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Search Results (921)

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Keywords = User-Centered Design

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30 pages, 3274 KB  
Article
Development of a Smart and Sustainable Rating System Platform for Saudi Neighborhoods
by Salma Dahab, Yusuf A. Adenle and Habib M. Alshuwaikhat
Urban Sci. 2025, 9(11), 466; https://doi.org/10.3390/urbansci9110466 - 6 Nov 2025
Abstract
Cities around the world are facing growing challenges related to climate change, urban sprawl, infrastructure strain, and digital transformation. In response, smart and sustainable urban development has become a global focus, aiming to integrate technology and environmental stewardship to improve the quality of [...] Read more.
Cities around the world are facing growing challenges related to climate change, urban sprawl, infrastructure strain, and digital transformation. In response, smart and sustainable urban development has become a global focus, aiming to integrate technology and environmental stewardship to improve the quality of life. The smart and sustainable city concept is typically applied at the city scale; however, its impact is most tangible at the neighborhood level, where residents interact directly with infrastructure, services, and community spaces. A variety of global frameworks have been developed to assess sustainability and technological integration. However, these models often fall short in addressing localized needs, particularly in regions with distinct environmental and cultural contexts. In Saudi Arabia, Vision 2030 emphasizes livability, sustainability, and digital transformation, yet there remains a lack of tailored tools to evaluate smart and sustainable progress at the neighborhood scale. This study develops HayyScore, a localized evaluation framework and prototype digital platform developed to assess neighborhood performance across five core categories: (i) Environment and Urban Resilience, (ii) Smart Infrastructure and Governance, (iii) Mobility and Accessibility, (iv) Quality of Life and Social Inclusion, and (v) Economy and Innovation. The HayyScore platform operationalizes this framework through an interactive web-based tool that allows users to input data through structured forms, calculate scores, receive category-based and overall certification levels, and view results through visual dashboards. The methodology involved a comprehensive review of global frameworks, expert input to define localized indicators, and iterative prototyping of the platform using Python 3.13.5 and Streamlit 1.45.1. To demonstrate its practical application, the prototype was tested on two Saudi neighborhoods: King Abdullah Petroleum Studies and Research Center (KAPSARC) and King Fahd University of Petroleum and Minerals (KFUPM). Key platform features include automated scoring logic, category weighting, certification generation, dynamic performance charts, and a rankings page for comparing multiple neighborhoods. The platform is designed to be scalable, with the ability to add new indicators, support multilingual access, and integrate with real-time data systems in future iterations. Full article
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20 pages, 1361 KB  
Review
State-of-the-Art HCI for Dementia Care: A Scoping Review of Recent Technological Advances
by Yong Ma, Yuchong Zhang, Oda Elise Nordberg, Arvid Rongve, Miroslav Bachinski and Morten Fjeld
J. Dement. Alzheimer's Dis. 2025, 2(4), 41; https://doi.org/10.3390/jdad2040041 - 6 Nov 2025
Abstract
Dementia significantly impacts cognitive, behavioral, and functional abilities, creating challenges for both individuals and caregivers. Recent advancements in HCI have introduced innovative technological solutions to support people with dementia (PwD) and their caregivers. This scoping review systematically examines 32 recent publications from leading [...] Read more.
Dementia significantly impacts cognitive, behavioral, and functional abilities, creating challenges for both individuals and caregivers. Recent advancements in HCI have introduced innovative technological solutions to support people with dementia (PwD) and their caregivers. This scoping review systematically examines 32 recent publications from leading digital libraries, categorizing technological interventions into four key domains: Assistive and Smart Technology for Daily Life, Social Interaction and Communication, Well-being and Psychological Support, and Caregiver Support and Training. Our analysis highlights how emerging technologies are transforming dementia care. These technologies enhance quality of life by promoting independence, fostering social engagement, and providing emotional and cognitive support. However, the review also identifies critical gaps, particularly in addressing the needs of individuals with early-stage dementia and the lack of individualized support mechanisms. By emphasizing user-centered design, accessibility, and ethical considerations, this paper offers a structured roadmap for future research and practice in dementia care. It bridges the gap between technological innovation and the real-world needs of PwD and their caregivers, providing valuable insights for researchers, practitioners, and policymakers. This review not only synthesizes current advancements but also sets the stage for future HCI-driven innovations in dementia care, aiming to improve outcomes for an aging global population. Findings primarily reflect older adults; implications for early-onset dementia are discussed. Full article
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21 pages, 1981 KB  
Systematic Review
User-Centered Perspectives in Prefabricated Timber Buildings: A Scoping Review
by Ludovica Maria Campagna, Francesco Carlucci and Francesco Fiorito
Buildings 2025, 15(21), 3979; https://doi.org/10.3390/buildings15213979 - 4 Nov 2025
Viewed by 135
Abstract
The construction of prefabricated timber buildings is a topic of growing interest, although research has primarily focused on technological aspects, while the users’ perspective remains underexplored. Accordingly, this paper aims to map the existing literature on prefabricated wooden buildings from a user-centered perspective, [...] Read more.
