Background Voice assistants enable older adults to communicate regarding their health as well as facilitate ageing in place. This study investigated the effects of communication style, anthropomorphic setting, and individual differences on the trust, acceptance, and mental workload of older adults using a voice assistant when communicating health issues. Methods This is a mixed-methods study utilising both quantitative and qualitative methods. One hundred and six older adults (M = 71.8 years, SD = 4.6 years) participated in a 2 (communication style: social- vs. task-oriented; between-subject)$$\times$$ × 2 (anthropomorphic setting: ordinary profession vs. medical background; within-subject) mixed design experiment. The study used multivariate analysis of variance (MANOVA) to examine the effects of communication style, anthropomorphic setting of the voice assistant, and participants’ use frequency of digital devices on the trust, technology acceptance, and mental workload of older adults using a voice assistant in a health context. End-of-study interviews regarding voice assistant use were conducted with participants. Qualitative content analyses were used to assess the interview findings about the communication content, the more trustworthy anthropomorphic setting, and suggestions for the voice assistant. Results Communication style, anthropomorphic setting, and individual differences all had statistically significant effects on older adults’ evaluations of the voice assistant. Compared with a task-oriented voice assistant, older adults preferred a social-oriented voice assistant in terms of trust in ability, integrity, and technology acceptance. Older adults also had better evaluations for a voice assistant with a medical background in terms of trust in ability, integrity, technology acceptance, and mental workload. In addition, older adults with more experience using digital products provided more positive evaluations in terms of trust in ability, integrity, and technology acceptance. Conclusions This study suggests that when designing a voice assistant for older adults in the health context, using a social-oriented communication style and providing an anthropomorphic setting in which the voice assistant has a medical background are effective ways to improve the trust and acceptance of older adults of voice assistants in an internet-of-things environment.
Voice assistants are widely used in smart home environments. This study aimed to investigate user acceptance of a smart home voice assistant. A questionnaire was designed, and 471 Chinese adults were recruited to complete the questionnaire. The data were analyzed using exploratory factor analysis and regression analysis. The results revealed that user requirements of adults were composed of six factors: hedonic motivation and trust ( β = .41, p < .001), social influence ( β = .22, p < .001), performance expectancy ( β = .15, p < .001), effort expectancy ( β = .08, p = .018), product features ( β = .15, p = .009), and facilitating conditions ( β = .06, p = .049). Among these six factors, hedonic motivation and trust are considered the most important. Younger, middle-aged, and older adults differed significantly in their requirements and acceptance of a smart home voice assistant. These findings have implications for the design of smart home voice assistants so that they are more acceptable to younger and older adults. Supplementary Information The online version contains supplementary material available at 10.1007/s10209-022-00936-1.
Objective: The majority of non-small cell lung cancer (NSCLC) cases remain undiagnosed until advanced stages of the disease. Accumulating studies have highlighted the utility of palliative care as an effective treatment option, which relieves patients' suffering by activating placebo effect in the body. To evaluate the clinical significance of palliative care, data from NSCLC drug-randomized controlled trials (RCTs) were collected and the effects of placebo treatment examined.Methods: PubMed (MEDLINE), Scopus, Web of Science, and China National Knowledge Infrastructure databases were searched from January 1,1978 to September 1,2020. Placebo-controlled phase II/III pharmaceutical RCTs enrolling patients with solely stage III/IV NSCLC were included. The quality of included studies was assessed using the Jadad method. Single-arm and two-arm meta-analyses of the therapeutic and adverse effects of placebo, that is, the primary and secondary outcome measures, were subsequently performed using either Bayesian or conventional models.Results: Five RCTs including 2245 drug-treated and 1510 placebo-treated patients at NSCLC stage III or IV were included for the study. Low risk of bias was observed for all five included studies using the Cochrane method. Following placebo treatment, controlled disease rate of 24.1% (95% credible interval [CrI], -0.126-0.609) and dropout rate of 2.1% (95% CrI, 0.007-0.039) were calculated, with a dose reduction rate of 3.0% (95% CrI, 0.017-0.045). Compared with active drug treatment, the placebo treatment group had a risk ratio of 0.81 (95% confidence interval, 0.68-0.97) and 0.85 (95% confidence interval, 0.76-0.96) for the achievement of progression-free survival and overall survival, respectively. Conclusion:In NSCLC drug RCTs, placebo treatment is indicated to generally induce low toxicity in patients by dropout and dose reduction rates and adverse events, although the therapeutic responses could not be precisely determined. The results suggest that under specific circumstances, palliative care which can activate placebo effect may have similar effects as active drugs (such as erlotinib, vandetanib, or pemetrexed) in terms of prolonging survival time.
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