PRE2016 1 Groep1

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Jasmijn  Kleij  0906848 (JA)
Jasmijn  Kleij  0906848 (JA)
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== Summary ==
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== Abstract ==
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The goal of this project was to improve the current passive patient hoist by making adjustments to enhance the convenience for primary users. In literature hardly any research was found about the use of passive patients hoists in hospitals and nursing homes. The first step of this research was to gain information from the users of the hoist by taking interviews and conducting a survey. Based on the results of the interviews and the survey seven requirements to improve the current passive hoist were made and implemented in the first design. Due to the feedback some alternations of the first design have been executed which resulted in the final design of the patient hoist. This final design consists of two different end products, one new patient hoist design that consists of all adjustments and one which is functioning as an add-on for the current patient hoist.
== Introduction ==  
== Introduction ==  
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Our current society is facing the societal dilemma of ageing, given that the ratio of care takers and caregivers is out of balance and will be expanded even more in the future.
Our current society is facing the societal dilemma of ageing, given that the ratio of care takers and caregivers is out of balance and will be expanded even more in the future.
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Considering the fact that technological advancements in health care are taking place, such as better treatment for diseases, also contribute to the increase of elderly people, because their lifespan is extended.
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Technological advancements in health care are taking place, such as better treatment for diseases, and those also contribute to the increase of elderly people, because their lifespan is extended.
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Due to this, there will be lack of caregivers in the future and therefore it will almost be inevitable that robots are partially taking over tasks. These tasks can not be of great complexity of course, as robots are unable to think autonomous like humans.
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Due to this, there will be a lack of caregivers in the future and therefore it will almost be inevitable that robots are partially taking over tasks. These tasks cannot be of great complexity of course, as robots are unable to think autonomous like humans.
From this point of view, we have come up with a good use for robotics in which the relatively few human caregivers left in the future can focus on important and risky care tasks which should not be given in the hands of robots, like for instance the use of robots in operating theatres.   
From this point of view, we have come up with a good use for robotics in which the relatively few human caregivers left in the future can focus on important and risky care tasks which should not be given in the hands of robots, like for instance the use of robots in operating theatres.   
Our idea will be realized by improving the current patient hoist in hospitals and nursing homes, in which patients who are not able to relocate themselves anymore, are transferred by lifting them. The patients can be transferred between for instance a bed and a chair or to places like restrooms and sitting rooms etc.  
Our idea will be realized by improving the current patient hoist in hospitals and nursing homes, in which patients who are not able to relocate themselves anymore, are transferred by lifting them. The patients can be transferred between for instance a bed and a chair or to places like restrooms and sitting rooms etc.  
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However, unlike already existing patient lifts, our improved patient hoist (I.P.H) can work partially autonomous and will be equipped with an interaction device. Due to this, the new patient hoist is able to detect the emotions of patients. The human-robot interaction will play a significant role in our design cycle.
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However, unlike already existing patient lifts, our improved patient hoist (I.P.H.) can work partially autonomous and will be equipped with an interaction device. Due to this, the new patient hoist is able to detect emotions of patients. The USE-centered design method will play a significant role in our design cycle so the I.P.H. can be beneficial for all sorts of groups.
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This improved hoist can be beneficial for all sorts of groups. The human caregivers for example can benefit from it, because the patient hoist is more manageable. They do not have to lift patients themselves anymore and they can exert less power to move the hoist, which is now partially autonomous. This is better for their own health by for example preventing back pain from heavy lifting and pushing. Due to the interaction device, the hoist can detect how a patient is feeling during the lifting process and is able to alert the caregiver whenever there is something wrong with the patient. Constant eye contact between patient and caregiver and better awareness of the environment of the hoist for the caregivers can also be obtained by the interaction device during the transportation process.
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=== Approach ===
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=== Hypothesis ===
=== Hypothesis ===
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To guide our research we have set up several hypotheses. These are divided in main hypotheses with several sub-hypotheses. Some of these will be investigated through surveys and others will become clear from interviews.  
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To guide the research several hypotheses have been set up. These are divided in main hypotheses with several sub-hypotheses. Some of these will be investigated through surveys and others will become clear from interviews.  
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- Caregivers need a patient hoist that can provide information about the weight or the 'BMI' of the patient.
- Caregivers need a patient hoist that can provide information about the weight or the 'BMI' of the patient.
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'''Patients and caregivers attach value to interacion during the process of lifting.'''
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'''Patients and caregivers attach value to interaction during the process of lifting.'''
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- Patients need a certain level of interaction with the caregiver during the process of lifting. (So more need for touch/eye contact/speach, or no need?) (Survey)   
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- Patients need a certain level of interaction with the caregiver during the process of lifting. (So more need for touch/eye contact/speech, or no need?) (Survey)   
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- During the interaction between patient and caregiver eye contact is more important than speach for a pleasant interaction. (Survey)
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- During the interaction between patient and caregiver eye contact is more important than speech for a pleasant interaction. (Survey)
- During the interaction between patient and caregiver eye contact is more important than physical contact for a pleasant interaction. (Survey)  
- During the interaction between patient and caregiver eye contact is more important than physical contact for a pleasant interaction. (Survey)  
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- Patients do not mind if the caregiver is absent for a certain part of the lifting process.  
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- Patients do not mind if the caregiver is absent for a certain part of the lifting process.
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'''The trust of patients in the modern patient hoist results in less necessity for assistance of the caregiver '''
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- Trust depends on the design of the device.
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- The degree of acquaintance with modern technology results in less necessity for interaction between caregiver and patient. (Survey)
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- The degree of acquaintance with the active of passive patient hoist results in less necessity for interaction between caregiver and patient. (Survey)
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=== Objectives ===
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=== Objectives and approach ===
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The main objective of the project is to improve the existing patient hoist.
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The main objective of the project is to improve the current passive patient hoist. The passive instead of the active patient hoist is chosen, because a human-robot interaction adjustment can be of good use for this hoist. The interaction between patient and caregiver by using a passive hoist is not constant during the process as the distance between caregiver (behind the hoist) and patient (in the yoke of the hoist) is much larger than with an active hoist.  
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To be able to establish the shortcommings and disadvantages of the current patient hoist it is of great importance to get enough inside information using personal interviews and surveys. After analysis the hypothesis stated above can either be confirmed or disconfirmed and are, next to the now known shortcommings and problems, used to draft requirements for the new design of the patient hoist. The new design will be sketched and if possible a prototype will be made, otherwise a 3D-model will be made of the new design. Either way feedback will be gathered to verify whether the adjustments are successful.
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To be able to determine the shortcomings and disadvantages of the current passive patient hoist it is important to get enough inside information. This information will be gathered by literature research,  taking interviews and conducting a survey of the primary users of the hoist. After analysis of all this collected information the hypotheses stated above can either be confirmed or disconfirmed. The answers of the hypotheses are, next to the now known shortcomings and problems, used to set up requirements for the new design of the passive hoist. The new design will be sketched and a demonstration film will be made to illustrate/clarify the meanings of the made adjustments in the design. At the end feedback will be gathered to verify whether the adjustments in the new design are successful and a final design will be proposed by taking the feedback into account.
== Scenarios ==
== Scenarios ==
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To give you all a proper view about the current use of the passive patient hoist, the current working method will be described in the next two scenarios:  
To give you all a proper view about the current use of the passive patient hoist, the current working method will be described in the next two scenarios:  
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=== '''Scenario 1''': - Inside 1 room - ===
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=== '''Scenario 1''': - Inside one room - ===
“Transporting from bed to chair inside a room with the passive patient hoist”
“Transporting from bed to chair inside a room with the passive patient hoist”
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Mr. A is a 75 year old inhabitant of Parc Imstenrade, a home for the elderly. Mr. A, who can not stand up by himself and therefore not able to relocate himself anymore, lies in his bed in room 23. Caregiver Lilly is going to put Mr. A in his chair near the window so he can see the nearby public garden. She will use the passive patient hoist to do so.
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Mr. A is a 75 year old inhabitant of Parc Imstenrade, a home for the elderly. Mr. A, who cannot stand up by himself and therefore not able to relocate himself anymore, lies in his bed in room 23. Caregiver Lilly is going to put Mr. A in his chair near the window so he can see the nearby public garden. She will use the passive patient hoist to do so.
Lilly takes a lifting mat of the proper size for Mr. A and puts 2 whalebones in the backside of the lifting mat for better support for Mr. A’s back during the lifting process. She brings the bed to the right working height so she can work more easily without risking back problems. Lilly explains to Mr. A. what she is doing and is going to do at every step of the lifting process so he will not be surprised by any actions. First she turns Mr. A to his left side and pushes the lifting mat underneath him. Then she turns him to his right side so the mat can be equally divided underneath him. As soon as Mr. A lies back on his back again, Lilly lowers the bed, because the working height is too high for the patient hoist to lift Mr. A from his bed. Now the bed is at proper height and Mr. A lies correctly in the lifting mat, the patient hoist is called over. Lilly pushes the legs of the hoist beneath Mr. A.’s bed and guides the yoke of the hoist to the right position above Mr. A. By using the remote control of the hoist Lilly lowers the yoke so it can be attached to the lifting mat. The yoke is attached between Mr. A.’s legs and along both sides at shoulder height to the mat. The arms of Mr. A will stay inside the yoke and the mat during the lifting process. Once the mat is well attached to the yoke, Lilly lifts the yoke by using the remote control again. During the lifting Mr. A. is brought from a lying position to a sitting position in the mat. This is not very comfortable for Mr. A. because the lifting mat cuts a little bit between his legs. Once free from the bed, Lilly can move the patient hoist with Mr. A. towards his chair near the window. Note that this is not an easy task for her, because she has to push hard enough to get the hoist into motion, mind the environment of the hoist to prevent bumping up against things and hold one hand at the yoke so it will not shake too much, so Mr. A. will not get motion sick or scared due to the trembling. As they arrive at the chair, Lilly brings the hoist to the right position in front of the chair and moves the legs of the hoist from each other with the remote control so the hoist can be placed around the chair. She places the yoke with Mr. A .inside exactly above his chair so his back and the back of the chair are exactly in the same position. When chair and yoke are in the right position Lilly presses the remote control again to lower the yoke. Mr. A. is then gently lowered into his chair with the lifting mat underneath him. Once Mr. A. sits in his chair the yoke is released from the mat and the hoist is slowly driven away from the chair by Lilly while preventing a collision between the yoke and Mr. A. The whalebones in the backside of the lifting mat are removed, because they are not comfortable for Mr. A.’s back while sitting. Lilly asks Mr. A. whether he wants the lifting mat to stay underneath him or not. He does not want it underneath him, therefore Lilly pulls the mat from between his legs to the outside of his hips towards his back to remove it underneath him. Now Mr. A. can enjoy his sightseeing.
Lilly takes a lifting mat of the proper size for Mr. A and puts 2 whalebones in the backside of the lifting mat for better support for Mr. A’s back during the lifting process. She brings the bed to the right working height so she can work more easily without risking back problems. Lilly explains to Mr. A. what she is doing and is going to do at every step of the lifting process so he will not be surprised by any actions. First she turns Mr. A to his left side and pushes the lifting mat underneath him. Then she turns him to his right side so the mat can be equally divided underneath him. As soon as Mr. A lies back on his back again, Lilly lowers the bed, because the working height is too high for the patient hoist to lift Mr. A from his bed. Now the bed is at proper height and Mr. A lies correctly in the lifting mat, the patient hoist is called over. Lilly pushes the legs of the hoist beneath Mr. A.’s bed and guides the yoke of the hoist to the right position above Mr. A. By using the remote control of the hoist Lilly lowers the yoke so it can be attached to the lifting mat. The yoke is attached between Mr. A.’s legs and along both sides at shoulder height to the mat. The arms of Mr. A will stay inside the yoke and the mat during the lifting process. Once the mat is well attached to the yoke, Lilly lifts the yoke by using the remote control again. During the lifting Mr. A. is brought from a lying position to a sitting position in the mat. This is not very comfortable for Mr. A. because the lifting mat cuts a little bit between his legs. Once free from the bed, Lilly can move the patient hoist with Mr. A. towards his chair near the window. Note that this is not an easy task for her, because she has to push hard enough to get the hoist into motion, mind the environment of the hoist to prevent bumping up against things and hold one hand at the yoke so it will not shake too much, so Mr. A. will not get motion sick or scared due to the trembling. As they arrive at the chair, Lilly brings the hoist to the right position in front of the chair and moves the legs of the hoist from each other with the remote control so the hoist can be placed around the chair. She places the yoke with Mr. A .inside exactly above his chair so his back and the back of the chair are exactly in the same position. When chair and yoke are in the right position Lilly presses the remote control again to lower the yoke. Mr. A. is then gently lowered into his chair with the lifting mat underneath him. Once Mr. A. sits in his chair the yoke is released from the mat and the hoist is slowly driven away from the chair by Lilly while preventing a collision between the yoke and Mr. A. The whalebones in the backside of the lifting mat are removed, because they are not comfortable for Mr. A.’s back while sitting. Lilly asks Mr. A. whether he wants the lifting mat to stay underneath him or not. He does not want it underneath him, therefore Lilly pulls the mat from between his legs to the outside of his hips towards his back to remove it underneath him. Now Mr. A. can enjoy his sightseeing.
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=== '''Scenario 2''': - Transportation - ===
=== '''Scenario 2''': - Transportation - ===
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It is morning in ‘De Tulp’, a home for the elderly and the 70 year old Mrs. B. who suffers from paraplegia lies in bed. She is ready for nurse Jane to transport her to the general living room where she can sit next to her close friend Mrs. C. to gossip about the cute Mr. D of next door. Due to her illness Mrs. B. is not able to replace herself anymore so she will be transferred from her bed to the chair in de living room next to Mrs. C. by the passive patient hoist. Nurse Jane will use the same method as caregiver Lilly to bring Mrs. B. from her bed in the yoke as was done with Mr. A. in scenario 1. When this is done and Mrs. B. hangs above her bed in the yoke, Jane will drive the hoist out of Mrs. B.’s room over the corridor to the living room. Just like Lilly, Jane will explain what she is doing to Mrs. B. during the lifting and transfer process so Mrs. B. will be at ease and not surprised by any actions during her transfer. Jane will need to coordinate the whole process very carefully, because she needs to exert enough force to push the patient hoist. She has to take into account the surroundings of the hoist to prevent accidents during the transfer. She also frequently has to keep the yoke steady with one hand during the process so Mrs. A will not get motion sick or scared due to the trembling of the yoke. Before the transportation process of Mrs. B. with the hoist really can start Jane has to turn the yoke with Mrs. B. inside manually into the right direction. Due to this Mrs. B.’s face points forward, while the hoist and Jane are behind her. Mrs. B. is now able to see in what direction she is pushed by Jane. Jane can now start the transportation by pushing the hoist towards the room door. At the door Jane needs to be extra careful and make sure that she does not bump into something. This is necessary, because her sight about what is happening directly outside the door is not sufficient enough. She also needs to push the hoist with more power to drive over the little threshold. Once outside Mrs. B.’s room, Jane needs to focus again extra carefully to provide Mrs. B. a safe ride and to prevent any collisions with other humans or items in the hallway. Keep in mind that Jane and Mrs. B. can not make any eye contact during the transportation process so Jane has to observe very attentively (as far as possible) whether something is going wrong with Mrs. B. The use of speaking is now the only solution for any interaction between them. Once arrived at the door of the living room, the threshold situation repeats itself and precise coordination of Jane is required. Jane puts Mrs. B. in the chair next to Mrs. C. by using the remote control to open the legs of the hoist and to lower the yoke just like was done to put Mr. A. in his chair in scenario 1. Mrs. B. en Mrs. C. can now finally continue their discussion about Mr. D.
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It is morning in ‘De Tulp’, a home for the elderly and the 70 year old Mrs. B. who suffers from paraplegia lies in bed. She is ready for nurse Jane to transport her to the general living room where she can sit next to her close friend Mrs. C. to gossip about the cute Mr. D of next door. Due to her illness Mrs. B. is not able to replace herself anymore so she will be transferred from her bed to the chair in de living room next to Mrs. C. by the passive patient hoist. Nurse Jane will use the same method as caregiver Lilly to bring Mrs. B. from her bed in the yoke as was done with Mr. A. in scenario 1. When this is done and Mrs. B. hangs above her bed in the yoke, Jane will drive the hoist out of Mrs. B.’s room over the corridor to the living room. Just like Lilly, Jane will explain what she is doing to Mrs. B. during the lifting and transfer process so Mrs. B. will be at ease and not surprised by any actions during her transfer. Jane will need to coordinate the whole process very carefully, because she needs to exert enough force to push the patient hoist. She has to take into account the surroundings of the hoist to prevent accidents during the transfer. She also frequently has to keep the yoke steady with one hand during the process so Mrs. A will not get motion sick or scared due to the trembling of the yoke. Before the transportation process of Mrs. B. with the hoist really can start Jane has to turn the yoke with Mrs. B. inside manually into the right direction. Due to this Mrs. B.’s face points forward, while the hoist and Jane are behind her. Mrs. B. is now able to see in what direction she is pushed by Jane. Jane can now start the transportation by pushing the hoist towards the room door. At the door Jane needs to be extra careful and make sure that she does not bump into something. This is necessary, because her sight about what is happening directly outside the door is not sufficient enough. She also needs to push the hoist with more power to drive over the little threshold. Once outside Mrs. B.’s room, Jane needs to focus again extra carefully to provide Mrs. B. a safe ride and to prevent any collisions with other humans or items in the hallway. Keep in mind that Jane and Mrs. B. cannot make any eye contact during the transportation process so Jane has to observe very attentively (as far as possible) whether something is going wrong with Mrs. B. The use of speaking is now the only solution for any interaction between them. Once arrived at the door of the living room, the threshold situation repeats itself and precise coordination of Jane is required. Jane puts Mrs. B. in the chair next to Mrs. C. by using the remote control to open the legs of the hoist and to lower the yoke just like was done to put Mr. A. in his chair in scenario 1. Mrs. B. en Mrs. C. can now finally continue their discussion about Mr. D.
== Literature study ==
== Literature study ==
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=== State-of-the-art ===
=== State-of-the-art ===
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A patient hoist is a mechanical device for lifting a patient out of bed into a (wheel)chair.  There are two kinds of hoists, the active and the passive one. The active hoist is meant for patients who still can stand up, but cannot move very well. It lifts the patient from a bed to a standing-up position on the hoist, after which the patient can be moved to a chair. The passive hoist is used for patients who are too weak to stay standing up. It moves the patient in a sitting position. (1)
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A patient hoist is a mechanical device for lifting a patient out of bed into a (wheel)chair.  There are two kinds of hoists, the active and the passive one. The active hoist is meant for patients who still can stand up, but cannot move very well. It lifts the patient from a bed to a standing-up position on the hoist, after which the patient can be moved to a chair. The passive hoist is used for patients who are too weak to stay standing up. It moves the patient in a sitting position.<ref>http://www.domicare.nl/tilliften-badliften-verrijdbaar/</ref>
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Most passive hoists consist of a frame with a sling attached to it. The patient gets secured in the sling by the nurse and the hoist lifts the patient upwards. After that the hoist can be moved by the nurse towards the bed or chair and afterwards the hoist lowers the patient onto the bed or chair. Finally, the nurse releases the patient from the sling. There are lots of different models for passive hoists. Most hoists move the patient along a vertical axis, after which the whole device can be moved by the nurse. Some work with a rail which can transport the patient over a horizontal axis, after the patient has been lifted up. These rails can be integrated into the room, or can be moved from bed to bed.
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Most passive hoists consist of a frame with a sling attached to it. The patient gets secured in the sling by the nurse and the hoist lifts the patient upwards. Next the hoist can be moved by the nurse towards the bed or chair and afterwards the hoist lowers the patient onto the bed or chair. Finally, the nurse releases the patient from the sling. There are lots of different models for passive hoists. Most hoists move the patient along a vertical axis, after which the whole device can be moved by the nurse. Some work with a rail which can transport the patient over a horizontal axis, after the patient has been lifted up. These rails can be integrated into the room, or can be moved from bed to bed.
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An active hoist does not move the patient from a lying position to a sitting position like the passive lift,  but moves the patient from a sitting to a standing position. It can be used to transport the patient, but sometimes the active hoist is only used to help the patient to stand after which he/she can walk him/herself, possibly with the help of a walker. This helps patients to maintain their mobility (2).
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An active hoist does not move the patient from a lying position to a sitting position like the passive lift,  but moves the patient from a sitting to a standing position. It can be used to transport the patient, but sometimes the active hoist is only used to help the patient to stand after which he/she can walk by him/herself, possibly with the help of a caregiver. This helps patients to maintain their mobility.<ref> http://www.arjohuntleigh.nl/producten/transfer-oplossingen/actieve-tilliften/</ref>
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A lot of research has been done about the use of patient hoists in hospitals and nursing homes. Johnsson et al. (2004) (5) proposed a model that simulated the balance between the nurse and the patient during a transfer task. The movement between the patient and the nurse should be harmonious, otherwise it may cause injuries.
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A lot of research has been done about the use of patient hoists in hospitals and nursing homes. Johnsson et al. (2004)<ref name=Johnsson>Johnsson C., Kjellberg K. & Lagerstrom M. (2004) A direct observation instrument for assessment of nurses’ patient transfer technique (DINO). Applied Ergonomics35 (6), 591–601.</ref> proposed a model that simulated the balance between the nurse and the patient during a transfer task. The movement between the patient and the nurse should be harmonious, otherwise it may cause injuries.
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Research has proven that a lot of difficulties exist with the current patient hoists. Even when a hoist is available nurses do not always use it. Several reasons are: “(..) lack of time and availability, difficulty of use, space constraints, and patient preferences.” (6). By including the nurses in the buying process and buying a powered lift instead of a mechanical one, a nursing home can improve the chance of the hoist actually being used. Furthermore a hoist cannot decrease the risk coming with lifting, but it can still reduce it significantly. (6)
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Research has proven that a lot of difficulties exist with the current patient hoists. Even when a hoist is available nurses do not always use it. Several reasons are: “(..) lack of time and availability, difficulty of use, space constraints, and patient preferences.”.<ref name=six{{>http://ovidsp.tx.ovid.com.dianus.libr.tue.nl/sp-3.22.0a/ovidweb.cgi?QS2=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}}</ref> By including the nurses in the buying process and buying a powered lift instead of a mechanical one, a nursing home can improve the chance of the hoist actually being used. Furthermore a hoist cannot decrease the risk coming with lifting, but it can still reduce it significantly.<ref name=six{{>http://ovidsp.tx.ovid.com.dianus.libr.tue.nl/sp-3.22.0a/ovidweb.cgi?QS2=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}}</ref>
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Despite several researches it is not clear what patients prefer. Some studies show that patients prefer a mechanical hoist, while other studies concluded that patients were more comfortable with a ceiling lift (5).
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Despite several researches it is not clear what patients prefer. Some studies show that patients prefer a mechanical hoist, while other studies concluded that patients were more comfortable with a ceiling lift.<ref name=Johnsson>Johnsson C., Kjellberg K. & Lagerstrom M. (2004) A direct observation instrument for assessment of nurses’ patient transfer technique (DINO). Applied Ergonomics35 (6), 591–601.</ref>
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There have been several attempts to improve the passive hoists with help of robotics. One of the earliest attempts was in the period 1990-1992 in a study of Patrick A. Finlay (3). In this study it was recognized that several specification were needed. First the robot should be able to move the patient without causing injuries. Of course, every patient is different and especially patients that have to be moved with the hoist can have numerous of physical problems the robot has to take into account. The robot should also be able to collect the patient from a lot of different positions and move them to lots of other possible positions. Third, the robot should be able to move through a hospital without accidents. Finally, the robot should not work too slow, because nurses and patients otherwise find the waiting time not worth to use the robot. The decision was made to make it a nurse controlled device, to get the patients and nurses to slowly get used to it.
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There have been several attempts to improve the passive hoists with help of robotics. One of the earliest attempts was in the period 1990-1992 in a study of Patrick A. Finlay.<ref name=Finlay>Finlay, P. A. (1992). PAM: a robotic solution to patient handling. Industrial robot, 19(3), 13-15.</ref> In this study it was recognized that several specification were needed. First the robot should be able to move the patient without causing injuries. Of course, every patient is different and especially patients that have to be moved with the hoist can have numerous of physical problems the robot has to take into account. The robot should also be able to collect the patient from a lot of different positions and move them to lots of other possible positions. Third, the robot should be able to move through a hospital without accidents. Finally, the robot should not work too slow, because nurses and patients otherwise find the waiting time not worth to use the robot. The decision was made to make it a nurse controlled device, to get the patients and nurses to slowly get used to it.
A initial design for the robot, which was called the Patient Assistant for Mobility (PAM) was already made up:  
A initial design for the robot, which was called the Patient Assistant for Mobility (PAM) was already made up:  
-
“The patient surface of PAM is made up of an array of slats or tines which, using a patented method of deployment, are able to be insinuated gently under the patient to support his/her weight and draw him/her onto the trolley surface. The patient surface has a Z-axis to adjust its height, is additionally articulated at the hip and knee joints, and can thus move to set the patient into a seated or other intermediate pose. (…) Sensors are used to monitor the stability of the platform, and as a useful by-product these are processed to provide a readout of patient weight. For patients with special nursing needs, selected tines can be disabled so that no contact is made with the corresponding part of the body.  The patient surface has an autonomous acquisition capability, so that a single command enables a patient to be collected from a bed once the PAM is parked in approximately the correct orientation at the bedside. Articulation of the patient surface is normally in telemanipulator mode, but the PAM also contains a memory enabling details of patients and furniture to be stored, so that a collection and placement sequence can be played back whenever required.” (3)
+
“The patient surface of PAM is made up of an array of slats or tines which, using a patented method of deployment, are able to be insinuated gently under the patient to support his/her weight and draw him/her onto the trolley surface. The patient surface has a Z-axis to adjust its height, is additionally articulated at the hip and knee joints, and can thus move to set the patient into a seated or other intermediate pose. (…) Sensors are used to monitor the stability of the platform, and as a useful by-product these are processed to provide a readout of patient weight. For patients with special nursing needs, selected tines can be disabled so that no contact is made with the corresponding part of the body.  The patient surface has an autonomous acquisition capability, so that a single command enables a patient to be collected from a bed once the PAM is parked in approximately the correct orientation at the bedside. Articulation of the patient surface is normally in telemanipulator mode, but the PAM also contains a memory enabling details of patients and furniture to be stored, so that a collection and placement sequence can be played back whenever required.”<ref name=Finlay>Finlay, P. A. (1992). PAM: a robotic solution to patient handling. Industrial robot, 19(3), 13-15.</ref>
Although this project started the demonstrator phase in 1992, it is unclear what happened with PAM after that.
Although this project started the demonstrator phase in 1992, it is unclear what happened with PAM after that.
-
Another attempt to improve the patient hoist was in 2007, in a project led by Lakshitha Dantanarayana (4). In this project the author developed a smart hoist in collaboration with the resident and carers of the residential care facility. Some adaptions they found to be useful were weight measurement, rear view mirrors, ability to monitor the environment and assisted manoeuvering.  
+
Another attempt to improve the patient hoist was in 2007, in a project led by Lakshitha Dantanarayana.<ref>Griffiths, H. (2012). Adverse risk: a ‘dynamic interaction model of patient moving and handling’. Journal of nursing management, 20(6), 713-736.</ref> In this project the author developed a smart hoist in collaboration with the resident and carers of the residential care facility. Some adaptions they found to be useful were weight measurement, rear view mirrors, ability to monitor the environment and assisted manoeuvering.  
The researchers equipped a standard patient hoist with cameras in the front, just above the floor to provide information about the part of the environment that is blocked from view by the hanging patient and implemented strain gauges into the design to measure the weight of patients.  Other improvements were cameras to monitor the environment behind the carers and robotic wheels. The patient hoist also had a navigation assistance algorithm implemented. The main change however was that the patient hoist was motor driven, but still moved by applying forces to the handles. The force was measured by the hoist and a similar movement was applied by the motors. This ensured the hoist could be used intuitively, and the learning curve was short.  
The researchers equipped a standard patient hoist with cameras in the front, just above the floor to provide information about the part of the environment that is blocked from view by the hanging patient and implemented strain gauges into the design to measure the weight of patients.  Other improvements were cameras to monitor the environment behind the carers and robotic wheels. The patient hoist also had a navigation assistance algorithm implemented. The main change however was that the patient hoist was motor driven, but still moved by applying forces to the handles. The force was measured by the hoist and a similar movement was applied by the motors. This ensured the hoist could be used intuitively, and the learning curve was short.  
Several users trials were executed, and the researchers implemented the feedback in the final design.  There was no clear conclusion whether the smart hoist was better than the traditional hoist, but several points for improvement were found.
Several users trials were executed, and the researchers implemented the feedback in the final design.  There was no clear conclusion whether the smart hoist was better than the traditional hoist, but several points for improvement were found.
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Besides the hoist other solutions for lifting patients are researched, like the HAL exoskeleton and the Japanese lifting robot RIBA, but those projects are beyond the scope of our research.
Besides the hoist other solutions for lifting patients are researched, like the HAL exoskeleton and the Japanese lifting robot RIBA, but those projects are beyond the scope of our research.
 +
== USE-aspects ==
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(1) http://www.domicare.nl/tilliften-badliften-verrijdbaar/
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This subject is in many ways related to USE-aspects. First of all there are many different stakeholders and users. The primary users are of course the patients and the nurses. The secondary users are the people who pay the hoist, in this case the hospital management and the government and the tertiary users are the maintenance people. The preferences of all these users have to be taken into account. For instance, the patients want the hoist to be comfortable, while the nurses want it to be easy to use. The hospital management wants the hoist to be made as cheap as possible and the maintenance people prefer that the important components are easy to repair or to replace. This can lead to conflicts since it can be difficult to take all these preferences into account at the same time.
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The focus of this project is therefore mainly on the preferences of the primary users. The main question is how the hoist can be improved so that it is less uncomfortable for both patient and nurse. An important aspect that will be taken into account in this research is the interaction between patient, hoist and nurse. The patients are a vulnerable group and being transferred with a hoist can be terrifying. The process however can also be bothersome for the caregiver. So important questions are: 'How does a patient want to be comforted?', 'Does this differ between different groups of patients?' and 'What does the nurse want?'. These are the kind of questions that will be answered in the research. The hoist however is not only a technical problem. A lot of these problems are actually more related to social or use aspects.
-
(2) http://www.arjohuntleigh.nl/producten/transfer-oplossingen/actieve-tilliften/
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(3) http://search.proquest.com.dianus.libr.tue.nl/docview/217008747/fulltext/AE31C6BAA874EE9PQ/1?accountid=27128
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(4) http://onlinelibrary.wiley.com.dianus.libr.tue.nl/doi/10.1111/j.1365-2834.2011.01276.x/full
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(5) Johnsson C., Kjellberg K. & Lagerstrom M. (2004) A direct observation instrument for assessment of nurses’ patient transfer technique (DINO). Applied Ergonomics35 (6), 591–601.
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(6) http://ovidsp.tx.ovid.com.dianus.libr.tue.nl/sp-3.22.0a/ovidweb.cgi?QS2=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=== Human-Robot Interaction ===
+
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Natural human-robot interaction plays an important role in effective nursing services system provided by service robots for the elderly and disabled people. This paper proposed a multimodal “human-robot integration” collaboration system, and set up a shared collaboration interface between human and service robot. Consequently, Users and service robots can naturally communicate and retrieve information from the collaborative interface with multimodality(e.g. head gesture, eye gaze) in an interactive dialogue approach. By this way, making the service robots fully understand human's intention, so they can collaborate and complete tasks well. Furthermore, some experiments were conducted, and the results suggest that it is effective to identify user's intention in light of the advantage of different modalities, the shared collaboration interface can provide more information both from human and robots to improve the naturalness of human-machine collaboration. The proposed methods can provide a new way for exploiting human-service robots cooperation.
+
-
 
+
-
 
+
-
http://ieeexplore.ieee.org/document/6999239/
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=== Emotion recognition using wireless signals ===
+
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-
MIT has written a paper about a new technology that can detect the emotion of a person by analysing reflecting radio frequency signals.off a body, which means that no sensors need to be applied. The EQ-radio sends a RF signal through the room, recognizes the person from the other objects, analyses its reflections and recognizes his emotional state. This all is done by a new underlying algorithm that extracts individual heartbeats from the wireless signal.The accuracy of the emotion recognition is comparable with state-of-the-art emotion recognition systems that needs a person to be hooked to an ECG monitor.
+
-
 
