september 2014 - university of...

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How smart home care systems can be used to provide better support and caring to elder people in China?

A study submitted in partial fulfillment of the requirements for the degree of

Master of Science in Information Systems

at

THE UNIVERSITY OF SHEFFIELD

by

Rong Yin

September 2014

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Abstract

Background. Currently, “Smart City” has been widely accepted all over the world.

The concept of Smart City can have a powerful effect on solving the problems in the

development of a city. SHCS is a specific and practical service part of Smart City

which can improve the life quality of people, especially benefit the elder people a

lot. SHCS is also a sub-system of Smart City. However, unlike the popularization of

Smarty City in China, SHCS is not widely used by the Chinese elder people.

Aims. This study aims to identify the barriers of Chinese elder people in using the

SHCS and find out the suitable SHCS functions and facilities for Chinese elder people.

To find out how SHCS can be used to provide better support and caring to elder

people in China.

Methods. The research approach is inductive approach and the research use

qualitative method. This study used the semi-structured interview as the data

collection method and used thematic analysis approach to analyse the data. The

interview is done by telephone.

Results. The research findings are mainly be summarized as 4 themes of barriers

and the corresponding expectations of each barrier. The four themes of the barriers

are: “Lack of understanding”, “Price and cost barriers”, “Reliability barriers” and

“Individual differences in demand”. The details of these barriers and expectations

are analysed with its cause and consequence code.

Conclusion. Although currently SHCS is not widely known or used in China, the

Chinese elder people have strong willing to experience it because of their high

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demands for the variety of functions of SHCS. However, the promotion of SHCS is

hard. Besides, the price and cost must be relatively low with a high price-

performance ratio. The supplier of its facilities and services must be reliable and the

functions should be easy to learn and use and can satisfy different kinds of

individual demands.

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Acknowledgement

At first, I would like to express my thanks to my supervisor, Dr G. C. Alex Peng. This

study cannot be finished without his efficient guidance and kindly support. He has

given patient help to me from the start of my dissertation proposal to the end of

this paper. I really appreciate all his advice and I have benefited so much from his

guidance.

Secondly, I want to thank my friends who kept encouraging me and studying

together with me during the dissertation period.

Thirdly, I would like to thank the interviewees of my study. Thanks for their

participation and they have provided a lot of useful first hand data.

Finally, I want to say thanks to my family. They are the people whom I love the most.

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Contents

Abstract ........................................................................................................................ 2

Acknowledgement ....................................................................................................... 4

Contents ....................................................................................................................... 5

Chapter 1 Introduction............................................................................................... 10

1.1 Research background ....................................................................................... 10

1.1.1 Concept of “Smart City” ............................................................................ 10

1.1.2 Smart home caring system........................................................................ 10

1.1.3 Usage of SHCS for Chinese elder people ................................................... 12

1.2 Research questions .......................................................................................... 13

1.3 Research aim and objectives............................................................................ 13

1.4 Dissertation structure ...................................................................................... 14

Chapter 2 Literature review ....................................................................................... 16

2.1 Introduction...................................................................................................... 16

2.2 Smart City overview ......................................................................................... 16

2.2.1 The concept of Smart City ......................................................................... 16

2.2.2 Advantage of using “Smart City”............................................................... 17

2.2.3 Smart City technologies ............................................................................ 18

2.2.4 Smart City in different part of the world .................................................. 20

2.2.4.1 Smart City in the USA ......................................................................... 20

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2.2.4.2 Smart City in Europe........................................................................... 20

2.2.4.3 Smart City in other areas of the world............................................... 21

2.3 Development of Smart City in China ................................................................ 22

2.3.1 Government support to Smart City........................................................... 22

2.3.2 Current development of Smart City in China ............................................ 23

2.4 SHCS and elder people caring .......................................................................... 24

2.4.1 Smart home caring systems (SHCS) overview........................................... 24

2.4.2 Usage of SHCS in elder people caring ....................................................... 25

2.4.3 Potential barriers for Chinese elderly in using SHCS................................. 26

2.5 Conclusion ........................................................................................................ 27

Chapter 3 Methodology ............................................................................................. 29

3.1 Introduction...................................................................................................... 29

3.2 Research approach ........................................................................................... 29

3.3 Research method ............................................................................................. 30

3.4 Data collection method .................................................................................... 31

3.5 Design of interview questions .......................................................................... 32

3.6 Sampling ........................................................................................................... 33

