Delirium, an acute state of confusion with sudden onset, poses a significant burden on patients, relatives, nurses and the care system. Yet, delirium management and education in Germany are currently underdeveloped. In the project at hand, HCI researchers worked in close collaboration with care staff and a care manager in a local hospital to develop a delirium training, including among other building blocks an immersive VR experience to sensitize care staff to the patient’s perspective and the power of nurses’ communication. The application was designed in a participatory process using insights from field research and co-design workshops in the hospital. A first user testing showed that DelirSens triggered emotional reactions from users and has potential to increase empathy for delirium patients.

IntroductionPrevious research suggested differential stress reactivity depending on individuals' coping style, e.g., as classified by the model of coping modes. Specifically, stronger physiological reactivity and weaker subjective stress ratings were found for repressors than for sensitizers. However, it remains to be investigated (i) whether these findings, which are largely based on social stress induction protocols, also generalize to other stressors, (ii) whether repressors vs. sensitizers also exhibit differential stress recovery following the application of a relaxation method, and (iii) which stress reactivity and recovery patterns are seen for the two remaining coping styles, i.e., fluctuating, and non-defensive copers. The current study thus examines stress reactivity in physiology and subjective ratings to a non-social stressor and the subsequent ability to relax for the four coping groups of repressors, sensitizers, fluctuating, and non-defensive copers.MethodsA total of 96 healthy participants took part in a stress induction (Mannheim Multicomponent Stress Test) and a subsequent relaxation intervention. Subjective ratings of stress and relaxation, heart rate (HR), heart rate variability (HRV), and blood pressure were assessed during the experiment. HR and blood pressure are markers of the sympathetic stress response that can be regulated by relaxation, while HRV should increase with relaxation. To investigate long-term relaxation effects, subjective ratings were also assessed on the evening of testing.ResultsDespite successful stress induction, no differential responses (baseline to stress, stress to relaxation) were observed between the different coping groups on any of the measures. In contrast, a strong baseline effect was observed that persisted throughout the experiment: In general, fluctuating copers showed lower HR and higher HRV than non-defensive copers, whereas repressors reported lower subjective stress levels and higher levels of relaxation during all study phases. No differences in subjective ratings were observed in the evening of testing.ConclusionContrary to previous research, no differential stress reactivity pattern was observed between coping groups, which could be due to the non-social type of stressor employed in this study. The novel finding of physiological baseline differences between fluctuating and non-defensive individuals is of interest and should be further investigated in other stressor types in future research.

User-centered and Participatory Design approaches have become widespread within HCI, also when designing digital media for older adults. These methodologies are seen as crucial to adapt technology design to older people's needs and increase their acceptance of digital technology. Nevertheless, it is often difficult to reach a diverse group of older people, for instance, people with limited technology skills, limited mobility, or cognitive issues. In addition, gerontologists criticized lately how older people's participation unfolds in technology design projects, e.g. that people are pushed into the role of users. Little is known about the motivations and needs of older adults regarding their participation in HCI research. To close this gap, we conducted an online survey (N=46) and semi-structured interviews (N=8) focusing on motivations, willingness and experiences regarding participation. Results show that people are generally willing to participate due to interest in the topic, learning new things and social bonding. However, despite the conceptions within HCI that long-term engagement is crucial within participatory design, older people in the study preferred less commitment and more open formats.

For good reason, a culture of user-centered and participatory design of technology has been established in the context of aging well in addition to the problem-solving approach for recent decades. We owe this shift in thinking not only to the collaboration of gerontologists, physicians, sociologists, and technology developers, but also to funding programs that explicitly call for user involvement and user studies in real life contexts. This is expected to lead to a better adaptation of the system requirements to the actual needs of the users and thus ensure a higher acceptance of the final product of technology. Finally, the approach should help to increase the subjective well-being of users and other stakeholders. This paper reports our own experiences and research on user-centered design and participation in the development of technology. From both an internal perspective as designers/developers and an external perspective as ethnographic researchers, we critically examine current practices of user integration in this paper. In doing so, we highlight and contextualize crucial aspects of reflexivity, reciprocity, and empowerment and provide the notion of configuring participation in the design process as matters of care. Moreover, we are convinced that participatory user-centered approaches should be at the center of future research on for ICT design in healthcare and thus also for the aging society.