The construction of prefabricated timber buildings is a topic of growing interest, although research has primarily focused on technological aspects, while the users’ perspective remains underexplored. Accordingly, this paper aims to map the existing literature on prefabricated wooden buildings from a user-centered perspective, considering the whole-building scale. A systematic literature search of publications between 2010 and 2025 was conducted following PRISMA guidelines, identifying relevant studies. A bibliometric analysis was then performed to map key research themes, which were further examined through a scoping review. Four main themes emerged, i.e., indoor comfort, indoor air quality, sustainability and energy efficiency, and building architectural design. The findings highlight numerous aspects that should be considered in prefabricated timber buildings design, including thermal, vibrational and acoustic comfort, air pollutant and ventilation control, user behavior in relation to energy use, and spatial design based on users’ needs. However, the limited number of existing studies makes comprehensive evaluation difficult. Furthermore, the results emphasize the need for multidisciplinary approaches to adequately integrate user experience into the design of these buildings. Full article
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28 pages, 6288 KB  
Article
Advancing Sustainability Through an IoT-Driven Smart Waste Management System with Software Engineering Integration
by Reem Alnanih, Lamiaa Elrefaei and Ayman Al-Ahwal
Sustainability 2025, 17(21), 9803; https://doi.org/10.3390/su17219803 - 3 Nov 2025
Viewed by 230
Abstract
Sustainability in software engineering encompasses environmental, human, social, and economic dimensions, each essential for ensuring software’s positive and lasting impact. This paper presents an innovative Internet of Things (IoT)-based Smart Waste Management (SWM) system. The proposed system addresses key limitations in existing solutions, [...] Read more.
Sustainability in software engineering encompasses environmental, human, social, and economic dimensions, each essential for ensuring software’s positive and lasting impact. This paper presents an innovative Internet of Things (IoT)-based Smart Waste Management (SWM) system. The proposed system addresses key limitations in existing solutions, including lack of real-time responsiveness, inefficient routing, inadequate emergency detection, and limited user-centric design. While prior studies have investigated IoT applications in SWM, challenges remain in achieving dynamic, integrated, and scalable systems for sustainable urban development. The proposed solution introduces a holistic architecture that enables real-time monitoring of waste bin levels and fire incidents through Waste Bin Level Monitoring Units (BLMUs) equipped with ultrasonic and flame sensors. Data is transmitted via Wi-Fi to a centralized City Command and Control Center (4C), allowing for automated alerts and dynamic route optimization. A dual-platform software suite supports both administrative and operational workflows: a desktop web application and a role-based Android mobile app developed in Flutter, and integrated with Google Cloud Firestore, enabling centralized data management and efficient resource allocation. We validated the system through a working prototype, demonstrating notable contributions including enhanced emergency responsiveness, optimized waste collection routes, and improved stakeholder engagement. This research contributes to the advancement of sustainable urban infrastructure by offering a scalable, data-driven SWM framework grounded in software engineering principles and aligned with smart city objectives. This paper presents an innovative IoT-based Smart Waste Management (SWM) system that addresses key limitations in existing solutions, including insufficient real-time responsiveness, inefficient routing, inadequate emergency detection, and limited user-centric design. Full article
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17 pages, 1595 KB  
Article
Long-Term Preservation of Emotion Analyses with OAIS: A Software Prototype Design Approach for Information Package Conversion in KM-EP
by Verena Schreyer, Michael Pfalzgraf, Marco Xaver Bornschlegl and Matthias Hemmje
Information 2025, 16(11), 951; https://doi.org/10.3390/info16110951 - 3 Nov 2025
Viewed by 238
Abstract
Ensuring the long-term preservation of complex, multimodal research, data such as video-based Emotion Analyses, is a growing challenge in digital science. Although numerous standards like OAIS, METS, and PREMIS define principles for sustainable archiving, their concrete integration into operational research environments remains limited. [...] Read more.