3.7 Data analysis approach .................................................................................... 35

3.8 Research methodology limitations .................................................................. 36

3.9 Ethical aspects .................................................................................................. 36

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Chapter 4 Findings...................................................................................................... 38

4.1 Introduction...................................................................................................... 38

4.2 Lack of understanding ...................................................................................... 38

4.2.1 Lack of popularization ............................................................................... 39

4.2.2 Unfamiliar with specific functions............................................................. 40

4.2.3 Corresponding expectations ..................................................................... 41

4.2.3.1Willing to experience .......................................................................... 41

4.2.3.2 Health caring and first aid .................................................................. 42

4.3 Price and cost barriers...................................................................................... 43

4.3.1 Economic capacity is not high ................................................................... 44

4.3.2 Maintenance and service fees .................................................................. 45

4.3.3 Replace the original home facilities .......................................................... 45


4.3.4.1 High Price–performance ratio ............................................................ 47

4.3.4.2 Pay fees separately............................................................................. 47

4.3.4.3 Free or paid trial service..................................................................... 48

4.4 Reliability barriers ............................................................................................ 49

4.4.1 Hard to find a most reliable way to promote SHCS .................................. 49


4.4.2.1 Reliability of facilities and service source .......................................... 51

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4.4.2.2 Reliability of real-time monitoring service......................................... 52

4.5 Individual differences in demand..................................................................... 53

4.5.1 Different demands in privacy protection .................................................. 53

4.5.2 Different demands in functions ................................................................ 55


4.5.3.1 Easy to learn and use ......................................................................... 56

4.5.3.2 Summary of other demands .............................................................. 58

Chapter 5 Conclusion and Recommendations ........................................................... 60

5.1 Introduction...................................................................................................... 60

5.2 Further discussion and Conclusion................................................................... 60

5.2.1 Summary of “Lack of understanding” ....................................................... 60

5.2.1.1 Barriers ............................................................................................... 60

5.2.1.2 Corresponding expectations .............................................................. 61

5.2.2 Summary of “Price and cost barriers”....................................................... 61

5.2.2.1 Barriers ............................................................................................... 61


5.2.3 Summary of “Reliability barriers” ............................................................. 62

5.2.3.1 Barriers ............................................................................................... 62


5.2.4 Summary of “Individual differences in demand” ...................................... 63

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5.2.4.1 Barriers ............................................................................................... 63


5.2.5 Final conclusion ......................................................................................... 64

5.3 Research limitation .......................................................................................... 65

5.4 Recommendation for further research ............................................................ 66

Reference ................................................................................................................... 67

Appendix 1 Semi-structured interview instrument ................................................... 78

Appendix 2 Semi-structured interview instrument Chinese and English version ..... 82

Appendix 3 Coding Scheme........................................................................................ 88

Appendix 4 Conceptual Map 1 ................................................................................... 90




Appendix 8 Research Ethics Approval Letter ............................................................. 94

Appendix 9 Proposal for Research Ethics Review ...................................................... 95

Appendix 10 Ethics Information/Consent form ....................................................... 102

Appendix 11 Ethics Information/Consent form English and Chinese version ......... 105

Appendix 12 Access to Dissertation ......................................................................... 110

Appendix 13 Address & First Employment Destination Detail ................................ 112

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Chapter 1 Introduction

1.1 Research background

1.1.1 Concept of “Smart City”

In recent years, the concept of “Smart City” has become an emergent and advanced

research area. A “Smart City” will make maximum utilization of modern information

and communication technologies (consist of some latest and most advanced

technologies such as wireless sensors, internet of things, mobile networks, cloud

computing, remote control and big data analytical tools) to make the citizens enjoy

convenient and high quality life (GSMA, 2013). After being first formally proposed in

the theory of “Smart planet” by IBM (International Business Machines Corporation)

in 2008 (Palmisano, 2008), “Smart City” has been widely accepted by many national

leaders and city leaders all over the world. According to Brookings Institution, “Over

the last five years, the concept of the technology-driven “smart city” has captured

the imagination of public, private, and nonprofit leaders alike” (Puentes & Tomer,

2014). Many huge cities are making great efforts to become a “Smart City”. As

ranked by Cohen (2012), the global top ten smart cities are Vienna, Toronto, Paris,

New York, London, Tokyo, Berlin, Copenhagen, Hong Kong and Barcelona, which are

all metropolises and very famous cities.