Despite the higher uptake of digital media also in older age groups, there are still challenges for people of high ages and with cognitive or motoric problems, which prevent them from learning and using devices like smartphones or tablets. Tangible user interfaces provide an opportunity to connect these people to social media, thereby increasing their digital participation in society and reducing loneliness. In this paper, we discuss the challenges of intergenerational communication and research the opportunities affiliated with tangible technologies to overcome technology barriers for adults of high ages. We present a hybrid system for social media interactions between young smartphone users and their old relatives, who do not use mobile technologies. The system consists of a tangible user interface designed specifically for old adults that connects to a standard mobile messenger service. TAMI was designed in a user-centered process to fulfill the needs of older adults and tested in a longer-term field study with pairs of young and old relatives.

The healthcare sector's digital transformation necessitates the involvement of stakeholders through participation and co-creation processes. This study aims to investigate the understanding and implementation of participation and co-creation in the development of hybrid interaction technologies in healthcare. Eight interdisciplinary research projects were examined through semi-structured group interviews with 49 participants from academia, industry, and the application field. The interviews focused on participants' perspectives on project goals, user groups, access to the field, methods of participation and co-creation, and user motivation. The results highlight the diverse understandings of participation and co-creation, with some perceiving them as research-driven and others as already embedded in user-centered design. The projects emphasized user needs but often excluded stakeholders from collaborative decision-making. Challenges in achieving continuous involvement and co-decision were acknowledged. The findings underscore the need for reflexive practice and evaluation of participation and co-creation throughout the development process, as well as further research on participation across projects. By addressing these challenges and embracing participatory approaches, digital health applications can better address ethical concerns, build trust, and increase acceptance and adoption in the healthcare sector.

During the ongoing pandemic, the need for senior-friendly remote communication systems became more than apparent. While communication could be switched with little effort from face-2-face to online video conferencing in many areas of life, these systems still provide barriers for a broad range of older people. In addition, the simple provision of a digital communication tool does not inherently provide opportunities for meaningful interactions and the creation of new memories. However, especially in times of (physical) contact limitations, it is not sufficient to do video telephony but also to engage in remote activities that are meaningful, playful, and lead to shared memories. We posit that a hybrid system offering tangible and web-based interactions, while each being adapted to the living situations of particular users (e.g. seniors and their younger relatives), can overcome the lack of meaningful engagement in existing video telephony systems. This paper provides a new interaction concept based on hybrid user interfaces and describes the development of a proof-of-concept prototype of a digital game of Ludo that comprises a senior-friendly tangible interface, a web-based interface, and an integrated video conferencing function.

Background Repeated or chronic stress is considered a major source of disease, in terms of both somatic and mental illnesses. The prevention of stress-related disease by interventions for relaxation has thus increased societal relevance. In this randomized controlled non-inferiority trial, we will compare a newly developed virtual reality (VR) environment for relaxation to an active control group applying a freely chosen relaxation method. To test if our VR environment supports relaxation in a situation of acute stress, a standardized stress induction protocol will precede the relaxation phase. Methods One hundred healthy participants will be recruited from the University of Siegen and randomly assigned to the VR or the active control group that will be free to choose their own relaxation strategy. The multi-sensory VR includes visual, acoustic, and haptic features to induce a strong feeling of presence. The laboratory testing will comprise a baseline measurement, a stress induction, a relaxation intervention, and a recovery measurement. The primary outcomes are self-reported stress and relaxation measured with a visual analog scale (VAS) at pre- and post-baseline, at the start, middle, and end of the stress induction, at pre- and post-relaxation, at pre- and post-recovery, and in the evening of testing. Secondary outcomes are the physiological parameters, namely heart rate and heart rate variability, tonic skin conductance level as well as the number of non-specific skin conductance responses, systolic and diastolic blood pressure and respiratory rate recorded during the four experimental phases as well as state mood, and state rumination assessed at four time points (pre- and post-stress, post-relaxation, and in the evening of testing). Finally, post-event processing will be assessed after relaxation and in the evening of testing. Repeated measures ANOVAs will be performed to test for statistical effects of group, time, and group × time interaction. Discussion The newly developed, multi-sensory VR offers an intervention for relaxation without prior training. Its immersive character might increase efficacy compared to other relaxation methods, especially in situations of acute stress. Future directions could be the development of a mobile version of the VR to enhance accessibility for users. To achieve a transfer of training effects to real life, VR components should successively be eliminated until relaxation is practiced without guidance by the VR. Trial registration ISRCTN Registry ISRCTN11162338 . Retrospectively registered on January 22, 2021

