The Development of decision support system to promote active ageing for older people

Abstract

Thailand has become a completely ageing society as the global population trends. The increasing proportion of older Thai population in Thailand has had an impact on Thai society, economy, and public health. The increasing age of older people causes an increase in their degeneration, resulting in increased demand for health care. Therefore, all sectors that provide services for the elderly should be prepared to support the transition to a super-aged society. Nowadays, technology and innovation are used more frequently to promote the health of older people. While this is ongoing, Occupational therapy services play an important role in promoting and supporting the elderly to have a good quality of life, well-being, and the potential to perform their activities of daily living independently. Utilizing the advantages of technology can improve the efficiency of occupational therapy services. Technology can be utilized to facilitate both assessment and processing of recommendations for active ageing that precisely and accurately reflect the concept of occupational therapy. This study was on a research and development design. The objectives were as follows: 1) to develop a measurement of active ageing for older people; 2) to develop a decision support system (DSS) to enhance active ageing for older people; and 3) to test the inter-rater reliability of a web-based active ageing measurement and the usability testing of the DSS. The study was divided into three phases. Phase I was to develop a measurement of active ageing for older people. There were two steps in this phase: 1) review of the methods for measuring an active ageing index under the concept of the World Health Organization at national and international levels from 2013 to 2020; and 2) psychometric property testing in terms of content validity and reliability. Content validity was investigated by five experts, consisting of two occupational therapists, one doctor, one nurse, and one social worker. The results showed an index of item objective congruence of between 0.90 and 1.00. Internal consistency and test-retest reliability were tested for reliability by thirty elderly people at the service center of Nongpakrang municipality, Mueang district, Chiang Mai province. The results showed that Cronbach’s alpha coefficient was 0.77 and Pearson’s correlation coefficient was 0.89. Then, the active ageing measurement was investigated the active ageing level in two hundred older people who lived in three communities: 1) Mueang municipality, Mueang district; 2) Sannameng municipality, Sansai district; and 3) Kewlaeluang village, Yuwa sub-district, Sanpatong district, Chiang Mai province. The finding revealed that thirty-two older people had a high active ageing level (Active Ageing Index: AAI = 0.82), one hundred older people had a moderate level (AAI = 0.77) and none of the older people had a low level. Phase II was the development of a DSS consisting of two steps: the development of sets of recommendations and the development of a web-based DSS. To develop sets of recommendations, a qualitative method was utilized to interview seventeen experts, including occupational therapists and older people in Chiang Mai province. The Data were analyzed using thematic analysis. Then, the analyzed data were integrated with the conceptual framework of occupational therapy, which was the Person-Environment-Occupation (PEO) model to obtain 12 sets of recommendations (300 items). The step of designing and developing the web-based DSS. The system requirement was explored using the interview method with eight occupational therapists. This system requirement consisted of seven parts, as follows: 1) login page; 2) main page; 3) register page; 4) active ageing measurement; 5) decision-making for older people; 6) the OT recommendation system; and 7) export information. Then a decision support system was developed by the software engineering team. After the development of the web-based DSS was completed, it was then brought to occupational therapists for trial with older people. The web-based DSS was improved by following user feedback to satisfy their demands for better completeness. The system performs analysis to generate recommendations for encouraging active ageing for each individual older person. Phase III was the testing of the inter-rater reliability of the web-based active ageing measurement and usability testing of the web-based DSS. The inter-rater reliability was examined by five occupational therapists using the web-based active ageing measurement to calculate intraclass correlation coefficient (ICC). The ICC value was 0.97, indicating very high reliability. The usability of the web-based DSS was tested by thirty occupational therapists in Chiang Mai, each of whom tried it out for five cases within five weeks. The effectiveness of the web-based DSS was investigated using the System Usability Scale (SUS). The result was found that the SUS score was 80.41, indicating that the web-based DSS had excellent usability in terms of effectiveness, efficiency, and satisfaction. The web-based DSS was developed as a result of this study. It is an innovative development to support occupational therapy services for promoting and supporting the active ageing of older people. This innovation can encourage older people to have the potential to perform daily life activities from an occupational therapy perspective. The system utilizes processing to provide recommendations specific to each older person. In summary, the web-based DSS is an innovation that occupational therapists can use efficiently in providing occupational therapy services in terms of promotion and prevention.