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This paper presents an attempt to understand how safe walking technology can be designed to fit the needs of people with dementia. Taking inspiration from modern dementia care philosophy, and its emphasis on the individual with dementia, we have performed in-depth investigations of three persons' experiences of living with early-stage dementia. From interviews and co-design workshops with them and their family caregivers, we identified several factors that influence people with dementia's attitudes toward safe walking technology, and how they want the technology to assist them. Relevant factors include: The desire for control and self-management, the subjective experiences of symptoms, personal routines and skills, empathy for care-givers, and the local environment in which they live. Based on these findings, we argue there is a need to reconsider "surveillance" as a concept on which to base design of safe walking technology. We also discuss implications for design ethics.

Controlled laboratory-based usability assessments of mobile information and communications technologies (ICT) for hospitals have been conducted. As part of these assessments, clinicians have acted out mobile work scenarios and used the systems to solve related tasks. The evaluations show that relevant usability issues go beyond those of graphical user interfaces. Many of these usability issues only show up when the real-world context of use is replicated in the laboratory to a high degree of fidelity. The complexity of the context of use for mobile ICT in hospitals has motivated us to explore training simulation fidelity theories. Based on a review of the training simulation literature, a set of fidelity dimensions through which training simulations are often adjusted to meet specific goals are identified. It is argued that the same mechanisms can be used in usability assessments of mobile ICT for hospitals. Our argument is substantiated by using the identified set of fidelity dimensions in a retrospective analysis of two usability assessments. The analysis explains how the configuration of fidelity dimensions, each reflecting various degrees of realism vis-à-vis the actual performance context, contributed to the identification of relevant usability issues.

Background: Exergames are increasingly used as an exercise intervention to reduce fall risk in elderly. However, few exergames have been designed specifically for elderly, and we lack knowledge about the characteristics of the movements elicited by exergames and thereby about their potential to train functions important for fall risk reduction. Objective: This study investigates game elements and older players' movement characteristics during stepping exergames in order to inform exergame design for movement quality in the context of fall preventive exercise. Methods: Fourteen senior citizens (mean age 73 years ± 5.7, range 65 - 85) played 3 stepping exergames in a laboratory. Each of the exergames was described with respect to 7 game elements (physical space, sensing hardware technology, game graphics and sound, model of user, avatar/mapping of movements, game mechanism and game narrative). Five movement characteristics (weight shift; variation in step length, speed, and movement direction; visual independency) were scored on a 5-point Likert scale based on video observations of each player and each game. Disagreement between raters was resolved by agreement. Differences in scores for the 3 exergames were analyzed with a multivariate one-way ANOVA. Results: The Mole received the highest sum score and the best score on each of the 5 movement characteristics (all p values <0.0005). LightRace scored the lowest of the 3 exergames on weight shift and variation in movement direction (both p values <0.0005), while DanceDanceRevolution scored lowest on step length variation and visual independency (p < 0.03 and p < 0.0005, respectively), and lower than The Mole on speed variation (p < 0.05). The physical space players used when exergaming and the on-screen representation of the player, affected movement quality positively as indexed by multiple weight shifts and variation in stepping size, direction, and speed. Furthermore, players' movements improved when playing speed-affected game progression and when the game narrative was related to a natural context. Conclusion: Comparing differences in game elements with associated differences in game movement requirements provides valuable insights about how to design for movement quality in exergames. This provided important lessons for the design of exergames for fall-preventive exercise in senior citizens and illustrates the value of including analyses of movement characteristics when designing such exergames.

Currently, exergames are used by different age groups for both recreational and training/rehabilitation purposes. However, little is known about how to design exergames so that they are motivating for specific age groups and health outcomes. Objective: In this paper, we compare motivational factors between healthy young and older adults by analyzing their assessments of the same balance training exergame. Materials and Method: We performed a laboratory-based assessment of a custom-made balance training exergame with twelve healthy young and ten healthy older adults. Their answers to a semi-structured text input questionnaire were analyzed qualitatively. Results: Both age groups were motivated by a combination of intrinsic and extrinsic motivational factors. We found that the young adults tended to be motivated by the game challenge and the in-game reward system (scores). In contrast, the older adults were more motivated by the perceived health effects (both physical and cognitive) and the joy of playing, with less regard for the in-game rewards. Conclusion:The differences in motivational factors that were identified between young and older adults have several design implications. For older adults less effort can be put on designing the in-game reward system, and more on showing the player the potential health effects of their play. Furthermore, the competition aspect can be downplayed, and more focus placed on simply making the gaming experience itself as joyful as possible.

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Patients with advanced cancer are influenced by the disease itself and by treatment side effects, both of which may have great impact on their lives. One of the most distressing symptoms is pain. However, pain in cancer patients can in most cases be relieved if the patient is able to communicate the nature and severity of the problem to the healthcare professionals through an effective assessment process. The main goal of this paper is to help form an understanding of central patient characteristics that should be taken into account when designing pain assessment tools for patients with advanced cancer. Traditionally, pain has been assessed by paper-based questionnaires and pain drawings. An iterative study was conducted based on repeated cycles of usability testing of a computerized pain body map for communicating pain by advanced cancer patients. Our aim was to provide a patient interface that most patients were able to interact with, collecting valuable, granular pain information with a minimum of strain on the patient. Through this process, we identified and solved design issues related to the sickest and frailest cancer patients. We further created a web-based solution for collecting individual pain drawings for evaluation by clinicians. The concept was appreciated by the patients, and the information provided was considered valuable by physicians. The main contribution of this paper is a list of suggestions to guide the design of an interactive tool for patients with advanced cancer.