Ensuring the long-term preservation of complex, multimodal research, data such as video-based Emotion Analyses, is a growing challenge in digital science. Although numerous standards like OAIS, METS, and PREMIS define principles for sustainable archiving, their concrete integration into operational research environments remains limited. This paper presents a software design approach for OAIS-compliant preservation that enables automated transformation, packaging, and validation of Emotion-Data Packages within the Knowledge Management Ecosystem Portal (KM-EP). The proposed prototype converts analysis data into archival formats, generates structured METS/PREMIS metadata, and embeds integrity and authenticity checks through hash values and digital signatures. A user-centered, step-by-step configuration interface supports both export and reimport of Emotion-Data Packages. The work provides a specific use case of implementing OAIS-compliant long-term preservation in the KM-EP context. Full article
(This article belongs to the Special Issue Advances in Human-Centered Artificial Intelligence)
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36 pages, 1841 KB  
Article
IoT-Enabled Digital Nudge Architecture for Sustainable Energy Behavior: An SEM-PLS Approach
by Feisal Hadi Masmali, Syed Md Faisal Ali Khan and Tahir Hakim
Technologies 2025, 13(11), 504; https://doi.org/10.3390/technologies13110504 - 1 Nov 2025
Viewed by 453
Abstract
The growing need for sustainable energy practices necessitates technology-driven interventions that can effectively bridge the disparity between consumer intentions and actual behavior. This paper formulates and empirically substantiates an IoT-enabled digital nudge architecture designed to promote sustainable energy behavior. The architecture provides goal-setting, [...] Read more.
The growing need for sustainable energy practices necessitates technology-driven interventions that can effectively bridge the disparity between consumer intentions and actual behavior. This paper formulates and empirically substantiates an IoT-enabled digital nudge architecture designed to promote sustainable energy behavior. The architecture provides goal-setting, social comparison, feedback, and informational nudges across multiple digital channels, utilizing linked devices, data processing layers, and a rule-based nudge engine. An 815-responder survey was analyzed using structural equation modeling with partial least squares (SEM-PLS) to identify the drivers of sustainable energy behavior and explore technology readiness as a moderating factor. The results show that nudges utilizing the Internet of Things (IoT) significantly enhance the alignment between intention and behavior. Goal-setting and feedback mechanisms have the highest effects. The findings also demonstrate that being ready for new technology improves nudge response, highlighting the importance of user-centered system design. This paper presents a scalable infrastructure for integrating IoT into sustainability projects, as well as theoretical contributions to technology adoption and behavioral intervention research. The study enhances the dialogue on environmental technology by illustrating the implementation of digital nudges through IoT infrastructures to expedite progress toward the Sustainable Development Goals (SDGs). Full article
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20 pages, 1446 KB  
Article
Design Thinking for the Development of an Affordable Pea Sheller: Addressing Co-Design in Rural Areas
by Ivonne Angelica Castiblanco Jimenez and Joan Paola Cruz Gonzalez
AgriEngineering 2025, 7(11), 360; https://doi.org/10.3390/agriengineering7110360 - 1 Nov 2025
Viewed by 340
Abstract
Manual pea shelling is a labor-intensive task facing small-scale farmers in rural areas, requiring substantial physical effort and limiting productivity. This study employed a Design Thinking methodology to co-design an affordable, automatic pea sheller addressing the specific needs of resource-constrained farmers. The methodology [...] Read more.
