Ecological assessments of activities of daily living and personal experiences with Mobus, an assistive technology for cognition: a pilot study in schizophrenia.

Neuroscience Cognitive Center CNRS UMR 5229, University of Lyon & Le Vinatier Hospital, France.
Assistive technology: the official journal of RESNA (Impact Factor: 0.51). 01/2012; 24(2):67-77. DOI: 10.1080/10400435.2012.659324
Source: PubMed

ABSTRACT Mobus is a cognitive orthotic designed for people with difficulties managing Activities of Daily Living (ADL), as encountered in schizophrenia. It provides a schedule manager as well as the possibility to report occurrences of symptomatic experiences. Receiving this information by Internet, caregivers can assist the patient rehabilitation process. Our aim was to explore the use and satisfaction of Mobus by people with schizophrenia. Nine outpatients tested Mobus for 6 weeks. Indicators of cognitive functioning and autonomy were measured with the CAmbridge Neuropsychological Tests Automated Battery (CANTAB) and the Independant Living Skills Scale (ILSS). On average, 42.6% of the planned ADL were validated and more than 1 symptom per week were reported. Mainly because of technical breakdown, more than 50% of the outpatients evaluated the Mobus satisfaction below 1.7/5, nevertheless 3 participants appreciated it greatly. Some enhancements were found on subscales of CANTAB and ILSS and some participants reported that they acquired planning skills by using Mobus. To ensure ease of use, refinements are needed from rehabilitation and technical approaches, especially to personalize the device. Discussions on ethical and methodological issues lead to an improved version of Mobus that will be tested with a larger sample size.

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    ABSTRACT: OBJECTIVE The aim of this review was to investigate to what extent information technology may support self-management among service users with psychotic disorders. The investigation aimed to answer the following questions: What types of e-mental health self-management interventions have been developed and evaluated? What is the current evidence on clinical outcome and cost-effectiveness of the identified interventions? To what extent are e-mental health self-management interventions oriented toward the service user? METHODS A systematic review of references through July 2012 derived from MEDLINE, PsycINFO, AMED, CINAHL, and the Library, Information Science and Technology database was performed. Studies of e-mental health self-management interventions for persons with psychotic disorders were selected independently by three reviewers. RESULTS Twenty-eight studies met the inclusion criteria. E-mental health self-management interventions included psychoeducation, medication management, communication and shared decision making, management of daily functioning, lifestyle management, peer support, and real-time self-monitoring by daily measurements (experience sampling monitoring). Summary effect sizes were large for medication management (.92) and small for psychoeducation (.37) and communication and shared decision making (.21). For all other studies, individual effect sizes were calculated. The only economic analysis conducted reported more short-term costs for the e-mental health intervention. CONCLUSIONS People with psychotic disorders were able and willing to use e-mental health services. Results suggest that e-mental health services are at least as effective as usual care or nontechnological approaches. Larger effects were found for medication management e-mental health services. No studies reported a negative effect. Results must be interpreted cautiously, because they are based on a small number of studies.
    Psychiatric services (Washington, D.C.) 10/2013; · 2.81 Impact Factor


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Jun 6, 2014