1.1.2 Smart home caring system

“Smart home caring system” (SHCS) is a specific and practical service part of Smart

City, it is related to nearly all the six characteristics of Smart City (which are “smart

economy, smart people, smart governance, smart mobility, smart environment,

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smart living” (Giffinger et al., 2007)). As a typical represent research area of Smart

City, SHCS have applied some advanced technologies such as wireless sensors (Huo

et al., 2009), wireless webcam and GPS (Global Positioning System) (Leijdekkers,

2007) and cloud computing and remote control (Chan, Estève, Escriba & Campo,

2008). By using these technologies, the conditions of people can be monitoring and

be taken cared in case of some physical emergency happens. “The integration of

smart home technology to support health and social care is acquiring an increasing

global significance.”(Martin, Kelly, Kernohan, McCreight & Nugent, 2008). A well

designed smart home care system which contains some good smart features and

functions can significantly improve the safety and quality of the citizens’ life. In

particular, many researches related “Smart Home” starts earlier than the formal

formation of the concept of “Smart Cities” (Noury et al., 2000; Rialle et al., 2002;

Stankovic et al., 2005. etc.). Thus, SHCS have relatively more mature theory and

longer history than Smart City.

For the elder people, smart home care system has some benefits such as it can

reduce the rate of accidental death. For example, as introduced in the research of

Tabar, Keshavarz, & Aghajan (2006), a wireless sensor network can be used

particularly for family with elder people to record whether the elder people are in a

safe situation and report the emergency. It can also analyse the image or other

information base on some action such as an accidental fall and report the

information to a caring center for help. This kind of smart features can be really

practical for the elder people especially when they are widowed or live alone.

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1.1.3 Usage of SHCS for Chinese elder people

According to the data of National Bureau of Statistics of China (2014), at the end of

2013, 53.73 percentage (731 million) of the total population in China live in the

urban areas, which makes Chinese government attach great importance to the city

planning and design. Currently, China is paying highly attention to build “Smart City”.

In the year 2013, 103 cities are chosen as the 2013 annual Chinese national smart

city pilot cities (Ministry of Housing and Urban-Rural Development of the People

Republic of China, 2013).

However, unlike the popularization of the concept of Smart City, the usage of SHCS

in China is very rare. Even in some highly developed Chinese cities like Beijing,

Tianjin and Shanghai, SHCS is not widely used or even known by the citizens. Until

the end of 2013, Chinese people aged over 60 are 202 million, 14.9% of the total

population, and people aged over 65 are 131 million, 9.7% of the total population

(National Bureau of Statistics of China, 2014), which is not a low percentage.

Meanwhile, the elder people are a vulnerable group which need more social care

and assistance. Especially in current days, there are many Chinese families which

have only one child. When the children get married, one couple have to support 4

elder people. This situation means when the parents are old, their children may not

be able to have enough ability to take good care of them. In this case, the elder

people need more outside assistance.

Therefore, in order to let Chinese elder people benefit the most from this advanced

technical achievement, “how smart home caring system can be used to provide

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better support and caring to elder people in China” is a question need to be

answered.

1.2 Research questions

According to the above description of the research background, this study aims to

answer these following research questions:

(1) What kind of smart features and functions are needed by the elder people?

(2) Which ones are perceived to be more important by the elder people?

(3) What are the difficulties and barriers for the elder people to use smart features

and functions?

(4) What kind of possible efforts can be made to help smart home care systems to

do the most benefits to elder people.

1.3 Research aim and objectives

As has been mentioned above, to answer the question “how smart home caring

system can be used to provide better support and caring to elder people in China”,

the main aims of this study are to identify the barriers of Chinese elder people to

use the SHCS and find out the suitable SHCS functions and facilities for Chinese

elder people. To achieve this aims, here is the detailed research objectives:

(1) To identify the suitable smart features of smart home care systems for the elder

people.

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(2) To find out the more important or more suitable smart features and functions

particularly for the elder people rather than for people of all ages among the smart

home care systems.

(3) To investigate the difficulties and barriers for the elder people to use smart

home care systems.

(4) To give a possible suggestion on how smart home care systems for the elder

people can be widely accepted and do the most benefits to elder people in China

based on the findings of the project.

1.4 Dissertation structure

This study consists of 5 chapters, and the brief introduction of each chapter is

showed as follows:

Chapter 1 is the introduction of this study. In this part, the main research

background, the research questions, the research aims and objectives and the

structure of the paper are given. The research scope and value of the research are

mainly showed in the part of research background.

Chapter 2 is the literature review of this study. In this chapter, the study will

introduce the overview of Smart City, the overview of SHCS and the needs of elder

people to give a more clearly introduction to the background information of this

study and clarify why this study is worth to be done.