Manual pea shelling is a labor-intensive task facing small-scale farmers in rural areas, requiring substantial physical effort and limiting productivity. This study employed a Design Thinking methodology to co-design an affordable, automatic pea sheller addressing the specific needs of resource-constrained farmers. The methodology comprised five phases: empathizing with farmers through interviews, defining technical specifications from user requirements and benchmarking analysis, ideating preliminary concepts through collaborative brainstorming, prototyping using 3D-printed food-grade materials, and testing with end-users under real operating conditions. The developed sheller features counter-rotating rollers operating at optimized speed with dual compartments for grain and shell separation. Experimental validation demonstrated good extraction efficiency with minimal grain damage, while field testing confirmed substantial time reduction compared to manual shelling and strong user acceptance. The fully 3D-printable design enables affordable, customizable production suitable for small-scale operations, demonstrating how user-centered co-design can create accessible agricultural technology that addresses both technical performance and socioeconomic constraints in rural communities. Full article
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20 pages, 68979 KB  
Article
Investigating the Role of Personality in Appearance Preferences for Huggable Communication Interfaces: A User-Centered Study
by Eleuda Nunez, Barbara Sienkiewicz, Valentina Ramirez Millan, Bipin Indurkhya and Kenji Suzuki
Electronics 2025, 14(21), 4295; https://doi.org/10.3390/electronics14214295 - 31 Oct 2025
Viewed by 177
Abstract
As alternative remote communication interfaces become increasingly common, ensuring that they seamlessly integrate into daily life has become a pressing design challenge. In this context, what should a huggable communication device look like—should it have arms or a face, or resemble a conventional [...] Read more.
As alternative remote communication interfaces become increasingly common, ensuring that they seamlessly integrate into daily life has become a pressing design challenge. In this context, what should a huggable communication device look like—should it have arms or a face, or resemble a conventional pillow? This study investigates users’ preferences and personalities regarding the appearance of such interfaces for remote emotional interaction. As a case study, we present HugBits, a round, cushion-like device that transmits hugs through visual and tactile feedback. Drawing on the prior literature and a participatory design workshop, we developed seven shape variations and evaluated them through an online survey with 79 Polish participants. The results reveal a consistent preference for less anthropomorphic designs, with users valuing comfort, simplicity, and intuitive affordances such as areas to rest the head or wrap the arms around. Although personality traits did not significantly predict preferences, the findings highlight broader design criteria: huggable communication interfaces, intended to remain visible and available in shared spaces, must balance emotional expressiveness with social acceptability. These insights provide guidelines for designing emotionally engaging, user-centered mediated touch technologies. Full article
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20 pages, 2503 KB  
Article
Towards Digital Transformation in SMEs: A Custom Software Solution for Shopfloor–ERP Integration
by Bárbara Amaro, Abílio Borges, Angela Semitela and António Completo
Machines 2025, 13(11), 1002; https://doi.org/10.3390/machines13111002 - 31 Oct 2025
Viewed by 289
Abstract
The increasing complexity of mechanical manufacturing demands intelligent, integrated solutions to maintain high levels of precision, efficiency, and traceability. While ERP systems provide centralized management for core business functions, they often fall short in addressing operational-level workflows on the shopfloor. This paper presents [...] Read more.
The increasing complexity of mechanical manufacturing demands intelligent, integrated solutions to maintain high levels of precision, efficiency, and traceability. While ERP systems provide centralized management for core business functions, they often fall short in addressing operational-level workflows on the shopfloor. This paper presents the development and implementation of GIP (Gestão Integrada de Produção—Integrated Production Management), a custom software solution designed to bridge this gap for a small-to-medium enterprise (SME) specializing in precision mechanical components. GIP automates manual tasks such as technical drawing validation, file management, and part tracking, significantly reducing approval times and human error while enhancing traceability through unique DataMatrix part marking and centralized data logging. Developed with a modular, user-centered design using C# and SQL Server, the system integrates seamlessly with existing ERP infrastructure, following Industry 4.0 principles. Its deployment resulted in quantifiable improvements in productivity, data security, interdepartmental communication, and project delivery times. The success of GIP underscores the benefits of complementing ERP platforms with task-specific tools tailored to real user workflows. This approach aligns with smart manufacturing trends such as digital threads and digital twins, laying the groundwork for future enhancements in predictive maintenance and real-time analytics. GIP demonstrates how agile, scalable digital tools can drive competitiveness in modern industrial environments. Full article
(This article belongs to the Section Automation and Control Systems)
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27 pages, 1286 KB  
Systematic Review
Smart Speakers for Health and Well-Being of Older Adults: A Mixed-Methods Review
by Michael Joseph Dino, Carla Leinbach, Gerald Dino, Ladda Thiamwong, Chloe Margalaux Villafuerte, Mona Shattell, Justin Pimentel, Maybelle Anne Zamora, Anbel Bautista, John Paul Vitug, Joyline Chepkorir and Nerceilyn Marave
Healthcare 2025, 13(21), 2772; https://doi.org/10.3390/healthcare13212772 - 31 Oct 2025
Viewed by 345
Abstract
Background: Rapid population aging poses significant challenges to health and wellness systems, necessitating innovative technological interventions. Smart home technologies, particularly voice-activated intelligent assistants (smart speakers), represent a promising avenue for supporting aging populations. Objectives: This study critically examines the empirical literature on smart [...] Read more.