+
-
http://eqradio.csail.mit.edu/files/eqradio-paper.pdf
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-
== USE aspects ==
+
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+
-
=== Primary users ===
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=== Secondary users ===
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=== Tertiary users ===
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=== User needs ===
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== Research ==
== Research ==
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==== Interview questions ====
==== Interview questions ====
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Before we took the interviews we made a list with questions about we wanted to know from the nurses and patients. After that several interviews were taken and the list was adapted a little to answer new questions that had arisen during the research.
+
Before the interviews were taken a list with questions was made to ask about the desired information which could be obtained from the nurses and patients. After that several interviews were taken and the list was adapted a little (version 2) to answer new questions that had arisen during the research.
 +
[[ Questions for caregiver and patient ]]
-
'''Vragen voor verzorger versie 1:'''
+
==== Collected interviews ====
-
1.     Hoe lang werkt u al in de zorg?
+
In total five interviews were taken. All of them were with nurses who had experience with the passive patient hoist. Unfortunately no interviews with patients have been taken as this group was unapproachable.  
-
2.     Hoeveel ervaring heeft u met het verplaatsen van cliënten uit bed?
+
The first two interviews were taken with Petra and Lianne, both nurses from Buurtzorg, which is a private care institution. Another two interviews were taken with Linda and Rachelle, both interns in their last year of their nurse education. The last interview was taken with Lisan who works in a nursing home with patients who suffer from dementia.
-
3.      Ervaart u het tillen als een lastig en zwaar onderdeel van uw baan?
+
A link for the full versions of the collected interviews: [[ Collected interviews ]]
-
4.      Wat komt er, buiten het fysieke gedeelte, nog meer bij het optillen van een cliënt kijken?
+
==== Results of interviews ====
-
5.     Maakt u wel eens gebruik van een tillift, zo ja, welk type?
+
Several problems emerged from the interviews. Here the most important points that were made clear in the interviews are summarized per interview.
-
6.      Hoe ervaart u het gebruik van de tillift?
+
===== Interview 1 =====
-
7.     Welke onderdelen van het proces maken tillen lastig voor u?
+
This interview states that interaction between patient and caregiver is very important to establish good collaboration and trust between them.
 +
Everybody should feel safe and comfortable while using the passive patient hoist.
 +
Whenever the patient feels scared or not secure a good explanation about the taken actions should be provided, so trust and feeling safe can be created within the patient. Therefore it is a good idea to implement a device that can recognize emotions of the patient to assist the caregiver at his work. The hoist is not always experienced suitable for both patient and caregiver. The patient often dislikes for example the lifting mat, because it can cut in the patient’s legs. The caregiver on the other hand finds it difficult to move the hoist over a unsmooth floor or in small rooms. Further, the caregiver does not stand very close to the patient while operating the hoist.
-
8.      Hoe is de interactie tussen u en de cliënt?
+
===== Interview 2 =====
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9.     Hoe gaat u ermee om als de cliënt angstig wordt?
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From this interview can be concluded that the use of the passive patient hoist is an improvement in comparison with lifting of patients manually by the caregiver in which for example back pain can be reduced or prevented. However the hoist is not perfect and consists flaws. Maneuverability of the hoist has proven to be a main issue. When working with demented patients interaction between them and caregiver is a bit different than with not demented patients. Direct commands and explanation about the taken actions are given to the demented patients to reassure them, but sometimes an explanation has no use for them, because they do not understand it. Therefore they are sometimes distracted with a stuffed animal to smoothen the lifting process. At the same time these patients do not always express whether they are feeling uncomfortable or scared. Caregivers try to make something out/read the facial gesticulation of the patients to estimate how they are feeling. A device that could determine their emotions and one that could distract or reassure them during the process would be of good use.
-
10.  Waaraan herkent u dat een cliënt angst ervaart?
+
===== Interview 3 =====
-
11.   In hoeverre is sociale interactie van belang?
+
This interview shows that using the passive patient hoist is not an easy task in nursing homes. In these homes are often small doorsteps present which makes it difficult for the caregiver to drive over. During the transport process the visibility for the caregiver is deficient due to the post of the hoist. To prevent this limited view the caregiver walks alongside the hoist. However, this is also not very convenient, because it makes it more difficult to push the hoist with sufficient power. A device that improves this navigation process is reflected as a good idea. Another practical aspect is the lifting mat. This mat is not very pleasant for patients, because it sometimes cuts in the legs of the patient during the lifting process. Further, during the process these mats are provided with whalebones at the backside for extra support for the patient. This whalebones need to be inserted before the process starts and removed by the caregiver whenever the patient sits, because it is not comfortable for the backbone while sitting. A big issue with these whalebones is that they get lost very easily, because they do not have a fixed place at the hoist.
 +
During the lifting process interaction is again important. Whenever a patient feels uncomfortable he is asked what is wrong and all actions are explained extensively. It depends on the patient, whether they are comfortable with more interaction or less.
-
12.  Is er behoefte vanuit uw kant voor een tillift die de cliënt meer kan geruststellen?
+
===== Interview 4 =====
-
13.   En als deze weet wanneer de cliënt pijn ervaart zich hierbij kan corrigeren?
+
Social interaction between patient and caregiver remains a crucial element during the lifting process. A lot of eye contact is made between them and they converse during the process. Whenever a patient is not acquainted with the hoist or if the patient is scared the caregiver will communicate more and try to make more eye contact as well to reassure the patient. When the patient is familiar with the hoist less interaction between him and the caregiver is needed to put the patient at ease. A technical aspect of the hoist is that the battery is heavy and it’s lifespan is very short. Another hoist like the ceiling hoist would be more suitable in smaller rooms and  steering is much easier. However it is not a practical solution for existing care homes, because rails need to be constructed all over the nursing home. 
-
14. Wat zijn voor u de voordelen van de huidige tillift?
+
===== Interview 5 =====
-
15. Wat kan er volgens u verbeterd worden aan de huidige tillift?
+
The main point that can be concluded from this interview is that interaction is an important, but also a difficult point. Especially since the patients are suffering from dementia they do not really understand what you are saying. Still it is important to keep communicating about what you are doing and to comfort the patient. This is also possible by touching the patient, by eye contact or by distracting them with a stuffed animal. Over time you learn to recognize whether the patient is uncomfortable, because you get to know them. It is very important for nurses to get to know their patients. The main problems with the hoist are that you have to do several things at the same time and it is heavy to turn and move the hoist when it is loaded with a patient. It is especially difficult to navigate the hoist safely through small spaces while watching the patient.
-
16. Heeft u moeite met het rijden met de tillift? Gebrekkig zicht?
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=== Survey ===
-
→ Wat zou u ervan vinden als de tillift ondersteunt wordt met camera’s voor het navigeren?
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==== Design of survey ====
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→ Wat zou u ervan vinden als de tillift zelf kan navigeren en obstakels kan ontwijken?
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'''Hypotheses:'''
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17. Zou u het handig vinden als de tillift u bepaalde informatie kan geven? Als ja, wat voor informatie? Bijv. gewicht kunnen wegen….
+
:- Both patients and caregivers prefer eye contact most in the process of caregiving during transportation in the hoist.
 +
:- Patients like to be comforted by voice interaction between patient and caregiver or between patient and someone else during the process of caregiving during transportation in the hoist.
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'''Vragen voor verzorger versie 2:'''
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:- Patients like to be comforted by physical contact in the process of caregiving during transportation in the hoist and also caregivers prefer to have some extent of body contact during care giving.
-
1. Hoe lang werkt u al in de zorg?
+
'''Design of the survey'''
-
2. Hoeveel ervaring heeft u met het verplaatsen van cliënten uit bed?
+
Link to survey: https://docs.google.com/forms/d/e/1FAIpQLScinjbrL8rMoxs1CQOP0JCgIO3u_tavH2K1LGRcKIa9q_bFVA/viewform
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3. Maakt u gebruik van zowel een actieve als een passieve tillift? Zo ja, welke heeft op het huidige moment de meeste verbeterpunten/bij welke treden de meeste problemen op?
+
==== Method ====
 +
The code in Stata can be found by this link: [[Stata code]].  
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4. Hoe ervaart u het gebruik van de tillift?
+
In the previous week (week 3) some data for the survey was already gathered and a power analysis was conducted. Since the standard deviation at that moment was around 0.7, this value is used for the power analysis, together with a power of 0.8 and an alpha level of 0.05.  
-
5. Welke onderdelen van het proces maken tillen en verplaatsen lastig voor u?
 
-
6. In hoeverre is sociale interactie van belang?
+
This showed that 24 to 32 respondents are needed to be able to see a significant result in the data. A mean difference of 0.5 points difference on the Likert-scale is used. The Likert-scale is the scale of 0 to 5 that was used in the survey.
-
7. Op welke momenten tijdens het hele proces (tillen en verplaatsen) is er weinig tot geen contact tussen u en de patiënt? (Is er verschil tussen til- en verplaatsproces?)
+
Then data was collected again, especially of patients, because there was not enough data of this group. A sample size of 29 participants for each group was gathered.
-
8.   Is er behoefte vanuit uw kant voor een tillift die de cliënt meer kan geruststellen?
+
The data was prepared for analysis, for example by giving proper names to the variables i.e. After that, the new standard deviation is determined.  
-
→ bijv. mimiek aflezen en seintje geven als er iets is (facial recognition)
+
The following hypotheses were analyzed.
 +
:- What way of interaction receives most preference?
 +
:- H0: There is no difference in the need for interaction between patients and caregivers
 +
:- H0: There is no difference in preference for eye contact between patients and caregivers
 +
:- H0: There is no difference in preference for voice interaction between patients and caregivers
 +
:- H0: There is no difference in preference for body contact between patients and caregivers
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→ Oogcontact met verzorger via beeldscherm (360 graden camera)
+
==== Results ====
 +
Using the new standard deviation (again 0.7), the sample size (29 participants per group) and again an alpha level of 0.05, the power is calculated. The value of the power is 0.76, this value is all right. In an ideal case 5 to 10 more patient participants should have been collected, but the analysis is continued anyway as the power has proven to be good enough.
-
→ Beeldscherm die handelingen beschrijft, vertelt, animatie etc..
+
Code:
 +
power twomeans 2 2.5, sd(0.7) n(58) alpha(0.05) //to compute power with given sample size -> 29 participants per group
-
9.  Hoe verloopt het transport proces? (houding patiënt ten opzichte van verzorger)
 
-
10. Heeft u moeite met het rijden met de tillift? Gebrekkig zicht?
+
The results, shown in figure 1, are:
 +
Total mean for eye contact is 2.21, for voice interaction 2.24 and for body contact/interaction 2.75. The difference between patient and caregiver in eye contact is 0.05, for voice interaction it is around 0.5 and for physical contact it is 0.75.
-
→ Wat zou u ervan vinden als de tillift ondersteunt wordt met camera’s voor het navigeren? (bij transport)
+
[[File:Result-interaction1.jpg]]Figure 1: Total mean values
-
→ Wat zou u ervan vinden als de tillift zelf kan navigeren en obstakels kan ontwijken?
 
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→ Wat zou u ervan vinden als de tillift een motor heeft/beter te besturen/duwen valt?
+
[[File:1.jpg]] Figure 2: T-test of interaction
-
11. Zou u het handig vinden als de tillift u bepaalde informatie kan geven? Als ja, wat voor informatie? Bijv. gewicht kunnen wegen…
+
For the t-test of interaction by role of patient of caregiver, the t-value is 2.49 (fig. 2). There are 37 degrees of freedom and the p-value is 0.009.
-
12. Wat zijn voor u de voordelen van de huidige tillift?
+
[[File:2.jpg]] Figure 3: T-test of eye contact
-
13. Wat kan er volgens u nog meer verbeterd worden aan de huidige tillift?
+
For the t-test of eye contact by role of patient of caregiver, the t-value is 0.17 and there are 37 degrees of freedom (fig. 3).
 +
[[File:3.jpg]] Figure 4: T-test of voice interaction
-
'''Vragen voor patiënt:'''
+
For the t-test of voice interaction by role of patient of caregiver, the t-value is 2.0 (fig. 4). There are 37 degrees of freedom and the p-value is 0.027.
-
1) Hoeveel ervaring heeft u met de tillift? (van en naar welke locatie?)
+
[[File:4.jpg]] Figure 5: T-test of physical contact
-
2) Hoe ervaart u het tillen door de tillift?
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For the t-test of physical contact by role of patient of caregiver, the t-value is 2.45 (fig. 5). There are 37 degrees of freedom and the p-value is 0.01.
-
3) Bent u wel eens bang/angstig tijdens het tilproces?
+
==== Discussion and conclusion of survey ====
 +
The results mean:
-
4) Bent u tevreden over de tillift of niet? Wat is er bijvoorbeeld fijn of juist vervelend etc?
+
What way of interaction receives most preference?
-
5) / Wat zijn voor u de voor- en nadelen van de tillift?
+
:Command: tabstat oog voice lichamelijkcontact, by(rol)
-
6) (Maakt u liever gebruik van de tillift om verplaatst te worden of vindt u het fijner als verzorgers het tilwerk verrichten?)
+
Eye contact receives most preference. With body contact you see that patients do not really like it. The value of preference is higher, which means their preference is lower. Also, the difference with preference of body contact between patients and caregivers is quite high.
-
7) Hoe is de interactie tussen u en de verzorger bij het tilproces?
+
What also turns out is that the preference for voice interaction is a little less for patients than for caregivers. This means that caregivers like talking to their patients more than patients prefer to talk to their caregivers. This is not what was hypothesized so further research will be done by using interviews and a t-test on voice interaction.
-
8) Vindt u de sociale interactie met de verzorger van belang/belangrijk tijdens het tilproces?
+
H0: There is no difference in the need for interaction between patients and caregivers
 +
:Command: t-test interactie, by(rol)
 +
There is a significant result, which means the preference for interaction between patients and caregivers is not the same. The p-value is significant, so H0 is rejected.
-
9) Wat zou u ervan vinden als de tillift (meer) autonoom zou werken? (dus verzorger niet bij hele tilproces nodig)
+
H0: There is no difference in preference for eye contact between patients and caregivers.
 +
:Command: t-test oog, by(rol)
 +
A t-test is conducted where the preference for eye contact is compared between patients and caregivers. There is no significant result because the p-value is not significant. This means that H0 cannot be rejected, so there is no difference in preference for eye contact between patients and caregivers.
-
10) Wat zou u ervan vinden als de tillift zelf voor de sociale interactie tijdens het tilproces kan zorgen (u op uw gemak stellen, uitleg geeft over wat er gaat gebeuren etc.)
 
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11) -->En op uw signalen kan inspelen als iets bijvoorbeeld niet prettig voor u verloopt? (verkeerde houding, drukt op zere plek etc.)
+
H0: There is no difference in preference for voice interaction between patients and caregivers
 +
:Command: t-test voice, by(rol)
 +
A t-test is conducted where the resulting p-value is 0.03. This value is below 0.05 which means that H0 can be rejected, so there actually is a significant difference in preference for voice interaction between patients and caregivers. However, this resulting p-value is not very far below 0.05, therefore it is not completely sure whether this difference is significant.
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12) Wat kan er volgens u verbeterd worden aan de huidige tillift?
 
-
==== Collected interviews ====
+
H0: There is no difference in preference for body contact between patients and caregivers
 +
:Command: t-test lichamelijkcontact, by(rol)
 +
This final t-test shows a large significant result, a significant p-value. This means H0 can be rejected and there is a difference in preference for body contact between patients and caregivers. Patients prefer this way less than caregivers.
-
In total five interviews were taken. All of them were with nurses who had experience with the passive patient hoist. The first two interviews were taken with Petra and Lianne, both nurses from Buurtzorg, which is a private care institution. Another two interviews were taken with Linda and Rachelle, both interns in their last year of their nurse education. The last one was taken with Lisan who works in a nursing home with patient who suffer from dementia.
 
 +
Noldus company for face detection software is contacted for a free trial software. Via telephonic contact Noldus promised to send this trial version as soon as possible.
-
===== Interview 1: Petra, zorgverleenster bij Buurtzorg (particulier) =====
+
== Analysis ==
 +
From both the survey and the interviews several things can be concluded. First a answer the question whether our hypotheses were true or not will be provided. 
-
1. Hoe lang werkt u al in de zorg?
 
-
:24 jaar
 
-
2. Hoeveel ervaring heeft u met het verplaatsen van cliënten uit bed?
+
'''Caregivers need to be supported by the patient hoist'''
-
:Veel ervaring
+
-
3. Ervaart u het tillen als een lastig en zwaar onderdeel van uw baan?
+
From the interviews can be concluded that caregivers do not really need to be supported by the patient hoist, they can manage without, but it could help much. Nurses have indicated that especially a hoist that helps with navigating through small spaces would be of great help. Thus the hypothesis that nurses would need to be supported by cameras for navigating can be confirmed. It is less clear whether the second sub-hypothesis, “Caregivers need a patient hoist that can navigate itself and avoid obstacles” can be confirmed. Nurses have mentioned that they would like to have help with navigating, but none of them mentioned they would like the hoist to move by itself. At least one of them, Lisan, has mentioned an aversion for a self-moving hoist. She was convinced a nurse should always be present. So it can be concluded that this sub-hypothesis is untrue. Not much consensus was found on the third sub-hypothesis: “The caregiver would like to be warned by the patient hoist whenever the patient is anxious”. Some nurses mentioned that it could be handy, but other nurses mentioned that this is the task of the caregiver and by getting to know the patient a caregiver could identify by herself whether the patient was anxious. So this hypothesis can neither be confirmed nor rejected. The fourth sub-hypothesis “Patients appreciate it when they are reassured by the patient hoist whenever they are anxious” can also neither be confirmed nor rejected, because it was not possible to interview a patient. As patients a very vulnerable group, the nurses did not want them to be interviewed. The last sub-hypothesis was: ”Caregivers need a patient hoist that can provide information about the weight or the 'BMI' of the patient”. One nurse mentioned it would not be necessary, because they weigh the patient already once a month. However, the other nurses never gave a clear answer to this question and therefore it can neither be confirmed nor rejected.
-
:Ja, zeker als er geen hulpmiddelen ter beschikking staan
+
-
4. Wat komt er, buiten het fysieke gedeelte, nog meer bij het optillen van een cliënt kijken?
 
-
:Interactie, samenwerking met de patiënt en vertrouwen; iedereen moet zich veilig voelen in het gebruik
 
-
5. Maakt u wel eens gebruik van een tillift, zo ja, welk type?
+
'''Patients and caregivers attach value to interaction during the process of lifting.'''
-
:In het verleden met tilliften in een verpleegtehuis gewerkt
+
-
6.Hoe ervaart u het gebruik van de tillift?
+
This hypothesis was examined by a survey. From this survey and the interviews can be concluded that most patients and caregivers do indeed attach much value to interaction during the lifting process. In the interviews it was mentioned as one the most important aspects of the tilling process. From the survey can be concluded that both patients and caregivers prefer eye contact most during the process of caregiving. This is also what was hypothesized. Results of the survey show also that both caregivers and patients like to have voice interaction to some extent. However, the preference for voice interaction is significantly larger for caregivers than for patients. Patients do prefer voice interaction, but to a much lesser extent than caregivers do, and also to a much lesser extent than was hypothesized. For body contact there is a large significant difference in preference for caregivers and patients. Patients actually dislike body contact during the process which was not hypothesized. From these results it can be concluded that eye contact is the most important factor of interaction during caregiving. This will be used to optimize interaction in the process of caregiving during transportation in the patient hoist. Voice interaction is less important for patients, but this can also be taken into consideration in the design for optimizing the patient hoist.
-
:Erg verlichtend voor de verzorgers, veilig voor patiënten en ook voor beide partijen minder belastend.  
+
-
7. Welke onderdelen van het proces maken tillen lastig voor u?
 
-
:Geen gladde vloer, te kleine ruimtes of een angstige patiënt.
 
-
8. Hoe is de interactie tussen u en de cliënt?
+
'''Problems'''
-
:Zeer belangrijk voor een goede samenwerking
+
-
9. Hoe gaat u ermee om als de cliënt angstig wordt?
+
As the hypotheses are now answered, the main problems of the current design can be identified and requirements that the improved design must meet can be proposed.
-
:Eerst proberen gerust te stellen, opnieuw uitleggen en zodanig tweede persoon erbij halen om vertrouwen en een veilig gevoel te krijgen
+
-
10. Waaraan herkent u dat een cliënt angst ervaart?
+
A lot of nurses have mentioned that they have trouble with moving the hoist. A lot of these problems were caused by wheels that got stuck. The swivel caster wheels, which are currently used, do not roll as smoothly as hoped. This is caused by a rough surface or the orientation of the wheels. Therefore the first requirement for the new design is that  ''wheels are used that do not get stuck''.
-
:Als deze dat aangeeft of ongebruikelijk gespannen is (ook non-verbaal is een signaal)
+
-
11. In hoeverre is sociale interactie van belang?
+
Another problem that many nurses encountered was that the hoist was heavy to push when loaded with a patient. It was also very difficult to turn the patient or the arm of the hoist when also focusing on the wellbeing of the patient. That is why the following two requirements were set up:  
-
:Van groot belang (vraag 4-9)
+
''Less force should be needed to push the hoist'' and ''less force should be needed to move or turn the patient when loaded in the hoist''.
-
12. Is er behoefte vanuit uw kant voor een tillift die de client meer kan geruststellen?
+
From the hypotheses can also be concluded that nurses do have trouble with moving the hoist around in small spaces and would like some assistance with that. It is difficult for the nurse to keep an eye on everything, mainly because the patient is blocking a significant part of the field of sight of the nurse. This leads to the fourth requirement: ''The hoist should give a better overview to the nurse during the transfer''.
-
:Momenteel niet. Een draagmat bij een passieve tillift vinden cliënten vaak naar. Zelf sta  je dan als verzorger ook ver van de patiënt af om te bedienen.  
+
-
13. En als deze weet wanneer de cliënt pijn ervaart zich hierbij kan corrigeren?
+
A conclusion that was drawn from the survey was that patient and nurses value eye contact during the transfer for a great deal. However, on longer distances where the patient is facing towards the moving direction of the hoist there is no eye contact at all. This can lead to a less comfortable experience for the patient, that is why another requirement holds that ''during the whole process eye contact between the patient and the nurse is guaranteed''.
-
:Zoiets is altijd beter
+
-
14. Wat zijn voor u de voordelen van de huidige tillift?
+
Another problem that was examined was whether the nurses would like assistance with recognizing whenever the patient is uncomfortable. Although some mentioned that a nurse would learn this by time, for inexperienced nurses recognizing anxiety can be a challenge, because the patients are not always able to express their feelings. That is why it is likely that the following requirement still can be an improvement to the hoist: ''The hoist should be able to recognize anxiety in the patients''.
-
:Minder fysieke belasting, bij goed gebruik zeer comfortabel
+
-
15. Wat kan er volgens u verbeterd worden aan de huidige tillift?
+
The last requirement is: ''The hoist should be able to comfort the patient''. It was not possible to examine whether the patients would like this, but especially since the design could be a bridge between the current lift and full automated one, it is likely that it can add something important to the hoist.
-
Wanneer cliënten niet goed in de draagmat komen is er een gevaar dat er tussenuit kiepen. Dit is natuurlijk een kwestie van goed gebruiken. Als bediener van de lift sta je er op afstand, als er iets mis dreigt te gaan is ingrijpen lastig.
+
-
===== Interview 2: Lianne, zorgverleenster bij Buurtzorg (particulier) =====
+
== Requirements ==
-
1. Hoe lang werkt u al in de zorg?
+
In this section the best solutions for the earlier stated requirements will be discussed.
-
:11,5 jaar (5,5 opleiding, 3 ziekenhuis en 3 particulier)
+
-
2. Hoeveel ervaring heeft u met het verplaatsen van cliënten uit bed?
 
-
:Veel in de particuliere zorg met een sta-op-lift en in het ziekenhuis een beetje met de tillift
 
-
3. Ervaart u het tillen als een lastig en zwaar onderdeel van uw baan?
+
'''Requirement a: During the whole process eye contact between the patient and the nurse is guaranteed. '''
-
:Ja, rugklachten zijn al vaker voorgekomen maar is verminderd nu ze die spieren traint
+
-
4. Wat komt er, buiten het fysieke gedeelte, nog meer bij het optillen van een cliënt kijken?
+
One way to realize this is by the use of cameras and displays. A patient, who is sitting in the lift, can be filmed by a camera. This images are transferred to a display that is attached to the back of the lift where the nurse is standing, who is also filmed. The patient also should have a display in sight, so eye contact can be established at all time. However, when you look at a screen, you do not look in the camera. This is because they are at two different places. For this reason, eye contact via videos is difficult. However, there has been a lot of research on improving video-mediated communication. As stated in “eye contact and video-mediated communication: a review”<ref>Leanne S. Bohannon a,⇑ , Andrew M. Herbert b , Jeff B. Pelz c , Esa M. Rantanen, Eye contact and video-mediated communication: A review., file:///C:/Users/s130798/Documents/School/Year%203/Robots%20everywhere/Literatuuronderzoek%203-10/1-s2.0-S0141938212001084-main.pdf</ref> video-conferencing has become a popular video technology because it improves real-time communication. Video-conferencing is a richer form of communication than email or telephone, however, the authors says that video-conferencing is not quite as informative as face-to-face communication. Some research was done about ways to improve video-conferencing and eye contact during the use of webcams. Franc Solina and Robert Ravnik proposed a method related to the mona lisa effect.<ref>Todorović D. Geometrical basis of perception of gaze direction. Vision Research 46:3549-3562, 2006
-
:Veel techniek dus hoe je iemand moet tillen, vooral bij patiënten die kwetsbaar of verwond zijn.   
+
</ref> This method establishes eye contact during video calling and it used big screens and cameras mounted above the screen.<ref>Franc Solina, Robert Ravnik, Fixing Missing Eye-Contact in Video Conferencing Systems, http://ieeexplore.ieee.org.dianus.libr.tue.nl/stamp/stamp.jsp?arnumber=5974027</ref> However, a still better method must be possible. Stereo matching method, shown in figure 6, is a method that could solve our problem. With stereo matching a color image is used in a stereo camera as an input. This is configured by two cameras, they create a reference point.<ref name=Hwang>Hwang et al. method and apparatus for providing eyecontact function to multiple points of attendance using stereo image in video conference system, 2016, http://www.freepatentsonline.com/20160150182.pdf</ref> However there is a problem with stereo matching, since most of the stereo matching methods only consider paired images in specific orders. To treat video images of stereo matching as a static image causes flickerings.<ref> Jinglin Zhang Cong Bai Jean-Francois Nezan Jean-Gabriel Cousin, Joint motion model for local stereo video-matching method,2015,
 +
http://opticalengineering.spiedigitallibrary.org.dianus.libr.tue.nl/article.aspx?articleid=2478969</ref>  
-
5. Maakt u wel eens gebruik van een tillift, zo ja, welk type?
+
[[file:Eye_contact1.jpg‎]]
-
:In het ziekenhuis af en toe een tillift maar momenteel alleen gebruik gemaakt van een sta-op-lift in de particuliere zorg
+
-
6. Hoe ervaart u het gebruik van de tillift?
+
Figure 6: Stereo matching method
-
:Voor diegene die niet getild hoeft te worden prima maar het lijkt haar gênant voor de patiënten om in zo’n ongemakkelijke en vernederende houding te blijven hangen
+
-
7. Welke onderdelen van het proces maken tillen lastig voor u?
+
Recently, a patent for “Method and apparatus for providing eye contact function to multiple points of attendance using stereo image in video conference system” has been proposed.<ref name=Hwang>Hwang et al. method and apparatus for providing eyecontact function to multiple points of attendance using stereo image in video conference system, 2016,http://www.freepatentsonline.com/20160150182.pdf</ref> The patent presents an invention to improve eye contact. It improves eye contact images between remote attendances during video calling. Since this invention is not on the market yet, this will not be included in the demo, but for future use this aspect is very important. This method uses the same ideas as stereo matching, two cameras are used. However in advance to that, a depth image camera is also used, this is to calculate the occlusion region. With this information, an object mask for an image is created. The completed object mask is the way in which eye contact can be improved. Figure 7 shows an illustration of this.
-
:Als iemand verward is, want bij een sta-op-lift moet de cliënt zichzelf een beetje vasthouden. Als hij/zij dat niet doet is de kans op een ongeluk verhoogd. Over tillift geen opmerkingen.
+
-
8. Hoe is de interactie tussen u en de cliënt?
+
[[file:Eye_contact2.jpg‎]]
-
:In verpleegtehuizen worden tilliften mede gebruikt voor demente patiënten waarmee moeilijk te communiceren valt. Alleen directe commando’s helpen en zeggen wat je aan het doen bent om de cliënt gerust te stellen, aangezien deze niet ziet waar die naar toe gaat (makkelijker vervoer) 
+
-
9. Hoe gaat u ermee om als de cliënt angstig wordt?
+
Figure 7: Object mask
-
:Proberen te voorkomen door te zeggen wat er allemaal gebeurd, mimiek proberen te lezen. Vooral eerste keren is dit van belang gezien de onwennigheid
+
-
10. Waaraan herkent u dat een cliënt angst ervaart?
 
-
:Zelf zeggen ze weinig blijkt uit mimiek of fysieke reactie om ergens naar te grijpen
 
-
11. In hoeverre is sociale interactie van belang?
+
'''Requirement b: Less force should be needed to move or turn the patient when loaded in the hoist.'''
-
:Van groot belang voor een soepel verloop, geen sociale interactie levert weerstand op voor het hele proces (patiënt gaat tegenwerken)
+
-
12. Is er behoefte vanuit uw kant voor een tillift die de cliënt meer kan geruststellen?
+
The patient loaded in the hoist should be easy to turn. In the interviews was mentioned that some nurses had trouble with turning the hoist in the right direction, while also making sure the hoist does not bump into something. The patient is turned by hand, which means all the applied force comes from the nurse. This could be made easier by also using an electromotor to turn the harness to which the sling is attached. For this user intention recognition will also be used, for the same reasons as mentioned above. To recognize the intention of the nurse the hoist needs a force control system. Usually force control is used in robots that have to pick up objects. It makes sure the robot does not squeeze anything. It does this by measuring the opposing force the object applies to the robot when the robot picks up the object. A feedback loop is used to ensure the robot responds in the correct way to the opposing force. This force control can be implemented in the hoist, so that the bigger force the nurse applies, the longer the robot continues this movement. To measure this force, force or strain sensors have to be implemented on every joint of the hoist. A computer measures this force and with the implemented logic determines the motion and velocities. Major motion patterns have to be identified and implemented in this computer, to ensure the hoist continues its movement in the same direction as the nurse applied the force in.
-
:Ja
+
-
13. En als deze weet wanneer de cliënt pijn ervaart zich hierbij kan corrigeren?
 
-
:Ja, want sommige houdingen zijn onaangenaam voor cliënten maar ze laten dit niet of nauwelijks weten
 
-
14. Wat zijn voor u de voordelen van de huidige tillift?
+
'''Requirement c: Less force should be needed to push the hoist.'''
-
:Lichamelijke ontlasting van het tilproces. Een zorgverlener maar nodig om een patiënt te kunnen verplaatsen 
+
-
15. Wat kan er volgens u verbeterd worden aan de huidige tillift?
+
The nurses mentioned in the interviews that they had trouble moving the hoist around in the rooms, because it was so heavy, especially when the patient was sitting inside the yoke. Sometimes the floors made it even more difficult to push the hoist forward. So it can be concluded that the improved hoist should have the ability to move without the nurse applying all the force. This is especially important when the hoist is used for larger distances, like moving the patient to the toilet or to another room. Our solution is to build in an electromotor to drive the wheels. This means the hoist requires a stronger battery. It was decided to not use a remote to steer the improved hoist, because that would add extra complexity to the hoist. The nurses would have to learn yet another thing. The learning curve needs to be kept short, so user intention recognition will be used to steer the hoist. This means the hoist anticipates on the intentions of the nurse by measuring how force is applied. For the nurse it means she can use the hoist the same way she was used to. More explanation of this can be found in requirement b.
-
:Wendbaarheid
+
-
===== Interview 3: Linda, stagiaire laatste jaar HBO verpleegkundige =====
+
'''Requirement d: The hoist should be able to recognize anxiety in the patients.'''
-
1. Hoe lang werkt u al in de zorg? en 2. Hoeveel ervaring heeft u met het verplaatsen van cliënten uit bed?
+
There are several ways a machine can recognize emotion in humans. One of the most obvious ways is of course the same as most humans do it, by reading a person's face. Software that is able do this already exists and is called facial expression recognition software. Reading the face by looking at the position of, for instance, the mouth and the eyes has proven to not work well enough, because every person is different. That is why these software analyze the relationship between points on the face. When somebody curls the corners of his/her mouth, the software registers that the point of the corner of the mounts moves. With a complex algorithm it concludes that the person expresses, to a certain amount, happiness. It is even possible for these software to recognize micro-expressions. Most of these software show the extent to which a person shows one of the seven basic emotions in percentages. The seven basic emotions these software uses are: joy, sadness, anger, fear, surprise, contempt, and disgust. Often a Neutral emotion is also added to the possible emotions. More complex emotions are always regarded as a combination of these seven emotions <ref>http://nordicapis.com/20-emotion-recognition-apis-that-will-leave-you-impressed-and-concerned/</ref>. It is therefore more difficult to recognize these emotions in the numbers the software generates. However, since the software only has to recognize fear, it could be accurate enough for the goal of this research. Of course there are also other ways to recognize a person's emotions. Other aspects researches often take into account are respiration and heart beating. MIT<ref>Zhao, M., Adib, F., & Katabi, D. (2016, October). Emotion recognition using wireless signals. In Proceedings of the 22nd Annual International Conference on Mobile Computing and Networking (pp. 95-108). ACM.</ref>  has written a paper about a new technology that can detect the emotion of a person by analyzing reflecting radio frequency signals of a body, which means that no sensors need to be applied. The EQ-radio sends a RF signal through the room, recognizes the person from the other objects, analyzes its reflections and recognizes his emotional state. This all is done by a new underlying algorithm that extracts individual heartbeats from the wireless signal. The accuracy of the emotion recognition is comparable with state-of-the-art emotion recognition systems that need a person to be hooked to an ECG monitor. For the design the facial expression recognition software will be used. The main reason for this is that this technology is already more developed and many different software are available. This makes it easy to implement in the design. The only things needed for this are software, cameras and a computer. Since the computer is also needed for other aspects of our design a computer will be implemented anyway. The camera is also already implemented for making eye-contact with the nurse. It is decided to go with the facial expression recognition software of Noldus. After contacting them a trial version of their software was obtained.
-
:Heeft 9 jaar ervaring. Gebruikt de tillift al vanaf het begin.
+
-
3. Ervaart u het tillen als een lastig en zwaar onderdeel van uw baan? en 4. Wat komt er, buiten het fysieke gedeelte, nog meer bij het optillen van een cliënt kijken?
 
