NegotiAge: Development and pilot testing of an artificial intelligence-based family caregiver negotiation program.

artificial intelligence education family caregivers negotiation

Journal

Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062

Informations de publication

Date de publication:
13 Jan 2024
Historique:
revised: 02 12 2023
received: 05 09 2023
accepted: 23 12 2023
medline: 13 1 2024
pubmed: 13 1 2024
entrez: 13 1 2024
Statut: aheadofprint

Résumé

Family caregivers of people with Alzheimer's disease experience conflicts as they navigate health care but lack training to resolve these disputes. We sought to develop and pilot test an artificial-intelligence negotiation training program, NegotiAge, for family caregivers. We convened negotiation experts, a geriatrician, a social worker, and community-based family caregivers. Content matter experts created short videos to teach negotiation skills. Caregivers generated dialogue surrounding conflicts. Computer scientists utilized the dialogue with the Interactive Arbitration Guide Online (IAGO) platform to develop avatar-based agents (e.g., sibling, older adult, physician) for caregivers to practice negotiating. Pilot testing was conducted with family caregivers to assess usability (USE) and satisfaction (open-ended questions with thematic analysis). Development: With NegotiAge, caregivers progress through didactic material, then receive scenarios to negotiate (e.g., physician recommends gastric tube, sibling disagrees with home support, older adult refusing support). Caregivers negotiate in real-time with avatars who are designed to act like humans, including emotional tactics and irrational behaviors. Caregivers send/receive offers, using tactics until either mutual agreement or time expires. Immediate feedback is generated for the user to improve skills training. Pilot testing: Family caregivers (n = 12) completed the program and survey. USE questionnaire (Likert scale 1-7) subset scores revealed: (1) Useful-Mean 5.69 (SD 0.76); (2) Ease-Mean 5.24 (SD 0.96); (3) Learn-Mean 5.69 (SD 0.74); (4) Satisfy-Mean 5.62 (SD 1.10). Items that received over 80% agreements were: It helps me be more effective; It helps me be more productive; It is useful; It gives me more control over the activities in my life; It makes the things I want to accomplish easier to get done. Participants were highly satisfied and found NegotiAge fun to use (91.7%), with 100% who would recommend it to a friend. NegotiAge is an Artificial-Intelligent Caregiver Negotiation Program, that is usable and feasible for family caregivers to become familiar with negotiating conflicts commonly seen in health care.

Sections du résumé

BACKGROUND BACKGROUND
Family caregivers of people with Alzheimer's disease experience conflicts as they navigate health care but lack training to resolve these disputes. We sought to develop and pilot test an artificial-intelligence negotiation training program, NegotiAge, for family caregivers.
METHODS METHODS
We convened negotiation experts, a geriatrician, a social worker, and community-based family caregivers. Content matter experts created short videos to teach negotiation skills. Caregivers generated dialogue surrounding conflicts. Computer scientists utilized the dialogue with the Interactive Arbitration Guide Online (IAGO) platform to develop avatar-based agents (e.g., sibling, older adult, physician) for caregivers to practice negotiating. Pilot testing was conducted with family caregivers to assess usability (USE) and satisfaction (open-ended questions with thematic analysis).
RESULTS RESULTS
Development: With NegotiAge, caregivers progress through didactic material, then receive scenarios to negotiate (e.g., physician recommends gastric tube, sibling disagrees with home support, older adult refusing support). Caregivers negotiate in real-time with avatars who are designed to act like humans, including emotional tactics and irrational behaviors. Caregivers send/receive offers, using tactics until either mutual agreement or time expires. Immediate feedback is generated for the user to improve skills training. Pilot testing: Family caregivers (n = 12) completed the program and survey. USE questionnaire (Likert scale 1-7) subset scores revealed: (1) Useful-Mean 5.69 (SD 0.76); (2) Ease-Mean 5.24 (SD 0.96); (3) Learn-Mean 5.69 (SD 0.74); (4) Satisfy-Mean 5.62 (SD 1.10). Items that received over 80% agreements were: It helps me be more effective; It helps me be more productive; It is useful; It gives me more control over the activities in my life; It makes the things I want to accomplish easier to get done. Participants were highly satisfied and found NegotiAge fun to use (91.7%), with 100% who would recommend it to a friend.
CONCLUSION CONCLUSIONS
NegotiAge is an Artificial-Intelligent Caregiver Negotiation Program, that is usable and feasible for family caregivers to become familiar with negotiating conflicts commonly seen in health care.

