| Objective:1.To investigate the acceptance of immersive virtual cognitive management system and its influencing factors among Chinese elderly.2.Research and develop the elderly cognitive management system based on immersive virtual technology.3.Explore the feasibility of immersive virtual cognitive assessment.4.Construct the elderly cognitive intervention program based on immersive virtual technology.Methods:1.Influencing factors of the intention to use immersive virtual reality technology:Based on the technology acceptance model,this paper introduces the "perceived enjoyment" variable,and constructs the influencing factors model of the Chinese elderly’s intention to use immersive virtual reality technology.Referring to the literature at home and abroad,the "immersion virtual technology use intention questionnaire" was compiled,and 55 elderly people in a municipal nursing home were investigated after experience.SPSS 22.0 and Amos 23.0 were used to analyze the reliability and validity of the questionnaire and to verify the structural equation model.2.Research and development of an immersive virtual technology-based elderly cognitive management system: Based on the literature review and the actual needs of the Chinese elderly,the design ideas of the immersive virtual elderly cognitive management system(CVSM)are clarified.Established a professional research and development team,the system uses Unity 3D game engine,C# language programming,and 3ds Max.3.The feasibility of immersive virtual cognitive assessment: The study selected 19 cases of mild AD patients,15 cases of MCI patients and 19 cases of normal people who were admitted to a municipal nursing home from August 2020 to December 2020 and met the enrollment criteria.The general clinical data of the patients were collected,and the immersion virtual cognitive assessment and neuropsychological assessment were performed,including Mini Mental Status Examination(MMSE),Montreal Cognitive Assessment Form(Mo CA),Auditory Vocabulary Learning Test(AVLT),Shape Trail Test(STT)and Symbol Digit Modalities Test(SDMT).SPSS 22.0 software was used for data analysis.4.Construct an immersive virtual cognitive intervention program: The action research group made full reference to foreign immersive virtual cognition intervention programs,and initially formulated immersive virtual cognition intervention programs.In this study,the purpose sampling method was used to select 31 patients with mild cognitive impairment and mild dementia in a municipal nursing home in Fuzhou.This study carried out three rounds of action research to upgrade and modify the immersion virtual cognitive intervention system and intervention program.We collected data through qualitative(observation,interview)and quantitative(scale,questionnaire)methods,and made statistical analysis through SPSS 22.0 to evaluate the effectiveness and feasibility of immersion virtual cognitive intervention.Results:1.This research cites the technology acceptance scale designed by Taiwan scholar Liu Fang and others,which includes five dimensions: perceived ease of use,perceived usefulness,perceived enjoyment,user experience,and use intention,and conducted reliability and validity tests.The results showed that Cronbach coefficient was 0.929,the combined reliability(C.R.)of the five dimensions of the scale was greater than 0.7,and the average variance extraction(AVE)was greater than 0.5.Structural equation modeling and mediating effect analysis found that perceived ease of use,perceived usefulness,perceived enjoyment and user experience had significant effects on behavioral intention(P = 0.007);perceived ease of use had significant effects on perceived usefulness(P <0.001);perceived enjoyment had significant effects on perceived usefulness(P < 0.001);perceived usefulness played a significant role in user experience and behavioral intention It plays a mediating role.2.This research successfully developed an immersive virtual elderly cognitive system(CVSM).The system simulated the supermarket scene and used 3DSMAX modeling technology to present the patients with three-dimensional real visual senses.The system was divided into three basic functional modules: operational learning,VR cognitive assessment and VR cognitive training.It included user registration,interactive learning and difficulty upgrading.Currently,the system has been applying for computer software copyright and national invention patents.3.The evaluation results of the feasibility of immersive VR cognitive assessment:(1)There were significant differences in the neuropsychological evaluation results(Mo CA,MMSE,AVLT,STT and SDMT)among the three groups of normal people,mild cognitive impairment and dementia(P<0.05).(2)There are significant differences in the VR cognitive evaluation indicators(the correct number of products,task completion time,correct product type,and correct payment)among the three groups(P<0.05).(3)The correct product quantity and correct product type in the three groups of patients in the immersive VR cognitive assessment task are positively correlated with the evaluation results of MMSE,Mo CA,AVLT,and SDMT(P<0.05),and negatively correlated with the results of STT evaluation(P<0.05);Task completion time was negatively correlated with the results of MMSE,Mo CA,AVLT,SDMT(P<0.05),and positively correlated with STT indicators(P<0.01);Correct payment was significantly positively correlated with MMSE,Mo CA,AVLT(P<0.05);There is a significant positive correlation between the purchase of non-listed goods and MMSE and SDMT(P<0.05).(4)The best combination of VR cognitive assessment was "task completion time & correct payment & purchase of non list goods & correct type of goods".The correct discrimination rate was 87.9%,the sensitivity and specificity were 93.33% and 83.33% respectively.(5)The correct commodity quantity index can be used to identify patients with mild cognitive impairment and mild dementia,the correct discrimination rate was 85.3%,the sensitivity and specificity were 94.74% and 73.33% respectively.4.Results of action research: a total of 31 patients with mild cognitive impairment and mild dementia were recruited for three rounds of action research.Each round of action research lasted for 4 weeks,with 12 times of immersive virtual cognitive intervention.Finally,the cognitive training function of CVSM was upgraded(CVSM1.0-CVSM2.0-CVAM3.0).At the same time,an immersive virtual cognitive intervention program for Chinese elderly patients with cognitive impairment was constructed.Statistical analysis of quantitative data showed that the scores of Mo CA(MMSE)and other cognitive domains(avlt,STT,SDMT)were significantly improved after three rounds of intervention(P < 0.05).There was no significant difference in the scores of perceived stress(PSS),quality of life(QOL-AD)and depression(GDS)before and after the three rounds of intervention,but it showed a positive trend.Conclusions:1.Perceived ease of use,perceived usefulness,perceived enjoyment and user experience are the main factors influencing the acceptance of immersive virtual technology cognitive management system by Chinese elderly.Among them,the impact of perceived usefulness is more obvious.Therefore,the future immersive virtual system with the elderly as the main user group should pay attention to the ease of use,scientific and interesting of the system.2.This study designed and developed an immersive virtual elderly cognitive management system,which can provide cognitive assessment and cognitive intervention for the elderly in one cognitive management platform.3.Immersive VR cognitive assessment can be used as a new cognitive assessment tool to distinguish normal people,mild cognitive impairment and mild dementia.There are different degrees of correlation between the indicators of immersion VR cognitive assessment and neuropsychological assessment results,which can provide clinical basis for early cognitive screening of patients with mild cognitive impairment and mild dementia.4.This stduy adopted the method of action research,cognitive training function iteration of CVSM system upgrade,and made the immersive virtual cognitive intervention plan more perfect.According to the immersive virtual cognitive intervention program for patients with mild cognitive impairment and mild dementia cognitive intervention immersive virtual cognitive intervention can improve the overall cognitive level and individual cognitive domain function in the elderly Immersive virtual fun of cognitive intervention can enhance the elderly adherence of cognitive intervention. |
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