-
: (Niet van toepassing, gebruiken tillift voor het verplaatsen met patiënten, als je patiënten zelf moet ondersteunen is dat wel zwaar)
 
-
 
-
5. Maakt u wel eens gebruik van een tillift, zo ja, welk type?
 
-
:Maakt gebruik bij het liften van zowel de '''actieve''' als de '''passieve''' tilliften. Ook een BEA-lift en een turner. De passieve lift voor mensen die niet zonder ondersteuning uit bed kunnen komen. De passieve lift bestaat uit een mat, met dunne plastische bandjes, die kunnen snijden in benen van patiënt.
 
-
6.Hoe ervaart u het gebruik van de tillift?
+
'''Requirement e: The hoist should be able to comfort the patient.'''
-
:Het gebruik van de tillift is lastig door de kamers met een drempel. Het gebruik is best wel zwaar, ook met het draaien van de tillift of als je alleen bent. Je hebt een afstandbediening en je moet de patiënt in de gaten houden. En tegen de knie aanduwen, en een knopje naar beneden dat je niks aanstoot. Veel handelingen tegelijk. In kleine ruimtes is het vooral lastig. Dan moet je met zo’n groot apparaat bewegen. Veel te zwaar als het een ruwe vloer is.  
+
-
7. Welke onderdelen van het proces maken tillen lastig voor u?
+
It was already stated the hoist should be able to recognize fear in the patient, but the hoist should also be able to react on it. It was already mentioned that a screen is attached to the hoist on which the patient can keep contact with the nurse, when the patient is moved. This screen can also be used to comfort the patient. One thing that was concluded from the interview is that it is important to tell the patient what is happening to him. So a feature is implemented in the hoist that can tell, either with spoken words or written on the screen, what is happening to the patient at the moment he/she is scared. The nurse should be able to turn this feature on and off at any moment. Another thing that was learned from the interviews is that a lot of patients who have to be transported by a hoist have dementia. They do not understand what the nurse is saying to them. Therefore they will not understand the hoist either when words are spoken or written on the screen to explain the taken actions. An option for them could be, that the screen on the hoist shows an animation which can distract the patient. This should also be a feature that the nurses should be able to turn on and off at any moment.
-
'''Korte scenario schets:'''
 
-
:'''Passieve tillift''': Vanuit ligpositie ga je de patiënt naar een kant draaien, mat eronder stoppen, schouders moeten in de rondingen van de mat en tussen de benen door. Dan de patiënt naar de andere kant draaien en de mat daar ook goed leggen. Vervolgens wordt patiënt weer in originele ligpositie teruggebracht. Tillift boven patiënt plaatsen en opletten dat de tillift niet tegen de patiënt aangaat. Voordat je tillift aan mat wilt vastmaken moet het bed op werkhoogte staan, anders krijgt verzorger last van de rug. Zo lang mogelijk patiënt in lighouding houden tot alles goed is aangesloten. Dan patiënt omhoog laten komen (naar zitstand m.b.v tillift) en ervoor zorgen dat de mat niet gaat knellen dus niet te recht laten zitten anders gaat de mat snijden, vooral bij de mannen zorgt de lighouding ervoor dat het minder snijdt bij hun ‘zaakje’. Bij zithouding heb je overzicht waar je heen gaat. (ligt ook aan de patiënt). Tijdens de verplaatsing van lighouding naar zithouding schuif je soms in overige ruimte van de zitzak, wat als eng ervaren kan worden.
+
'''Requirement f: The hoist should give a better overview to the nurse during the transfer.'''  
-
:'''Actieve tillift''': Zorg je dat de patiënt op de bedrand zit. Til benen omhoog. Tillift onder benen schuiven, let op dat de voeten goed staan: recht. Knieën moeten tegen een zwarte steun, zodat de patiënt niet door de knieën heen zakt. Band onder de oksel. Patiënt armen om de band heen, anders glijdt heel de band er tussen uit. Vragen aan de cliënt hoe het gaat, contact houden. ‘’Ohh ik vind het zo eng’’ durven ze niet recht op te staan: Dan stel je ze op hun gemak. ‘’Rustig, er kan niks gebeuren’’.
+
This problem can be solved by the use of a camera, which is placed at the front of the lift and films in the moving direction of the lift. Transferring these images to the display of the nurse, he/she can easily see what is in front of the lift and if there are any obstacles that could be possibly dangerous. Another addition would be sensors that indicate how close the lift is to a certain object, for instance a wall, so the nurse has an even more complete overview. These sensors, often used in cars for parking assistance, use super sound to determine the distance between the sensor and an object. If a minimum distance is exceeded the nurse will get a signal on het screen and the hoist will break automatically to prevent collision. However, since this partly takes away the control the nurse has, it was decided to go with the cameras. Maybe in the future when nurses and patients are more familiar with automation and robot technology, parking sensors could still be implemented.
-
'''Antwoord:'''
 
-
:Welke onderdelen? De drempels. Zwaar om ze erover heen te slepen. Matten afhankelijk van gewicht. Je hebt grote en kleine mensen, grote en kleine zakken, anders vallen mensen er uit. Voor de veiligheid zijn er verschillende maten. Qua zwaarte heeft het er niks mee te maken. Je hebt ook een 'verblijfmat' die standaard bij iemand in de rolstoel blijft zitten, wanneer deze patiënt geregeld vervoerd wordt door de tillift. Die zijn dunner, zitten gaten in, is luchtiger.
+
'''Requirement g: Wheels that do not get stuck are used.'''
-
8. Hoe is de interactie tussen u en de cliënt?
+
A solution for this is to use solid spherical wheels, which are part of a ball bearing. Since these wheels can move freely in every direction they will not get stuck due to orientation and can as well move over surfaces which are rough. Since these wheels do not have an axis around which they turn, it is difficult to support them with an electromotor. Therefore these wheels are mainly useful as replacement for the front wheels of the patient hoist.
-
: Per cliënt verschillend. Sommige pakken iets vast, heel plukkerig, dat is nog al ongemakkelijk: Oogcontact houden: kijken of iemand angstig is. Inlichten van te voren: Als het de eerste keer is: hoe het gaat, dat het veilig is, nu ga je draaien, nu ga je omhoog. Als ze er bekend mee zijn, dan is de begeleiding minder nodig. Draaien ze al vanzelf, weten ze wat ze moeten doen: ‘’Ja dat weet ik, is al de zoveelste keer dat we dit moeten doen: dat weet ik ook wel’’. Heel verschillend, mensen die het gewend zijn: Wringen zich zo dat ze fijn zitten. Als het de eerste keer is durf je dat echt niet. In de tilmatten heb je ‘baleinen’, plastic platte strips/stelen. Kunnen in de rugkant van de mat geplaatst worden om stabiliteit te brengen. Moeten qua veiligheid sowieso gebruikt worden. Moet je apart aanbrengen. Gebruik je tijdens alle transfers, tijdens zitten eruit, anders zit het ongemakkelijk. Is weer een extra handeling. Anders zakken ze te ver door en heb je geen stabiliteit. Raken vaak deze dingen kwijt, in de rug meer stevigheid.
+
-
9. Hoe gaat u ermee om als de cliënt angstig wordt?
 
-
:Tijdens liften altijd oogcontact houden of in het zichten blijven. Als je iemand lang kent, ga je niet kijken of de patiënt angstig is.
 
-
10. Waaraan herkent u dat een cliënt angst ervaart?
+
Finally, in the interviews it was mentioned that the whalebones get lost easily. That is why a small adjustment will be added, besides the requirements. A pocket to the hoist to store the whalebones in will be attached.
-
:Ze benoemen het: ‘’ohh wat eng’’: Je ziet het aan het gezicht en dat ze een teruggetrokken houding hebben. Ze stralen angst uit of zeggen juist niks zeggen. Verder willen ze niet laten blijken dat ze angstig zijn. Er wordt hier op ingespeeld door ze heel rustig te benaderen en vooral te vertellen wat je aan het doet bent. Uitleggen wat ze eng vinden. Een voorbeeld hiervan is dat de kraan zo beweegt; dat ding zit zo in elkaar; dat beweeg ik met dit. De conclusie is vooral veel uitleg geven over de handelingen die er gepleegd worden. Je vraagt waar het probleem van hun angstige reactie ligt.
+
-
11. In hoeverre is sociale interactie van belang?
+
== Design 1 ==
-
:Ligt aan de cliënt.
+
-
12. Is er behoefte vanuit uw kant voor een tillift die de cliënt meer kan geruststellen?
 
-
:Praatsysteem uit de muur: ‘’hee wat gebeurt hier allemaal.’’  Zou wel werken, maar niet voor iedereen. Geen idee hoe ze op een beeldscherm reageren.
 
-
14. Wat zijn voor u de voordelen van de huidige tillift?
 
-
:Automatisch boven/beneden, Poten gaan uit elkaar, Zeppelin is ook heel fijn ← is een nieuwe tillift, super klein, je kunt hem overal meenemen en ergens anders aanhangen (rachel) In een ziekenhuis heb je zo’n railing. Dit is niet handig hier, want je hebt hem in elke kamer nodig, overal railing maken?
 
-
15. Wat kan er volgens u verbeterd worden aan de huidige tillift?
 
-
:* reeds behandeld, of in interview Rachel.
 
-
16. Heeft u moeite met het rijden met de tillift? Gebrekkig zicht?
+
[[File:DesignPassive.png|800px|Figure 8]]
-
:Rijden lastig, gebrekkig zicht door de paal (valt wel mee, niet vervelend)
+
Figure 8: Design 1
 +
[[File:InterfacesPatient.png|thumb|250px|Figure 9: Interface options for patient]]
-
17. Zou u het handig vinden als de tillift u bepaalde informatie kan geven? Als ja, wat voor informatie? Bijv. gewicht kunnen wegen….
+
An optimized design for the hoist is made with the program Photoshop CS6 (fig. 8). In this design the requirements were taken into account and added to an adapted version of the 'Wendy' passive hoist.
-
: * reeds behandeld, of in interview Rachel.
+
-
===== Interview 4: Rachelle, stagiaire laatste jaar HBO verpleegkundige =====
+
:1. (Following requirement a)
 +
:Screen display that is able to sustain a live connection between the caregiver and the patient by an implemented camera. The software on the display is able to show information about the patient in the hoist.
-
1. Hoe lang werkt u al in de zorg? en 2. Hoeveel ervaring heeft u met het verplaatsen van cliënten uit bed?
+
:2. (Following requirement b)
-
:Heeft 4 jaar stage ervaring op MBO en al 1 jaar een bijbaantje in het ziekenhuis. Naast HBO studie werkend in het ziekenhuis als verpleegkundige. (totaal iets meer dan  5 jaar ervaring). Al vanaf het begin van deze 5 jaar bezig met de tillift.
+
:Force sensors in handgrips that are able to measure how much force the caregiver is applying while pushing the hoist.  
-
3. Ervaart u het tillen als een lastig en zwaar onderdeel van uw baan? en 4. Wat komt er, buiten het fysieke gedeelte, nog meer bij het optillen van een cliënt kijken?
+
:3. (Extra requirement)
-
: (Niet van toepassing, gebruiken tillift voor het verplaatsen met patiënten, als je patiënten zelf moet ondersteunen is dat wel zwaar)
+
:Emergency stop button for the caregiver that will immediately shut down all the systems of the hoist when pressed.
-
5. Maakt u wel eens gebruik van een tillift, zo ja, welk type?
+
:4. (Following requirement c)
-
:Net als Linda ervaring met de '''passieve''' en '''actieve''' tilliften. Er wordt geprobeerd zo min mogelijk de passieve tillift te gebruiken. Patiënten kunnen dan sneller revalideren. Als patiënt al een beetje hersteld is ga je steeds meer de actieve tillift gebruiken --> Dan staat de patiënt op eigen kracht op
+
:Electronic powered motor that, in combination with the force sensors, move the hoist by amplifying the force of the caregiver in a certain direction.
 +
:5. (Following requirement d)
 +
:Camera with a real-time connection pointed at the face of the patient, to sustain eye contact. The camera is also connected with the facial recognition software to detect the emotions of patients.
-
6.Hoe ervaart u het gebruik van de tillift? en 14. Wat zijn voor u de voordelen van de huidige tillift?
+
:6. (Following requirement e)
-
: ‘’Als je voor de eerste keer het apparaat gebruikt weet je niet waar de toetsen zitten. Het duurt even voordat je weet hoe het werkt’’.
+
:Screen to comfort the patient and make eye contact with the care giver.
-
:Vroeger moest je mensen gewoon tillen en dit was zwaar. De tillift is een verbetering, vergeleken met dit proces. Er wordt stiekem best wel vaak iemand omhoog getrokken. Je hebt speciale tiltechnieken, dan trek je onder de armen de patiënt omhoog. Als dit bij een patiënt mogelijk is scheelt dit de moeite om er een tillift bij te gebruiken.
+
 +
:7. (Extra requirement)
 +
:Holder for the stiffeners.
-
7. Welke onderdelen van het proces maken tillen lastig voor u?
+
:8. (Following requirement f)
-
:Je moet het apparaat er bij halen, of je moet het zoeken. Twee afdelingen, een tillift. Nadeel van tillift: Per afdeling 1 lift. Er is vaak een tekort aan matten, doordat er maar een bepaald aantal matten zijn in een bepaalde maat en als dan meerdere personen met hetzelfde postuur geholpen moeten worden kan dit tot lang wachten duren.
+
:Camera to create a better view of the environment. The caregiver is more able to spot if there are object obstructing the path of the hoist.
-
8. Hoe is de interactie tussen u en de cliënt?
+
:9. (Following requirement g)
-
:*zie interview Linda
+
:Spherical wheels for better manoeuvrability.
-
9. Hoe gaat u ermee om als de cliënt angstig wordt?
 
-
:*zie interview Linda
 
-
10. Waaraan herkent u dat een cliënt angst ervaart?
+
The improved patient hoist (I.P.H.) in our design 1 is equipped with two interfaces, that will now be evaluated further. There is one interface for the patient (nr. 6 in Design 1) and one for the caregiver (nr. 1 in Design 1).
-
: *staat in interview Linda
+
-
11. In hoeverre is sociale interactie van belang?
+
'''Interface patient:'''
-
:Sociale interactie is echt belangrijk. Als een patiënt al jaren de tillift gebruikt hebben ze minder behoefte aan constante interactie en praten ze bijvoorbeeld over het weer. Sociale interactie hoeft niet als ze het allemaal zelf kunnen.
+
 +
The interface for the patient is sketched in figure 9. This will be a display, like for example a tablet. To fill up this display three options can be chosen by the patient and caregiver. In this case they have both control over how they are supported by the added technology.
-
12. Is er behoefte vanuit uw kant voor een tillift die de cliënt meer kan geruststellen?
+
The first option is that the caregiver is visible for the patient on the display so eye contact between them can be obtained. This is an improvement in comparison with the current patient hoist in which, like in scenario 2, there is no direct eye contact possible between patient and caregiver during the transportation.
-
:Geen idee. Zou ik wel onderzoek naar willen doen, is misschien wel behoefte naar. Of ze moeten zo ver heen zijn dat ze het als een heel nieuw iets ervaren. ( Of met een aan/uit knop) Je moet het wel aan/uit kunnen zetten. Apparaat zou wel zien hoe je op gezichtsuitdrukkingen reageert.
+
-
+
-
'''Er werd gevraagd of je dan zelf in moest toetsen hoe de patiënt zich voelde. Hierop antwoorden wij dat het bijvoorbeeld afgelezen kon worden door middel van gezichtsuitdrukkingen. Dit vonden ze, mocht het met software mogelijk zijn, een goed idee.
+
-
Nicky vroeg of het handig was om een beeldscherm met de verzorgster erop te gebruiken. Hierop werd het volgende geantwoord:'''
+
-
Het is lastig omdat je onbewust veel loopt, 360 graden camera zou hiervoor minstens gebruikt moeten worden. De vraag was of je op het beeldscherm wel duidelijk ziet waar de verzorgster staat, hierover waren vele twijfels. Echter vonden ze dit ook helemaal niet nodig. Je kan net zo goed blijven praten als de patiënt angstig is. Het zou geen meerwaarde bieden voor de patiënt.
+
-
15. Wat kan er volgens u verbeterd worden aan de huidige tillift?
+
The second option consist of the first option with an extra window on the display. This window shows a short animated film clip with a speech function in which the actions of the lifting process are explained to the patient. This option is implemented, because results of the survey and interviews showed that patients like to be informed about what is happening and going to happen during the process. As the patient wishes this option can be switched on or off by the caregiver.
-
:De accu gaat snel op. Er is 1 accu punt om ze op te laden, alleen zijn de accu's erg zwaar om op te tillen.
+
-
16. Heeft u moeite met het rijden met de tillift? Gebrekkig zicht?
+
A third option can be implemented to the first option in case the process is executed with for example a demented patient. In this case the display contains an extra window in which an animation is showed to distract the patient during the process. Consequently the process will go more smoothly and pleasant for both patient and caregiver.  
-
:*reeds behandeld
+
-
17. Zou u het handig vinden als de tillift u bepaalde informatie kan geven? Als ja, wat voor informatie? Bijv. gewicht kunnen wegen….
+
All options can in fact be put on or off by the caregiver in compliance with the patient leading to actually four options for the interface of the patient.
-
:Is wel handig als de lift informatie geeft over de handelingen. Alleen moet het wel uitgezet worden als de patiënt het al weet. Verder moet er soms langer gewacht worden voor het uitvoeren van een volgende handeling, want er kunnen obstakels zoals schoenen voor liggen en dan werkt het niet meer. wacht je iets langer als er een schoen voor ligt.
+
 +
[[File:InterfaceCaregiver.png|thumb|250px|Figure 10: Interface caregiver]]
 +
'''Interface caregiver:'''
 +
The interface for the caregiver is shown in figure 10. This will also be a display, like for example a tablet, which will be attached at the backside of the patient hoist at face/shoulder height of the caregiver (nr. 1 in Design 1). This display can be changed of position (up and down) so even a tall or a small caregiver can use it properly. On this display the patient lying in the yoke is visible for the caregiver, so eye contact between them can be accomplished. In another window an overview of the environment just in front of the hoist will also be visible on the interface. Due to this the caregiver can easily see what is in front of the hoist and if there are any obstacles that he cannot see for himself from behind the hoist. Further, on the right side of the interface a kind of traffic light system will be visible. This traffic light displays the well-being of the patient during the lifting and transport process. The traffic light is connected to the camera of the patient (nr. 5 in Design 1) which can due to the implemented software of Noldus recognize facial emotions of the patient.
-
===== Interview 5: Lisan, zorgverleenster =====
+
Green light shines when the patient is feeling good and comfortable. In this case the caregiver does not need to change his procedure, the patient is doing just fine in the yoke. Orange light lights up whenever the patient is a little uncomfortable, but the caregiver does not necessarily need to take any actions or alter the transport process for the patient. The caregiver just needs to be more alert, because the chance of changing from orange to red light is higher. The red light shines when the patient is not feeling good, he is scared or uncomfortable. In this situation the caregiver should give attention to the patient and figure out why he is feeling uncomfortable and take action to change this feeling.
-
1. Hoe lang werkt u al in de zorg?
+
The distinction between which color light should shine when will be determined by the results of the test plan for the used facial recognition software of Noldus.
-
:Werkt sinds 2009, dus al 7 jaar in de zorg. Ze werkt nu 3 jaar met dementerenden.
+
-
2. Hoeveel ervaring heeft u met het verplaatsen van cliënten uit bed?
+
== Noldus ==
-
:Ze verplaatst dagelijks drie bewoners met de passieve lift, en één bewoner met de actieve lift.
+
-
3. Maakt u gebruik van zowel een actieve als een passieve tillift? Zo ja, welke heeft op het huidige moment de meeste verbeterpunten/bij welke treden de meeste problemen op?
+
In this section the facial expression recognition software 'FaceReader 7.0' from Noldus will be looked into. First a measurement plan is discussed, after which the results are presented after analysis. Lastly conclusions regarding this software will be drawn.
-
:Actieve lift werkt elektrisch waardoor het omhoog bewegen en de poten van elkaar bewegen niet tegelijk kan. Dit kost meer tijd. Er zijn twee passieve liften aanwezig, één daarvan is ook elektrisch en heeft dus hetzelfde probleem. De ander die niet elektrisch is werkt dus net iets sneller, waardoor de bewoner minder lang in de lucht hangt.
+
-
4. Welke onderdelen van het proces maken tillen en verplaatsen lastig voor u?
+
===Measurement plan===
-
:Het gewicht van de bewoners is een probleem, daardoor zijn ze moeilijk met de hand te verplaatsen of van positie te veranderen. Ze hebben namelijk zelf moeite mee te werken. Met een lift is het makkelijker maar één van de liften rolt moeilijk.
+
The goal of this measurement plan is to create a guideline for the two experiments that will be carried out. This will result in a smoother transition between acquiring the materials necessary for the set-ups, performing the experiments and exporting the data.
-
+
-
5. In hoeverre is sociale interactie van belang?
+
-
:Sociale interactie is belangrijk, het is belangrijk te vertellen wat je gaat doen en waarheen je de bewoner verplaatst. Op dit moment zitten er twee bewoners in het verzorgingstehuis die het niet snappen, maar toch is het belangrijk te blijven praten.  Gewenning is belangrijk, want dan vinden ze het minder eng, maar de bewoners zijn dementerend en hebben dus een gebrekkig korte termijn geheugen. Het lange termijn geheugen werkt nog wel, dus als het daar uiteindelijk terecht komt vinden ze het minder eng.
+
-
6. Op welke momenten tijdens het hele proces (tillen en verplaatsen) is er weinig tot geen contact tussen u en de patiënt?
+
With the first experiment it is possible to verify if the impact of different circumstances results in a deviant output. What will a difference in distance, angle or light/dark ratio do to the results?
-
:Ook al snappen ze niet wat er gebeurt of wat je zegt, het is belangrijk te blijven uitleggen op elk moment tijdens de handeling. Op de een één of andere manier komt het uiteindelijk wel binnen. Als verzorger moet je blijven contact maken, door communicatie, maar ook door je  gezichtsuitdrukking of oogcontact.
+
-
7. Is er behoefte vanuit uw kant voor een tillift die de cliënt meer kan geruststellen?
+
With the second experiment the performance of the Noldus software will be verified by testing a range of basic emotions, by using certain movie segments. Experimental participants (varying in age) are positioned in front of a camera, while being exposed to fragments of themed video material. Key is to execute the experiments with comparable circumstances.
-
:Geruststellen is iets wat de verzorger moet doen. Iemand met weinig ervaring, is soms nog meer met de verplaatsing bezig en maakt daardoor weinig tot geen contact met de bewoner, maar al doende leert men.
+
-
8. Bijv. mimiek aflezen en seintje geven als er iets is (facial recognition),  oogcontact met verzorger via beeldscherm (360 graden camera) of beeldscherm die handelingen beschrijft, vertelt, animatie etc.?
+
The specific steps that should be taken can be found in the linked file below.  
-
:Voor bewoners die cognitief goed zijn kan het helpen, maar de bewoners waar ik mee werk snappen ook een schermpje niet.
+
-
Je leert gezichtsuitdrukkingen vanzelf te  herkennen, doordat je bewoners leert kennen, dus daar zijn geen extra hulpmiddelen bij nodig.
+
-
Verder is houding ook heel belangrijk. Als je rustig en kalm blijft dan zijn de bewoners ook meer op hun gemak dan als je alles snel en gehaast doet. Bewoners reageren daar angstig op.
+
-
9. Waaraan herkent u dat een cliënt angst ervaart?
+
[[ Measurement plan ]]
-
:Dat herken je aan de ogen, bijvoorbeeld als ze naar links en naar rechts vliegen. Symptomen leer je herkennen naarmate je de bewoner beter leert kennen. Veel bewoners krijgen een meer gespannen houding, als ze angstig zijn. Op dat moment moet je als verzorger je actie aanpassen, bijvoorbeeld door een geruststellende hand op schouders te leggen, of de handeling  langzamer uit te voeren. Het is de truc om een balans te vinden in snelheid, want langzamer werken betekent ook dat de bewoner langer in de lucht hangt.
+
-
10. Hoe verloopt het transport proces (houding patient ten opzichte van verzorger)?
+
=== Validation of Noldus ===
-
:Belangrijk is om op te letten of de bewoner op z’n gemak is. Ondanks je wel moet uitleggen wat je aan het doen bent moet je niet teveel informatie in één keer geven, want daarvan kan de bewoner in de war raken. Ook moet je er op letten dat de poten niet ergens tegen aanstoten,  want dan begint de bewoner te wiebelen en is het nog veel ongemakkelijker voor de persoon.
+
After the experiments were executed the facial expressions had to be analyzed. How this is done is discussed in this section as well as the results of both experiments.  
-
+
-
11. Heeft u moeite met het rijden met de tillift?
+
-
:Eentje rijdt lastig (Wendy), want de poten zijn niet elektrisch en hij rolt daardoor lastig. De ander rijdt beter maar die is vaak bezet. Het is niet haalbaar om maar één lift te gebruiken.
+
-
12. Gebrekkig zicht?
+
====Method====
-
:Valt mee dat bewoner in de weg hangt, je aandacht focus toch vooral op de bewoner om te zorgen dat hij/zij op zijn/haar gemak is.
+
-
13. Wat zou u ervan vinden als de tillift ondersteunt wordt met camera’s voor het navigeren? (bij transport)
+
The recordings of the participants are analyzed using Noldus software and their feelings were asked and written down. By combining these two factors and the literature about the movies, it will be determined whether the Noldus software gives valid data about facial expressions.
-
:Camera’s zouden kunnen helpen, vooral rond het bed. De bewoner moet dan gedraaid worden, om parallel aan het bed te hangen, maar tegelijkertijd moet je opletten dat de poten niet ergens tegenaan aanstoten, om en rond het bed. Een camera zou meer zicht daarop kunnen bieden.  
+
-
14. Wat zou u ervan vinden als de tillift een motor heeft/beter te besturen/duwen valt?
+
After the analysis is completed the data can be exported to a .txt file where for every time sample the intensity of every emotion is given. This intensity varies from 0, not present, to 1, fully present, whereas the sum of every emotion never exceeds 1.
-
:Duwen is lastig zeker met vervelende vloeren, dus een actuator zou handig zijn. Soms is net of je drie handen nodig heb, omdat je zoveel dingen tegelijk moet doen dus als de tillift dat automatisch zou kunnen zou dat ook helpen.  
+
For every recording where one specific emotion should have been generated, a matlab script ([[File:Analysis.pdf]]) determines the mean intensity and maximum intensity. Next, the mean of these means as well as the mean of these maxima were calculated and the standard deviation is determined.
-
15. Zou u het handig vinden als de tillift u bepaalde informatie kan geven? Als ja, wat voor informatie? Bijv. gewicht kunnen wegen...
+
Finally, both values for all emotions are plotted, with and without taking neutral intro account, leading to four figures (fig. 13-16).  
-
:Wegen gebeurt eens per maand. De meeste bewoners wegen tussen 60 en 80 kilo en de lift kan 130 kilo aan. Wegen gebeurt door met een rolstoel op de weegschaal te rijden. De lift hoeft niet de bewoner ook nog eens te wegen, want dat gebeurt al.
+
     
 +
It can be concluded that the Noldus FaceReader software is valid if the highest mean and maximum emotion is the emotion that is expected from reporting of participants and from the literature.
-
16. Wat zijn voor u de voordelen van de huidige tillift?
+
===Results===
-
:Het belangrijkste voordeel is het verplaatsen van de patiënt. Maar het blijft wel belangrijk dat de bewoner op z’n gemak is, want het blijft een enge actie voor hem/haar.
+
-
17. Helpt het ook om de patiënt af te lijden met een voorwerp of verhaal?
+
====Experiment 1====
-
:Een verhaal houden helpt niet, want dat volgen ze toch niet, maar het kan helpen de patiënten af te leiden met behulp van attributen, bijvoorbeeld een knuffel.
+
By daylight the software was able to detect the face of the participant until a distance of 2 meters between the webcam and the participants face.  
 +
By daylight and 0.5 meter distance between the participant and the webcam the software was able to detect the face that was turned right until an angle of 45 degrees was reached. The same holds for turning the face to the left. Turning the face down the software was able to detect the face until an angle of 20 degrees, whereas the software kept on detecting the face when looking up until the neck of the participant was fully stretched. Increasing the distance led to an increase of allowable error in every direction. 
 +
By changing the dark/light ratio is was observed that the software is very sensitive to light. By daylight there are no problems, however in a slightly darker room, where the curtains are closed, the maximum distance between the face and the webcam decreases rather fast, as well as the allowable angle. Turning light right into the camera has the same effect.
-
18. Wat kan er volgens u nog meer verbeterd worden aan de huidige tillift?
+
==== Experiment 2 ====
-
:Voornamelijk de mechanica, bijvoorbeeld dat voortbewegen en de hoogte veranderen wel tegelijk mogelijk is en draaien elektrisch mogelijk maken kan ook handig zijn. Het uiterlijk hoeft niet per se aangepast te worden, want het engste is vooral..
+
First one has to note that the movies that are selected in the research show strong emotional responses, but not facial expression responses as these emotional responses were determined by measuring heart rate and respiration. So there is a chance that not much responses will be shown in the tests, but this does not mean that the software is not valid. Furthermore it is mainly focused on analyzing only the most important emotions for this project, meaning happy, sad and fear.
-
==== Results of interviews ====
+
Figure 13 shows the analysis of the sad movie. What stands out is that neutral is minimally twice as high as the other emotions. This can be due to the selected movie as not every moment was sad. When the neutral emotion is neglected it is shown that sad is indeed the main mean emotion. For this reason in the next analyses the focus lies on the graphs where neutral is filtered out. Happy is also quite high in the maximum emotion graph. This is a striking result, because it could mean that in the software a sad emotion is easily confused by a happy emotion. This could however also be due to a high intensity of happiness at some point, because the happiness in the mean graph is not that high at all. Also anger is somewhat higher than the other emotions, however none of the participants reported feelings of anger so this might be an error in the software. Nonetheless, sadness and anger are on the same side of arousal in the valence arousal model so this also is a very plausible observation.
-
Several problems emerged from the interviews. Here we will summarize the most important points that were made clear in the interviews.
+
Figure 14 shows the analysis of the happy movie. It can be seen that the values of happy are high. The mean of happiness is even similar to the mean of neutral and the max is even higher. When neutral is neglected, a peak is visible in sad emotions, however happy still is twice as high. As in the previous figure sadness also was confused with happiness it can be stated that the recognition of Noldus needs some improvement. Happy and sad seem to be coherent in the software to some extent. Nonetheless, it can be concluded that the software of Noldus appropriately reports happiness as the main emotion when participants also report happiness.
 +
{|
 +
|-
 +
| [[File:Sad analysis.jpg|thumb|none|alt=ALT|800px|Figure 13: Analysis of sad movie]]
 +
| [[File:Happy analysis.jpg|thumb|none|alt=ALT|800px|Figure 14: Analysis of happy movie]]
 +
|}
-
Interview 1:
 