Identifiants

pubmed: 38217356
doi: 10.1111/jgs.18775
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIA NIH HHS
ID : R01AG068421
Pays : United States
Organisme : NIA NIH HHS
ID : R01AG058777
Pays : United States
Organisme : NIA NIH HHS
ID : R01AG083034
Pays : United States
Organisme : NIA NIH HHS
ID : P30AG05998
Pays : United States

Informations de copyright

© 2024 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.

Références

McKune SL. Caregiving: A National Profile and Assessment of Caregiver Services and Needs. Rosalynn Carter Institute; 2016.
Willink A, Davis K, Mulcahy J, Wolff JL. Use of paid and unpaid personal help by Medicare beneficiaries needing long-term services and supports. Issue Brief (Commonw Fund). 2017;2017:1-9.
Johnson RW, Wiener JM. A Profile of Older Americans and their Caregivers (Occasional Paper Number 8). The Urban Institute; 2006.
Family Caregiver Alliance. Definitions from National Center on Caregiving. 2021. Accessed September 1, 2023. https://www.caregiver.org/definitions-0
Vig EK, Sudore RL, Berg KM, Fromme EK, Arnold RM. Responding to surrogate requests that seem inconsistent with a patient's living will. J Pain Symptom Manage. 2011;42(5):777-782.
Scherbring M. Effect of caregiver perception of preparedness on burden in an oncology population. Oncol Nurs Forum. 2002;29(6):E70-E76.
Given B, Sherwood PR, Given CW. What knowledge and skills do caregivers need? J Soc Work Educ. 2008;44(sup3):115-123.
Reinhard SC, Given B, Huhtala N, Bemis A. Supporting family caregivers in providing care. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. AHRQ Publication No. 08-0043. Agency for Healthcare Research and Quality; 2008.
Krieger T, Feron F, Dorant E. Developing a complex intervention programme for informal caregivers of stroke survivors: the caregivers' guide. Scand J Caring Sci. 2017;31(1):146-156.
Garlo K, O'Leary JR, Van Ness PH, Fried TR. Burden in caregivers of older adults with advanced illness. J Am Geriatr Soc. 2010;58(12):2315-2322.
Andren S, Elmstahl S. Family caregivers' subjective experiences of satisfaction in dementia care: aspects of burden, subjective health and sense of coherence. Scand J Caring Sci. 2015;19(2):157-168.
Ko JY, Aycock DM, Clark PC. A comparison of working versus nonworking family caregivers of stroke survivors. J Neurosci Nurs. 2007;39(4):217-225.
Barken R. Reconciling tensions: needing formal and family/friend care but feeling like a burden. Can J Aging. 2017;36(1):81-96.
Lee JE, Shin DW, Cho J, et al. Caregiver burden, patients' self-perceived burden, and preference for palliative care among cancer patients and caregivers. Psychooncology. 2015;24(11):1545-1551.
Lilly MB, Robinson CA, Holtzman S, Bottorff JL. Can we move beyond burden and burnout to support the health and wellness of family caregivers to persons with dementia? Evidence from British Columbia, Canada. Health Soc Care Community. 2012;20(1):103-112.
Higginson I, Gao W. Caregiver assessment of patients with advanced cancer: concordance with patients, effect of burden and positivity. Health Qual Life Outcomes. 2016;6(42):110-114.
Farran CJ, Gilley DW, McCann JJ, Bienias JL, Lindeman DA, Evans DA. Efficacy of behavioral interventions for dementia caregivers. West J Nurs Res. 2007;29(8):944-960.
Foster M, Chaboyer W. Family carers of ICU survivors: a survey of the burden they experience. Scand J Caring Sci. 2003;17:205-214.
Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver burden: a clinical review. JAMA. 2010;311(10):1052-1060.
Ryan AA, Scullion HF. Nursing home placement: an exploration of the experiences of family carers. J Adv Nurs. 2000;32(5):1187-1195.
Pohl JM, Boyd C, Liang J, Given CW. Analysis of the impact of mother-daughter relationships on the commitment to caregiving. Nurs Res. 1995;44(2):68-75.
Aasbo G, Rugkasa J, Solbraekke KN, Werner A. Negotiating the care-giving role: family members' experience during critical exacerbation of COPD in Norway. Health Soc Care Community. 2017;25(2):612-620.