Chapter 3 is the methodology of this study. In this section, the research approach,

the research method, the data collection method, the design of interview questions,

the data analysis method and research ethic issues will be presented.

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Chapter 4 is the findings of this study. The collected data will be analysed by

thematic analysis approach. According to the research aims of this study, the

findings of the study contain the barriers of Chinese elder people to use SHCS and

their corresponding expectations of each barrier. To some extent, these

expectations are also their demands of their ideal SHCS.

Chapter 5 is the conclusion and recommendations of this study. In this part, the

study will summarize all the barriers and expectations to get the conclusion

regarding to the research questions and aims. And the research limitation and

recommendation for further research will be given at last.

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Chapter 2 Literature review

2.1 Introduction

By the discussion of this chapter, the researcher intends to make a clearer and more

detailed introduction about the worldwide background about this study. And by the

review of the literature, the researcher will clarify why this study is worthy to be

done. The study will first introduce the whole concept of Smart City and its

development in China; followed by the introduction of its important constituent

part and sub-system, Smart Home Caring System (SHCS); and the usage of SHCS and

elder people caring; and finally, the conclusion of literature review. Some of this

literature review is from the dissertation proposal.

2.2 Smart City overview

In this section, the study will have an overview of smart city, which includes the

concept of smart city, advantage of using “Smart City”, Smart City technologies and

Smart City in different parts of the world, to give some general background

information about the origin of smart home caring system. In fact, the developing of

SHCS can be regarded as a sub-system of Smart City, which involves not only the

concept of Smart City but also relationships with many latest ICTs and other part of

Smart City.

2.2.1 The concept of Smart City

Although the concept of smart city is very popular in these years, the definition of

smart city differs from one scholar to another, and it has not a unique definition

because of the different methods used to achieve this goal (Chourabi et al., 2012,

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January). At the same time, by changing the word “Smart” into other words, there

are some alternative names of Smart city, such as “intelligent city” (Komninos, 2009)

which has nearly the same concept as smart city. The Department for Business

Innovation & Skills (2013) of The United Kingdom agrees that the concept of smart

city “is not static and there is no absolute definition of a smart city, no end point,

but rather a process, or series of steps, by which cities become more ‘liveable’ and

resilient and, hence, able to respond quicker to new challenges”.

In fact, the concept of smart city is updating all the time along with the developing

of information and communication technologies (ICTs). The government from many

countries have a slightly different understanding about the concept of smart city,

but nearly all the concept about smart city consent that ICT is a key factor (Nam &

Pardo, 2011). A widely accepted definition of smart city is by Caragliu (2009): “We

believe a city to be smart when investments in human and social capital and

traditional (transport) and modern (ICT) communication infrastructure fuel

sustainable economic growth and a high quality of life, with a wise management of

natural resources, through participatory governance.”

2.2.2 Advantage of using “Smart City”

Nowadays, the world population is increasing in a fast speed. According to the data

of Department of Economic and social Affairs of United Nations (2013), the world

population increased from 6127 million to 6916 million from the year 2000 to 2010,

which is a growth of 12.88 percent. By the forecast of United Nations Population

Fund (UNFPA) (2007), the world population who lives in urban areas will increase to

5000 million by 2030, with urban growth concentrated in Africa and Asia. Many

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cities are facing more complex and more variable problems in nearly all the parts of

the city management. For example, air pollution caused by industrial pollution and

vehicle exhaust, traffic pressure, climate change, the shortage of living resources

such as water and electric (Anania, Sairamesh & Lee, 2004).

The concept of “Smart city” is considered as a suitable approach to overcome the

complex challenges comes up during the development of modern cities (Schaffers

et al., 2011). As summarized by Harrison and Donnelly (2011, September, p.3), using

the concept of Smart City has the following benefits:

1. “Reducing the consumption of resource”,

2. “Improving the utilization of existing infrastructure capacity”,

3. “Making new services available to citizens and commuters”,

4. “Improving commercial enterprises”

5. Leading to that the “city managers can collaborate” resource peaks and

“improve resilience”.

The concept of Smart city can have a powerful effect on solving the problems in the

area of politics, economics and technology during the development of a city (Dirks

& Keeling, 2009). Washburn et al. (2009) point out Smart City can be adopted to

enhance to management of cities in the areas of “city administration, education,

healthcare, public safety, real estate, transportation and utilities ”, through applying

the modern information and communication technologies to make this service

smarter and more efficient.

