: The goal of the current study was to examine whether older adults use of a health information website was affected by an alternative information architecture and access interface (hierarchical versus tag-based). Methods: Fifty younger adults (aged 18-23) and 50 older adults (aged 60-80) navigated a health information website, which was organized hierarchically or used tags/keywords, to find answers to health-related questions while their performance was tracked. We hypothesized that older adults would perform better in the tag-based health information website because it placed greater demands on abilities that remain intact with aging (verbal ability and vocabulary). Results: The pattern of age-related differences in computer use was consistent with prior research with older adults. We found that older adults had been using computers for less time (F1,98= 10.6, P= .002) and used them less often (F1,98= 11.3, P= .001) than younger adults. Also consistent with the cognitive aging literature, younger adults had greater spatial visualization and orientation abilities (F1,98= 34.6, P< .001 and F1,98= 6.8, P= .01) and a larger memory span (F1,98= 5.7, P= .02) than older adults, but older adults had greater vocabulary (F1,98= 11.4, P= .001). Older adults also took significantly more medications than younger adults (F1,98= 57.7, P< .001). In the information search task, older adults performed worse than younger adults (F1,96= 18.0, P< .001). However, there was a significant age × condition interaction indicating that while younger adults outperformed older adults in the hierarchical condition (F1,96= 25.2, P< .001), there were no significant age-related differences in the tag-based condition, indicating that older adults performed as well as younger adults in this condition. Conclusions: Access to online health information is increasing in popularity and can lead to a more informed health consumer. However, usability barriers may differentially affect older adults. The results of the current study suggest that the design of health information websites that take into account age-related changes in cognition can enhance older adults’ access to such information.

Battisto, D. B., Pak, R., Vander Wood, M. A., & Pilcher, J. J. (2009). Employing a task analysis to describe nursing work in acute care patient environments. Journal of Nursing Administration, 39(12), 537-547.

ABSTRACT
To improve the healthcare environment where nurses work and patients receive care, it is necessary to understand the elements that define the healthcare environment. Primary elements include (a) the occupants of the room and what knowledge, skills, and abilities they bring to the situation; (b) what tasks the occupants will be doing in the room; and (c) the characteristics of the built environment. To better understand these components, a task analysis from human factor research was conducted to study nurses as they cared for hospitalized patients. Multiple methods, including a review of nursing textbooks, observations, and interviews, were used to describe nurses’ capabilities, nursing activities, and the environmental problems with current patient room models. Findings from this initial study are being used to inform the design and evaluation of inpatient room prototype and to generate future research in improving clinical environments to support nursing productivity.

The picture at the top of this post is the room prototype referenced in the abstract above.  Further details on its design and evaluation will be covered in another forthcoming paper.