Koren D, Laidsaar-Powell R, Tilden W, Latt M, Butow P. Health care providers' perceptions of family caregivers' involvement in consultations within a geriatric hospital setting. Geriatr Nurs. 2018;39(4):419-427.
Jones CD, Jones J, Bowles KH, et al. Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study. J Hosp Med. 2019;14(2):90-95.
Kuluski K, McGeown M. “It's a waiting game” a qualitative study of the experience of carers of patients who require an alternate level of care. BMC Health Serv Res. 2017;17(1):318.
Takahashi PY, Finnie DM, Quigg SM, et al. Understanding experiences of patients and family caregivers in the Mayo Clinic Care Transitions program: a qualitative study. Clin Interv Aging. 2019;14:17-25.
Olasoji M, Maude P, McCauley K. Not sick enough: experiences of carers of people with mental illness negotiating care for their relatives with mental health services. J Psychiatr Ment Health Nurs. 2017;24(6):403-411.
Rajanala A, Ramirez-Zohfeld V, O'Conor R, Brown D, Lindquist LA. Conflicts experienced by caregivers of older adults with the health-care system. J Patient Exp. 2020;7(6):1130-1135.
Ury W. The Power of a Positive No: How to Say No and Still Get to Yes. Bantam Books; 2007.
Fisher R, Patton B, Ury W. Getting to Yes: Negotiating Agreement without Giving in (Rev. ed.). Penguin Books; 2011.
Bucher J, Loscalzo M, Zabora J, et al. Problem solving cancer care education for patients and caregivers. Cancer Pract. 2001;9(2):66-70.
Barg FK. A description of a psychoeducational intervention for family caregivers of cancer patients. J Fam Nurs. 1998;4:394-413.
Farran CJ. Efficacy of behavioral interventions for dementia caregivers. West J Nurs Res. 2007;29:944-960.
Lytle AL, Brett JM, Shapiro DL. The strategic use of interests, rights and power to resolve disputes. Negot J. 1999;15(1):31-49.
Mell J, Gratch J. IAGO: Interactive Arbitration Guide Online. In: Proceedings of the 2016 International Conference on Autonomous Agents and Multiagent Systems International Foundation for Autonomous Agents and Multiagent Systems. 2016.
Mell J. Towards social-emotional virtual humans. In: Proceedings of the 2015 International Conference on Autonomous Agents and Multiagent Systems International Foundation for Autonomous Agents and Multiagent Systems. 2015.
Mell J, Gratch J. Grumpy & Pinocchio: answering human-agent negotiation questions through realistic agent design. In: Proceedings of the 2017 International Conference on Autonomous Agents and Multiagent Systems. International Foundation for Autonomous Agents and Multiagent Systems. 2017.
Galvin JE, Roe CM, Powlishta KK, et al. The AD8: a brief informant interview to detect dementia. Neurology. 2005;65(4):559-564.
Rubin J, Chisnell D. Handbook of Usability Testing: How to Plan, Design and Conduct Effective Tests. John Wiley & Sons; 2008.
De Vito DA, Myers BA, Mc Curry KR, et al. User-centered design and interactive health technologies for patients. Comput Inform Nurs. 2009;27(3):175-183.
Brooke J. SUS: a retrospective. J Usability Stud. 2013;8(2):29-40.
Laver K, George S, Ratcliffe J, Crotty M. Measuring technology self efficacy: reliability and construct validity of a modified computer self-efficacy scale in a clinical rehabilitation setting. Disabil Rehabil. 2012;34(3):220-227.

Auteurs

Alaine Murawski (A)

Division of Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Vanessa Ramirez-Zohfeld (V)

Division of Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Johnathan Mell (J)

Department of Computer Science, University of Central Florida, Orlando, Florida, USA.

Marianne Tschoe (M)

Division of Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Allison Schierer (A)

Division of Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Charles Olvera (C)

Division of Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Jeanne Brett (J)

Kellogg School of Management, Northwestern University, Evanston, Illinois, USA.

Jonathan Gratch (J)

Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA.

Lee A Lindquist (LA)

Division of Geriatrics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Classifications MeSH