: In the last decade user-centered and participatory design have become central approaches for the design of technology in the context of ageing well. They promise a better fit of system requirements to user needs and, eventually, a higher user acceptance of the end-product. In Germany funding programs explicitly ask for the integration of users and user studies in real life contexts. They also started to fund accompanying research on how technical projects implement user-centered methods. Given our own experience and research on user-centered design from both an inside perspective as designers and developers as well as an outside perspective as ethnographic researchers, we examine the current practice of user integration critically in this paper and provide a list of crucial aspects including reflexivity, reciprocity, and empowerment that should be the focus of the research on user-centered approaches for ICT design in healthcare in the coming years.

Negative thoughts are a widespread everyday experience. Failures to appropriately cope with negative thoughts are related to serious mental health issues, such as depression. Consequently, preventive technology-mediated everyday interventions to support coping with negative thoughts are of interest. One promising platform for mental health applications is personalized virtual reality (VR). We developed an explorative VR prototype based on personally relevant textual messages from email, messengers and alike, which trigger negative thoughts. The prototype presented these messages in VR and allowed to physically manipulate them, for example, by physically punching and trashing them. A qualitative empirical exploration (N=10) revealed a general positive shift in thoughts and emotions after using the prototype, mainly in form of increased relaxation and self-reflection. Based on this and further insights, we derive four themes for VR in mental health, touching upon the importance of personalization, immersion and focus, interaction design and embodiment, as well as, integration into everyday life.

Nowadays, automation not only permeates industry but also becomes a substantial part of our private, everyday lives. Driven by the idea of increased convenience and more time for the "important things in life," automation relieves us from many daily chores - robots vacuum floors and automated coffee makers produce supposedly barista-quality coffee on the press of a button. In many cases, these offers are embraced by people without further questioning. However, while we save time by delegating more and more everyday activities to automation, we also may lose chances for enjoyable and meaningful experiences. In two field studies, we demonstrate that a manual process has experiential benefits over more automated processes by using the example of coffee-making. We present a way to account for potential experiential costs of everyday automation and strategies of how to design interaction with automation to reconcile experience with the advantages of a more and more powerful automation.

Nowadays, automation not only dominates industry but becomes more and more a part of our private, everyday lives. Following the notion of increased convenience and more time for the "important things in life", automation relieves us from many daily household chores - robots vacuum floors and automated coffeemakers produce supposedly barista-quality coffee on the press of a button. In many cases these offers are embraced by people without further questioning. Of course, automation frees us from many unloved activities, but we may also lose something by delegating more and more everyday activities to automation. In a series of four studies, we explored the experiential costs of everyday automation and strategies of how to design technology to reconcile experience with the advantages of ever more powerful automation.

Human–Computer Interaction (HCI) and Interaction Design (ID) focus increasingly on designing technology in ways to increase users’ subjective wellbeing through interaction (see Diefenbach, 2017). Consequently, a number of models attempt to describe ‘wellbeing’ and ‘positive experiences’. For instance, Desmet and Pohlmeyer (2013) provided a ‘framework for positive design [...] that includes three main components of subjective wellbeing: pleasure, personal significance and virtue’. Jordan (2000) distinguished four types of pleasure: physio-, socio-, psychoand ideo-pleasure. Hassenzahl et al. (2013) introduced an approach based on psychological needs, such as autonomy, relatedness, competence, stimulation, and popularity, which provide ‘potential “sources” of positivity, meaning – and ultimately – happiness, when fulfilled’. Those approaches mainly provide a general mindset, that is, a high-level model of how wellbeing might be best understood in the context of technology design. However, in design the devil is in the details. While understanding positive experience is a good start, this alone does not provide sufficient support to design for wellbeing. In other words, there is a substantial gap between the abstract models of wellbeing in HCI/ID and the concrete design of wellbeing-driven technology. In this chapter, we suggest a practice-oriented approach to begin to bridge the gap between abstract experiential design objectives and specific products and interactions. We start with a short introduction to our theoretical understanding of wellbeing-driven design and show how elements of social practice theory can inspire a set of practical design-supporting activities. Then, we present and discuss a case study to highlight challenges and opportunities of the suggested approach. Finally, we discuss potential future work and some ethical challenges.