 +
The most important emotion for improvement the hoist is scared. Therefore two analyses of this emotion were conducted. Scared 1 shows fearfulness over a longer period of time and Scared 2 shows a very brief moment of shock. As visualized in Figure 15, happy is the main mean emotion besides neutral. Furthermore, the second highest mean emotion is sad. This is not as expected. In Figure 16 the sudden shock is analyzed. This is another way of measuring fearfulness. Contrary to the scene of the shining, in this movie happy is not high. Neutral on the other hand is high, but this is neglected. Visible again is that sadness is high instead of the scared that was expected. Also disgusted is slightly higher than the other emotions. Disgust can be difficult to distinguish from fear, because jaw drops and eyebrow changes. The emotions on one side of the valence level are often somewhat confused, but there is little confusion between the negative of positive valence levels.
-
Interview 2:
+
{|
 +
|-
 +
| [[File:Scared1.jpg|thumb|none|alt=ALT|800px|Figure 15: Analysis of scared 1 movie (the shining)]]
 +
| [[File:Scared2 analysis.jpg|thumb|none|alt=ALT|800px|Figure 16: Analysis of scared 2 movie (sudden shock)]]
 +
|}
 +
===Conclusion===
 +
By daylight and an angle between the face that should be detected (in the allowable range of left/right: 45 degrees, down:20 degrees and up: 60 degrees) and the webcam, the software is able to detect the face without any problems. As soon as more or less light is available the software’s performance is decreasing. A solution for this could be to attach a light near the camera that shines on the face of the patient in the patient hoist, so the software is able to detect the face, even when the room is dark
-
Interview 3:
+
What mainly can be concluded is that the Noldus Software did not always respond as expected. Reasons for this could be because small facial changes of, for example, fear are very hard to observe, the movie fragments were not good and long enough to arouse certain emotions or the participants were too much influenced by their environment to take the experiment seriously. However, something else is standing out. The software might not show the precise emotion accurately, because mainly happiness, sadness and neutral were reported, but the level of arousal on the other hand is quite precise. When Noldus reports neutral the level of arousal is 0, for negative emotions the level becomes negative and for positive emotions the level becomes positive. Negative arousal emotions are anger, sad and disgust while positive arousal emotions are happy and surprise. This can be seen from the valence arousal model of Russell. In the analysis it can be seen that the emotions on one side of the valence level are often somewhat confused, but there is little confusion between the negative and positive valence levels. For this reason, and also due to the fact that the received software only exports data from which valence can be determined, the “traffic light” system mentioned above will be based on the level of valence instead of the specific emotion. The next section will more elaborate on this.
-
:- Gebruik tillift blijft lastig, in verzorgingstehuizen vaak wel drempels aanwezig en dan is het lastig de tillift daaroverheen te krijgen
+
-
:- Zicht tijdens het rijden met de tillift vaak gebrekkig, zit paal in de weg, nu sta je altijd schuin van de tillift zodat je genoeg ziet --> mogelijke oplossing: Camera's aan tillift maken en beeldscherm bij verzorger plaatsen zodat er voldoende zicht tijdens het rijden kan worden gecreërd.
+
-
:- Matten van tillift kunnen snijden in benen van patiënten
+
-
:- 'Belijnen' moeten in de rugkant van de matten worden aangebracht voor extra stabiliteit, maar wanneer patiënt gaat zitten, moeten ze weer weg, zit namelijk niet fijn in de rug.
+
-
:- 'Belijnen' raken vaak kwijt, worden maar ergens neergelegd wanneer tilproces voorbij is --> kan misschien worden opgelost door magneetjes erin aan te brengen, zodat ze rechtstreeks aan de tillift kunnen worden gehangen na gebruik
+
-
:- Als de patiënt angstig is wordt er veel uitleg gegeven over de handelingen die er verricht worden en vraagt waar het probleem van hun angstige reactie ligt.
+
-
:- Per patiënt afhankelijk of ze sociale interactie tijdens het tilproces belangrijk vinden en of er behoefte is naar meer interactiemogelijkheden zoals een beeldscherm etc.
+
-
:- Plafondliften zouden fijner zijn (kleiner en makkelijker qua vervoer), maar niet praktisch in bestaande verzorgingshuizen, want dan moet er overal een railing worden aangebracht
+
-
:- Accu snel leeg van tillift, accu is ook zwaar
+
-
Interview 4:
+
===Emotion detection===
-
:- Sociale interactie tussen patiënt en verzorger blijft cruciaal onderdeel. Er wordt vaak oogcontact gemaakt tussen beiden en er wordt gepraat tijdens het proces.
+
As explained above, distinguishing different specific emotions lead to complications, which are undesirable. So, instead of focusing on these specific emotions and whether this one emotion exceeds a certain intensity, valence is used to determine the state of a patient’s emotion. (Arousal is not taken into account, since the software received from Noldus is not able to output the activity of the Action Units, which are needed to be able to calculate arousal). To calculate valence the intensity of positive emotions, like happy, as well as negative emotions, like anger, fear, sad and disgust, are needed for every time sample (surprise is not taken into account since it can be positive and negative).<ref>Loijens, L. and Krips, O. FaceReader: Methodology Note, Retrieved from http://www.noldus.com/files/file_manager/downloads/whitepaper/FaceReader_Methodology.pdf</ref> Consequently, valence is the subtraction of the intensity of happy and the highest negative intensity, leading to a range for valence from -1 to 1, where -1 is purely negative and 1 purely positive. Using this, the idea of a traffic light system on the nurses display can now be realized, as can be seen in the figure below. The matlab script is given in this file: [[File:Trafficlight.pdf]]
-
:Als een patiënt nog niet of niet goed bekend is met de tillift worden genomen handelingen uitgelegd en wanneer patiënt angstig is wordt er extra gecommuniceerd en zorgt de verzorger voor goed oogcontact en blijft hij in het zicht van de patiënt.
+
-
:Als een patiënt al bekend is met de tillift vindt er minder interactie tussen verzorgen en patiënt plaats, wordt dan over andere onderwerpen gesproken dan over het tilproces.
+
-
:Sommige patiënten voeren bepaalde onderdelen van het tilproces zelfs zelf uit, bedienen bijvoorbeeld zelf de knoppen voor omhoog en omlaag --> deze zelfstandigheid (en meer) zou bij jongeren die gebruik moeten maken van de passieve tillift bijvoorbeeld een goede uitkomst kunnen zijn, zij zouden het fijner vinden acties zelf te kunnen ondernemen.
+
-
:- Passieve tillift: Er zijn verschillende maten matten per postuur, wel kan dezelfde tillift alle soorten matten aan (t/m 150 kg ongeveer, daarna een specialere tillift nodig)
+
-
Interview 5:
+
The traffic light given in Figure 17 is green when the valence is higher than 0.3, red if it is less than -0.3 and yellow when the valence is in between. This treshold can be varied for every patient personally.
-
The main pont that can be concluded from this interview is that interaction is an important, but also a difficult point. Especially since the patients are suffering from dementia they do not really understand what you are saying. Still it is important to keep communicating about what you are doing and to comfort the patient. This is also possible by touching the patient, by eye contact or by distracting them with a stuffed animal. Over time you learn to recognize whether the patient is uncomfortable, because you get to know them. It is very important for nurses to get to know their patients. The main problems with the hoist are that you have to do several things at the same time and it is heavy to turn and move the hoist when it is loaded with a patient. It is especially difficult to navigate the hoist safely through small spaces while watching the patient.
+
{|
 +
|-
 +
| [[File:Trafficlight.PNG|thumb|400px|Figure 17: The traffic light system]]
 +
|}
-
=== Survey ===
+
== Demonstration ==
-
==== Design enquete ====
+
The purpose of the demonstration is to form a clear image of the future vision of the improved hoist. The invented adjustments that have been examined in the last few weeks are also implemented.
-
'''Verbanden/ hypotheses:'''
+
Here a link to the created short film clip of the demonstration is given: https://www.youtube.com/watch?v=r1jxQCQQBQQ&feature=youtu.be
-
:- Both patients and caregivers prefer eye contact most during the process of caregiving during transportation in the “til lift”.
+
== Feedback ==
-
:- Patients like to be comforted by voice interaction between patient and caregiver of between patient and someone else during the process of caregiving during transportation in the “til lift”.
+
To verify whether the implemented adjustments on the passive patient hoist shown in Design 1 are successful enough, feedback has been gathered from several caregivers who are acquainted with this hoist. Two of these caregivers have also taken part in the interviews at the beginning of our research, so they were a little bit more informed about the project already and three new caregivers were asked for feedback.
-
:- Patients like to be comforted by bodily contact during the process of caregiving during transportation in the “til lift” and also caregivers prefer to have some extent of body contact during care giving.
+
The feedback was gathered by first briefly explaining to the caregivers what our research is about and how our arranged requirements are implemented in our first design. Secondly Design 1 with the several invented interfaces were shown to the caregivers and per adjustment was explained why it has been implemented. The caregivers were asked to give their opinion about the adjustments and whether they would adjust or add anything to the design.  
-
'''Opzet voor de enquête'''
+
The results per feedback interview are listed below and a general conclusion from these feedback interviews is concluded.
-
Link to survey: https://docs.google.com/forms/d/e/1FAIpQLScinjbrL8rMoxs1CQOP0JCgIO3u_tavH2K1LGRcKIa9q_bFVA/viewform
+
==== Feedback 1 ====
-
==== Method ====
+
From this feedback interview can be concluded that our adjusted design of the passive patient hoist is indeed a good improvement. The bigger wheels actuated by a motor are very convenient as it reduces the required power of the caregiver to move the hoist, because it is not an easy task to push the current hoist with a patient in the yoke. The solid spherical wheels in the front of the hoist are also considered as handy since they make it easier to turn the hoist in another direction. The emergency stop is already implemented on the current hoist, however the position of this button is too low. The one shown in the design has a better position in the working space of the caregiver. The camera for navigating the hoist is regarded as a good adjustment. Especially with for example cables lying underneath beds etc. it is a fine implementation that can make spots visible for the caregiver and it can prevent collisions. This camera can be of good use for distances in one small busy room as well as for the transportation process. The addition of a holder for the whalebones of the lifting mat is considered very clever, even though it is such a simple adjustment it is really a good one, because the whalebones are now in no way connected to the hoist. The interface of the caregiver can support the caregiver in his tasks, although the caregiver should be able to open or close windows however he prefers. The traffic light system makes the caregiver extra alert which is therefore an advantage to provide good care. The options for the interface of the patient should all be possible as every patient is different and it should again be possible to switch options on or off. The control over these options should be given to both caregiver and patient, as long as patients are able to use these digital methods. An extra improvement for this design could be a kind of peg adjusted on the hoist so the lifting mat can be hung up on. Now the lifting mat is just thrown over the hoist which makes it easier to be worn out and whenever there is just a small hole in the mat it may not be used anymore because of safety aspects. The overall impression of the design is therefore positive and it will be an advantage for both patient and caregiver.
-
In the previous week some data for the enquête was already gathered, a powere analysis was conducted. The standard deviation at that moment was around 0.7, so this is the value that we used for the power analysis, together with a power of 0.8 and an alpha level of 0.05.
+
==== Feedback 2 ====
-
Code:
+
The feedback from this interview is quite similar to the first one. The motorized wheels are considered as a real advantage for the caregiver. It can prevent back pain for the caregiver as it reduces their needed strength to push the hoist. The spherical wheels are just as in feedback 1 found very handy so turning the hoist in the desired direction will not be an issue anymore. It is found strange that those spherical wheels are not implemented yet or in more other equipment like for example a wheelchair. The position of the safety button in the design is more suitable than the current position, especially when more electronics are implemented it is important to be able to switch the hoist off. The camera for navigation and the holder for the whalebones are considered as a good addition just like in feedback 1. For the interface of the caregiver again the same good feedback was provided, however now the question arose whether it was possible for the used software of Noldus to determine the emotions of patients who have a facial paralysis or a defacement. Further the approach of a traffic light system to warn the caregiver is just fine, however instead of different light colors also smileys could have been used or something similar considering caregivers that are colorblind. The options for the interface of the patient are a good implementation to ease them when they are not feeling comfortable or scared. It depends on the patient which option will be chosen and this should be chosen by the patient if possible. Option three for demented or retarded patients is good, because an animation can distract them, however the animation should be chosen with care, because some subjects are sensitive.
-
tab rol //see sample size
+
-
tabstat oog voice lichamelijkcontact, by(rol) stat(mean sd min max) total col(stat) long format // see standard deviation
+
-
power twomeans 2 2.5, sd(0.7) power(0.8) alpha(0.05)
+
-
This showed that we need 24 to 32 respondents to be able to see a significant result in our data. We used a mean difference of 0.5 points difference on the Likert-scale. The Likert-scale is the scale of 0 to 5 that we used in the enquête.
+
==== Feedback 3 ====
-
Then we started collecting data again, especially of patiënts, because there was not enough data of this group. A sample size of 29 participants for each group was gathered.
+
The overall impression about the improved design was stated as positive during this interview. The motorized wheels are a good idea, however they should be carefully tested especially in small rooms. The motorized hoist and the strength by which the caregiver pushes the hoist should be well adjusted to each other, so the hoist does not react jerky or moves to fast and risks to bump into things. The spherical wheels, the emergency button, the camera for navigation and the holder for the whalebones are all considered as good adjustments in the current design of the passive hoist. Option one (visible caregiver), three (visible caregiver and a short film clip for distraction) and four (different options combined or switched on and off) for the interface of the patient are useful supplements and can either improve the interaction between caregiver and patient or comfort the patient more during the lifting process. Option two (visible caregiver and a short film with instruction) is on the other hand not necessary. Not all patients will understand these kind of instruction film and as a caregiver you provide these instructions yourselves to the patients verbally. The interface of the caregiver is also a good adjustment to improve the interaction between patient and caregiver and it can smoothen the whole process by giving feedback about a patient’s condition with the traffic light system and by giving information about the badly visible surroundings just in front of the hoist. However questions arose whether the used software to detect facial emotions will be useful for patients with for example Parkinson’s disease and whether caregivers will not focus too much on the interface instead of the whole hoist so the risk of collisions will increase while moving the hoist.
 +
At the end another option for a more future design for the interface of the caregiver and the control of the hoist was given. Instead of pushing the hoist by the caregiver himself, it should be driven by using something like a IPad by the caregiver. In this case the caregiver can walk next to the hoist and the patient while stirring the hoist from the IPad. Interaction between caregiver and patient will be improved by reducing the distance between them and the workload for the caregiver will decrease as he does not need to push the hoist manually anymore.
-
The data was prepared for analysis, for example by giving proper names to the variables i.e. After that, the new standard deviation is determined.
+
==== Feedback 4 ====
-
The follow hypothesis were analysed.
+
From this interview can be concluded that the made adjustments in the current hoist are good and useful to improve the lifting process. Especially the motorized wheels in combination with the spherical wheels in front of the hoist are a very big improvement. The turning and pushing of the hoist is now experienced as hard and even more difficult then moving a full and heavy shopping cart. The motorized and spherical wheels will make this process a lot easier by reducing the workload of the caregiver. The emergency button, the camera for navigation, the holder for the whalebones and the interface of the caregiver are considered equally as in feedback 3. The options for the interface of the patient is also evaluated the same as in feedback 3 where option two should be omitted. Option three is a good option for comforting and distracting the patient, but no animation should be used. Instead a short film clip about nature with waterfalls or woods should be used to entice their attention.
-
:- What way of interaction receives most preference?
+
-
:- H0: there is no difference in the need for interaction between patients and caregivers
+
-
:- H0: there is no difference in preference for eye contact between patients and caregivers
+
-
:- H0: there is no difference in preference for voice interaction between patients and caregivers
+
-
:- H0: there is no difference in preference for body contact between patients and caregivers
+
-
Commands used in Stata:
+
==== Feedback 5 ====
-
://welke manier van interactie krijgt de meeste voorkeur?
+
-
:tabstat oog voice lichamelijkcontact, by(rol)
+
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://H0: er zit geen verschil in de vraag naar interactie tussen patienten en verzorgers
+
-
:ttest interactie, by(rol)
+
-
://H0: er zit geen verschil in voorkeur voor oogcontact tussen patienten en verzorgers
+
-
:ttest oog, by(rol)
+
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://H0: er zit geen verschil in voorkeur voor stem tussen patienten en verzorgers
+
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:ttest voice, by(rol)
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://H0: er zit geen verschil in voorkeur voor lichaamscontact tussen patienten en verzorgers
+
-
:ttest lichamelijkcontact, by(rol)
+
-
==== Results ====
+
Just like the other feedback interviews the overall impression of design 1 is considered positive and with real advantages in comparison with the current hoist. Just as stated in feedback 4, the motorized wheels and spherical wheels are very handy as turning will not be an issue anymore and  less physical power of the caregiver is needed. This adjustment will reduce the workload of the patient and their back pain which is obtained by frequently using the hoist. The emergency button and the holder for the whalebones are considered equally as in feedback 3. The camera for navigation will also be of good use. Especially for managing the hoist under beds and chairs where cables or attributes like shoes can be avoided now and it is not necessary for the caregiver to get down on his knees anymore to see what is interfering with the hoist. Therefore the interface of the caregiver is well equipped especially with the window of the surrounding just in front of the hoist. Option three for the interface of the patient can be of good use for demented patients. A short film clip as mentioned in feedback 4 should be used or perhaps a little bit of music could be added to it. It is probably good that the caregiver is also visible on the interface of the patient as it is more comforting to see a matching face from the caregiver who is talking to the patient from behind the hoist.
-
Using the new standard deviation (0.7 again), the sample size (29 participants per group) and again an alpha level of 0.05, the power is calculated. The value of the power is 0.76, this value is oké. In an ideal case we collect 5 to 10 more patient participants, but we continue with the analysis anyway because the power is good enough.  
+
-
Code:
+
=== Conclusion feedback ===
-
power twomeans 2 2.5, sd(0.7) n(58) alpha(0.05) //to compute power with given sample size -> 29 participants per group
+
 +
From all the gathered feedback can be concluded that design 1 is indeed an improvement of the current passive patient hoist. The bigger motorized wheels are a very good adjustment to the current hoist. They reduce the workload of the caregiver to move the hoist and be doing so they can prevent back pain for the caregiver by frequently use of the hoist. However this motorized system including the force sensors (nr. 2 in design 1) should be tested very properly, because the motorized hoist and push load of the caregiver should be well adjusted to each other so no jerky reactions or collisions by too fast movements are obtained. In all the feedback interviews was stated that the spherical solid wheels are actually a must for the improved design of the hoist. They make it easier to turn the hoist in a desired direction and in combination with the motorized wheels they will make the lifting process a lot easier by reducing the workload of the caregiver so less physical power of the caregiver is needed. The position of the emergency stop in design 1 is more suitable than the lower current position on the hoist, because it is positioned in the working space of the caregiver. Especially when more electronics are implemented it is important that the hoist can be turned off right away. The camera for navigation is regarded as another good adjustment to the current design. Especially for managing the hoist underneath beds and chairs where cables and other attributes can be avoided. It is a fine implementation that can make spots visible for the caregiver and it can prevent collisions. It can be of good use in small busy rooms as well as for the transportation process. Although simple yet a very handy adjustment has proven to be the addition of a holder for the whalebones of the lifting mat as they are now in no way connected to the hoist and they are often lost. The interface of the caregiver can support the caregiver in his tasks. It improves the interaction between patient and caregiver by making eye contact possible form behind the hoist, it smoothens the process by giving feedback about a patient’s condition by use of the traffic light system and it provides information about the surroundings just in front of the hoist. The traffic light system extra alerts the caregiver which is therefore an advantage to provide good care, but questions arose whether the used software to detect facial emotions can be used for patients with facial paralysis or defacements and whether caregivers will not focus too much on the interface so the risk of collisions will increase while moving the hoist. Options one, three and four for the interface of the patient are useful adjustments and can either improve the interaction between caregiver and patient or comfort the patient more during the lifting process. Option three is a good option for comforting and distracting patients when both caregiver and short film clips about the nature are visible to entice their attention. Option two is not necessary, because not all patients will understand the given instructions. The caregiver provides these instructions himself verbally to the patient during the process. The control over these options which can be turned on or off should be given to both caregiver and patient, as long as the patient is capable to do so.
 +
Other adjustments like a peg for the lifting mat and another kind of control system for the hoist by using an IPad have been stated in the gathered feedback. These can perhaps be incorporated in a final or future design.
-
The results are:
+
== Final Design ==
-
[[File:Result-interaction1.jpg]]
+
Based on the gathered feedback about design 1, it can be concluded that most of the made adjustments on the current hoist are useful and should indeed be implemented in the new design. To create a final design of the passive patient hoist a few changes in design 1 will be made which will be explained further.  
-
Total mean for eyecontact is 2.22, for voice-interaction is 2.21 and for bodycontact/interaction is 2.96. The difference between patient and caregiver in eyecontact is 0.20, for voice interaction it is 0.31 and for body contact it is 0.41.
+
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[[File:result-interaction2.jpg]]
+
An extra improvement which is stated in feedback interview 1 for design 1 is that a kind of peg should be adjusted on the hoist so the lifting mat, which is now just thrown over the hoist, can be hung up on. This adjustment is implemented in the final design as it is proven that the current manner at which the lifting mat is hung up is bad for the mat as it is easier worn out which reduces the safety of its use.  
-
For the ttest of interaction by role of patient of caregiver, the t value is 2.55. There are 61 degrees of freedom. The p-value is 0.006.
+
-
[[File:result-eyecontact.jpg]]
+
Another addition to the design is a small light source next to camera for navigation (nr. 8 in design 1). This will improve the visibility of the environment of the camera as it has been stated in the feedback interviews that the legs of the hoist will be shoved underneath beds and chairs.
-
For the ttest of eye contact by role of patient of caregiver, the t value is 1.06. There are 61 degrees of freedom. The p-value is 0.146.
+
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[[File:result-voicecontact.jpg]]
+
Requirement d (“The hoist should be able to recognize anxiety in the patients”) is satisfied in design 1 by using facial expression recognition software of Noldus. However, the software cannot detect facial emotions by patients with facial paralysis or defacements. Therefore the previously proposed software of MIT in which emotions of persons are detected by taking respiration and heart beat into account will be implemented in the final design besides the software of Noldus. The output of the MIT software will also be connected to the traffic light system just like the output of the Noldus software so the caregiver can be alerted whenever the patient is feeling uncomfortable. This way more patients, even patients with facial paralysis or defacements can be taken into account for the improved design.  
-
For the ttest of voice interaction by role of patient of caregiver, the t value is 1.762. There are 61 degrees of freedom. The p-value is 0.042.
+
-
[[File:result-bodycontact.jpg]]
+
To make the implemented traffic light system in the interface of the caregiver also functional for colorblind caregivers as stated in feedback interview 2, symbols inside the red, yellow and green light are used like in figure 10. These symbols will be visible whenever the red, yellow or green light shines.
-
For the ttest of body contact by role of patient of caregiver, the t value is 2.46. There are 61 degrees of freedom. The p-value is 0.008.
+
-
==== Discussion ====
+
Due to the feedback about the interface of the patient the following changes are made for the final design of the hoist. Firstly, the second option for the interface of the patient in which the caregiver and a short film clip about the actions of the lifting process are explained is removed. This is done because not all patients will understand the given instructions and the caregiver prefers to give these instructions himself verbally to the patient during the process. Secondly, the third option for the interface of the caregiver in which the caregiver and an animation for distracting the patient is showed is adapted. This change consists of showing a different short film clip, like one about nature with waterfalls or woods to entice the attention of patients with for example dementia as these sort of films are more comforting for them.
-
The results mean:
+
-
What way of interaction receives most preference?
+
Finally the control over all options for the interface of the patient which can be turned on or off is given to both patient and caregiver. The patient can choose from the different options on his own interface (nr. 6 in design 1) and the caregiver from his interface (nr. 1 in design 1). Normally the patient will have full control over the given options, but whenever the patient is no longer capable of controlling these options, the caregiver will do it for him. 
-
:Command: tabstat oog voice lichamelijkcontact, by(rol)
+
All the above mentioned changes lead to the final design of the I.P.H.
-
Eyecontact receives most preference. With bodycontact you see that patients do not really like it. The value of preference is higher, which means their preference is lower. Also, the difference with preference of body contact between patients and caregivers is quite high.
+
== Discussion ==
 +
A design for an improved hoist was obtained. Although this design well-founded, there are also several limitations to the research done. Some of these problems can be solved in further research.
-
What also stands out is that the preference for voice interaction is a little less with patients that with caregivers. This means that caregivers like talking to their patients more than that patients prefer to talk to their caregivers. This is not what we hypothesized so we will look into this, using interviews and a ttest on voice interaction.  
+
First of all, it was not possible to interview patients and a limited amount of surveys were filled in by patients. This is due to the fact that patients who have experience with the hoist, are a very fragile group. Often they are old and have dementia. Most nursing homes would not let us ask questions to this patients, because that could upset them or they would not understand us anyway.  Nurses could tell us a lot of what they thought to be the desires of the patients, but it would be better if the patients were asked themselves. Some of our solutions might have been rejected or patient could have had very specific problems with hoist the nurses did not know about. The improvements in our design are therefore mainly based on the view of nurses on the problems of patients. This can be different from the problems the patients experience themselves.
-
H0: there is no difference in the need for interaction between patients and caregivers
+
Secondly, there were a couple of problems with the Noldus Facial expression recognition that was used. For instance, the version that was obtained did not have the possibility to export the data real-time. This meant that it was only possible to export and analyze the data at the end of recording. It was possible to see the data in the program itself real-time, but for using it for the interface of the nurse, it needed to be exported it to the script that was written, in real-time. The traffic light system that was designed could only work afterwards. This problem, however can be easily solved for anyone who would like to implement our design by obtaining the right software.
-
:command: ttest interactie, by(rol)
+
Another problem that was encountered was that the software was not able to export the data on arousal, only on valence. The script for the lights of the traffic light could be more accurate with this data. At the moment it only uses valence, which means that every negative emotion can change the traffic light. Ideally the traffic light would only respond to fear, but for that data on arousal is needed. This problem could also be solved by obtaining the right software.
-
There is a significant result, which means the preference for interaction between patients and caregivers is not the same. The p value is 0.006, so H0 is rejected.
+
-
H0: there is no difference in preference for eye contact between patients and caregivers.
+
Furthermore, an important limitation of the research is that the software was not tested on people who are partly paralyzed or have a disfiguration in the face. It is possible that the software does not work well on these kind of patients, which can lead to false signals towards the nurse. This problem can be solved however by measuring heart beat or respiration as mentioned in the requirements. The technology using radio frequency signals (see requirements) that MIT has invented can also work for this, but this technology is rather new and needs to be developed further, before it is possible to implement it in the hoist.
-
:Command: ttest oog, by(rol)
+
-
A ttest is conducted where the preference in eyecontact is compared between patients and caregivers. There is no significant result because the p value is 0.146. This means H0 cannot be rejected, so there is no difference in preference for eye contact between patients and caregivers.
+
 +
== Conclusion ==
-
H0: there is no difference in preference for voice interaction between patients and caregivers
+
The goal of this project and the experiments was to improve the current passive patient hoist in ways that would result in more convenience for the primary users, thus for the caregiver and the patient. In literature hardly any research is found about the use of patients hoists in hospitals and nursing homes.  
-
:Command: ttest voice, by(rol)
+
-
A ttest is conducted where the resulting p value is 0.042. This value is below 0.05 which means that H0 can be rejected, so there actually is a significant difference in preference for voice interaction between patients and caregivers. However, this resulting p value of 0.042 is not very far below 0.05, so we cannot be totally sure that this difference is significant.  
+
 +
Considering the fact that there has been little research done about the passive patient hoist, it was stimulating to start a new experiment in which the current hoist could be improved, whereby two main hypotheses were formulated: ‘Caregivers need to be supported by the patient hoist’ and ‘Patients and caregivers attach value to interaction during the process of lifting’. Based on the results of the interviews and the survey of the first hypothesis can be concluded that there is a need for care givers to be supported by cameras for navigating the patient hoist and that the caregiver would like to be warned by the hoist whenever the patient is feeling anxious. From the second hypothesis can be concluded that both caregivers and patients prefer eye contact more during the interaction than speech and physical contact.
-
H0: there is no difference in preference for body contact between patients and caregivers
+
Based on the results of the interviews and the survey seven requirements to improve the current passive hoist were made and implemented in the first design. Two of these requirements, which are more elaborated in the experiment, are ‘During the whole process eye contact between the patient and the nurse is guaranteed’ and ‘The hoist should be able to recognize anxiety in the patients’. To satisfy these two requirements cameras are implemented in the first design and software of Noldus was used to test the facial expressions of the patient. Additionally a traffic light system is implemented on the interface of the caregiver which is connected to the camera of the patient. Due to the implemented software of Noldus it could recognize facial emotions of the patient. This traffic light system had been tested and works sufficiently.  
-
:Command: ttest lichamelijkcontact, by(rol)
+
-
This final ttest shows a large significant result again. We got a p value of 0.008. This means H0 can be rejected and there is a difference preference for body contact between patients and caregivers. Patients prefer this way less than caregivers.
+
 +
As the overall impression about the gathered feedback of design 1 is positive, it can be concluded that the implemented adjustments of design 1 are indeed an improvement of the current passive patient hoist. Due to this feedback some little adaptations have been done leading to the final design of the passive hoist. This all has resulted in the creation of two different end products, namely one new hoist design that consists of all adjustments, portrayed in figure 18, and another one that will function as an add-on for the current hoist, portrayed in figure 19.
 +
{|
 +
|-
 +
| [[File:DesignPassive.png|thumb|none|alt=ALT|600px|Figure 18: New hoist with the list of improvements implemented ]]
 +
| [[File:Add-on.png|thumb|none|alt=ALT|700px|Figure 19: Current hoist with the Add-on]]
 +
|}
-
Noldus company for face detection software is contacted for a free trial software. Via telephonic contact it is promised that we will receive this before the end of the week.
+
==Future research==
-
== Analyse ==
+
Finally possibilities for future research will be examined. The most important follow-up research that needs to be done is research on the actual implementation of the improved hoist. It needs to be researched in what extent the design improves the comfort for the patient and nurse and the effectiveness of the nurse.  This can be done by actually producing the hoist and testing it in a nursing home under standard circumstances.
-
 
+
Furthermore, a lot of other aspects need to be taken into account before the design can be implemented. For this research, only the primary users were considered, but before implementation takes place it is important to look into the requirements for secondary and tertiary users, too. For instance, the costs of the design are still unclear just like the regulation concerning the improvements. These aspects are beyond the scope of this research, but it should be investigated in future research.
-
From both the survey and the interviews we can conclude several things. First of all we will try to answer the question whether our hypotheses were true or not.
+
The patients and nurses could also be more directly involved with the implementation. In further research it would be recommended to include the users in the research group.
-
 
+
Lastly, in the proposed design the nurse is still present during the transfer. However the proposed design can be a stepping stone towards full automation, because some of the needed technology for full automation is already implemented in our design. Thus it can make the caregivers and nurses become more familiar with robotics.
-
 
+
-
'''Caregivers need to be supported by the patient hoist'''
+
-
 
+
-
From the interviews we can conclude that they don’t really need to be supported by the patient hoist, they can manage without, but it would help much.
+
-
Nurses have indicated that especially a hoist that helps with navigating through small spaces would be of great help. Thus we can confirm the hypothesis that nurses would need to be supported by camera’s for navigating.
+
-
It is less clear whether the second hypothesis,  “caregivers need a patient hoist that can navigate itself and avoid obstacles” can be confirmed. Nurses have mentioned they would like to have help with navigating but none them have mentioned they would like the hoist to move on itself. At least one of them, Lisan, has mentioned an aversion for a self-moving hoist. She was convinced a nurse should always be present. So we conclude that this hypothesis is untrue.
+
-
Not much consensus was found on the third hypothesis: The caregiver would like to be warned by the patient hoist whenever the patient is anxious. Some nurses mentioned that it could be handy, but other nurses mentioned that this is the task of the caregiver and by getting to know the patient a caregiver could identify whether the patient was anxious perfectly well themselves. So we will neither confirm nor reject this hypothesis.
+
-
We can also neither confirm or reject the hypothesis “patients appreciate it when they are reassured by the patient hoist whenever they are anxious”,  because it was not possible to interview a patient. It is a very vulnerable group, so nursing had rather not us interviewing them.  
+
-
The last hypothesis was: ”Caregivers need a patient hoist that can provide information about the weight or the 'BMI' of the patient.” One nurse mentioned it would not be necessary, because they weigh the patient already once a month. But since the other nurses never gave a clear answer to this question we neither confirm nor reject it.
+
-
 
+
-
 
+
-
'''Patients and caregivers attach value to interaction during the process of lifting.'''
+
-
 
+
-
We have researched this hypothesis with a survey. From this and the interviews it can be concluded that most patient and care givers do indeed attach much value to interaction. In the interviews it was mentioned as one the most important aspects of the tilling process.
+
-
From the survey can be concluded that both patients and caregivers prefer eye contact most during the process of caregiving. This is also what we hypothesized.
+
-
We also see that both caregivers and patients like to have voice interaction to some extent. However, the preference for voice interaction is significantly larger for caregivers than for patients. Patients do prefer voice interaction, but to a much lesser extent than caregivers do, and also to a much lesser extent than we hypothesized.
+
-
For body contact there is a large significant difference in preference for caregivers and patients. Patients actually dislike body contact during care giving. This is not what we hypothesized.
+
-
From these results we conclude that eye contact is the most important factor of interaction during caregiving. We will use this to optimize interaction during the process of caregiving during transportation in the patient hoist. Voice contact is less important to patients, but we could also take this into consideration with our design for optimizing the patient hoist.
+
-
 
+
-
 
+
-
'''The trust of patients in the modern patient hoist results in less necessity for assistance of the caregiver'''
+
-
 
+
-
We did not research this hypothesis in the same extent as the previous hypothesis, but there are some things we can say about it.
+
-
The nurses mentioned it interviews that patient mostly are afraid when they are actually in the hoist and cannot feel the ground. It doesn’t really matter what the hoist looks like, it probably won’t reduce their fear. So the hypothesis “Trust depends on the design of the device” is rejected.
+
-
 
+
-
- The degree of acquaintance with modern technology results in less necessity for interaction between caregiver and patient. (Survey)
+
-
 
+
-
- The degree of acquaintance with the active of passive patient hoist results in less necessity for interaction between caregiver and patient. (Survey)
+
-
 
+
-
 
+
-
 
+
-
Problems observed:
+
-
 
+
-
Problem 1:
+
-
By the transfer of the patient with the lift it can happen that the swivel caster wheels, which are currently used, do not roll as smoothly as hoped. This is caused by a rough surface or the orientation of the wheels. Therefore one requirement for the new design is that wheels are used that do not get stuck.
+
-
 