Background: Rapid population aging poses significant challenges to health and wellness systems, necessitating innovative technological interventions. Smart home technologies, particularly voice-activated intelligent assistants (smart speakers), represent a promising avenue for supporting aging populations. Objectives: This study critically examines the empirical literature on smart speakers’ influence on older adults’ health and well-being, mapping the characteristics of existing studies, assessing the current state of this domain, and providing a comprehensive overview. Methods: A mixed-methods systematic review was conducted in accordance with published guidelines. Bibliometric data, article purposes and outcomes, keyword network analysis, and mixed-methods findings from articles retrieved from five major databases were managed through the Covidence and VosViewer applications. Results: The majority of studies were conducted in the American region. Bibliometric analysis revealed five predominant thematic clusters: health management, psychological support, social connectedness, technology adoption, and usability. Findings demonstrated multifaceted benefits across several domains. Older adults reported improvements in daily living activities, enhanced emotional well-being, strengthened social connections, and overall health benefits. Qualitative evidence particularly emphasized the advantages of medication adherence, routine maintenance, and facilitated social support. However, mixed-method synthesis revealed significant barriers to adoption and sustained use, including privacy concerns, technical difficulties, cost constraints, and limited digital literacy among older users. Conclusions: The integration of smart speakers into the homes of older adults offers considerable potential to enhance technological wellness and promote successful aging in place, underscoring the need for structured integration of smart speaker technology and human-centered designs within geriatric care systems. Full article
(This article belongs to the Section Digital Health Technologies)
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18 pages, 18287 KB  
Article
Daily Life Adaptation in Autism: A Co-Design Framework for the Validation of Virtual Reality Experiential Training Systems
by Agata Marta Soccini and Alessandro Clocchiatti
Electronics 2025, 14(21), 4268; https://doi.org/10.3390/electronics14214268 - 30 Oct 2025
Viewed by 339
Abstract
Individuals with Autism Spectrum Disorder often experience distress or discomfort when facing changes in daily routines, particularly during major transitions such as beginning attendance at a Day Activity Center. To address this challenge, we designed and developed a virtual reality system based on [...] Read more.
Individuals with Autism Spectrum Disorder often experience distress or discomfort when facing changes in daily routines, particularly during major transitions such as beginning attendance at a Day Activity Center. To address this challenge, we designed and developed a virtual reality system based on an interactive digital twin of an actual center. The application allows users to explore the environment and engage in typical daily activities through repeated exposures in an immersive, caregiver-guided virtual setting, following an experiential training approach. The current study presents a method for validating the system, conducted with individuals formally diagnosed with Autism at DSM-5 Level 1 and currently attending the center, within a user-centered co-design framework. The results indicate that the system is both usable and suitable for the target population, and the caregiver’s presence is perceived as important for an enjoyable and supportive experience. The proposed framework can be adapted to other use cases and used for the validation of virtual reality systems for people on the spectrum at different levels. Full article
(This article belongs to the Special Issue Virtual Reality Applications in Enhancing Human Lives)
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27 pages, 1283 KB  
Article
Salutogenic Factors and Sustainable Development Criteria in Architectural and Interior Design: Analysis of Polish and EU Standards and Recommendations
by Agnieszka Rek-Lipczyńska
Sustainability 2025, 17(21), 9661; https://doi.org/10.3390/su17219661 - 30 Oct 2025
Viewed by 268
Abstract
This article examines the integration of salutogenic design principles into the legal and regulatory framework for buildings in Poland, situating the analysis within a broader European and international context. The study combines a systematic literature review, a comparative analysis of Polish building law [...] Read more.