2.2.3 Smart City technologies

Mitchell (2006) believes that by merging the latest ICTs with traditional

infrastructures, it could enable the citizens to enjoy more convenient life. As

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challenged by Hollands (2008), a real Smart City should be able to dramatically

improve the quality of people’s life by using current ICTs, which is the key factor to

identify whether a city is smart city of not. A Smart City consists of many parts, such

as smart transportation, smart education, smart agriculture, smart energy, smart

healthcare, smart home (Batty et al., 2012). In these parts, the usage of ICTs can

benefits people a lot. The latest ICTs used in the concept of smart city have a wide

range of types, such as wireless sensor, cloud computing technology, big data

storage, mobile network, Global Positioning System (GPS), automatic control

network and remote control. These ICTs covers the areas like human computer

interaction, smart control and smart database resources (Al-Hader, Rodzi, Sharif &

Ahmad, 2009).

For example, in the area of smart transportation, by using the cloud computing

technology, big data storage and mobile network, the city government can supply

the data of traffic conditions to the drivers. This can give the drivers guidance to

choose a less crowded road. There is also relative research in the field of platoon

control of the vehicle by developing a “Reconfigurable and adaptable urban

transportation systems” (El-Zaher, 2011). According to the research of Li, Liu & Yin

(2011), by using remote Sensing (RS) and geographic Information System, a

database of urban land-cover information can be constructed. The usage of these

modern ICTs can significantly improve the living environment of citizen and the

management efficiency of the government.

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2.2.4 Smart City in different part of the world

Along with the popularity of the concept of Smart city, governments all over the

world have attached great importance to the research and constructions of Smart

city. Many researchers have done a variety of researches related to Smart City. In

this section, the study will give a brief introduction to them.

2.2.4.1 Smart City in the USA

As one of the most developed countries in the world, the USA (United States of

America) has showed great interest in the building of Smart City. As ranked by

Cohen (2013), among the top 10 Smartest Cities in North America, there are 7 cities

in the USA (with the other 3 cities are in Canada). According to their ranking order,

these 7 cities are: 1, SEATTLE, 2, BOSTON (TIE), 2, SAN FRANCISCO (TIE) 4,

WASHINGTON, D.C. 5, NEW YORK 8, PORTLAND, OREGON 9, CHICAGO. These cities

have a relatively higher fits to the concept of Smart City. Taking Chicago as an

example, since there is widely usage of networks, Chicago is regarded as a digital

metropolis (Widmayer, 1999). Citizens of Chicago can have widely access with

public open data, and have high speed broadband and public Wi-Fi service (Cohen,

2013). The citizens can get more convenient service such as getting connection with

local weather information, traffic information, parking information and news report

by using mobile technology.

2.2.4.2 Smart City in Europe

As has been mentioned in chapter 1, among all the top 10 smartest cities in the

world ranked by Cohen (2012), there are 6 European cities. Also, there are some

ranking in the medium sized European cities, for example, Giffinger (2014) has

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leaded 3 times of smart cities ranking in the year 2007, 2013 and 2014. The concept

of smart city has received great attention from European countries and researchers.

In fact, there are too many examples about the popularity of the concept Smart City

in Europe. Here are some examples of the researches in related to the construction

of smart city. Caragliu, Del Bo and Nijkamp (2011, p.1) have done research to

“present consistent evidence on the geography of smart cities in the” 27 member

countries of European Union. In Germany, the city of Freiburg is treated as a world-

class model in building smart cities by its wide range application of solar (Medearis

& Daseking, 2012). In the United Kingdom, Lim and Liu (2010) have conducted a

research about the role of smart cities in related to ecological protection. In France,

researchers have conducted an analysis in the field of mobile network in cities, to

analyse the behaviour of tourists from the mobile phone data (Pfaender & Fen-

Chong, 2011).

2.2.4.3 Smart City in other areas of the world

The concept of smart city is also popular in other area of the world except for the

USA and Europe. Toronto, Tokyo and Hong Kong are separately ranked as No2, No6

and No9 in the top 10 smartest cities in the world (Cohen, 2012). In the year, 2011

Korea proposed the “SMART education promoting strategy”, which intends to

invest more than 2 billion U.S dollars to achieve their goals in the field of Smart

Education (Education, Korea. Research Information Service, 2011). In particular, the

government of China has also attached great importance to the construction of

Smart City. This is also one of the reasons why this study chooses China as the

research country.

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2.3 Development of Smart City in China

In this section, the study will introduce the development and the application of

Smart City in China, which is the research country of this study.