+
-
Problem 4:
+
-
During the transportation phase there is a possibility that the patient loses eye contact with the nurse. Also, on longer distances where the patient is facing towards the moving direction there is no eye contact at all. This can lead to a less comfortable experience for the patient, why another requirement holds that during the whole process eye contact between the patient and the nurse is guaranteed.
+
-
 
+
-
Problem 5:
+
-
During the transport it is difficult for the nurse to keep an eye on everything, mainly because the patient is blocking a significant part of the field of sight of the nurse. Improving the overview of the nurse during transportation is therefore another requirement.
+
-
 
+
-
== Requirements ==
+
-
 
+
-
In this section the best solutions for the requirements stated earlier will be discussed.
+
-
 
+
-
Requirement 1:
+
-
 
+
-
A solution for this is to use solid spherical wheels, which are part of a ball bearing. Since these wheels can move freely in every direction they will not get stuck due to orientation and can as well move over surfaces which are rough. Since these wheels do not have an axis around which they turn it is difficult to support them with an electomotor. Therefore these wheels are mainly useful as replacement for the front wheels of the patient hoist. 
+
-
 
+
-
Requirement 2:
+
-
 
+
-
The hoist should be easier (less force needed) to move around by the nurse.
+
-
The nurses mentioned in the interviews we held that they had trouble moving the hoist around in the rooms, because it was so heavy, especially when the patient was lifted. Sometimes the floors made it even more difficult to push the hoist forward. So we concluded that the improved hoist should have the ability to move without the nurse applying al the force. This especially important when the hoist is used for larger distances, like moving the patient to the toilet or to another room.  
+
-
Our solution is to build in an electromotor to drive the wheels. This means the hoist requires a stronger battery. (calculation of the kind of battery).  We decided to not use a remote to steer the improved hoist, because that would add extra complexity to the hoist. The nurses would have to learn yet another thing. We want to keep the learning curve short, so we would user intention recognition to steer the hoist. This means the hoist anticipates on the intentions of the nurse by measuring how force is applied. For the nurse it means she can use the hoist the same way she was used to. More explanation of this can be found at requirement 3.
+
-
 
+
-
 
+
-
Requirement 3:
+
-
 
+
-
The patient loaded in the hoist should be easy to turn.
+
-
From the interviews we know some nurses had trouble with turning the patient in the right direction, while also making sure the hoist does not bump into something. The patient is turned by hand, which means all the force applied comes from the nurse. We want to make that easier by also using an electromotor to turn the harness to which the sling is attached. For this we also want to use user intention recognition, for the same reasons as mentioned above.
+
-
To recognize the intention of the nurse the hoist needs force control system. Usually force control is used in robot that have to pick up objects. It makes sure the robot doesn’t squeeze anything. It does this by measuring the opposing force the object applies to the robot when the robot picks up the object. A feedback loop is used to ensure the robot responds in the correct way to the opposing force. This force control can be implemented in the hoist, so that the bigger force the nurse applies, the longer the robot continues this movement. To measure this force, force or strain sensors have to be implemented on every joint of the hoist.  A computer measure this force and with the implemented logic determines the motion and velocities. Major motion patterns have to be identified and implemented in this computer, to ensure the hoist continues its movement in the same direction as the nurse applied the force in. The final block diagram will look something like this:
+
-
 
+
-
[[File:Block_diagram.PNG| Block diagram force control (Dantanarayana L., 2007)]]
+
-
 
+
-
 
+
-
Requirement 3:
+
-
 
+
-
The hoist should be able to comfort the patient when he/she is afraid.
+
-
We already stated the hoist should be able to recognize fear in the patient, but we also want the hoist to react on it. We already mentioned a screen attached to the hoist on which the patient can keep contact  with the nurse, when the patient is moved. This screen can also be used to comfort the patient. One thing we concluded from the interview that it is important to tell the patient what is happening to them. So a feature is implemented in the hoist that it can tell, either with spoken words or written on the screen, what is happening to the patient at the moment he/she is scared. The nurse should be able to disable this feature at any moment. Another thing we learned from the interviews is that  a lot of patient who have to transported by a hoist have dementia. They don’t understand what the nurse is saying to them. Therefore they won’t understand the hoist either. An option for them would be, that the screen on the hoist would show an animation which can distract the patient. The screen could also show a big red button if the patient is easily scared, so they can stop the hoist at any time. This should also be a feature that the nurses should be able to disable at any moment.
+
-
 
+
-
Requirement 4:
+
-
 
+
-
One way to realise this is by the use of cameras and displays. A patient, who is sitting in the lift, can be filmed by a camera. This images are transferred to a display that is attached to the back of the lift where the nurse is standing, who is also filmed. The patient also should have a display in sight, so eye contact can be established at all time.
+
-
 
+
-
Requirement 5:     
+
-
+
-
Also this problem can be solved by the use of a camera, which is placed at the front of the lift and films in the moving direction of the lift. Transferring these images to the display of the nurse, he/she can easily see what is in front of the lift and if there are any obstacles that could be possibly dangerous. Another addition would be sensors that indicate how close the lift is to a certain object, for instance a wall, so the nurse has an even more complete overview. These sensors, often used in cars for parking assistance, use super sound to determine the distance between the sensor and a object. If a minimum distance is exceeded the nurse will get a signal on het screen and the hoist will break automatically to prevent collision. 
+
-
 
+
-
== Design 1 ==
+
-
 
+
-
 
+
-
 
+
-
 
+
-
[[File:DesignPassive.png]]
+
-
 
+
-
A first design in Photoshop CS6 has been drawn after the requirements were taken into account. The numbers are attached to the changes that are made to the passive hoist, type 'Wendy'.
+
-
:1. Screen display with built in camera, which is able to live record the care giver. The software on the display is able to show information about the patient in the hoist.
+
-
:2. Force sensors. To measure how much power the care giver is currently applying.
+
-
:3. Emergency stop button for the care giver.
+
-
:4. Electronic powered motor.
+
-
:5. Gyroscope to prevent unneccesary oscillations for the patient.
+
-
:6. Camera live recording the patient.
+
-
:7. Screen to make eye contact with the care giver.
+
-
:8. Holder for the stiffeners.
+
-
:9. Camera to create more overview for the care giver.
+
-
:10. Wheels for better manoeuvrability
+
-
 
+
-
== Discussion ==
+
-
 
+
-
== Conclusion ==
+
== References ==
== References ==
 +
<references />
== Appendix ==
== Appendix ==
-
 
-
== Collaboration ==
 
-
 
-
=== Milestones ===
 
=== Planning ===  
=== Planning ===  
Line 848: Line 629:
Week 7 (each member 2 hours)
Week 7 (each member 2 hours)
 +
==== [[ Extensive version planning ]] ====
-
==== Extensive version planning ====
+
=== [[ Weekly meetings ]] ===
-
 
+
-
 
+
-
 
+
-
'''Week 2:'''
+
-
 
+
-
- Making of interviews: JE (1h, come up with questions), N (1h, come up with questions)
+
-
 
+
-
- Conducting interviews: JE (2h), JO(2h), N(2h) (digitalize answers)
+
-
 
+
-
- Making and preparing presentatie: JO (2h), N(2h) (making power point)
+
-
 
+
-
- Literature research (state-of-the art): JA (3h) (list of articles and start of working out articles)
+
-
 
+
-
- Making of survey: M( 2h)
+
-
 
+
-
- Making of planning maken: JE, JO, JA, N (4h)
+
-
 
+
-
-Meeting: (3h)
+
-
 
+
-
 
+
-
'''Week 3:'''
+
-
 
+
-
- Literature study (state-of-the art): JA (6h) (summary)
+
-
 
+
-
- Literature study (Human-Robot interaction) JE(3h), JO (3h), N(3h), M(3h) (list of articles + summary)
+
-
 
+
-
- Conducting survey: EVERYBODY (8h)
+
-
 
+
-
- Conducting interviews: JE (2h), JO(2h), N(2h) (digitalize answers)
+
-
 
+
-
- Meeting: dividing literature study, processing feedback,
+
-
 
+
-
 
+
-
'''Week 4:'''
+
-
 
+
-
- Processing survey: M(4h)), JA(4h)
+
-
 
+
-
- Processing interviews: JO, N, JE (12h)
+
-
 
+
-
- Meeting: making 1st design EVERYBODY (Thursday 20h)
+
-
 
+
-
- Literature study (specific): JA(5h), JE(5h)
+
-
 
+
-
 
+
-
'''Week 5a:'''
+
-
 
+
-
- Meeting: Working out design EVERYBODY (20h)
+
-
 
+
-
- Preparing prototype, searching information etc: JE, JO (8h) (asking for help)
+
-
 
+
-
- Making prototype: JE, JO (8h)
+
-
+
-
- Research plan:N, M en JA (12h)
+
-
 
+
-
- Design/sketch: N, M en JA (12h)
+
-
 
+
-
 
+
-
'''Week 5b:'''
+
-
 
+
-
- Meeting: work out design EVERYBODY (20h)
+
-
 
+
-
- Preparing 3D-program, look up information etc: JE, JO (8h) (asking for help)
+
-
 
+
-
- Making 3D-model: JE, JO (8h)
+
-
 
+
-
- Design/sketch: N, M en JA (12h) (Visio or SketchUp)
+
-
 
+
-
- Feedback: N, M en JA (12h)
+
-
 
+
-
 
+
-
'''Week 6a:'''
+
-
 
+
-
- Testing prototype: EVERYBODY (10h)
+
-
 
+
-
- Meeting: EVERYBODY (20h)
+
-
 
+
-
- Buffer
+
-
 
+
-
 
+
-
'''Week 6b:'''
+
-
 
+
-
- Feedback: N, M en JA (12h) processsing
+
-
 
+
-
- Meeting: EVERYBODY (20h)
+
-
 
+
-
- Buffer
+
-
 
+
-
 
+
-
Week 2-6: Per week 5 uur aan wiki besteden (1uur p.p)
+
-
 
+
-
 
+
-
'''Week 7:'''
+
-
 
+
-
- ‘Eindredactie’ fixing Wiki: N, JA (8h)
+
-
 
+
-
- Meeting: Discussing final design, adapting design/sketch, adapting 3D-model EVERYBODY (20h)
+
-
 
+
-
- Conclusion/ in summary A4: N, JO (8h)
+
-
 
+
-
- Making Presentation
+
-
 
+
-
 
+
-
=== Meetings ===
+
-
 
+
-
==== Meeting week 1 ====
+
-
 
+
-
'''Deadlines:'''
+
-
 
+
-
Info (Jochem, Jesse, Jasmijn):            Donderdag 14:00
+
-
Presentatie Marissa:                    Vrijdag 12:00
+
-
Presentatie Jesse:                        Zondag
+
-
+
-
'''Eerste presentatie''': Marissa en Jesse
+
-
 
+
-
Iedereen: literatuur onderzoek
+
-
+
-
'''Probleemstelling  ''' :                      Nicky
+
-
oude mensen, vergrijzing, op langere termijn meer mensen in de zorg nodig
+
-
dienstverleners in de zorg hebben zware lasten
+
-
doelgroepen -> verwijzing naar users
+
-
leuke getallen (hoeveel verzorgers zijn er? Hoe veel hulp is er nodig? Hoe concreet zijn de problemen?) en bronnen noemen
+
-
nieuwe plan & doel is een robot die meer focust op de interactie door middel van gezichts/emotie herkenning
+
-
 
+
-
'''Onderwerp/ keuze''' :                    Nicky
+
-
mogelijke oplossingen
+
-
nieuwe plan & doel is een robot die meer focust op de interactie door middel van gezichts/emotie herkenning
+
-
 
+
-
'''Use cases ''' :                                    Jasmijn
+
-
primare, secondaire, tertaire users
+
-
use probleem: mensen die een beroerte hebben gehad zijn moeilijk om gezichten van af te lezen, of mensen die blind zijn kunnen geen oogcontact hebben.
+
-
Hoe kijken mensen tegen een robot aan? Willen mensen automatisch benaderd worden? Of willen ze eerst toestemming geven?
+
-
 
+
-
'''Objectives  ''' :                                Jochem
+
-
·    Objective: Describe the specific objectives for the project[1], which should be clear, measurable, realistic and achievable within the duration of the project. Objectives should be consistent with the expected exploitation and impact of the project (see section 2).
+
-
hoofddoel
+
-
wat hebben mensen nodig om op hun gemak te voelen? -> interviews
+
-
herkenning van emoties om mensen op hun gemak te stellen
+
-
optimale design specifications van een tilrobot/ mechanisme
+
-
patiënten behoeftes en behoeften van verzorger, en hoe ga je dit implementeren in de robot?
+
-
 
+
-
'''Aanpak ''' :                                        Jesse
+
-
interview
+
-
experiment- webcam en software
+
-
iets met de robot?
+
-
planning komt nog, met milestones etc.
+
-
 
+
-
'''Conclusie ''': Nicky
+
-
herhaling/ terugkoppeling van probleemstelling: toekomstperspectief
+
-
 
+
-
==== Meeting week 2.1 ====
+
-
 
+
-
'''13-9 Meeting 2'''
+
-
 
+
-
'''Feedback na de presentatie:'''
+
-
De mannen zagen de link niet zo goed tussen robots en gezichtsherkenning.
+
-
ze wisten niet of facial recognition de interactie echt verbeterd.
+
-
ze zagen het nut van een til-robot niet zo goed, is dit wel de beste manier? “bed die veranderdt in een stoel”
+
-
We moeten dingen kwantificeren, meer getallen en bronnen (meer statistieken)
+
-
Is er vraag naar?
+
-
Hoe weet je welke interactie wel/ niet goed is.
+
-
 
+
-
'''Updates:'''
+
-
Jesse heeft met een verzorgster gepraat, kwamen opvallende dingen uit. Dit zal nog verwerkt worden naar een kwantitatief report.
+
-
Let op! Altijd als je iemand interviewt moet je een informed consent form laten invullen (staat in de drive)
+
-
 
+
-
Nicky heeft met haar moeder gepraat, die twijfelde of de tilrobot wel een goed mechanisme was omdat het gevaarlijk kan zijn. Hoe speelt de robot in op verwondingen?
+
-
 
+
-
'''Het plan:'''
+
-
we gaan ons richten op het optimaliseren/ automatiseren van een bestaande passieve tillift. Hierbij willen we een aspect van interactie toevoegen. De precieze interactie moeten we later nog verder uitzoeken, maar een van de dingen waar we gewoon zeker mee aan de slag kunnen is een webcam en eventuele gezichtserkenning software. En een apart scherm waarop de verzorger het in de gaten kunnen houden. Ook nog iets met de afleiding van de patiënt.
+
-
Aspecten voor verbetering:
+
-
de verzorger hoeft er niet de hele tijd bij te staan
+
-
de geruststelling van de patient kan/ moet beter, hoe kan dit? Gezichtsherkenning?
+
-
Hoe kan het begin/ einde van het tillen beter? Dat de persoon niet de hele tijd heen en weer hoeft te sjorren.
+
-
Let op! Deze aspecten moeten uit ons onderzoek blijken
+
-
 
+
-
'''Design/ concept:'''
+
-
We willen naar een verzorgingstehuis waarbij we zelf opgetild worden door een tillift, en hierbij kunnen we dan onze eigen interactie toepassen. Dit is ter illustratie tijdens onze eindpresentatie
+
-
 
+
-
'''Aanpak:'''
+
-
we beginnen met enquetes (quantitatief onderzoek)
+
-
1 a 2 interviews over welke aspecten van interactie iets zouden kunnen toevoegen (qualitatief onderzoek)
+
-
Tegelijkertijd moet er uitgebreid literatuur onderzoek gedaan worden, over de bestaande tillift, wat is goede geautomatiseerde zorg? En iets over de interactie.
+
-
Wanneer enquetes en interviews zijn gedaan kunnen de statiestieken geanalyseerd worden (mooie cijfers en grafiekjes in eventueel spss)
+
-
En dan?
+
-
 
+
-
'''Wat we moeten uitzoeken:'''
+
-
de goede interactie die we kunnen toepassen
+
-
hoe wil een persoon behandeld worden, en wat wil de verzorger?
+
-
Hoe kunnen we de tillift verbeteren zodat de persoon niet helemaal heen en weer hoeft te schuiven? Dat er niet gesjord hoeft te worden!
+
-
 
+
-
'''Planning:'''
+
-
Jesse: Voor zaterdag: vragenlijst maken en interview houden
+
-
Nicky: Voor zaterdag: helpen met de vragenlijst en ook interview houden
+
-
Vergeet niet de informed consent form
+
-
Jasmijn: Literatuur onderzoek + artikel over stat-of-the art
+
-
Jochem: Planning maken, dit wordt donderdag nog besproken: ook in de
+
-
planning wie wat doet, milestones, deadlines etc
+
-
Marissa: Voor zaterdag: Vragen voor en enquêtes opstellen en alvast opzet in
+
-
spss voor de mogelijke verbanden
+
-
Bellen naar Noldes voor gezichtssoftware
+
-
 
+
-
En er moet nog gepresenteerd worden
+
-
 
+
-
==== Meeting week 2.2 ====
+
-
 
+
-
15-09-2016 Meeting 2.2
+
-
 
+
-
 
+
-
'''Planning maken:
+
-
'''
+
-
'''Milestones:'''
+
-
* Informatievergaren (week 1-3)
+
-
1) Interviews houden (week 2-4)
+
-
Interview maken (week 2) (1uur)
+
-
Afnemen (week 3) (8 uur)
+
-
Verwerken en conclusie (week 4) (4 uur)
+
-
 
+
-
2) Enquêtes afnemen (week 2-4)
+
-
Enquêtes maken (week2-3) (
+
-
Afnemen (week 3) (8uur)
+
-
Verwerken en conclusie (week 4) (4uur)
+
-
 
+
-
3) Literatuuronderzoek (week 2-4)
+
-
State-of the-art (9uur)
+
-
Human-Robot interaction (9 uur)
+
-
Specifiek (...uur)
+
-
 
+
-
4) 1e design maken (week 4-5)
+
-
Tekening (optioneel 3D model) (week 5-6) (4uur)
+
-
Beschrijving (week 5) (10 uur)
+
-
 
+
-
5) Eventueel prototype (week 5)
+
-
Inlezen (3 à 4 uur)
+
-
Programmeren (7 uur)
+
-
 
+
-
6) Feedback (autoritair) (week 4-6) (6uur)
+
-
 
+
-
7) Eventueel prototype testen (week 6) (10 uur)
+
-
8) Final design (week 7) (5 uur)
+
-
 
+
-
9) Wiki
+
-
Week 2-6 (per persoon 1 uur per week voor aanvullen, in orde brengen etc)
+
-
Week 7 (per persoon 2 uur)
+
-
 
+
-
 
+
-
 
+
-
'''Week 2:'''
+
-
 
+
-
- Intervieuws maken: JE (1uur, vragen verzinnen), N (1uur, vragen verzinnen)
+
-
 
+
-
- Interviews afnemen: JE (2uur), JO(2uur), N(2uur) (antwoorden op vragen digitaliseren)
+
-
 
+
-
- Presentatie maken en voorbereiden: JO (2uur), N(2uur) (pp maken)
+
-
 
+
-
- Literatuuronderzoek (state-of-the art): JA (3uur) (lijst met gevonden artikelen en al beginnen aan uitwerken etc.)
+
-
 
+
-
- Enquêtes maken: M( 4 uur)
+
-
 
+
-
- Planning maken: JE, JO, JA, N (4uur)
+
-
 
+
-
-Meeting: (3uur)
+
-
 
+
-
 
+
-
'''Week 3:'''
+
-
 
+
-
- Literatuuronderzoek (state-of-the art): JA (6uur) (samenvatting)
+
-
 
+
-
- Literatuuronderzoek  (Human-Robot interaction) JE(3 uur), JO (3uur), N(3uur), M(3uur) (ljst met gevonden artikelen + sam)
+
-
 
+
-
- Enquêtes afnemen: iedereen (10 uur)
+
-
 
+
-
- Interviews afnemen: JE (2uur), JO(2uur), N(2uur) (antwoorden op vragen digitaliseren)
+
-
 
+
-
- Meeting: literatuurverdelen, feedback verwerken,
+
-
 
+
-
 
+
-
'''Week 4:'''
+
-
 
+
-
- Enquêtes verwerken/ analyseren: M( 10 uur)
+
-
 
+
-
- Interviews verwerken: JO, N, JE (12uur)
+
-
 
+
-
- Meeting: 1e design maken IEDEREEN (donderdag 20uur)
+
-
 
+
-
- Literatuuronderzoek (specifiek): JA(5uur), JE(5uur)
+
-
 
+
-
 
+
-
'''Week 5a:'''
+
-
 
+
-
- Meeting:design uitwerken IEDEREEN (20uur)
+
-
 
+
-
- Voorbereiden prototype, info opzoeken etc: JE, JO (8uur) (hulp vragen)
+
-
 
+
-
- Prototype maken: JE, JO (8uur)
+
-
+
-
- Onderzoeksplan:N, M en JA (4uur)
+
-
 
+
-
- Tekening: N, M en JA (4uur)
+
-
 
+
-
 
+
-
'''Week 5b:'''
+
-
 
+
-
- Meeting:design uitwerken IEDEREEN (20uur)
+
-
 
+
-
- Voorbereiden 3D-programma, info opzoeken etc: JE, JO (8uur) (hulp vragen)
+
-
 
+
-
- 3D-model maken: JE, JO (8uur)
+
-
 
+
-
- Tekening: N, M en JA (4uur) (Visio of SketchUp)
+
-
 
+
-
- Feedback: N, M en JA (4uur)
+
-
 
+
-
 
+
-
'''Week 6a:'''
+
-
 
+
-
- Prototype testen: IEDEREEN (10uur)
+
-
 
+
-
- Meeting: IEDEREEN (20uur)
+
-
 
+
-
- Buffer
+
-
 
+
-
 
+
-
'''Week 6b:'''
+
-
 
+
-
- Feedback: N, M en JA (4uur) verwerken
+
-
 
+
-
- Meeting: IEDEREEN (20uur)
+
-
 
+
-
- Buffer:
+
-
 
+
-
 
+
-
Week 2-6: Per week 5 uur aan wiki besteden (1uur p.p)
+
-
 
+
-
 
+
-
'''Week 7:'''
+
-
 
+
-
- ‘Eindredactie’ Wiki in orde maken: N, JA (8uur)
+
-
 
+
-
- Meeting: Final Design bespreken, tekening aanpassen, 3D-model aanpassen IEDEREEN (20uur)
+
-
 
+
-
- Conclusie/ samenvattend A4: N, JO (4uur)
+
-
 
+
-
- Presentatie maken
+
-
 
+
-
 
+
-
'''Presentatie 19-09-2016: N en JO'''
+
-
 
+
-
Samenvattend waarom deze tillift verbeteren etc...minder mensen in de zorg etc…
+
-
 
+
-
Nu: Eng voor patiënten...internet opzoeken main issues huidige lift
+
-
 
+
-
intro: onderwerp klein beetje aangepast, specifieker, huidige liftmodel automatiseren en interactie verbeteren → blijkt uit interviews en enquêtes en literatuuronderzoek zoals straks blijkt uit planning
+
-
 
+
-
Geinspireerd door design cyclus (Design cyclus: scope(2-3), analyse(4), design(4-5), validate(6) and deliver(7-8)) → planning op gebasseerd → zie hier: JO:week 2 etc
+
-
 
+
-
Per week scope, analyse etc erbij noemen
+
-
Deliverables, einddoelen
+
-
Eindzin
+
-
 
+
-
 
+
-
N: inleiding, 4, 6a,b
+
-
JO:  2-3, 5a,b, 7, 8 + afronding, delivirables: presentatie, (poster)
+
-
 
+
-
 
+
-
'''To do list t/m eind week 2:'''
+
-
 
+
-
JO: presentatie, interview afnemen
+
-
 
+
-
JA: literatuuronderzoek
+
-
 
+
-
JE: interview afnemen
+
-
 
+
-
M: enquête afmaken
+
-
 
+
-
N: presentatie, eventueel interview
+
-
 
+
-
==== Meeting week 3.1 ====
+
-
 
+
-
'''19-09-2016''' '''Meeting 3.1'''
+
-
 
+
-
 
+
-
'''Feedback presentatie:'''
+
-
 
+
-
- Hypotheses opstellen
+
-
 
+
-
- Explicieter maken/concreet maken
+
-
 
+
-
- Kijk naar hoe ze t in andere landen doen: verschillende apparaten in gebruik
+
-
 
+
-
- Twee questionnaires? Wel/niet in aanraking met de tillift
+
-
 
+
-
- Hypotheses feedback: bijv. was stem nou zo belangrijk?
+
-
 
+
-
- Op wat voor manier interpreteer je het 3d model?
+
-
 
+
-
- Ga veel gebruikers opzoeken?
+
-
 
+
-
 
+
-
'''Plan van aanpak deze week:'''
+
-
 
+
-
- Hypotheses maken
+
-
 
+
-
- Literatuuronderzoek
+
-
 
+
-
- Interviews en enquêtes concreet maken en afnemen
+
-
 
+
-
- Verzorgingstehuizen, ziekenhuizen en revalidatiecentra contacteren en bezoeken 
+
-
 
+
-
 
+
-
'''Hypotheses:'''
+
-
 
+
-
'''Hoofdhypotheses:'''
+
-
 
+
-
* Verzorgers hebben behoefte aan ondersteuning door de tillift.
+
-
 
+
-
Verzorgers hebben behoefte aan ondersteuning met camera’s bij het navigeren van de tillift.
+
-
 
+
-
Verzorgers hebben behoefte aan een tillift die zelf kan navigeren en obstakels kan ontwijken.
+
-
 
+
-
De verzorger wil graag gewaarschuwd worden door de tillift als de patiënt angstig is.
+
-
 
+
-
PatiËnten stellen het op prijs als ze gerustgesteld worden door de tillift als ze angstig zijn.
+
-
 
+
-
Verzorgers hebben behoeft aan een tillift die informatie kan geven over het gewicht en de BMI van de patiënt
+
-
 
+
-
 
+
-
* Patiënten en verzorgers hechten waarde aan interactie tijdens het proces van liften
+
-
 
+
-
Patiënten hebben tijdens het werken met een tillift veel behoefte aan een bepaalde mate van interactie met de verzorger. (dus meer behoefte aan aanraking/ oogcontact/ spraak, of helemaal geen behoefte?) (enquête)
+
-
 
+
-
Tijdens de interactie tussen patiënt en verzorger is oogcontact belangrijker dan spraak voor een aangename interactie.  (enquête)
+
-
 
+
-
Tijdens de interactie tussen patiënt en verzorger is  oogcontact belangrijker dan fysiek contact voor een aangename interactie. (enquête)
+
-
 
+
-
Patiënten vinden het niet erg als de verzorger tijdens een deel van de handeling met tillift afwezig is.
+
-
 
+
-
 
+
-
* Het vertrouwen van patiënten in de moderne tillift zorgt voor minder behoefte aan ondersteuning van de verzorger
+
-
 
+
-
Het vertrouwen hangt af van het design van het apparaat
+
-
 
+
-
De mate van bekendheid met moderne technologie zorgt voor minder behoefte aan interactie tussen verzorger en patiënt.  (enquête)
+
-
 
+
-
De mate van bekendheid met een actieve of passieve tillift zorgt voor minder behoefte aan interactie tussen verzorger en patiënt. (enquête)
+
-
 
+
-
 
+
-
==== Meeting week 3.2 ====
+
-
 
+
-
'''20-09-2016''' '''Meeting 3.2'''
+
-
 
+
-
 
+
-
'''Vandaag gedaan:'''
+
-
 
+
-
Enquêtes geprint
+
-
 
+
-
Interviewvragen gecheckt en aangevuld
+
-
 
+
-
2 routes door Eindhoven gemaakt langs ziekenhuizen en verzorgingscentra
+
-
 
+
-
Langs ziekenhuizen en verzorgingscentra gegaan
+
-
 
+
-
 
+
-
'''Route 1: 'Noordelijke route''''
+
-
 
+
-
{| class="wikitable" style="border:1px solid #000000;"
+
-
! Naam || Adres || E-mail || Telefoonnummer || Contactpersoon || Opmerking
+
-
|-
+
-
| Maxima Medisch Centrum || Ds.Th.Fliednerstraat 1 || j.geerings@mmc.nl
+
-
|-
+
-
| Vitalis Peppelrode || Dominee Theodor Flitnerstraat 5 || k.ebben@vitalisgroep.nl ||  || Katja Ebben
+
-
|-
+
-
| Archipel Landrijt || Drosserstraat 1 || landrijt@archipelzorggroep.nl  || 040-2158017 || Joyce van de Eijnden (fysiotherapeut)
+
-
|-
+
-
| Vitalis Brunswijck || Generaal Bradleystraat 1 || r.van.boerdonk@vitalisgroep.nl en j.mathijssen@vitalisgroep.nl  ||  || Roos van Boerdonk en Jacqueline Mathijssen 
+
-
|-
+
-
| Catharina ziekenhuis || Michelangelolaan 2 ||  || 040-2398412 || Communicaitie || Of Zuid Zorg proberen te bereiken
+
-
|-
+
-
| Vitalis Kronehoef || Kloosterdreef 23 || e.klyl@vitalisgroep.nl
+
-
|-
+
-
| Vitalis Residentie Petruspark || Monseigneur Swinkelsstraat 2 || c.vaneldijk@vitalisgroep.nl
+
-
|-
+
-
|}
+
-
 
+
-
 
+
-
 
+
-
'''Route 2: ‘Zuidererlijke route’  '''
+
-
 
+
-
{| class="wikitable" style="border:1px solid #000000;"
+
-
! Naam || Adres || E-mail || Telefoonnummer || Contactpersoon || Opmerking
+
-
|-
+
-
| Dommelhoef Archipel || Parklaan 97 || demer.dommelhoef@archipel.zorggroep.nl || 0657910838 ||
+
-
Marie Louise || Aanstaande week terug van vakantie
+
-
|-
+
-
| Vitalis Vonderhof || Bernhardplaats 1 || m.voorneld@vitalisgroep.n ||  ||  || Gemaild maar nog geen reactie
+
-
|-
+
-
| Passaat Archipel || Strijpsestraat 144 || passaathofvanstrijp@archipelzorggroep.nl en mark.brouwer@archipelzorggroep.nl ||  || Mark Brouwer (fysiotherapeut) || Algemeen e-mailadres voor de enquête, aanstaande week terug van vakantie
+
-
|-
+
-
| Vitalis Engelsbergen || Maria van Bourgondielaan 8 ||  ||  || || Geen echt verzorgingstehuis, meer een wooncomplex
+
-
|-
+
-
|}
+
-
 
+
-
 
+
-
Eventueel nog:
+
-
 
+
-
- Vitalis Wilgenhof                                                    Gasthuisstraat 1
+
-
 
+
-
- Archipel Ekelhof                                                  Sint Claralaan 38
+
-
 
+
-
- Vitalis Theresia                                                  Bredalaan 77
+
-
 
+
-
- Sint Annaklooster, Klooster Terhaghe                                  Glorieuxlaan 38
+
-
 
+
-
- Vitalis Woonzorg Groep                                              Herman Gorterlaan 300
+
-
 
+
-
- Vitalis Wisseheage                                                    Herman Gorterlaan 4
+
-
 
+
-
 
+
-
==== Meeting week 4.1 ====
+
-
 
+
-
'''26-09-2016'''
+
-
 
+
-
 
+
-
'''Uur 1: Feedback'''
+
-
 
+
-
Baleinen ipv belijnen
+
-
 
+
-
Allleen tillen zelf is geautomatiseerd, duurt vrij lang
+
-
 
+
-
 
+
-
Uitleggen wat we afgelopen week hebben gedaan: interviews afgenomen, tillift filmpje
+
-
→ Hoe verbeteren?
+
-
 
+
-
- Poweranalyse checken over hoeveel mensen we willen interviewen en enquête laten afnemen etc.
+
-
- Actieve of passieve tillift?
+
-
- Requirements?
+
-
- Prototype
+
-
 
+
-
 
+
-
Interactie verbeteren: oogcontact belangrijk
+
-
 
+
-
Camera leest mimiek af → angst detecteren
+
-
 
+
-
Scenarios
+
-
 
+
-
Opleveren: prototype of 3D-model
+
-
 
+
-
Onderscheid tussen tilfase en transportfase (--> dan verlies je interactie) (patiënt kijkt niet zoals in kinderwagen)
+
-
 
+
-
 
+
-
'''Literatuuronderzoek:'''
+
-
 
+
-
- Facial recognition
+
-
- Wat je leest → op papier zetten!
+
-
- Interactie tijdens transport verbeteren?
+
-
- Girafrobot! Tip Emilia
+
-
- Japanse tilrobot, kijk daar naar!
+
-
 
+
-
 
+
-
'''Planning volgende week:'''
+
-
 
+
-
- Enquêtes verwerken mbv SPSS, factoranalyse/poweranalyse
+
-
- Doemscenario? → uit literatuur en interviews conclusies trekken
+
-
- Vragenlijst: hypotheses en gerichtere vragen verzinnen etc
+
-
- Opnieuw vragen specificeren voor (enquête en) interview!
+
-
- Requirements zijn belangriijk!!! (willen ze zien en prototype)
+
-
 