This article examines the integration of salutogenic design principles into the legal and regulatory framework for buildings in Poland, situating the analysis within a broader European and international context. The study combines a systematic literature review, a comparative analysis of Polish building law and technical conditions with international standards and empirical evidence from case studies and Post-Occupancy Evaluations (POE) conducted in hospitals, offices, and schools. This triangulated approach allowed for both qualitative and quantitative assessment of key salutogenic factors, including daylight access, acoustic comfort, air quality, thermal conditions, aesthetics, ergonomics, and opportunities for social interaction. The results demonstrate that Polish regulations continue to focus on minimum hygienic and safety requirements, thereby reflecting a pathogenic rather than salutogenic approach. While some factors—such as daylight and ventilation—are partially included, critical dimensions of psychosocial well-being remain underrepresented. By contrast, both European EN standards and voluntary frameworks such as WELL systematically incorporate broader salutogenic dimensions. Evidence from Polish POE studies further highlights gaps between regulatory compliance and actual user experiences, e.g., excessive hospital noise, insufficient lighting in operating rooms, and the absence of biophilic or therapeutic features. The discussion highlights challenges of measurability, economic feasibility, and stakeholder acceptance, while also emphasizing long-term health and social benefits. The conclusions recommend incorporating salutogenic principles into Polish law and sustainability policies, promoting pilot projects, and strengthening interdisciplinary collaboration. In this way, buildings can evolve from merely preventing harm to actively supporting health, well-being, and resilience—aligning with global trends in human-centered sustainable design. Full article
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29 pages, 3217 KB  
Article
Integrating Artificial Intelligence, Electronic Health Records, and Wearables for Predictive, Patient-Centered Decision Support in Healthcare
by Deepa Fernandes Prabhu, Varadraj Gurupur, Alexa Stone and Elizabeth Trader
Healthcare 2025, 13(21), 2753; https://doi.org/10.3390/healthcare13212753 - 30 Oct 2025
Viewed by 732
Abstract
This study explores how patients and stakeholders envision integrated digital health systems. Background/Objectives: Integrating artificial intelligence (AI), wearable data, electronic health records (EHRs), and patient-reported outcomes could enable proactive and personalized healthcare. However, current solutions remain fragmented and poorly aligned with user expectations. [...] Read more.
This study explores how patients and stakeholders envision integrated digital health systems. Background/Objectives: Integrating artificial intelligence (AI), wearable data, electronic health records (EHRs), and patient-reported outcomes could enable proactive and personalized healthcare. However, current solutions remain fragmented and poorly aligned with user expectations. This study aimed to explore patient and stakeholder needs for AI-driven integration and propose a conceptual framework to inform future system design. Methods: As part of the NSF Innovation Corps (I-Corps) program, we conducted semi-structured interviews with 44 participants representing Health Enthusiasts, Chronic Condition Managers, and Low-Engagement Users. Interviews followed the I-Corps customer discovery framework and were thematically analyzed using a hybrid deductive–inductive approach. Results: Participants highlighted four priorities: (i) interoperability and unification of data from wearables, EHRs, and self-reports; (ii) actionable personalization with predictive insights; (iii) trust and transparency in AI recommendations, often requiring clinician oversight; and (iv) usability through low-friction, intuitive interfaces. Age- and persona-specific differences emerged: younger participants favoring predictive features and older participants emphasizing safety, reassurance, and clinical integration. Conclusions: This exploratory qualitative study identified stakeholder needs that informed a conceptual framework for integrated digital health platforms. While preliminary, the framework provides a blueprint for future technical development and validation of patient- and provider-centered systems. Full article
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23 pages, 980 KB  
Article
Development and Evaluation of a Self-Assessment Tool for Family Caregivers: A Step Toward Empowering Family Members
by Laura Schwedler, Jan P. Ehlers, Thomas Ostermann and Gregor Hohenberg
Nurs. Rep. 2025, 15(11), 385; https://doi.org/10.3390/nursrep15110385 - 29 Oct 2025
Viewed by 410
Abstract
Background/Objectives: Family members who provide care play a central but often underestimated role in the healthcare system and are frequently exposed to considerable physical, emotional, and social stress. To better understand and support their needs, a structured self-assessment tool (SSA-PA) was developed. This [...] Read more.
