Teses de Doutoramento
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Browsing Teses de Doutoramento by Sustainable Development Goals (SDG) "03:Saúde de Qualidade"
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- From design to evaluation: a human-centered approach to AI-powered remote cognitive training for stroke patientsPublication . Paulino, Teresa da Conceição Madureira; Cameirão, Mónica da SilvaStroke is a leading cause of long-term disability worldwide, often resulting in cognitive impairments that significantly impact patients' quality of life and independence. This doctoral thesis presents the design, development of the client-side modules, and evaluation of the NeuroAIreh@b platform, a remote cognitive training system specifically tailored for stroke survivors. The focus of this thesis is dual. First, a focus on a comprehensive human-centered design approach was used to design the modular platform that addresses the specific needs of stroke patients and healthcare professionals. Second, the automation of cognitive training through the development of the software module Reh@Sync allows the training to be performed remotely with reduced need for therapist intervention. The system integrates a set of cognitive training apps that incorporate activities of daily living, enhancing ecological validity and potential skill transfer to real-life situations. One of the key innovations of the Reh@Sync is the implementation of personalization and difficulty adaptation features, which use cognitive profiles and machine learning models to tailor interventions to the individual patient's needs and abilities. Moreover, the engineered system can universally integrate independent apps beyond the cognition dimension, making it a multipurpose system for multidimensional training. The design process involved multiple stakeholders and employed various techniques, including requirements engineering, ideation sessions, prototyping, and iterative usability evaluations. The development phase resulted in a modular system capable of integrating multiple cognitive training apps while maintaining customizability for individual users. The results of a feasibility study with 10 chronic stroke survivors who used the system for 4 weeks showed high levels of adherence, usability, and user satisfaction, indicating the potential for widespread adoption in home based rehabilitation settings. Regarding clinical outcomes after the intervention, we observed significant improvements for a subgroup that showed baseline cognition below the norm. Evaluation of the automation process revealed that the system efficiently personalized and adapted the training to each participant's profile. This research contributes to the fields of cognitive rehabilitation, informatics engineering, and human-computer interaction by providing a detailed account of the design, engineering, and development process of an automated remote cognitive training system for stroke survivors. The findings support the feasibility of self-administered digital cognitive training and highlight areas for future improvements, including expanding the difficulty range to accommodate higher-functioning individuals and incorporating a wider variety of content to enhance engagement.
- Virtual environments for improving the emotional states of informal caregivers: the role of digital nature and virtual companionsPublication . Peres, Beatriz Rodrigues Jardim Rino; Lopes, Daniel Simões; Jorge, Joaquim Armando PiresBy 2050, the global senior population is expected to double to 2.1 billion, including 426 million aged over 80, significantly increasing the number of informal caregivers. Caring for family members with Alzheimer’s and Related Dementias presents emotional and physical challenges, worsened by the need to balance caregiving with full-time jobs and limited time for self-care. Interaction with nature is a type of self-care activity that improves emotional states, but caregivers often struggle to access these environments due to time. With this, this thesis explores interventions to enhance the emotional state of informal caregivers, focusing on digital and virtual natural environments and types of companionship. This research begins by examining how reminders improve self-care practices and then how digital and virtual natural environments affect caregivers’ emo tional states. We also explore the benefits of virtual companionship on their emotional state. Findings show that digital and virtual natural environments significantly boost caregivers’ emotional state, especially when they can choose their settings. Virtual companionship, such as interacting with a virtual dog, reduces tension, boosts energy, fosters feelings of safety, and alleviates loneliness. These results highlight the poten tial of virtual companionship and virtual natural environments to improve the emotional state of informal caregivers of family members with Alzheimer’s and Related Demen tias.