+
-
 
+
-
'''Uur 2&3:  Meeting 4.1'''
+
-
 
+
-
 
+
-
'''Wat te doen:'''
+
-
 
+
-
- Requirements!
+
-
- Idee prototype
+
-
- Duidelijke, concrete lijst over literatuur en wat we er aan hebben
+
-
_ Elke keuze moet een reden hebben en verantwoord worden
+
-
 
+
-
 
+
-
Kiezen '''passieve tillift''' → interactie belangrijker, bron erbij nodig! (interviewbron en literatuurbron eventueel)
+
-
 
+
-
 
+
-
'''Week 4:'''
+
-
 
+
-
 
+
-
'''Taakverdeling:'''
+
-
 
+
-
 
+
-
 
+
-
'''Maandag 26-9-2016'''
+
-
 
+
-
'''IEDEREEN''': Interviewvragen gerichter maken.
+
-
 
+
-
'''Marissa''': Power Analyse voor morgen: Hieruit blijkt of we voldoende enquêtes hebben.
+
-
 
+
-
'''Jesse''': Onderzoek doen waarom we ons gaan focussen op de passieve, en de actieve naast ons laten. (goede reden geven, keuze onderbouwen.)
+
-
 
+
-
'''Nicky''': wiki doorlopen en bijwerken (kijken wat verandert moet worden)
+
-
 
+
-
'''Jochem en Jasmijn''': interview afnemen en verwerken
+
-
 
+
-
 
+
-
'''Dinsdag 27-9-2016'''
+
-
 
+
-
- Requirements opstellen → aspecten die we gaan optimaliseren
+
-
- Beslissen op welk literatuuronderzoek we gaan focussen
+
-
- Concrete lijst met welke literatuur we hebben en waar het voor toepasbaar/ van belang is
+
-
- Wat zou doen als de tillift gezichtsherkenning had?
+
-
- Scenario voor tijdens het transport.
+
-
 
+
-
 
+
-
==== Meeting week 4.2 ====
+
-
 
+
-
'''27-09-2016'''
+
-
 
+
-
 
+
-
'''Updates/ mededelingen:'''
+
-
 
+
-
* Enquête: Power analyse moet nog, wat er nu al uit blijkt:
+
-
:- Oogcontact zowel voor verzorger als patiënt belangrijk
+
-
:- Spraak voor beide liever wel dan niet, belangrijker voor verzorgers dan voor patiënten
+
-
:- Verzorgers wel lichamelijk contact, patiënten minder
+
-
:- Interview Jasmijn en Jochem (26-09-2016)
+
-
:- Transport zoals bij kinderwagen
+
-
:- In bed zetten, lastig draaien
+
-
:- Navigeren met camera’s wel handig
+
-
 
+
-
 
+
-
http://eqradio.csail.mit.edu/
+
-
 
+
-
 
+
-
Verslagen gevonden deels vergelijkbaar: Onderzoek naar de tillift:
+
-
 
+
-
http://www.ontwerpenvoorzorgverleners.nl/wp-content/uploads/2013/09/ovzt_tillift_v1.0.pdf
+
-
 
+
-
http://www.anderszorgen.nl/documenten/Eindrapport%20AZ.pdf
+
-
 
+
-
 
+
-
'''To do this week:'''
+
-
 
+
-
- 2 scenario’s maken
+
-
- Requirements opstellen en uitleggen (verdelen per persoon)
+
-
- Motivatie keuze 1st design
+
-
- Enquête analyseren
+
-
- Wiki bijwerken
+
-
- Inleiding en motivatie voor ons project en de keuzes die we maken en waar we aan gaan werken en onze hypotheses en de doelen
+
-
- A3 of A2: tekening 1st design
+
-
- Hypotheses checken
+
-
 
+
-
'''Requirements:'''
+
-
 
+
-
- Smooth wheels, that don’t get stuck (Jochem)
+
-
:- Kogelwieltjes
+
-
:- Grotere wielen met demping (buggy-achtig) (of “tires without air”)
+
-
- Makkelijker voort te bewegen (Jasmijn)
+
-
:- Elektromotor (zoals met trapondersteuning)
+
-
:- Automatisch draaien met afstandsbediening
+
-
- Makkelijk draaien (Jasmijn)
+
-
:- Elektromotor (zoals met trapondersteuning)
+
-
:- Automatisch draaien met afstandsbediening
+
-
- Oogcontact tussen patiënt en verzorger gedurende hele proces (Jochem)
+
-
:- Camera’s en schermpjes voor zowel verzorger als patiënt (camera moet constant zichtbaar zijn voor patiënt)
+
-
- Beter overzicht voor de verzorger tijdens transfer (Jochem)
+
-
:- Camera’s
+
-
:- Parkeersensor (+daarbij uitleg hoe parkeersensoren werken)
+
-
- Lift moet emotie patiënt kunnen meten (Marissa en Jesse)
+
-
:- Gezichtsherkenning: http://eqradio.csail.mit.edu/
+
-
:- Noldus software
+
-
- Lift moet patiënt kunnen geruststellen als hij angstig is (Jasmijn)
+
-
:- Animatie
+
-
:- Stappen van het proces tonen
+
-
:- Audio
+
-
 
+
-
 
+
-
'''Hypotheses:'''
+
-
 
+
-
- Verzorgers hebben behoefte aan ondersteuning door de tillift
+
-
:- Verzorgers hebben behoefte aan ondersteuning met camera’s bij het navigeren van de tillift.
+
-
:- Verzorgers hebben behoefte aan een tillift die zelf kan navigeren en obstakels kan ontwijken.
+
-
:- De verzorger wil graag gewaarschuwd worden door de tillift als de patiËnt angstig is
+
-
:- Patienten stellen het op prijs als ze gerustgesteld worden door de tillift als ze angstig zijn.
+
-
:- Verzorgers hebben behoeft aan een tillift die informatie kan geven over het gewicht en de BMI van de patiënt
+
-
- Patiënten en verzorgers hechten waarde aan interactie tijdens het proces van liften
+
-
:- Patiënten hebben tijdens het werken met een tillift veel behoefte aan een bepaalde mate van interactie met de verzorger. (dus meer behoefte aan aanraking/ oogcontact/ spraak, of helemaal geen behoefte?) (enquête)
+
-
:- Tijdens de interactie tussen patiënt en verzorger is oogcontact belangrijker dan spraak voor een aangename interactie.  (enquête)
+
-
:- Tijdens de interactie tussen patiënt en verzorger is  oogcontact belangrijker dan fysiek contact voor een aangename interactie. (enquête)
+
-
:- Patiënten vinden het niet erg als de verzorger tijdens een deel van de handeling met tillift afwezig is.
+
-
- Het vertrouwen van patiënten in de moderne tillift zorgt voor minder behoefte aan ondersteuning van de verzorger
+
-
:- Het vertrouwen hangt af van het design van het apparaat
+
-
:- De mate van bekendheid met moderne technologie zorgt voor minder behoefte aan interactie tussen verzorger en patiënt.  (enquête)
+
-
: -> niet relevant
+
-
:- De mate van bekendheid met een actieve of passieve tillift zorgt voor minder behoefte aan interactie tussen verzorger en patiënt. (enquete)
+
-
: -> kan niet+ niet relevant
+
-
 
+
-
 
+
-
'''Duidelijk verhaaltje:'''
+
-
 
+
-
Op dit moment wordt de tillift gebruikt voor de verplaatsing van kleinere afstanden, dus er wordt geen tot nauwelijks gereden met de lift. (Waarom wordt er niet mee gereden? Is hier behoefte aan?)
+
-
We focussen op de passieve tillift omdat …?
+
-
Manier van interactie: Uit onze enquête is gekomen dat tijdens het proces van tillen oogcontact belangrijk is en lichamelijk contact niet als meer positief ervaren wordt. Dit zou kunnen betekenen dat tot een bepaalde extensie zorg op afstand door middel van sensortechnologie en videocommunicatie mogelijk is.
+
-
 
+
-
Als recommendations
+
-
 
+
-
de constructie heeft veel op te merken, kleinere draaicirkel etc. Dus in de toekomst zou de hele tillift op de schop moeten voor een makkelijkere handelingen.
+
-
 
+
-
Op het einde veel aandacht besteden aan toekomstvisie, als we tijd over hebben
+
-
 
+
-
 
+
-
'''Wie doet wat:'''
+
-
 
+
-
'''Jesse:'''
+
-
 
+
-
- Afbeelding van tillift op A2 uitprinten en tekenen en laten zien volgende week maandag
+
-
- Requirements (http://eqradio.csail.mit.edu/)
+
-
 
+
-
'''Marissa:'''
+
-
 
+
-
- Enquête analyseren
+
-
- Contact opnemen met Noldus
+
-
- Hypothese beantwoorden/ verwerken
+
-
 
+
-
'''Nicky:'''
+
-
 
+
-
- Wiki bijwerken en scenario’s
+
-
- Scenario’s opstellen
+
-
 
+
-
'''Jasmijn:'''
+
-
 
+
-
-Requirements
+
-
 
+
-
'''Jochem:'''
+
-
 
+
-
- Requirements
+
-
 
+
-
 
+
-
==== Meeting week 4.3 ====
+
-
 
+
-
'''29-09-2016'''
+
-
 
+
-
 
+
-
'''Updates Marissa:'''
+
-
 
+
-
Noldus is gecontacteerd voor gezichtsherkennings software: FaceReader van Noldus. Het is via telefonisch contact toegezegd en als het goed is krijgen we binnen 24 uur een demo. Maar nog niks gehad.
+
-
 
+
-
Uit de power analyse in Stata bleek dat we nog meer patienten nodig hebben die de enquete invullen. Hier ga ik achter aan. Hopelijk heb ik voor maandag de analyse af.
+
-
 
+
-
De hypotheses zijn aangepast, kunnen jullie die nog doorkijken?
+
-
 
+
-
'''Aangepaste hypotheses:'''
+
-
 
+
-
'''Support''':
+
-
 
+
-
:- Caregivers have needs for the tillift to support them during care giving by camera support, help during navigation and help by comforting the patient.
+
-
::- Dit zijn meerdere kleinere onderzoeksvragen in een. Dit moet blijken uit de interviews en dit is de basis voor de aanpassingen aan de tillift
+
-
:- Patients appreciate it when they are being comforted (by caregiver of by someone else) when they feel anxious during the process of caregiving during transportation in the “til lift”.
+
-
:: -Deze mag misschien ook nog wel weg?
+
-
 
+
-
'''Interaction:''':
+
-
 
+
-
:- Patients and caregivers value interaction to a high extent during the process of caregiving during transportation in the “til lift”
+
-
:- Both patients and caregivers prefer eye contact most during the process of caregiving during transportation in the “til lift”
+
-
enquete
+
-
:- Patients like to be comforted by voice interaction between patient and caregiver of between patient and someone else during the process of caregiving during transportation in the “til lift”
+
-
enquete
+
-
:- Patients like to be comforted by bodily contact during the process of caregiving during transportation in the “til lift” and also caregivers prefer to have some extent of body contact during care giving.
+
-
enquete
+
-
 
+
-
 
+
-
'''Uitleg/ stappenplan analyseren enquete:'''
+
-
 
+
-
Vorige week hadden we dus al data verzameld, er is een power analysis uitgevoerd op de data. Er is gekeken naar de standaard deviatie die we op dat moment hadden:
+
-
: '''Code:'''
+
-
: tab rol //see sample size
+
-
: tabstat oog voice lichamelijkcontact, by(rol) stat(mean sd min max) total col(stat) long format // see : standard deviation
+
-
: power twomeans 2 2.5, sd(0.7) power(0.8) alpha(0.05)
+
-
 
+
-
Hier kwam uit dat we een standaard deviatie hebben van ongeveer 0.7. Uit de power analysis bleek dat we per conditie 24-32 respondenten nodig hebben om een significant verschil te kunnen zien in een gemiddelde van 0.5 punt verschil op de Likert-schaal (de schaal van 0-5 die we hebben gebruikt).
+
-
 
+
-
Toen opnieuw data gaan verzamelen, vooral van patienten want daar hadden we nog niet genoeg van.
+
-
Vragen over de tillift en eerste pagina van voorkeuren tijdens verzorging heb ik nog niet bewerkt, want deze heb ik nog niet gebruikt om iets te analyseren dus dat zou verspilde tijd zijn.
+
-
 
+
-
Dit moet er nog gebeuren: -> ik hoop dat dit voor maandag lukt
+
-
 
+
-
 
+
-
 
+
-
'''Requirements for the new design:'''
+
-
+
-
- '''Problem''': By the transfer of the patient with the lift it can happen that the swivel caster wheels, which are currently used, do not roll as smoothly as hoped. This is caused by a rough surface or the orientation of the wheels. Therefore one requirement for the new design is that wheels are used that do not get stuck.
+
-
+
-
: A solution for this is to use solid spherical wheels, which are part of a ball bearing, see Figure below. 
+
-
 
+
-
 
+
-
Source: http://img.directindustry.com/images_di/photo-g/54147-5700041.jpg
+
-
 
+
-
+
-
+
-
- '''Problem''': During the transportation phase there is a possibility that the patient loses eye contact with the nurse. Also, on longer distances where the patient is facing towards the moving direction there is no eye contact at all. This can lead to a less comfortable experience for the patient, why another requirement holds that during the whole process eye contact between the patient and the nurse is guaranteed.
+
-
+
-
: One way to realise this is by the use of cameras and displays. A patient, who is sitting in the lift, can be filmed by a camera. This images are transferred to a display that is attached to the back of the lift where the nurse is standing, who is also filmed. The patient also should have a display in sight, so eye contact can be established at all time.     
+
-
+
-
+
-
- '''Problem''': During the transport it is difficult for the nurse to keep an eye on everything, mainly because the patient is blocking a significant part of the field of sight of the nurse. Improving the overview of the nurse during transportation is therefore another requirement.
+
-
+
-
: Also this problem can be solved by the use of a camera, which is placed at the front of the lift and films in the moving direction of the lift. Transferring these images to the display of the nurse, he/she can easily see what is in front of the lift and if there are any obstacles that could be possibly dangerous. Another addition would be sensors that indicate how close the lift is to a certain object, for instance a wall, so the nurse has an even more complete overview. These sensors, often used in cars for parking assistance, use super sound to determine the distance between the sensor and a object.     
+
-
 
+
-
 
+
-
'''Meeting 4.3''' (donderdagmiddag)
+
-
 
+
-
- Als we software Noldus krijgen → output verwerken in kleurenschema
+
-
 
+
-
- Stel software lukt niet, worst case: Tekening maken, software wel gebruiken → new design en feedback optie
+
-
 
+
-
'''Met software:'''
+
-
 
+
-
Marissa en Jochem: verdiepen in de software, uitproberen etc. en kijken of output verwerkt kan worden in kleurenschema etc.
+
-
 
+
-
'''Zonder software:'''
+
-
 
+
-
Tekening maken design + feedback
+
-
 
+
-
 
+
-
'''Te doen vandaag:'''
+
-
 
+
-
- Naar tekening kijken → schets gemaakt, gaat Jesse verder uitwerken
+
-
 
+
-
- Taakverdeling maken
+
-
 
+
-
- Kijken naar wat iedereen gedaan heeft
+
-
 
+
-
- Meer patiënten-enquêtes? Wel of niet?
+
-
 
+
-
- USE aspects
+
-
 
+
-
- Objectives
+
-
 
+
-
- Approach  bij proposal
+
-
 
+
-
- Scenario’s bespreken
+
-
 
+
-
 
+
-
'''Wiki afgaan:'''
+
-
 
+
-
- Proposal is Approach
+
-
 
+
-
- Bij hypotheses: inleiding van dit zijn onze hypotheses etc. Nederlandse weg
+
-
 
+
-
- Objectives: opnieuw gemaakt worden
+
-
 
+
-
- Literature study
+
-
 
+
-
- USE aspects: Jasmijn bijwerken
+
-
 
+
-
- Research: inleiding hoe we het hebben aangepakt
+
-
 
+
-
- Interviews: Inleiding, hoe vragen tot stand zijn gekomen, waarom versie 2 etc
+
-
 
+
-
- Collected interviews: links naar uitgebreide interviews → alleen sam interviews geven
+
-
 
+
-
- Survey: Inleiding (aantal mensen benoemen), wat we ermee willen bereiken, verbanden, mooi verhaaltje, resultaten (grafieken SPSS)
+
-
 
+
-
- Analyse: Kort herhalen results en zeggen wat de problemen dus zijn en dan welke requirements eruit komen
+
-
 
+
-
- Requirements: korte inleiding,
+
-
 
+
-
- Prototype: inleiding (wat voor prototype maken we etc, achtergrondinformatie
+
-
 
+
-
- Discussie: in week 7
+
-
 
+
-
 
+
-
'''Requirements:'''
+
-
Bij Analyse probleem als genoemd -->
+
-
Algemene requirements noemen → opties tegen elkaar afwegen en beste kiezen (in een lopend verhaaltje zetten).
+
-
Wielen: voren bollen, achter gewone die aangedreven worden door motor
+
-
 
+
-
 
+
-
'''Wie doet wat voor maandag 03-10-2016:'''
+
-
 
+
-
'''Marissa''': Software Noldus verdiepen, enquête analyseren, hypotheses aanpassen
+
-
 
+
-
'''Jochem''': Software Noldus verdiepen, wiki, requirements
+
-
 
+
-
'''Jasmijn''': USE aspects (of voor volgende week), requirements
+
-
 
+
-
'''Jesse''': A2/A3 tekening maken + requirement gezichtsherkenning
+
-
 
+
-
'''Nicky''': Introductie wiki, scenario’s uitwerken huidige situatie, mailen andere groep voor 2e uur maandag
+
-
 
+
-
 
+
-
'''Maandag bespreken:'''
+
-
 
+
-
- Hypotheses aangepast?
+
-
 
+
-
- Kostenanalyse
+
-
 
+
-
- Wiebelen
+
-
 
+
-
 
+
-
==== Meeting week 5.1 ====
+
-
 
+
-
'''03-10-2016'''
+
-
 
+
-
 
+
-
'''2e uur''': Bespreking afgelopen week
+
-
 
+
-
Ter sprake gekomen:
+
-
 
+
-
- Korte samenvatting progressie
+
-
 
+
-
- Noldus: kijken naar output-verwerking
+
-
 
+
-
- Oogcontact echt mogelijk of niet? Literatuur: kan het? → Wat zijn de voorwaardes (camera achter scherm?)
+
-
 
+
-
- Tillift acties filmen → sensor checken(!) met proefpersonen, analyse, objectieve beoordeling over hoe je je wanneer voelde
+
-
 
+
-
- Literatuuronderzoek: requirement (verminderde kracht), techniek bestaat al, maar nog niet standaard ergens in geïmplementeerd
+
-
 
+
-
- Sensor helemaal testen!!! Zelf testen doen en miss mensen op leeftijd of het anders op hen reageert
+
-
 
+
-
- Referentie situaties creëren
+
-
 
+
-
- Artikel Emilia: over 4 films→ emoties herkennen (paper is 20 jaar oud) OPZOEKEN!
+
-
 
+
-
- Grenzen stoplicht definiëren!
+
-
 
+
-
- Wat wil je met de hypotheses doen → conclusies uithalen
+
-
 
+
-
- Kwantitatief idee hebben wanneer requirement is behaald, moet toetsbaar zijn → Nog duidelijk maken wanneer requirement behaald is
+
-
 
+
-
- Wanneer is de eindpresentatie: '''24-10: presentatie''' en '''31-11: Wiki af''' zijn
+
-
 
+
-
 
+
-
'''Meeting na 2e uur:'''
+
-
 
+
-
Bespreken tijdens meeting
+
-
 
+
-
:- Hoe gaan we nu verder?
+
-
 
+
-
:- Software gaan testen
+
-
gezichten filmen terwijl naar een filmpje wordt gekeken, filmpjes kiezen waar literatuur over te vinden is dat het bepaalde emoties op roept.
+
-
 
+
-
:- Kijken naar hypotheses en wat gebleken is uit onderzoek
+
-
 
+
-
:- Verwerken output software (real time exporteren?)
+
-
 
+
-
:- Oogcontact wel of niet mogelijk (literatuur: onderzoek over oogcontact via skype -> faculteit IE&IS aan de TU)
+
-
 
+
-
:- Goeie programmeur zoeken die ons wellicht kan helpen om output te verwerken → mailen docenten voor verwerking output
+
-
 
+
-
:- Vragen of tillift beschikbaar is
+
-
 
+
-
:- Nodig: 2 webcams, tablet / laptop → prototype
+
-
 
+
-
:- Interfaces uitwerken (tekening)
+
-
 
+
-
:- 2 minuten filmen
+
-
 
+
-
 
+
-
'''Wat moeten we nog doen:'''
+
-
1) Output verwerken → geen script maken, alleen software testen en rood-geel-groen systeem beschrijven (met grenzen etc.) Uitleggen wanneer iets rood, geel of groen is
+
-
::bij welk niveau angstigheid veranderd een kleurtje?
+
-
::niemand weet echt hoe we dit moeten doen...
+
-
 
+
-
2) Literatuuronderzoek
+
-
 
+
-
:a. Noldus smiley onderzoeken (zie ook manual- reporting client)  -> kunnen
+
-
 
+
-
:b. Literatuuronderzoek: Oogcontact via camera en scherm
+
-
 
+
-
:c. Filmpjes over basisemoties (voor tests)
+
-
 
+
-
:d. Valence arousal model
+
-
 
+
-
:e. Eckmans faces
+
-
 
+
-
3) Software testen
+
-
+
-
:a. TESTPLAN OPSTELLEN! (Jochem & Jesse)
+
-
 
+
-
:b. Filmpjes opzoeken: artikel over basisemoties
+
-
 
+
-
:c. Testen
+
-
 
+
-
:d. Resultaten verwerken
+
-
 
+
-
4) Plan voor de demo opstellen
+
-
 
+
-
:a. Afspraak maken/ datum prikken
+
-
 
+
-
:b. Testplan opstellen
+
-
 
+
-
:c. Spullen regelen
+
-
 
+
-
5) Interview met feedback over de nieuwe ontwikkeling en of mensen daar enthousiast over zijn -> week 7
+
-
 
+
-
6) Wiki in orde maken
+
-
 
+
-
 
+
-
'''To do this week:'''
+
-
 
+
-
- Mailen Emilia artikel over 4 films en emotieherkenning (Marissa)
+
-
 
+
-
- Testplan opstellen testen software (Jesse en Jochem)
+
-
 
+
-
- Testen software -> Donderdag en dit weekend
+
-
 
+
-
- (Test)plan opstellen demo (Jesse en Jochem)
+
-
 
+
-
- Spullen regelen voor de demo
+
-
 
+
-
: 1 webcam (Marissa)
+
-
 
+
-
: Andere spullen??
+
-
 
+
-
- Afspraak maken om met tillift demo te gebruiken (Nicky) over 2 weken proberen
+
-
 
+
-
- Hypotheses verwerken en resultaten verwerken en beantwoorden -> analyse (Jasmijn)
+
-
 
+
-
- Literatuuronderzoek over oogcontact, en die filmpjes over basisemotie, valence arousal model &
+
-
eckmans faces (Marissa)
+
-
 
+
-
- Interface design uitwerken etc (Nicky) (tekening, welke data van noldus willen gaan gebruiken, interface patiënt(vraag Jasmijn) en verzorger
+
-
 
+
-
- Wiki nog verder goed maken (Nicky)
+
-
 
+
-
- IEDEREEN: manual Noldus doorlezen
+
-
 
+
-
 
+
-
'''Meetplan''' opzet:
+
-
 
+
-
Waarom experiment, wat je wilt testen, welke filmpjes gebruiken, welke volgorde, welke mensen (leeftijdsgroep)
+
-
 
+
-
== Work done so far ==
+
-
 
+
-
=== Week 2 presentatie 1 groep 1 ===
+
-
 
+
-
'''Problem and subject/solution:'''
+
-
 
+
-
Our current society is facing the societal dilemma of ageing, given that the ratio of care takers and caregivers is out of balance and will be expanded even more in the future.
+
-
 
+
-
Considering the fact that technological advancements in health care are taking place, such as better treatment for diseases, also contributes to the increase of elderly people, because their lifespan is extended.
+
-
 
+
-
Due to this, there will be lack of care givers in the future and therefore it will almost be inevitable that robots are partially taking over tasks. These tasks can not be of great complexity of course, as robots are unable to think autonomous like humans.
+
-
From this point of view, we have come up with a good use for robotics in which the relatively few human caregivers left in the future can focus on important and risky care tasks which should not be given in the hands of robots, like for instance the use of robots in operating theatres. 
+
-
 
+
-
Our idea will be realized by improving the current patient hoist, which will transfer patients, who are not able to relocate themselves anymore, in hospitals and nursing homes by lifting them. The patients can be transferred between for instance a bed and a chair or to places like restrooms etc.
+
-
+
-
However, unlike already existing patient lifts, our improved patient hoist (I.P.H) can work partially autonomous and will be equipped with some kind of interaction device. Due to this, the new patient hoist is able to react to the patient and can adapt or stop it’s action whenever the patient expresses he is uncomfortable or whatever. The human-robot interaction will play an significant role in our design cycle.
+
-
 
+
-
This improved hoist is beneficial for all sorts of groups. The human care givers for example can benefit from it, because they do not have to lift patients themselves anymore which is better for their own health by preventing back pain from heavy lifting and they do not need to assist the transportation all the way anymore which is necessary with the current patient lifts so they can spare precious time and focus on their other care tasks. Another advantage is that more patients can be helped by human care givers when some parts of their tasks are taken over by robotics.
+
-
 
+
-
 
+
-
 
+
-
'''Objective'''
+
-
 
+
-
The main objective of the project is to improve the interaction between a patient and a care robot. To be more specific, it can be divided into three sub-objectives.
+
-
 
+
-
The first one is regarding facial expression recognition, which is closely connected to the recognition of certain emotions. We will try to find out what techniques are already used. Also we will go further into the principle of Eckman’s faces, where there are a few basic emotions. If there is not an already existing technology, a new one has to be given thought to. This is important in order to make the robot able to detect facial expressions. Once these expressions or emotions are detected by the care robot, it can react properly to let the patient feel more comfortable. This reaction can vary from a verbal response to a physical action, where the care robot adjusts its lifting mechanism accordingly.
+
-
 
+
-
Secondly, it is of great importance to know what the general needs of patients are to feel comfortable as well as the needs of the nurses, so they are able to deliver good and comfortable care. By interviewing these groups of people certain knowledge will be gained, which should also be taken into account by designing the robotic system.
+
-
 
+
-
Which leads to the third and final sub-objective, where the optimal design specifications are discussed. On the one hand this includes the mechanical aspect of a comfortable and safe lifting movement and on the other hand the specific look of the care robot; whether it should be more human like and risking that the ‘uncanny valley’ becomes an issue or designing it in a more abstract way.               
+
-
 
+
-
 
+
-
'''Use cases'''
+
-
 
+
-
This subject is in many ways related to USE-aspects. First of all there are many different stakeholders and users.
+
-
The primary users are ofcourse the patients and the nurses.
+
-
The secondary users are the people who pay for the robot, in this case the hospital management and the government. Also the family members of the patients are secondary users
+
-
The tertiary users are the maintenance people and cleaners of the hospital.  Because they have to take care of the robot, or work around it.
+
-
The preferences of all these users have to be taken into account. For instance, the patients want the robot to be comforting, while the nurses want it easy to be used. The hospital management wants the robot to be made as cheap as possible and the maintenance people prefer the important components easy to repair or replace. This can lead to conflicts since it can be difficult to take all these preferences into account at the same time.
+
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We mainly focus on the preferences of the primary users. The main question is how you let a robot assist them without affecting their dignity and making them uncomfortable. An important aspect is the  interaction between the robot and the patient. Do the patients want to be approached by the robot first or do they want to ask the robot for help themselves? Another aspect is how the robot will understand if he’s hurting the patient or not. Maybe he can ask the patient or scan their faces to see if they are in pain. But in this case another question arises: What if the patient is not able to communicate in that way anymore. Maybe the patient had a stroke, which paralyzed a part of his face, and thus the robot cannot read the face anymore. The patient could also has lost the ability to speak clearly to communicate with the robot. These problems should all be taken into account.
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'''Approach'''
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By creating a clear approach, the list of objectives can be answered with back up of different sources. Each method contains a brief description of the task that will be performed.
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Interviews
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One of the objectives is verifiying what kind of needs both patients and care takers have. This will be tested by interviewing a number of nursary homes and private individuals, thus assesing a varierty of problems that can occur, as different institutions can have different sets of problems.The results of these interviews will be taken into account when the design of our ‘’Lift Robot’’ is made.
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List of nursary homes around Eindhoven ( https://www.zorgkaartnederland.nl/zorginstelling )
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Experiments
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Furthermore, to test the recognition of emotions, as this is one of the key concepts that will make our ‘’Lift Robot’’ unique, we will conduct an experiment. This experiment makes use of a webcam and software, which is able to spot the micro-expressions of the face of an user, and validate in what state the user is currently. If the outcome of this experiment is postive, thus being a good method to recognize the emotions of the patient, we will use it in our ‘’Lift Robot’’. This makes it possible to tell if the patient is at ease or experiencing a form of discomfort, where the ‘’Lift Robot’’ will react upon.
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Companies with software:
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-> http://emovu.com/e/
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-> Software Marissa
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Literature study
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As some of the information of our subject may already been researched, we will conduct a study in literature, by assesing databases on scientific research like the library of the TU/E and Focus. This will give us a better idea about current robots that can perform a similair task and get an idea of their imperfections.
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Milestones
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In the upcoming week this approach will be extended with milestones, setting dates for each of our methods and dividing the tasks so that we will make optimal use of our time.
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'''Conclusion:'''
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We think the I.P.H will be an advantage for all kind of groups. Although users can have diverse opinions about the use of robotics during the interaction with humans. Some fear there will be less human personal contact, others are more comfortable with the human-robot interaction, because it increases their independence on other humans and streamlines the care process.
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Our believe is that using this system will make human caregivers be able to work more efficiently.
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So our goal will be to satisfy as many stakeholders as possible, but the main focus will lie on the preferences of the primary users. Of course it should be comfortable for the users by improving the interaction between patient and ‘care robot’.
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To do so we will look at current state of the art by a literature study to complete our design. We will also be taking into account the opinion of the users to make it as comfortable as possible by taking interviews and conducting a survey by the patients and care takers. We will also try to test the interaction equipment by experiments which will be chosen out of the results of the interviews and surveys.
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Further, in the upcoming week this approach will be extended with milestones, setting dates for each of our methods and dividing the tasks so that we will make optimal use of our time.
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We strongly believe that our improved patient lift can be useful for human beings.
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== NOTES ==
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Current revision as of 21:41, 30 October 2016

Contents

Group members

Marissa Damink 0858700 (M)

Jochem Meijer 0899769 (JO)

Nicky Alexander 0886116 (N)

Jesse van Kempen 0907453 (JE)

Jasmijn Kleij 0906848 (JA)

Abstract

The goal of this project was to improve the current passive patient hoist by making adjustments to enhance the convenience for primary users. In literature hardly any research was found about the use of passive patients hoists in hospitals and nursing homes. The first step of this research was to gain information from the users of the hoist by taking interviews and conducting a survey. Based on the results of the interviews and the survey seven requirements to improve the current passive hoist were made and implemented in the first design. Due to the feedback some alternations of the first design have been executed which resulted in the final design of the patient hoist. This final design consists of two different end products, one new patient hoist design that consists of all adjustments and one which is functioning as an add-on for the current patient hoist.

Introduction

Our current society is facing the societal dilemma of ageing, given that the ratio of care takers and caregivers is out of balance and will be expanded even more in the future.

Technological advancements in health care are taking place, such as better treatment for diseases, and those also contribute to the increase of elderly people, because their lifespan is extended.

Due to this, there will be a lack of caregivers in the future and therefore it will almost be inevitable that robots are partially taking over tasks. These tasks cannot be of great complexity of course, as robots are unable to think autonomous like humans. From this point of view, we have come up with a good use for robotics in which the relatively few human caregivers left in the future can focus on important and risky care tasks which should not be given in the hands of robots, like for instance the use of robots in operating theatres.

Our idea will be realized by improving the current patient hoist in hospitals and nursing homes, in which patients who are not able to relocate themselves anymore, are transferred by lifting them. The patients can be transferred between for instance a bed and a chair or to places like restrooms and sitting rooms etc.

However, unlike already existing patient lifts, our improved patient hoist (I.P.H.) can work partially autonomous and will be equipped with an interaction device. Due to this, the new patient hoist is able to detect emotions of patients. The USE-centered design method will play a significant role in our design cycle so the I.P.H. can be beneficial for all sorts of groups.

Hypothesis

To guide the research several hypotheses have been set up. These are divided in main hypotheses with several sub-hypotheses. Some of these will be investigated through surveys and others will become clear from interviews.


Caregivers need to be supported by the patient hoist

- Caregivers need to be supported by cameras for navigating the patient hoist.

- Caregivers need a patient hoist that can navigate itself and avoid obstacles.

- The caregiver would like to be warned by the patient hoist whenever the patient is anxious.

- Patients appreciate it when they are reassured by the patient hoist whenever they are anxious.

- Caregivers need a patient hoist that can provide information about the weight or the 'BMI' of the patient.

