Zelf-monitoring van fysieke kwetsbaarheid
Een proactieve aanpak in de zorg voor thuiswonende ouderen
Summary
Self-monitoring of physical frailty
A proactive approach in community-dwelling elderly people
Joan Vermeulen
The main objective of the thesis was to develop and evaluate a self-monitoring and feedback system that can be used by community-dwelling older adults to gain insight into (changes in) indicators of physical frailty that are predictors of increased risk of disability. To achieve this, the following research questions were addressed: 1) What is the predictive value of physical frailty indicators on disability in communitydwelling older adults?, 2) Can simple, innovative technologies be used to obtain valid and reliable estimates of physical frailty indicators?, and 3) How can simple, innovative technologies be integrated into a selfmonitoring system that provides regular feedback to older adults regarding (changes in) physical frailty indicators? The studies described in the thesis show that physical frailty indicators (e.g., physical activity, weight, grip strength, balance) are predictive of disability development in community-dwelling older adults. Simple, innovative technologies that can be used by older adults to obtain valid and reliable estimates of these indicators are a bathroom scale that can measure weight and balance, a Gripball that can measure grip strength, and a smartphone that can measure physical activity during the day. These devices were incorporated into a self-monitoring and feedback system during a usercentered design process. Small scale usability tests and a pilot study show that the system satisfied most needs of the end users and, despite a few technical errors, older adults considered the system easyto use which resulted in good adherence to the daily monitoring regimen. Older adults indicated that they would appreciate it if their data could be forwarded to a care professional, for example the general practitioner or the practice nurse. The system could support and facilitate a more pro-active approach in early detection of increased risk for disability in community-dwelling older adults with a stronger focus on self-management.