2.3.1 Government support to Smart City

The Chinese government is attaching great importance to the building of smart

cities with smart ICT facility and many related smart services such as smart

transport, smart healthcare systems, smart energy and smart education. In the

“National new urbanization plan (2014-2020)” of China, the State Council of China

(2014) clearly expressed that China will promote the construction of smart city from

the year 2014 to 2020, by promoting the innovative application of new generation

information technologies such as Internet of things, cloud computing and big data.

According to the information of the website of the Central People’s Government of

China, “China and Europe Union will make further cooperation in the construction

of smart cities”, both of each have 15 pilot cities for this project (XINHUA NEWS

AGENCY, 2014). In China, except for the central government, the government of

each province and city are also taking the construction of Smart City as an

important development direction. As has been mentioned, in the year 2013, 103

cities are chosen as the 2013 annual Chinese national smart city pilot cities (Ministry

of Housing and Urban-Rural Development of the People Republic of China, 2013).

To build a successful smart city, the Internet or mobile network is one of the most

important or even essential technology supports. Thus, the broadband penetration

has a significant influence. To enhance the Chinese people’s access of broadband, in

2013 August, the State Council of China (2013) issued the gazette of “‘Broadband

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China’ Strategy and Its Implementation Scheme”. In this scheme, by the year of

2020, the Chinese government intend to let the broadband network cover both the

urban and rural areas, the broadband penetration of fixed broadband users is

expected to be 70%, the broadband penetration of administrative villages reach

98%, the broadband speed of urban users can reach 50Mbps. According to Shang

Bing, the Vice Minister of Ministry of Industry and Information Technology of China,

in order to achieve this goal, China need to invest around RMB 2,000 billion(around

200 billion pounds) until 2020 (website of Central People’s Government of China,

2013). Form the information above, it can be figure out that the government of

China has firm stand in the construction of Smart City in China.

2.3.2 Current development of Smart City in China

Along with the strong support of the Chinese government, the promotion of Smart

City in China has smooth and positive process. There are a large amount and many

kinds of projects in related to the construction of Smart City in many provinces of

China. In one word, the development of Smart City in China is currently in a high

speed. In this part, the study will take one of these numerous projects as an

example to show one corner of the total development of Smart City in China.

From the year 2007, the government of China and Singapore proposed to jointly

construct a “resource-saving, environment-friendly and society harmonious” city

(Government website of Sino-Singapore Tianjin Eco-City, 2014a), which was treated

as a landmark project of Smart City by the government of China. The location of this

city was finally chosen in Tianjin, China, which was named as “Sino-Singapore

Tianjin Eco-City”. The total area is approximately 31.23 square kilometres with a

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design of the living population to be 350,000 residential planning. This city is

applying the latest ICTs in the field of Smart renewable energy, smart water supply,

and smart transport to achieve its design aims. According to its “List of Events”

(Government website of Sino-Singapore Tianjin Eco-City, 2014b), by the end of the

year 2013, the city has successful been a landmark project in the construction of

Smart City in China and still is receiving continuously attention from the Central

People’s Government of China.

However, the Tianjin Eco-City is only one representative project in the development

of Smart City in China. There are many other successful examples cannot be

introduced in this study in considering of the limitation of the paper length.

2.4 SHCS and elder people caring

After the introduction of the overview of Smart City and its development in China,

in this section, the study will focus on its sub-system, Smart home caring system

(SHCS), especially from the view of its benefits for elder people caring.

2.4.1 Smart home caring systems (SHCS) overview

SHCS is one specific part of smart city which mainly aims to improve the indoor life

of the users by using the modern ICTs. Smart home features have been a global

research topic. There are many researches in related to the development of SHCS,

this section will give a brief introduction to some of them. In America, researchers

have developed a smart house system called “Gator Tech Smart House” by using

service-oriented programmable spaces. In this smart house, the designers use some

most advanced ICTs such as the biometric technologies and sensor platform to help

the systems to detect the possessor’s action. They have achieved the house to be

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“smart” or automatic, for example, the smart mailbox can inform a new arrival

letter to the householder automatically ( Helal, Mann, El-Zabadani, King, Kaddoura

& Jansen, 2005 ). Cerny & Penhaker (2009, January) developed a smart home care

system by using the infrared sensors to monitor circadian rhythm. In fact, wireless

sensor technology, audio and video technology, networked appliances, remote

assistance and other technologies have made great contributions to the promotion

of smart home (Yamazaki, 2006). By the research of Wang, Xiang, Chen and Wen

(2011), A “wireless sensor home automation networks based upon sun Spot” is

developed by merely using the sun SPOTs and virtual motes. Chan (2009, chapter

3.3) also claimed that “some wearable, implantable, and microsystems that can be

swallowed such as microcapsule devices are now available”, which can report the

carriers physical data such as blood pressure and body temperature in real time.