Patients and caregivers attach value to interaction during the process of lifting.

- Patients need a certain level of interaction with the caregiver during the process of lifting. (So more need for touch/eye contact/speech, or no need?) (Survey)

- During the interaction between patient and caregiver eye contact is more important than speech for a pleasant interaction. (Survey)

- During the interaction between patient and caregiver eye contact is more important than physical contact for a pleasant interaction. (Survey)

- Patients do not mind if the caregiver is absent for a certain part of the lifting process.

Objectives and approach

The main objective of the project is to improve the current passive patient hoist. The passive instead of the active patient hoist is chosen, because a human-robot interaction adjustment can be of good use for this hoist. The interaction between patient and caregiver by using a passive hoist is not constant during the process as the distance between caregiver (behind the hoist) and patient (in the yoke of the hoist) is much larger than with an active hoist. To be able to determine the shortcomings and disadvantages of the current passive patient hoist it is important to get enough inside information. This information will be gathered by literature research, taking interviews and conducting a survey of the primary users of the hoist. After analysis of all this collected information the hypotheses stated above can either be confirmed or disconfirmed. The answers of the hypotheses are, next to the now known shortcomings and problems, used to set up requirements for the new design of the passive hoist. The new design will be sketched and a demonstration film will be made to illustrate/clarify the meanings of the made adjustments in the design. At the end feedback will be gathered to verify whether the adjustments in the new design are successful and a final design will be proposed by taking the feedback into account.

Scenarios

To give you all a proper view about the current use of the passive patient hoist, the current working method will be described in the next two scenarios:

Scenario 1: - Inside one room -

“Transporting from bed to chair inside a room with the passive patient hoist”


Mr. A is a 75 year old inhabitant of Parc Imstenrade, a home for the elderly. Mr. A, who cannot stand up by himself and therefore not able to relocate himself anymore, lies in his bed in room 23. Caregiver Lilly is going to put Mr. A in his chair near the window so he can see the nearby public garden. She will use the passive patient hoist to do so.

Lilly takes a lifting mat of the proper size for Mr. A and puts 2 whalebones in the backside of the lifting mat for better support for Mr. A’s back during the lifting process. She brings the bed to the right working height so she can work more easily without risking back problems. Lilly explains to Mr. A. what she is doing and is going to do at every step of the lifting process so he will not be surprised by any actions. First she turns Mr. A to his left side and pushes the lifting mat underneath him. Then she turns him to his right side so the mat can be equally divided underneath him. As soon as Mr. A lies back on his back again, Lilly lowers the bed, because the working height is too high for the patient hoist to lift Mr. A from his bed. Now the bed is at proper height and Mr. A lies correctly in the lifting mat, the patient hoist is called over. Lilly pushes the legs of the hoist beneath Mr. A.’s bed and guides the yoke of the hoist to the right position above Mr. A. By using the remote control of the hoist Lilly lowers the yoke so it can be attached to the lifting mat. The yoke is attached between Mr. A.’s legs and along both sides at shoulder height to the mat. The arms of Mr. A will stay inside the yoke and the mat during the lifting process. Once the mat is well attached to the yoke, Lilly lifts the yoke by using the remote control again. During the lifting Mr. A. is brought from a lying position to a sitting position in the mat. This is not very comfortable for Mr. A. because the lifting mat cuts a little bit between his legs. Once free from the bed, Lilly can move the patient hoist with Mr. A. towards his chair near the window. Note that this is not an easy task for her, because she has to push hard enough to get the hoist into motion, mind the environment of the hoist to prevent bumping up against things and hold one hand at the yoke so it will not shake too much, so Mr. A. will not get motion sick or scared due to the trembling. As they arrive at the chair, Lilly brings the hoist to the right position in front of the chair and moves the legs of the hoist from each other with the remote control so the hoist can be placed around the chair. She places the yoke with Mr. A .inside exactly above his chair so his back and the back of the chair are exactly in the same position. When chair and yoke are in the right position Lilly presses the remote control again to lower the yoke. Mr. A. is then gently lowered into his chair with the lifting mat underneath him. Once Mr. A. sits in his chair the yoke is released from the mat and the hoist is slowly driven away from the chair by Lilly while preventing a collision between the yoke and Mr. A. The whalebones in the backside of the lifting mat are removed, because they are not comfortable for Mr. A.’s back while sitting. Lilly asks Mr. A. whether he wants the lifting mat to stay underneath him or not. He does not want it underneath him, therefore Lilly pulls the mat from between his legs to the outside of his hips towards his back to remove it underneath him. Now Mr. A. can enjoy his sightseeing.

Scenario 2: - Transportation -

“Transporting from bed to general living room with the passive patient hoist”


It is morning in ‘De Tulp’, a home for the elderly and the 70 year old Mrs. B. who suffers from paraplegia lies in bed. She is ready for nurse Jane to transport her to the general living room where she can sit next to her close friend Mrs. C. to gossip about the cute Mr. D of next door. Due to her illness Mrs. B. is not able to replace herself anymore so she will be transferred from her bed to the chair in de living room next to Mrs. C. by the passive patient hoist. Nurse Jane will use the same method as caregiver Lilly to bring Mrs. B. from her bed in the yoke as was done with Mr. A. in scenario 1. When this is done and Mrs. B. hangs above her bed in the yoke, Jane will drive the hoist out of Mrs. B.’s room over the corridor to the living room. Just like Lilly, Jane will explain what she is doing to Mrs. B. during the lifting and transfer process so Mrs. B. will be at ease and not surprised by any actions during her transfer. Jane will need to coordinate the whole process very carefully, because she needs to exert enough force to push the patient hoist. She has to take into account the surroundings of the hoist to prevent accidents during the transfer. She also frequently has to keep the yoke steady with one hand during the process so Mrs. A will not get motion sick or scared due to the trembling of the yoke. Before the transportation process of Mrs. B. with the hoist really can start Jane has to turn the yoke with Mrs. B. inside manually into the right direction. Due to this Mrs. B.’s face points forward, while the hoist and Jane are behind her. Mrs. B. is now able to see in what direction she is pushed by Jane. Jane can now start the transportation by pushing the hoist towards the room door. At the door Jane needs to be extra careful and make sure that she does not bump into something. This is necessary, because her sight about what is happening directly outside the door is not sufficient enough. She also needs to push the hoist with more power to drive over the little threshold. Once outside Mrs. B.’s room, Jane needs to focus again extra carefully to provide Mrs. B. a safe ride and to prevent any collisions with other humans or items in the hallway. Keep in mind that Jane and Mrs. B. cannot make any eye contact during the transportation process so Jane has to observe very attentively (as far as possible) whether something is going wrong with Mrs. B. The use of speaking is now the only solution for any interaction between them. Once arrived at the door of the living room, the threshold situation repeats itself and precise coordination of Jane is required. Jane puts Mrs. B. in the chair next to Mrs. C. by using the remote control to open the legs of the hoist and to lower the yoke just like was done to put Mr. A. in his chair in scenario 1. Mrs. B. en Mrs. C. can now finally continue their discussion about Mr. D.

Literature study

State-of-the-art

A patient hoist is a mechanical device for lifting a patient out of bed into a (wheel)chair. There are two kinds of hoists, the active and the passive one. The active hoist is meant for patients who still can stand up, but cannot move very well. It lifts the patient from a bed to a standing-up position on the hoist, after which the patient can be moved to a chair. The passive hoist is used for patients who are too weak to stay standing up. It moves the patient in a sitting position.[1]

Most passive hoists consist of a frame with a sling attached to it. The patient gets secured in the sling by the nurse and the hoist lifts the patient upwards. Next the hoist can be moved by the nurse towards the bed or chair and afterwards the hoist lowers the patient onto the bed or chair. Finally, the nurse releases the patient from the sling. There are lots of different models for passive hoists. Most hoists move the patient along a vertical axis, after which the whole device can be moved by the nurse. Some work with a rail which can transport the patient over a horizontal axis, after the patient has been lifted up. These rails can be integrated into the room, or can be moved from bed to bed. An active hoist does not move the patient from a lying position to a sitting position like the passive lift, but moves the patient from a sitting to a standing position. It can be used to transport the patient, but sometimes the active hoist is only used to help the patient to stand after which he/she can walk by him/herself, possibly with the help of a caregiver. This helps patients to maintain their mobility.[2]

A lot of research has been done about the use of patient hoists in hospitals and nursing homes. Johnsson et al. (2004)[3] proposed a model that simulated the balance between the nurse and the patient during a transfer task. The movement between the patient and the nurse should be harmonious, otherwise it may cause injuries. Research has proven that a lot of difficulties exist with the current patient hoists. Even when a hoist is available nurses do not always use it. Several reasons are: “(..) lack of time and availability, difficulty of use, space constraints, and patient preferences.”.[4] By including the nurses in the buying process and buying a powered lift instead of a mechanical one, a nursing home can improve the chance of the hoist actually being used. Furthermore a hoist cannot decrease the risk coming with lifting, but it can still reduce it significantly.[4] Despite several researches it is not clear what patients prefer. Some studies show that patients prefer a mechanical hoist, while other studies concluded that patients were more comfortable with a ceiling lift.[3]

There have been several attempts to improve the passive hoists with help of robotics. One of the earliest attempts was in the period 1990-1992 in a study of Patrick A. Finlay.[5] In this study it was recognized that several specification were needed. First the robot should be able to move the patient without causing injuries. Of course, every patient is different and especially patients that have to be moved with the hoist can have numerous of physical problems the robot has to take into account. The robot should also be able to collect the patient from a lot of different positions and move them to lots of other possible positions. Third, the robot should be able to move through a hospital without accidents. Finally, the robot should not work too slow, because nurses and patients otherwise find the waiting time not worth to use the robot. The decision was made to make it a nurse controlled device, to get the patients and nurses to slowly get used to it. A initial design for the robot, which was called the Patient Assistant for Mobility (PAM) was already made up: “The patient surface of PAM is made up of an array of slats or tines which, using a patented method of deployment, are able to be insinuated gently under the patient to support his/her weight and draw him/her onto the trolley surface. The patient surface has a Z-axis to adjust its height, is additionally articulated at the hip and knee joints, and can thus move to set the patient into a seated or other intermediate pose. (…) Sensors are used to monitor the stability of the platform, and as a useful by-product these are processed to provide a readout of patient weight. For patients with special nursing needs, selected tines can be disabled so that no contact is made with the corresponding part of the body. The patient surface has an autonomous acquisition capability, so that a single command enables a patient to be collected from a bed once the PAM is parked in approximately the correct orientation at the bedside. Articulation of the patient surface is normally in telemanipulator mode, but the PAM also contains a memory enabling details of patients and furniture to be stored, so that a collection and placement sequence can be played back whenever required.”[5]

Although this project started the demonstrator phase in 1992, it is unclear what happened with PAM after that.

Another attempt to improve the patient hoist was in 2007, in a project led by Lakshitha Dantanarayana.[6] In this project the author developed a smart hoist in collaboration with the resident and carers of the residential care facility. Some adaptions they found to be useful were weight measurement, rear view mirrors, ability to monitor the environment and assisted manoeuvering. The researchers equipped a standard patient hoist with cameras in the front, just above the floor to provide information about the part of the environment that is blocked from view by the hanging patient and implemented strain gauges into the design to measure the weight of patients. Other improvements were cameras to monitor the environment behind the carers and robotic wheels. The patient hoist also had a navigation assistance algorithm implemented. The main change however was that the patient hoist was motor driven, but still moved by applying forces to the handles. The force was measured by the hoist and a similar movement was applied by the motors. This ensured the hoist could be used intuitively, and the learning curve was short. Several users trials were executed, and the researchers implemented the feedback in the final design. There was no clear conclusion whether the smart hoist was better than the traditional hoist, but several points for improvement were found.

Besides the hoist other solutions for lifting patients are researched, like the HAL exoskeleton and the Japanese lifting robot RIBA, but those projects are beyond the scope of our research.

USE-aspects

This subject is in many ways related to USE-aspects. First of all there are many different stakeholders and users. The primary users are of course the patients and the nurses. The secondary users are the people who pay the hoist, in this case the hospital management and the government and the tertiary users are the maintenance people. The preferences of all these users have to be taken into account. For instance, the patients want the hoist to be comfortable, while the nurses want it to be easy to use. The hospital management wants the hoist to be made as cheap as possible and the maintenance people prefer that the important components are easy to repair or to replace. This can lead to conflicts since it can be difficult to take all these preferences into account at the same time. The focus of this project is therefore mainly on the preferences of the primary users. The main question is how the hoist can be improved so that it is less uncomfortable for both patient and nurse. An important aspect that will be taken into account in this research is the interaction between patient, hoist and nurse. The patients are a vulnerable group and being transferred with a hoist can be terrifying. The process however can also be bothersome for the caregiver. So important questions are: 'How does a patient want to be comforted?', 'Does this differ between different groups of patients?' and 'What does the nurse want?'. These are the kind of questions that will be answered in the research. The hoist however is not only a technical problem. A lot of these problems are actually more related to social or use aspects.

Research

Interviews

Interview questions

Before the interviews were taken a list with questions was made to ask about the desired information which could be obtained from the nurses and patients. After that several interviews were taken and the list was adapted a little (version 2) to answer new questions that had arisen during the research.

Questions for caregiver and patient

Collected interviews

In total five interviews were taken. All of them were with nurses who had experience with the passive patient hoist. Unfortunately no interviews with patients have been taken as this group was unapproachable.

The first two interviews were taken with Petra and Lianne, both nurses from Buurtzorg, which is a private care institution. Another two interviews were taken with Linda and Rachelle, both interns in their last year of their nurse education. The last interview was taken with Lisan who works in a nursing home with patients who suffer from dementia.

A link for the full versions of the collected interviews: Collected interviews

Results of interviews

Several problems emerged from the interviews. Here the most important points that were made clear in the interviews are summarized per interview.

Interview 1

This interview states that interaction between patient and caregiver is very important to establish good collaboration and trust between them. Everybody should feel safe and comfortable while using the passive patient hoist. Whenever the patient feels scared or not secure a good explanation about the taken actions should be provided, so trust and feeling safe can be created within the patient. Therefore it is a good idea to implement a device that can recognize emotions of the patient to assist the caregiver at his work. The hoist is not always experienced suitable for both patient and caregiver. The patient often dislikes for example the lifting mat, because it can cut in the patient’s legs. The caregiver on the other hand finds it difficult to move the hoist over a unsmooth floor or in small rooms. Further, the caregiver does not stand very close to the patient while operating the hoist.

Interview 2

From this interview can be concluded that the use of the passive patient hoist is an improvement in comparison with lifting of patients manually by the caregiver in which for example back pain can be reduced or prevented. However the hoist is not perfect and consists flaws. Maneuverability of the hoist has proven to be a main issue. When working with demented patients interaction between them and caregiver is a bit different than with not demented patients. Direct commands and explanation about the taken actions are given to the demented patients to reassure them, but sometimes an explanation has no use for them, because they do not understand it. Therefore they are sometimes distracted with a stuffed animal to smoothen the lifting process. At the same time these patients do not always express whether they are feeling uncomfortable or scared. Caregivers try to make something out/read the facial gesticulation of the patients to estimate how they are feeling. A device that could determine their emotions and one that could distract or reassure them during the process would be of good use.

Interview 3

This interview shows that using the passive patient hoist is not an easy task in nursing homes. In these homes are often small doorsteps present which makes it difficult for the caregiver to drive over. During the transport process the visibility for the caregiver is deficient due to the post of the hoist. To prevent this limited view the caregiver walks alongside the hoist. However, this is also not very convenient, because it makes it more difficult to push the hoist with sufficient power. A device that improves this navigation process is reflected as a good idea. Another practical aspect is the lifting mat. This mat is not very pleasant for patients, because it sometimes cuts in the legs of the patient during the lifting process. Further, during the process these mats are provided with whalebones at the backside for extra support for the patient. This whalebones need to be inserted before the process starts and removed by the caregiver whenever the patient sits, because it is not comfortable for the backbone while sitting. A big issue with these whalebones is that they get lost very easily, because they do not have a fixed place at the hoist. During the lifting process interaction is again important. Whenever a patient feels uncomfortable he is asked what is wrong and all actions are explained extensively. It depends on the patient, whether they are comfortable with more interaction or less.

Interview 4

Social interaction between patient and caregiver remains a crucial element during the lifting process. A lot of eye contact is made between them and they converse during the process. Whenever a patient is not acquainted with the hoist or if the patient is scared the caregiver will communicate more and try to make more eye contact as well to reassure the patient. When the patient is familiar with the hoist less interaction between him and the caregiver is needed to put the patient at ease. A technical aspect of the hoist is that the battery is heavy and it’s lifespan is very short. Another hoist like the ceiling hoist would be more suitable in smaller rooms and steering is much easier. However it is not a practical solution for existing care homes, because rails need to be constructed all over the nursing home.

Interview 5

The main point that can be concluded from this interview is that interaction is an important, but also a difficult point. Especially since the patients are suffering from dementia they do not really understand what you are saying. Still it is important to keep communicating about what you are doing and to comfort the patient. This is also possible by touching the patient, by eye contact or by distracting them with a stuffed animal. Over time you learn to recognize whether the patient is uncomfortable, because you get to know them. It is very important for nurses to get to know their patients. The main problems with the hoist are that you have to do several things at the same time and it is heavy to turn and move the hoist when it is loaded with a patient. It is especially difficult to navigate the hoist safely through small spaces while watching the patient.

Survey

Design of survey

Hypotheses:

- Both patients and caregivers prefer eye contact most in the process of caregiving during transportation in the hoist.
- Patients like to be comforted by voice interaction between patient and caregiver or between patient and someone else during the process of caregiving during transportation in the hoist.
- Patients like to be comforted by physical contact in the process of caregiving during transportation in the hoist and also caregivers prefer to have some extent of body contact during care giving.

Design of the survey

Link to survey: https://docs.google.com/forms/d/e/1FAIpQLScinjbrL8rMoxs1CQOP0JCgIO3u_tavH2K1LGRcKIa9q_bFVA/viewform

Method

The code in Stata can be found by this link: Stata code.

In the previous week (week 3) some data for the survey was already gathered and a power analysis was conducted. Since the standard deviation at that moment was around 0.7, this value is used for the power analysis, together with a power of 0.8 and an alpha level of 0.05.


This showed that 24 to 32 respondents are needed to be able to see a significant result in the data. A mean difference of 0.5 points difference on the Likert-scale is used. The Likert-scale is the scale of 0 to 5 that was used in the survey.

Then data was collected again, especially of patients, because there was not enough data of this group. A sample size of 29 participants for each group was gathered.

The data was prepared for analysis, for example by giving proper names to the variables i.e. After that, the new standard deviation is determined.

The following hypotheses were analyzed.

- What way of interaction receives most preference?
- H0: There is no difference in the need for interaction between patients and caregivers
- H0: There is no difference in preference for eye contact between patients and caregivers
- H0: There is no difference in preference for voice interaction between patients and caregivers
- H0: There is no difference in preference for body contact between patients and caregivers

Results

Using the new standard deviation (again 0.7), the sample size (29 participants per group) and again an alpha level of 0.05, the power is calculated. The value of the power is 0.76, this value is all right. In an ideal case 5 to 10 more patient participants should have been collected, but the analysis is continued anyway as the power has proven to be good enough.

Code: power twomeans 2 2.5, sd(0.7) n(58) alpha(0.05) //to compute power with given sample size -> 29 participants per group


The results, shown in figure 1, are: Total mean for eye contact is 2.21, for voice interaction 2.24 and for body contact/interaction 2.75. The difference between patient and caregiver in eye contact is 0.05, for voice interaction it is around 0.5 and for physical contact it is 0.75.

File:Result-interaction1.jpgFigure 1: Total mean values


File:1.jpg Figure 2: T-test of interaction

For the t-test of interaction by role of patient of caregiver, the t-value is 2.49 (fig. 2). There are 37 degrees of freedom and the p-value is 0.009.

File:2.jpg Figure 3: T-test of eye contact

For the t-test of eye contact by role of patient of caregiver, the t-value is 0.17 and there are 37 degrees of freedom (fig. 3).

File:3.jpg Figure 4: T-test of voice interaction

For the t-test of voice interaction by role of patient of caregiver, the t-value is 2.0 (fig. 4). There are 37 degrees of freedom and the p-value is 0.027.

File:4.jpg Figure 5: T-test of physical contact

For the t-test of physical contact by role of patient of caregiver, the t-value is 2.45 (fig. 5). There are 37 degrees of freedom and the p-value is 0.01.

Discussion and conclusion of survey

The results mean:

What way of interaction receives most preference?

Command: tabstat oog voice lichamelijkcontact, by(rol)

Eye contact receives most preference. With body contact you see that patients do not really like it. The value of preference is higher, which means their preference is lower. Also, the difference with preference of body contact between patients and caregivers is quite high.

What also turns out is that the preference for voice interaction is a little less for patients than for caregivers. This means that caregivers like talking to their patients more than patients prefer to talk to their caregivers. This is not what was hypothesized so further research will be done by using interviews and a t-test on voice interaction.

H0: There is no difference in the need for interaction between patients and caregivers

Command: t-test interactie, by(rol)

There is a significant result, which means the preference for interaction between patients and caregivers is not the same. The p-value is significant, so H0 is rejected.

H0: There is no difference in preference for eye contact between patients and caregivers.

Command: t-test oog, by(rol)

A t-test is conducted where the preference for eye contact is compared between patients and caregivers. There is no significant result because the p-value is not significant. This means that H0 cannot be rejected, so there is no difference in preference for eye contact between patients and caregivers.


H0: There is no difference in preference for voice interaction between patients and caregivers

Command: t-test voice, by(rol)

A t-test is conducted where the resulting p-value is 0.03. This value is below 0.05 which means that H0 can be rejected, so there actually is a significant difference in preference for voice interaction between patients and caregivers. However, this resulting p-value is not very far below 0.05, therefore it is not completely sure whether this difference is significant.


H0: There is no difference in preference for body contact between patients and caregivers

Command: t-test lichamelijkcontact, by(rol)

This final t-test shows a large significant result, a significant p-value. This means H0 can be rejected and there is a difference in preference for body contact between patients and caregivers. Patients prefer this way less than caregivers.


Noldus company for face detection software is contacted for a free trial software. Via telephonic contact Noldus promised to send this trial version as soon as possible.

Analysis

From both the survey and the interviews several things can be concluded. First a answer the question whether our hypotheses were true or not will be provided.


Caregivers need to be supported by the patient hoist

From the interviews can be concluded that caregivers do not really need to be supported by the patient hoist, they can manage without, but it could help much. Nurses have indicated that especially a hoist that helps with navigating through small spaces would be of great help. Thus the hypothesis that nurses would need to be supported by cameras for navigating can be confirmed. It is less clear whether the second sub-hypothesis, “Caregivers need a patient hoist that can navigate itself and avoid obstacles” can be confirmed. Nurses have mentioned that they would like to have help with navigating, but none of them mentioned they would like the hoist to move by itself. At least one of them, Lisan, has mentioned an aversion for a self-moving hoist. She was convinced a nurse should always be present. So it can be concluded that this sub-hypothesis is untrue. Not much consensus was found on the third sub-hypothesis: “The caregiver would like to be warned by the patient hoist whenever the patient is anxious”. Some nurses mentioned that it could be handy, but other nurses mentioned that this is the task of the caregiver and by getting to know the patient a caregiver could identify by herself whether the patient was anxious. So this hypothesis can neither be confirmed nor rejected. The fourth sub-hypothesis “Patients appreciate it when they are reassured by the patient hoist whenever they are anxious” can also neither be confirmed nor rejected, because it was not possible to interview a patient. As patients a very vulnerable group, the nurses did not want them to be interviewed. The last sub-hypothesis was: ”Caregivers need a patient hoist that can provide information about the weight or the 'BMI' of the patient”. One nurse mentioned it would not be necessary, because they weigh the patient already once a month. However, the other nurses never gave a clear answer to this question and therefore it can neither be confirmed nor rejected.


Patients and caregivers attach value to interaction during the process of lifting.

This hypothesis was examined by a survey. From this survey and the interviews can be concluded that most patients and caregivers do indeed attach much value to interaction during the lifting process. In the interviews it was mentioned as one the most important aspects of the tilling process. From the survey can be concluded that both patients and caregivers prefer eye contact most during the process of caregiving. This is also what was hypothesized. Results of the survey show also that both caregivers and patients like to have voice interaction to some extent. However, the preference for voice interaction is significantly larger for caregivers than for patients. Patients do prefer voice interaction, but to a much lesser extent than caregivers do, and also to a much lesser extent than was hypothesized. For body contact there is a large significant difference in preference for caregivers and patients. Patients actually dislike body contact during the process which was not hypothesized. From these results it can be concluded that eye contact is the most important factor of interaction during caregiving. This will be used to optimize interaction in the process of caregiving during transportation in the patient hoist. Voice interaction is less important for patients, but this can also be taken into consideration in the design for optimizing the patient hoist.


Problems

As the hypotheses are now answered, the main problems of the current design can be identified and requirements that the improved design must meet can be proposed.

A lot of nurses have mentioned that they have trouble with moving the hoist. A lot of these problems were caused by wheels that got stuck. The swivel caster wheels, which are currently used, do not roll as smoothly as hoped. This is caused by a rough surface or the orientation of the wheels. Therefore the first requirement for the new design is that wheels are used that do not get stuck.

Another problem that many nurses encountered was that the hoist was heavy to push when loaded with a patient. It was also very difficult to turn the patient or the arm of the hoist when also focusing on the wellbeing of the patient. That is why the following two requirements were set up: Less force should be needed to push the hoist and less force should be needed to move or turn the patient when loaded in the hoist.

From the hypotheses can also be concluded that nurses do have trouble with moving the hoist around in small spaces and would like some assistance with that. It is difficult for the nurse to keep an eye on everything, mainly because the patient is blocking a significant part of the field of sight of the nurse. This leads to the fourth requirement: The hoist should give a better overview to the nurse during the transfer.

A conclusion that was drawn from the survey was that patient and nurses value eye contact during the transfer for a great deal. However, on longer distances where the patient is facing towards the moving direction of the hoist there is no eye contact at all. This can lead to a less comfortable experience for the patient, that is why another requirement holds that during the whole process eye contact between the patient and the nurse is guaranteed.

Another problem that was examined was whether the nurses would like assistance with recognizing whenever the patient is uncomfortable. Although some mentioned that a nurse would learn this by time, for inexperienced nurses recognizing anxiety can be a challenge, because the patients are not always able to express their feelings. That is why it is likely that the following requirement still can be an improvement to the hoist: The hoist should be able to recognize anxiety in the patients.

The last requirement is: The hoist should be able to comfort the patient. It was not possible to examine whether the patients would like this, but especially since the design could be a bridge between the current lift and full automated one, it is likely that it can add something important to the hoist.

Requirements

In this section the best solutions for the earlier stated requirements will be discussed.


Requirement a: During the whole process eye contact between the patient and the nurse is guaranteed.

One way to realize this is by the use of cameras and displays. A patient, who is sitting in the lift, can be filmed by a camera. This images are transferred to a display that is attached to the back of the lift where the nurse is standing, who is also filmed. The patient also should have a display in sight, so eye contact can be established at all time. However, when you look at a screen, you do not look in the camera. This is because they are at two different places. For this reason, eye contact via videos is difficult. However, there has been a lot of research on improving video-mediated communication. As stated in “eye contact and video-mediated communication: a review”[7] video-conferencing has become a popular video technology because it improves real-time communication. Video-conferencing is a richer form of communication than email or telephone, however, the authors says that video-conferencing is not quite as informative as face-to-face communication. Some research was done about ways to improve video-conferencing and eye contact during the use of webcams. Franc Solina and Robert Ravnik proposed a method related to the mona lisa effect.[8] This method establishes eye contact during video calling and it used big screens and cameras mounted above the screen.[9] However, a still better method must be possible. Stereo matching method, shown in figure 6, is a method that could solve our problem. With stereo matching a color image is used in a stereo camera as an input. This is configured by two cameras, they create a reference point.[10] However there is a problem with stereo matching, since most of the stereo matching methods only consider paired images in specific orders. To treat video images of stereo matching as a static image causes flickerings.[11]

file:Eye_contact1.jpg‎

Figure 6: Stereo matching method

Recently, a patent for “Method and apparatus for providing eye contact function to multiple points of attendance using stereo image in video conference system” has been proposed.[10] The patent presents an invention to improve eye contact. It improves eye contact images between remote attendances during video calling. Since this invention is not on the market yet, this will not be included in the demo, but for future use this aspect is very important. This method uses the same ideas as stereo matching, two cameras are used. However in advance to that, a depth image camera is also used, this is to calculate the occlusion region. With this information, an object mask for an image is created. The completed object mask is the way in which eye contact can be improved. Figure 7 shows an illustration of this.

file:Eye_contact2.jpg‎

Figure 7: Object mask


Requirement b: Less force should be needed to move or turn the patient when loaded in the hoist.

The patient loaded in the hoist should be easy to turn. In the interviews was mentioned that some nurses had trouble with turning the hoist in the right direction, while also making sure the hoist does not bump into something. The patient is turned by hand, which means all the applied force comes from the nurse. This could be made easier by also using an electromotor to turn the harness to which the sling is attached. For this user intention recognition will also be used, for the same reasons as mentioned above. To recognize the intention of the nurse the hoist needs a force control system. Usually force control is used in robots that have to pick up objects. It makes sure the robot does not squeeze anything. It does this by measuring the opposing force the object applies to the robot when the robot picks up the object. A feedback loop is used to ensure the robot responds in the correct way to the opposing force. This force control can be implemented in the hoist, so that the bigger force the nurse applies, the longer the robot continues this movement. To measure this force, force or strain sensors have to be implemented on every joint of the hoist. A computer measures this force and with the implemented logic determines the motion and velocities. Major motion patterns have to be identified and implemented in this computer, to ensure the hoist continues its movement in the same direction as the nurse applied the force in.


Requirement c: Less force should be needed to push the hoist.

The nurses mentioned in the interviews that they had trouble moving the hoist around in the rooms, because it was so heavy, especially when the patient was sitting inside the yoke. Sometimes the floors made it even more difficult to push the hoist forward. So it can be concluded that the improved hoist should have the ability to move without the nurse applying all the force. This is especially important when the hoist is used for larger distances, like moving the patient to the toilet or to another room. Our solution is to build in an electromotor to drive the wheels. This means the hoist requires a stronger battery. It was decided to not use a remote to steer the improved hoist, because that would add extra complexity to the hoist. The nurses would have to learn yet another thing. The learning curve needs to be kept short, so user intention recognition will be used to steer the hoist. This means the hoist anticipates on the intentions of the nurse by measuring how force is applied. For the nurse it means she can use the hoist the same way she was used to. More explanation of this can be found in requirement b.


Requirement d: The hoist should be able to recognize anxiety in the patients.

There are several ways a machine can recognize emotion in humans. One of the most obvious ways is of course the same as most humans do it, by reading a person's face. Software that is able do this already exists and is called facial expression recognition software. Reading the face by looking at the position of, for instance, the mouth and the eyes has proven to not work well enough, because every person is different. That is why these software analyze the relationship between points on the face. When somebody curls the corners of his/her mouth, the software registers that the point of the corner of the mounts moves. With a complex algorithm it concludes that the person expresses, to a certain amount, happiness. It is even possible for these software to recognize micro-expressions. Most of these software show the extent to which a person shows one of the seven basic emotions in percentages. The seven basic emotions these software uses are: joy, sadness, anger, fear, surprise, contempt, and disgust. Often a Neutral emotion is also added to the possible emotions. More complex emotions are always regarded as a combination of these seven emotions [12]. It is therefore more difficult to recognize these emotions in the numbers the software generates. However, since the software only has to recognize fear, it could be accurate enough for the goal of this research. Of course there are also other ways to recognize a person's emotions. Other aspects researches often take into account are respiration and heart beating. MIT[13] has written a paper about a new technology that can detect the emotion of a person by analyzing reflecting radio frequency signals of a body, which means that no sensors need to be applied. The EQ-radio sends a RF signal through the room, recognizes the person from the other objects, analyzes its reflections and recognizes his emotional state. This all is done by a new underlying algorithm that extracts individual heartbeats from the wireless signal. The accuracy of the emotion recognition is comparable with state-of-the-art emotion recognition systems that need a person to be hooked to an ECG monitor. For the design the facial expression recognition software will be used. The main reason for this is that this technology is already more developed and many different software are available. This makes it easy to implement in the design. The only things needed for this are software, cameras and a computer. Since the computer is also needed for other aspects of our design a computer will be implemented anyway. The camera is also already implemented for making eye-contact with the nurse. It is decided to go with the facial expression recognition software of Noldus. After contacting them a trial version of their software was obtained.


Requirement e: The hoist should be able to comfort the patient.

It was already stated the hoist should be able to recognize fear in the patient, but the hoist should also be able to react on it. It was already mentioned that a screen is attached to the hoist on which the patient can keep contact with the nurse, when the patient is moved. This screen can also be used to comfort the patient. One thing that was concluded from the interview is that it is important to tell the patient what is happening to him. So a feature is implemented in the hoist that can tell, either with spoken words or written on the screen, what is happening to the patient at the moment he/she is scared. The nurse should be able to turn this feature on and off at any moment. Another thing that was learned from the interviews is that a lot of patients who have to be transported by a hoist have dementia. They do not understand what the nurse is saying to them. Therefore they will not understand the hoist either when words are spoken or written on the screen to explain the taken actions. An option for them could be, that the screen on the hoist shows an animation which can distract the patient. This should also be a feature that the nurses should be able to turn on and off at any moment.