Background/Objectives: Family members who provide care play a central but often underestimated role in the healthcare system and are frequently exposed to considerable physical, emotional, and social stress. To better understand and support their needs, a structured self-assessment tool (SSA-PA) was developed. This development addresses the current lack of practical, validated instruments that enable caregivers to systematically reflect on their own stress levels and resources, which is becoming increasingly important in view of the growing demand for care and the risk of caregiver burnout. This tool aims to promote self-reflection, identify individual stresses and resources, and enable more targeted support for family caregivers. Methods: The development process (September–December 2024) followed a multi-phase design that integrated theoretical foundations from nursing, health, and psychology, in particular Orem’s theory of self-care deficit, Lazarus and Folkman’s stress and coping model, and Engel’s biopsychosocial model. Four core dimensions were defined: (1) health and self-care, (2) burden and stress, (3) support and resources, and (4) satisfaction and quality of life. The final tool comprises 37 items (mostly 5-point Likert scales), supplemented by multiple-choice and open-ended questions. Content validity was ensured through expert review and testing with nine family caregivers. Internal consistency was assessed using Cronbach’s alpha (α = 0.998), indicating very high reliability, although possible item redundancies were identified. The evaluation took place in January 2025 with 33 family caregivers to assess user-friendliness, relevance, and perceived usefulness. Results: The majority of participants rated the tool as user-friendly and clearly structured. Around 80% reported a high level of comprehensibility, and over half stated that the tool provided new insights into their own health and care burden. Qualitative feedback highlighted the value of the tool for self-reflection and motivation to seek external support. Suggestions for improvement included shorter item formulations, improved visual feedback (e.g., progress bars or charts), and expanded question areas on financial burdens and digital support options. Conclusions: The SSA-PA is a theoretically grounded and user-centered tool for assessing and reflecting on the situation of family caregivers. It not only enables systematic self-assessments but also promotes awareness and proactive coping strategies. Future research should focus on conducting factor analyses to further validate the construct, testing the tool in larger samples, and exploring its integration into structured care consultations to improve the quality of home care. Full article
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27 pages, 624 KB  
Article
Explainable AI for Clinical Decision Support Systems: Literature Review, Key Gaps, and Research Synthesis
by Mozhgan Salimparsa, Kamran Sedig, Daniel J. Lizotte, Sheikh S. Abdullah, Niaz Chalabianloo and Flory T. Muanda
Informatics 2025, 12(4), 119; https://doi.org/10.3390/informatics12040119 - 28 Oct 2025
Viewed by 884
Abstract
While Artificial Intelligence (AI) promises significant enhancements for Clinical Decision Support Systems (CDSSs), the opacity of many AI models remains a major barrier to clinical adoption, primarily due to interpretability and trust challenges. Explainable AI (XAI) seeks to bridge this gap by making [...] Read more.
While Artificial Intelligence (AI) promises significant enhancements for Clinical Decision Support Systems (CDSSs), the opacity of many AI models remains a major barrier to clinical adoption, primarily due to interpretability and trust challenges. Explainable AI (XAI) seeks to bridge this gap by making model reasoning understandable to clinicians, but technical XAI solutions have too often failed to address real-world clinician needs, workflow integration, and usability concerns. This study synthesizes persistent challenges in applying XAI to CDSS—including mismatched explanation methods, suboptimal interface designs, and insufficient evaluation practices—and proposes a structured, user-centered framework to guide more effective and trustworthy XAI-CDSS development. Drawing on a comprehensive literature review, we detail a three-phase framework encompassing user-centered XAI method selection, interface co-design, and iterative evaluation and refinement. We demonstrate its application through a retrospective case study analysis of a published XAI-CDSS for sepsis care. Our synthesis highlights the importance of aligning XAI with clinical workflows, supporting calibrated trust, and deploying robust evaluation methodologies that capture real-world clinician–AI interaction patterns, such as negotiation. The case analysis shows how the framework can systematically identify and address user-centric gaps, leading to better workflow integration, tailored explanations, and more usable interfaces. We conclude that achieving trustworthy and clinically useful XAI-CDSS requires a fundamentally user-centered approach; our framework offers actionable guidance for creating explainable, usable, and trusted AI systems in healthcare. Full article
(This article belongs to the Section Health Informatics)
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