This can be well adoptable for elder people who have hypertension.

2.4.2 Usage of SHCS in elder people caring

WHO (2007a) proposes the concept of “age-friendly city”, which is intend to

improve the quality of life of ageing people in the area of “hea lth, participation and

security” and give the elder people an comfortable and reliable life. One essential

features of an Age-friendly City (WHO, 2007b) is to supply enough housing which is

convenient for elder people to get access to services such as healthcare services.

Smart home can provide the elder people, especially the ones who have some

diseases (such as heart disease and hypertension) and live alone, with a safer life

and more reliable medical assistance support by transfer information to health care

centers in time (Chan, M., Campo, E., Estève, D., & Fourniols, J. Y., 2009). Hence,

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some smart features, for example telehomecare systems (Finkelstein, S. M., Speedie,

S. M., Demiris, G., Veen, M., Lundgren, J. M., & Potthoff, S., 2004; Rialle, V.,

Duchene, F., Noury, N., Bajolle, L., & Demongeot, J. , 2002), can make housing far

away from these kind of services be “Age-friendly” housing: the elder people can

get enough health care or support within their house. A wide range of universal

application of smart home care systems can lead a city one step to be an “Age-

friendly City”. The smart home care systems can provide safe and no-human

caregiving home environment to elder people, especially to the elder people with

chronic illness and live alone (Chan, M., Campo, E., Estève, D., & Fourniols, J. Y.,

2009). In summary, the usage of SHCS in elder people caring is mainly in two parts:

emergency assistance and more convenient life service. However, to some extent,

in the level of making life more convenient, it does not have much difference in

essence with the usage of SHCS for all age groups.

2.4.3 Potential barriers for Chinese elderly in using SHCS

The elder people may have some difficulties and barriers in using the smart home

care systems, both may be in the physical level and spiritual level, which is a

research aim of this project. The ageing people usually have physical difficulties in

hearing, vision, brain and other part of the body. For example, 24% of the elder

people aged over 65 have difficulties in hearing and eyesight (Bond, Coleman &

Peace, 1993). Hence, the elder people may have potential barriers in using some

smart features with audible alarm. In terms to the barriers in spiritual level, for

example, although smart cities theory has achieved some success, some people,

especially the elder people, have no confidence in the smart automatic systems

27

because of little experience of using this kind of unmanned system (Mahizhnan,

1999).

Chan (2009) points out that some elder people also worried about their personal

privacy when a closed monitoring of their daily body data happens -they suspect the

safety of their personal information. Another potential barrier is that the elder

people may spend more time to learn how to use the smart home system and be

familiar with the new smart technologies that they have need to purchase.

Moreover, as China is still a developing country, the economic capacity of Chinese

people is relatively not high, which makes the price of SHCS an important

considering factor for Chinese elder people. In one word, more researches need to

be done to learn more about: what kind of difficulties and barriers the elder people

have when they are using the smart home care systems. This is one of the reasons

why this project is taken: the project aims to find out the potential barriers and

expectations for the elder people in China in using SHCS.

2.5 Conclusion

From the review of literature above, it can be indicated that the concept of Smart

City is a very popular concept all over the world and has many benefits in dealing

with the complex challenges in the development of modern cities. In particular, the

government of China has attached great importance in the construction of Smart

City. As an important and practical constituent part of Smart City, SHCS can have

many benefits in helping to ensure the normal daily life of Chinese elder people,

especially for the prevention of physical damage. However, the SHCS is not widely

used in China. Meanwhile, there are few researches in related to this area. Hence,

28

regarding to the research aims of this study (to identify the barriers of Chinese elder

people in using the SHCS and find out the suitable SHCS functions and facilities for

Chinese elder people), and to find out “how smart home care systems can be used

to provide better support and caring to elder people in China?” is meaningful, which

makes this study worthy to be done.

29

Chapter 3 Methodology

3.1 Introduction

In this chapter, the methodology applied in this study will be introduced. It consists

of the discussion of the following areas: 1. the research approach: why choose

inductive approach instead of deductive approach, 2. the research method: why

choose the qualitative research method, 3. the data collection method: semi-

structured interview by telephone, 4. the design of interview questions, 5.sampling:

the research data source, participants 6. the data analysis approach: thematic

analysis approach, 7. Research methodology limitations, and finally 8. the ethical

aspects.