Requirement f: The hoist should give a better overview to the nurse during the transfer.

This problem can be solved by the use of a camera, which is placed at the front of the lift and films in the moving direction of the lift. Transferring these images to the display of the nurse, he/she can easily see what is in front of the lift and if there are any obstacles that could be possibly dangerous. Another addition would be sensors that indicate how close the lift is to a certain object, for instance a wall, so the nurse has an even more complete overview. These sensors, often used in cars for parking assistance, use super sound to determine the distance between the sensor and an object. If a minimum distance is exceeded the nurse will get a signal on het screen and the hoist will break automatically to prevent collision. However, since this partly takes away the control the nurse has, it was decided to go with the cameras. Maybe in the future when nurses and patients are more familiar with automation and robot technology, parking sensors could still be implemented.


Requirement g: Wheels that do not get stuck are used.

A solution for this is to use solid spherical wheels, which are part of a ball bearing. Since these wheels can move freely in every direction they will not get stuck due to orientation and can as well move over surfaces which are rough. Since these wheels do not have an axis around which they turn, it is difficult to support them with an electromotor. Therefore these wheels are mainly useful as replacement for the front wheels of the patient hoist.


Finally, in the interviews it was mentioned that the whalebones get lost easily. That is why a small adjustment will be added, besides the requirements. A pocket to the hoist to store the whalebones in will be attached.

Design 1

Figure 8 Figure 8: Design 1

Figure 9: Interface options for patient

An optimized design for the hoist is made with the program Photoshop CS6 (fig. 8). In this design the requirements were taken into account and added to an adapted version of the 'Wendy' passive hoist.

1. (Following requirement a)
Screen display that is able to sustain a live connection between the caregiver and the patient by an implemented camera. The software on the display is able to show information about the patient in the hoist.
2. (Following requirement b)
Force sensors in handgrips that are able to measure how much force the caregiver is applying while pushing the hoist.
3. (Extra requirement)
Emergency stop button for the caregiver that will immediately shut down all the systems of the hoist when pressed.
4. (Following requirement c)
Electronic powered motor that, in combination with the force sensors, move the hoist by amplifying the force of the caregiver in a certain direction.
5. (Following requirement d)
Camera with a real-time connection pointed at the face of the patient, to sustain eye contact. The camera is also connected with the facial recognition software to detect the emotions of patients.
6. (Following requirement e)
Screen to comfort the patient and make eye contact with the care giver.
7. (Extra requirement)
Holder for the stiffeners.
8. (Following requirement f)
Camera to create a better view of the environment. The caregiver is more able to spot if there are object obstructing the path of the hoist.
9. (Following requirement g)
Spherical wheels for better manoeuvrability.


The improved patient hoist (I.P.H.) in our design 1 is equipped with two interfaces, that will now be evaluated further. There is one interface for the patient (nr. 6 in Design 1) and one for the caregiver (nr. 1 in Design 1).

Interface patient:

The interface for the patient is sketched in figure 9. This will be a display, like for example a tablet. To fill up this display three options can be chosen by the patient and caregiver. In this case they have both control over how they are supported by the added technology.

The first option is that the caregiver is visible for the patient on the display so eye contact between them can be obtained. This is an improvement in comparison with the current patient hoist in which, like in scenario 2, there is no direct eye contact possible between patient and caregiver during the transportation.

The second option consist of the first option with an extra window on the display. This window shows a short animated film clip with a speech function in which the actions of the lifting process are explained to the patient. This option is implemented, because results of the survey and interviews showed that patients like to be informed about what is happening and going to happen during the process. As the patient wishes this option can be switched on or off by the caregiver.

A third option can be implemented to the first option in case the process is executed with for example a demented patient. In this case the display contains an extra window in which an animation is showed to distract the patient during the process. Consequently the process will go more smoothly and pleasant for both patient and caregiver.

All options can in fact be put on or off by the caregiver in compliance with the patient leading to actually four options for the interface of the patient.

Figure 10: Interface caregiver

Interface caregiver:

The interface for the caregiver is shown in figure 10. This will also be a display, like for example a tablet, which will be attached at the backside of the patient hoist at face/shoulder height of the caregiver (nr. 1 in Design 1). This display can be changed of position (up and down) so even a tall or a small caregiver can use it properly. On this display the patient lying in the yoke is visible for the caregiver, so eye contact between them can be accomplished. In another window an overview of the environment just in front of the hoist will also be visible on the interface. Due to this the caregiver can easily see what is in front of the hoist and if there are any obstacles that he cannot see for himself from behind the hoist. Further, on the right side of the interface a kind of traffic light system will be visible. This traffic light displays the well-being of the patient during the lifting and transport process. The traffic light is connected to the camera of the patient (nr. 5 in Design 1) which can due to the implemented software of Noldus recognize facial emotions of the patient.

Green light shines when the patient is feeling good and comfortable. In this case the caregiver does not need to change his procedure, the patient is doing just fine in the yoke. Orange light lights up whenever the patient is a little uncomfortable, but the caregiver does not necessarily need to take any actions or alter the transport process for the patient. The caregiver just needs to be more alert, because the chance of changing from orange to red light is higher. The red light shines when the patient is not feeling good, he is scared or uncomfortable. In this situation the caregiver should give attention to the patient and figure out why he is feeling uncomfortable and take action to change this feeling.

The distinction between which color light should shine when will be determined by the results of the test plan for the used facial recognition software of Noldus.

Noldus

In this section the facial expression recognition software 'FaceReader 7.0' from Noldus will be looked into. First a measurement plan is discussed, after which the results are presented after analysis. Lastly conclusions regarding this software will be drawn.

Measurement plan

The goal of this measurement plan is to create a guideline for the two experiments that will be carried out. This will result in a smoother transition between acquiring the materials necessary for the set-ups, performing the experiments and exporting the data.

With the first experiment it is possible to verify if the impact of different circumstances results in a deviant output. What will a difference in distance, angle or light/dark ratio do to the results?

With the second experiment the performance of the Noldus software will be verified by testing a range of basic emotions, by using certain movie segments. Experimental participants (varying in age) are positioned in front of a camera, while being exposed to fragments of themed video material. Key is to execute the experiments with comparable circumstances.

The specific steps that should be taken can be found in the linked file below.

Measurement plan

Validation of Noldus

After the experiments were executed the facial expressions had to be analyzed. How this is done is discussed in this section as well as the results of both experiments.

Method

The recordings of the participants are analyzed using Noldus software and their feelings were asked and written down. By combining these two factors and the literature about the movies, it will be determined whether the Noldus software gives valid data about facial expressions.

After the analysis is completed the data can be exported to a .txt file where for every time sample the intensity of every emotion is given. This intensity varies from 0, not present, to 1, fully present, whereas the sum of every emotion never exceeds 1. For every recording where one specific emotion should have been generated, a matlab script (File:Analysis.pdf) determines the mean intensity and maximum intensity. Next, the mean of these means as well as the mean of these maxima were calculated and the standard deviation is determined.

Finally, both values for all emotions are plotted, with and without taking neutral intro account, leading to four figures (fig. 13-16).

It can be concluded that the Noldus FaceReader software is valid if the highest mean and maximum emotion is the emotion that is expected from reporting of participants and from the literature.

Results

Experiment 1

By daylight the software was able to detect the face of the participant until a distance of 2 meters between the webcam and the participants face. By daylight and 0.5 meter distance between the participant and the webcam the software was able to detect the face that was turned right until an angle of 45 degrees was reached. The same holds for turning the face to the left. Turning the face down the software was able to detect the face until an angle of 20 degrees, whereas the software kept on detecting the face when looking up until the neck of the participant was fully stretched. Increasing the distance led to an increase of allowable error in every direction. By changing the dark/light ratio is was observed that the software is very sensitive to light. By daylight there are no problems, however in a slightly darker room, where the curtains are closed, the maximum distance between the face and the webcam decreases rather fast, as well as the allowable angle. Turning light right into the camera has the same effect.

Experiment 2

First one has to note that the movies that are selected in the research show strong emotional responses, but not facial expression responses as these emotional responses were determined by measuring heart rate and respiration. So there is a chance that not much responses will be shown in the tests, but this does not mean that the software is not valid. Furthermore it is mainly focused on analyzing only the most important emotions for this project, meaning happy, sad and fear.

Figure 13 shows the analysis of the sad movie. What stands out is that neutral is minimally twice as high as the other emotions. This can be due to the selected movie as not every moment was sad. When the neutral emotion is neglected it is shown that sad is indeed the main mean emotion. For this reason in the next analyses the focus lies on the graphs where neutral is filtered out. Happy is also quite high in the maximum emotion graph. This is a striking result, because it could mean that in the software a sad emotion is easily confused by a happy emotion. This could however also be due to a high intensity of happiness at some point, because the happiness in the mean graph is not that high at all. Also anger is somewhat higher than the other emotions, however none of the participants reported feelings of anger so this might be an error in the software. Nonetheless, sadness and anger are on the same side of arousal in the valence arousal model so this also is a very plausible observation.

Figure 14 shows the analysis of the happy movie. It can be seen that the values of happy are high. The mean of happiness is even similar to the mean of neutral and the max is even higher. When neutral is neglected, a peak is visible in sad emotions, however happy still is twice as high. As in the previous figure sadness also was confused with happiness it can be stated that the recognition of Noldus needs some improvement. Happy and sad seem to be coherent in the software to some extent. Nonetheless, it can be concluded that the software of Noldus appropriately reports happiness as the main emotion when participants also report happiness.

ALT
Figure 13: Analysis of sad movie
ALT
Figure 14: Analysis of happy movie


The most important emotion for improvement the hoist is scared. Therefore two analyses of this emotion were conducted. Scared 1 shows fearfulness over a longer period of time and Scared 2 shows a very brief moment of shock. As visualized in Figure 15, happy is the main mean emotion besides neutral. Furthermore, the second highest mean emotion is sad. This is not as expected. In Figure 16 the sudden shock is analyzed. This is another way of measuring fearfulness. Contrary to the scene of the shining, in this movie happy is not high. Neutral on the other hand is high, but this is neglected. Visible again is that sadness is high instead of the scared that was expected. Also disgusted is slightly higher than the other emotions. Disgust can be difficult to distinguish from fear, because jaw drops and eyebrow changes. The emotions on one side of the valence level are often somewhat confused, but there is little confusion between the negative of positive valence levels.

ALT
Figure 15: Analysis of scared 1 movie (the shining)
ALT
Figure 16: Analysis of scared 2 movie (sudden shock)

Conclusion

By daylight and an angle between the face that should be detected (in the allowable range of left/right: 45 degrees, down:20 degrees and up: 60 degrees) and the webcam, the software is able to detect the face without any problems. As soon as more or less light is available the software’s performance is decreasing. A solution for this could be to attach a light near the camera that shines on the face of the patient in the patient hoist, so the software is able to detect the face, even when the room is dark

What mainly can be concluded is that the Noldus Software did not always respond as expected. Reasons for this could be because small facial changes of, for example, fear are very hard to observe, the movie fragments were not good and long enough to arouse certain emotions or the participants were too much influenced by their environment to take the experiment seriously. However, something else is standing out. The software might not show the precise emotion accurately, because mainly happiness, sadness and neutral were reported, but the level of arousal on the other hand is quite precise. When Noldus reports neutral the level of arousal is 0, for negative emotions the level becomes negative and for positive emotions the level becomes positive. Negative arousal emotions are anger, sad and disgust while positive arousal emotions are happy and surprise. This can be seen from the valence arousal model of Russell. In the analysis it can be seen that the emotions on one side of the valence level are often somewhat confused, but there is little confusion between the negative and positive valence levels. For this reason, and also due to the fact that the received software only exports data from which valence can be determined, the “traffic light” system mentioned above will be based on the level of valence instead of the specific emotion. The next section will more elaborate on this.

Emotion detection

As explained above, distinguishing different specific emotions lead to complications, which are undesirable. So, instead of focusing on these specific emotions and whether this one emotion exceeds a certain intensity, valence is used to determine the state of a patient’s emotion. (Arousal is not taken into account, since the software received from Noldus is not able to output the activity of the Action Units, which are needed to be able to calculate arousal). To calculate valence the intensity of positive emotions, like happy, as well as negative emotions, like anger, fear, sad and disgust, are needed for every time sample (surprise is not taken into account since it can be positive and negative).[14] Consequently, valence is the subtraction of the intensity of happy and the highest negative intensity, leading to a range for valence from -1 to 1, where -1 is purely negative and 1 purely positive. Using this, the idea of a traffic light system on the nurses display can now be realized, as can be seen in the figure below. The matlab script is given in this file: File:Trafficlight.pdf


The traffic light given in Figure 17 is green when the valence is higher than 0.3, red if it is less than -0.3 and yellow when the valence is in between. This treshold can be varied for every patient personally.

Figure 17: The traffic light system

Demonstration

The purpose of the demonstration is to form a clear image of the future vision of the improved hoist. The invented adjustments that have been examined in the last few weeks are also implemented.

Here a link to the created short film clip of the demonstration is given: https://www.youtube.com/watch?v=r1jxQCQQBQQ&feature=youtu.be

Feedback

To verify whether the implemented adjustments on the passive patient hoist shown in Design 1 are successful enough, feedback has been gathered from several caregivers who are acquainted with this hoist. Two of these caregivers have also taken part in the interviews at the beginning of our research, so they were a little bit more informed about the project already and three new caregivers were asked for feedback.

The feedback was gathered by first briefly explaining to the caregivers what our research is about and how our arranged requirements are implemented in our first design. Secondly Design 1 with the several invented interfaces were shown to the caregivers and per adjustment was explained why it has been implemented. The caregivers were asked to give their opinion about the adjustments and whether they would adjust or add anything to the design.

The results per feedback interview are listed below and a general conclusion from these feedback interviews is concluded.

Feedback 1

From this feedback interview can be concluded that our adjusted design of the passive patient hoist is indeed a good improvement. The bigger wheels actuated by a motor are very convenient as it reduces the required power of the caregiver to move the hoist, because it is not an easy task to push the current hoist with a patient in the yoke. The solid spherical wheels in the front of the hoist are also considered as handy since they make it easier to turn the hoist in another direction. The emergency stop is already implemented on the current hoist, however the position of this button is too low. The one shown in the design has a better position in the working space of the caregiver. The camera for navigating the hoist is regarded as a good adjustment. Especially with for example cables lying underneath beds etc. it is a fine implementation that can make spots visible for the caregiver and it can prevent collisions. This camera can be of good use for distances in one small busy room as well as for the transportation process. The addition of a holder for the whalebones of the lifting mat is considered very clever, even though it is such a simple adjustment it is really a good one, because the whalebones are now in no way connected to the hoist. The interface of the caregiver can support the caregiver in his tasks, although the caregiver should be able to open or close windows however he prefers. The traffic light system makes the caregiver extra alert which is therefore an advantage to provide good care. The options for the interface of the patient should all be possible as every patient is different and it should again be possible to switch options on or off. The control over these options should be given to both caregiver and patient, as long as patients are able to use these digital methods. An extra improvement for this design could be a kind of peg adjusted on the hoist so the lifting mat can be hung up on. Now the lifting mat is just thrown over the hoist which makes it easier to be worn out and whenever there is just a small hole in the mat it may not be used anymore because of safety aspects. The overall impression of the design is therefore positive and it will be an advantage for both patient and caregiver.

Feedback 2

The feedback from this interview is quite similar to the first one. The motorized wheels are considered as a real advantage for the caregiver. It can prevent back pain for the caregiver as it reduces their needed strength to push the hoist. The spherical wheels are just as in feedback 1 found very handy so turning the hoist in the desired direction will not be an issue anymore. It is found strange that those spherical wheels are not implemented yet or in more other equipment like for example a wheelchair. The position of the safety button in the design is more suitable than the current position, especially when more electronics are implemented it is important to be able to switch the hoist off. The camera for navigation and the holder for the whalebones are considered as a good addition just like in feedback 1. For the interface of the caregiver again the same good feedback was provided, however now the question arose whether it was possible for the used software of Noldus to determine the emotions of patients who have a facial paralysis or a defacement. Further the approach of a traffic light system to warn the caregiver is just fine, however instead of different light colors also smileys could have been used or something similar considering caregivers that are colorblind. The options for the interface of the patient are a good implementation to ease them when they are not feeling comfortable or scared. It depends on the patient which option will be chosen and this should be chosen by the patient if possible. Option three for demented or retarded patients is good, because an animation can distract them, however the animation should be chosen with care, because some subjects are sensitive.

Feedback 3

The overall impression about the improved design was stated as positive during this interview. The motorized wheels are a good idea, however they should be carefully tested especially in small rooms. The motorized hoist and the strength by which the caregiver pushes the hoist should be well adjusted to each other, so the hoist does not react jerky or moves to fast and risks to bump into things. The spherical wheels, the emergency button, the camera for navigation and the holder for the whalebones are all considered as good adjustments in the current design of the passive hoist. Option one (visible caregiver), three (visible caregiver and a short film clip for distraction) and four (different options combined or switched on and off) for the interface of the patient are useful supplements and can either improve the interaction between caregiver and patient or comfort the patient more during the lifting process. Option two (visible caregiver and a short film with instruction) is on the other hand not necessary. Not all patients will understand these kind of instruction film and as a caregiver you provide these instructions yourselves to the patients verbally. The interface of the caregiver is also a good adjustment to improve the interaction between patient and caregiver and it can smoothen the whole process by giving feedback about a patient’s condition with the traffic light system and by giving information about the badly visible surroundings just in front of the hoist. However questions arose whether the used software to detect facial emotions will be useful for patients with for example Parkinson’s disease and whether caregivers will not focus too much on the interface instead of the whole hoist so the risk of collisions will increase while moving the hoist. At the end another option for a more future design for the interface of the caregiver and the control of the hoist was given. Instead of pushing the hoist by the caregiver himself, it should be driven by using something like a IPad by the caregiver. In this case the caregiver can walk next to the hoist and the patient while stirring the hoist from the IPad. Interaction between caregiver and patient will be improved by reducing the distance between them and the workload for the caregiver will decrease as he does not need to push the hoist manually anymore.

Feedback 4

From this interview can be concluded that the made adjustments in the current hoist are good and useful to improve the lifting process. Especially the motorized wheels in combination with the spherical wheels in front of the hoist are a very big improvement. The turning and pushing of the hoist is now experienced as hard and even more difficult then moving a full and heavy shopping cart. The motorized and spherical wheels will make this process a lot easier by reducing the workload of the caregiver. The emergency button, the camera for navigation, the holder for the whalebones and the interface of the caregiver are considered equally as in feedback 3. The options for the interface of the patient is also evaluated the same as in feedback 3 where option two should be omitted. Option three is a good option for comforting and distracting the patient, but no animation should be used. Instead a short film clip about nature with waterfalls or woods should be used to entice their attention.

Feedback 5

Just like the other feedback interviews the overall impression of design 1 is considered positive and with real advantages in comparison with the current hoist. Just as stated in feedback 4, the motorized wheels and spherical wheels are very handy as turning will not be an issue anymore and less physical power of the caregiver is needed. This adjustment will reduce the workload of the patient and their back pain which is obtained by frequently using the hoist. The emergency button and the holder for the whalebones are considered equally as in feedback 3. The camera for navigation will also be of good use. Especially for managing the hoist under beds and chairs where cables or attributes like shoes can be avoided now and it is not necessary for the caregiver to get down on his knees anymore to see what is interfering with the hoist. Therefore the interface of the caregiver is well equipped especially with the window of the surrounding just in front of the hoist. Option three for the interface of the patient can be of good use for demented patients. A short film clip as mentioned in feedback 4 should be used or perhaps a little bit of music could be added to it. It is probably good that the caregiver is also visible on the interface of the patient as it is more comforting to see a matching face from the caregiver who is talking to the patient from behind the hoist.

Conclusion feedback

From all the gathered feedback can be concluded that design 1 is indeed an improvement of the current passive patient hoist. The bigger motorized wheels are a very good adjustment to the current hoist. They reduce the workload of the caregiver to move the hoist and be doing so they can prevent back pain for the caregiver by frequently use of the hoist. However this motorized system including the force sensors (nr. 2 in design 1) should be tested very properly, because the motorized hoist and push load of the caregiver should be well adjusted to each other so no jerky reactions or collisions by too fast movements are obtained. In all the feedback interviews was stated that the spherical solid wheels are actually a must for the improved design of the hoist. They make it easier to turn the hoist in a desired direction and in combination with the motorized wheels they will make the lifting process a lot easier by reducing the workload of the caregiver so less physical power of the caregiver is needed. The position of the emergency stop in design 1 is more suitable than the lower current position on the hoist, because it is positioned in the working space of the caregiver. Especially when more electronics are implemented it is important that the hoist can be turned off right away. The camera for navigation is regarded as another good adjustment to the current design. Especially for managing the hoist underneath beds and chairs where cables and other attributes can be avoided. It is a fine implementation that can make spots visible for the caregiver and it can prevent collisions. It can be of good use in small busy rooms as well as for the transportation process. Although simple yet a very handy adjustment has proven to be the addition of a holder for the whalebones of the lifting mat as they are now in no way connected to the hoist and they are often lost. The interface of the caregiver can support the caregiver in his tasks. It improves the interaction between patient and caregiver by making eye contact possible form behind the hoist, it smoothens the process by giving feedback about a patient’s condition by use of the traffic light system and it provides information about the surroundings just in front of the hoist. The traffic light system extra alerts the caregiver which is therefore an advantage to provide good care, but questions arose whether the used software to detect facial emotions can be used for patients with facial paralysis or defacements and whether caregivers will not focus too much on the interface so the risk of collisions will increase while moving the hoist. Options one, three and four for the interface of the patient are useful adjustments and can either improve the interaction between caregiver and patient or comfort the patient more during the lifting process. Option three is a good option for comforting and distracting patients when both caregiver and short film clips about the nature are visible to entice their attention. Option two is not necessary, because not all patients will understand the given instructions. The caregiver provides these instructions himself verbally to the patient during the process. The control over these options which can be turned on or off should be given to both caregiver and patient, as long as the patient is capable to do so. Other adjustments like a peg for the lifting mat and another kind of control system for the hoist by using an IPad have been stated in the gathered feedback. These can perhaps be incorporated in a final or future design.

Final Design

Based on the gathered feedback about design 1, it can be concluded that most of the made adjustments on the current hoist are useful and should indeed be implemented in the new design. To create a final design of the passive patient hoist a few changes in design 1 will be made which will be explained further.

An extra improvement which is stated in feedback interview 1 for design 1 is that a kind of peg should be adjusted on the hoist so the lifting mat, which is now just thrown over the hoist, can be hung up on. This adjustment is implemented in the final design as it is proven that the current manner at which the lifting mat is hung up is bad for the mat as it is easier worn out which reduces the safety of its use.

Another addition to the design is a small light source next to camera for navigation (nr. 8 in design 1). This will improve the visibility of the environment of the camera as it has been stated in the feedback interviews that the legs of the hoist will be shoved underneath beds and chairs.

Requirement d (“The hoist should be able to recognize anxiety in the patients”) is satisfied in design 1 by using facial expression recognition software of Noldus. However, the software cannot detect facial emotions by patients with facial paralysis or defacements. Therefore the previously proposed software of MIT in which emotions of persons are detected by taking respiration and heart beat into account will be implemented in the final design besides the software of Noldus. The output of the MIT software will also be connected to the traffic light system just like the output of the Noldus software so the caregiver can be alerted whenever the patient is feeling uncomfortable. This way more patients, even patients with facial paralysis or defacements can be taken into account for the improved design.

To make the implemented traffic light system in the interface of the caregiver also functional for colorblind caregivers as stated in feedback interview 2, symbols inside the red, yellow and green light are used like in figure 10. These symbols will be visible whenever the red, yellow or green light shines.

Due to the feedback about the interface of the patient the following changes are made for the final design of the hoist. Firstly, the second option for the interface of the patient in which the caregiver and a short film clip about the actions of the lifting process are explained is removed. This is done because not all patients will understand the given instructions and the caregiver prefers to give these instructions himself verbally to the patient during the process. Secondly, the third option for the interface of the caregiver in which the caregiver and an animation for distracting the patient is showed is adapted. This change consists of showing a different short film clip, like one about nature with waterfalls or woods to entice the attention of patients with for example dementia as these sort of films are more comforting for them.

Finally the control over all options for the interface of the patient which can be turned on or off is given to both patient and caregiver. The patient can choose from the different options on his own interface (nr. 6 in design 1) and the caregiver from his interface (nr. 1 in design 1). Normally the patient will have full control over the given options, but whenever the patient is no longer capable of controlling these options, the caregiver will do it for him.

All the above mentioned changes lead to the final design of the I.P.H.

Discussion

A design for an improved hoist was obtained. Although this design well-founded, there are also several limitations to the research done. Some of these problems can be solved in further research.

First of all, it was not possible to interview patients and a limited amount of surveys were filled in by patients. This is due to the fact that patients who have experience with the hoist, are a very fragile group. Often they are old and have dementia. Most nursing homes would not let us ask questions to this patients, because that could upset them or they would not understand us anyway. Nurses could tell us a lot of what they thought to be the desires of the patients, but it would be better if the patients were asked themselves. Some of our solutions might have been rejected or patient could have had very specific problems with hoist the nurses did not know about. The improvements in our design are therefore mainly based on the view of nurses on the problems of patients. This can be different from the problems the patients experience themselves.

Secondly, there were a couple of problems with the Noldus Facial expression recognition that was used. For instance, the version that was obtained did not have the possibility to export the data real-time. This meant that it was only possible to export and analyze the data at the end of recording. It was possible to see the data in the program itself real-time, but for using it for the interface of the nurse, it needed to be exported it to the script that was written, in real-time. The traffic light system that was designed could only work afterwards. This problem, however can be easily solved for anyone who would like to implement our design by obtaining the right software. Another problem that was encountered was that the software was not able to export the data on arousal, only on valence. The script for the lights of the traffic light could be more accurate with this data. At the moment it only uses valence, which means that every negative emotion can change the traffic light. Ideally the traffic light would only respond to fear, but for that data on arousal is needed. This problem could also be solved by obtaining the right software.

Furthermore, an important limitation of the research is that the software was not tested on people who are partly paralyzed or have a disfiguration in the face. It is possible that the software does not work well on these kind of patients, which can lead to false signals towards the nurse. This problem can be solved however by measuring heart beat or respiration as mentioned in the requirements. The technology using radio frequency signals (see requirements) that MIT has invented can also work for this, but this technology is rather new and needs to be developed further, before it is possible to implement it in the hoist.

Conclusion

The goal of this project and the experiments was to improve the current passive patient hoist in ways that would result in more convenience for the primary users, thus for the caregiver and the patient. In literature hardly any research is found about the use of patients hoists in hospitals and nursing homes.

Considering the fact that there has been little research done about the passive patient hoist, it was stimulating to start a new experiment in which the current hoist could be improved, whereby two main hypotheses were formulated: ‘Caregivers need to be supported by the patient hoist’ and ‘Patients and caregivers attach value to interaction during the process of lifting’. Based on the results of the interviews and the survey of the first hypothesis can be concluded that there is a need for care givers to be supported by cameras for navigating the patient hoist and that the caregiver would like to be warned by the hoist whenever the patient is feeling anxious. From the second hypothesis can be concluded that both caregivers and patients prefer eye contact more during the interaction than speech and physical contact.

Based on the results of the interviews and the survey seven requirements to improve the current passive hoist were made and implemented in the first design. Two of these requirements, which are more elaborated in the experiment, are ‘During the whole process eye contact between the patient and the nurse is guaranteed’ and ‘The hoist should be able to recognize anxiety in the patients’. To satisfy these two requirements cameras are implemented in the first design and software of Noldus was used to test the facial expressions of the patient. Additionally a traffic light system is implemented on the interface of the caregiver which is connected to the camera of the patient. Due to the implemented software of Noldus it could recognize facial emotions of the patient. This traffic light system had been tested and works sufficiently.

As the overall impression about the gathered feedback of design 1 is positive, it can be concluded that the implemented adjustments of design 1 are indeed an improvement of the current passive patient hoist. Due to this feedback some little adaptations have been done leading to the final design of the passive hoist. This all has resulted in the creation of two different end products, namely one new hoist design that consists of all adjustments, portrayed in figure 18, and another one that will function as an add-on for the current hoist, portrayed in figure 19.

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Figure 18: New hoist with the list of improvements implemented
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Figure 19: Current hoist with the Add-on

Future research

Finally possibilities for future research will be examined. The most important follow-up research that needs to be done is research on the actual implementation of the improved hoist. It needs to be researched in what extent the design improves the comfort for the patient and nurse and the effectiveness of the nurse. This can be done by actually producing the hoist and testing it in a nursing home under standard circumstances. Furthermore, a lot of other aspects need to be taken into account before the design can be implemented. For this research, only the primary users were considered, but before implementation takes place it is important to look into the requirements for secondary and tertiary users, too. For instance, the costs of the design are still unclear just like the regulation concerning the improvements. These aspects are beyond the scope of this research, but it should be investigated in future research. The patients and nurses could also be more directly involved with the implementation. In further research it would be recommended to include the users in the research group. Lastly, in the proposed design the nurse is still present during the transfer. However the proposed design can be a stepping stone towards full automation, because some of the needed technology for full automation is already implemented in our design. Thus it can make the caregivers and nurses become more familiar with robotics.

References

  1. http://www.domicare.nl/tilliften-badliften-verrijdbaar/
  2. http://www.arjohuntleigh.nl/producten/transfer-oplossingen/actieve-tilliften/
  3. 3.0 3.1 Johnsson C., Kjellberg K. & Lagerstrom M. (2004) A direct observation instrument for assessment of nurses’ patient transfer technique (DINO). Applied Ergonomics35 (6), 591–601.
  4. 4.0 4.1 http://ovidsp.tx.ovid.com.dianus.libr.tue.nl/sp-3.22.0a/ovidweb.cgi?QS2=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}}
  5. 5.0 5.1 Finlay, P. A. (1992). PAM: a robotic solution to patient handling. Industrial robot, 19(3), 13-15.
  6. Griffiths, H. (2012). Adverse risk: a ‘dynamic interaction model of patient moving and handling’. Journal of nursing management, 20(6), 713-736.
  7. Leanne S. Bohannon a,⇑ , Andrew M. Herbert b , Jeff B. Pelz c , Esa M. Rantanen, Eye contact and video-mediated communication: A review., file:///C:/Users/s130798/Documents/School/Year%203/Robots%20everywhere/Literatuuronderzoek%203-10/1-s2.0-S0141938212001084-main.pdf
  8. Todorović D. Geometrical basis of perception of gaze direction. Vision Research 46:3549-3562, 2006
  9. Franc Solina, Robert Ravnik, Fixing Missing Eye-Contact in Video Conferencing Systems, http://ieeexplore.ieee.org.dianus.libr.tue.nl/stamp/stamp.jsp?arnumber=5974027
  10. 10.0 10.1 Hwang et al. method and apparatus for providing eyecontact function to multiple points of attendance using stereo image in video conference system, 2016, http://www.freepatentsonline.com/20160150182.pdf
  11. Jinglin Zhang Cong Bai Jean-Francois Nezan Jean-Gabriel Cousin, Joint motion model for local stereo video-matching method,2015, http://opticalengineering.spiedigitallibrary.org.dianus.libr.tue.nl/article.aspx?articleid=2478969
  12. http://nordicapis.com/20-emotion-recognition-apis-that-will-leave-you-impressed-and-concerned/
  13. Zhao, M., Adib, F., & Katabi, D. (2016, October). Emotion recognition using wireless signals. In Proceedings of the 22nd Annual International Conference on Mobile Computing and Networking (pp. 95-108). ACM.
  14. Loijens, L. and Krips, O. FaceReader: Methodology Note, Retrieved from http://www.noldus.com/files/file_manager/downloads/whitepaper/FaceReader_Methodology.pdf

Appendix

Planning

Short version planning

  • Gathering information (week 1-3)


1) Interviews (week 2-4)

Making interview (week 2) (1h)

Conducting interviews (week 3-4) (10h)

Processing results interviews and conclusion (week 4) (4h)

2) Surveys (week 2-4)

Making survey (week2-3) ( https://docs.google.com/forms/d/e/1FAIpQLScinjbrL8rMoxs1CQOP0JCgIO3u_tavH2K1LGRcKIa9q_bFVA/viewform )

Conducting survey (week 3) (8h)

Processing results survey and conclusion (week 4) (4h)

3) Literature research (week 2-4)

State-of the-art (9h)

Human-Robot interaction (9h)

Specific (...h)

4) 1st design (week 4-5)

Design/sketch (perhaps 3D-model) (week 5-6) (4h)

Description (week 5) (10h)

5) Potentially prototype (week 5)

Reading in(4h)

Programming (7h)

6) Feedback (autorative) (week 4-6) (6h)

7) Potentially testing prototype (week 6) (10h)

8) Final design (week 7) (5h)

9) Wiki

Week 2-6 (Every member 1 hour per week for adding and restoring information etc)

Week 7 (each member 2 hours)

Extensive version planning

Weekly meetings

Personal tools