3.2 Research approach

A successful selection of the research approach of a study can significantly improve

its research efficiency and quality. In general, there are two types of research

approaches: inductive approach and deductive approach (Burney, 2008). Inductive

approach starts from the observations of specific things (such as interview,

questionnaires and observing people) to finally generate general theories after a

series of hypothesis (Silverman, 2005). In other words, inductive approach begins

with the data collection to get general conclusions. Inductive approach is mainly

applied in qualitative researches (Jupp, 2006). On contrast, deductive approach

starts from general theory to make hypothesis and then collect research data to

verify the hypothesis and get the final conclusion (Hayes, 2000).

30

As has been mentioned, the concept of Smart City is a relatively emerging area for

Chinese people. Meanwhile, in this study, because SHCS is a relatively new technical

achievement for Chinese elder people, there are relative few researches about the

usage of SHCS for the elder people in China. According to the research aims, to

investigate the barriers of Chinese elder people to use SHCS and the suitable SHCS

functions, this study need to collect the data about the opinions of Chinese elder

people first and then generate the conclusion. The study begins with the research

data collection rather than the theory hypothesis. The research data is the starting

point and base to conduct the following part of this study. Therefore, inductive

approach is a more appropriate research approach for this study.

3.3 Research method

Both quantitative method and qualitative method are widely used research

methods. Quantitative method is mainly starts form collecting a certain amount of

countable data, and then generate conclusion based on the statistical analysis of

the internal and external relations of the data (Neuman, 2006). On the other hand,

Flick(2007, p.2) pointed out that “qualitative research uses text as empirical

material (instead of numbers), starts from the notion of the social construction of

realities under study, is interested in the perspectives of participants, in everyday

practices and everyday knowledge referring to the issue under study.” In this study,

as the research aims to find out the barriers of Chinese elder people to sue SHCS

and find the suitable functions of SHCS, the research are more related to their

concerns about humanistic and social field. According to Berg and Luna (2004),

qualitative method can fit the researches very well which are in related to the

31

comments of people on specific social problems. Qualitative method can also

cooperate with inductive approach very well (Patton, 2005). To better complete the

research aims, the specific views of Chinese elder people to SHCS and its functions

are very important and indispensable. At the same time, the study need a deep

discussion with Chinese elder people to get more clearly and detailed information.

Thus, this study chose to apply the qualitative research method along with inductive

research approach.

3.4 Data collection method

In this study, the method used to collect qualitative data is semi-structured

interview. Interview is used as a quite common method to collect qualitative data.

As pointed out by Creswell (2013), interview is a suitable method to explore

qualitative data like the views of people. There are 3 kinds of interview, structured

interview, unstructured interview and semi-structured interview. In this study, the

research area is about SHCS, it is very unfamiliar by Chinese elder people and few

previous studies have been done in related areas. Therefore, there might be some

new and useful questions come up with the different response of the interviewees.

The researcher need to add or drop some interview questions based on the

interviewees’ answers, and this research demand is exactly one of the benefits of

semi-structured interview (Schwandt, 2007). Thus, to satisfy this potential research

demand, semi-structured interview is chosen as the data collection method.

In addition, during the period of data collection, the interviewees are Chinese elder

people who are staying in China and the researcher is studying in the United

Kingdom. To overcome the distance limitation and reduce the research cost, the

32

semi-structured interview is done by telephone instead of face to face. As pointed

out by Thomas and Purdon (1994), “The main attraction of telephone interviewing

is that it enables data to be collected from geographically scattered samples more

cheaply and quickly than by field interviewing.” At the same time, as the

interviewees are elder people, telephone interview can avoid their physical risk of

being unsafe: the interviewees just need to stay in a comfortable and safe place

(such as at home and accompanied by their family) and answer the questions by

telephone. Telephone interview can also reduce the research time consumed by the

traveling to interview location.

3.5 Design of interview questions

According to the literature review, the study design interview questions based on

the potential barriers and the potential expectations or demand the elder people

may have in using SHCS. However, as has been mentioned, there are relatively few

researches in the field of investigating the usage of SHCS of Chinese elder people.

The potential forecast of the barriers and expectations is not comprehensive and

totally accurate. Hence, the interview was designed with mainly some open

questions. And based on the answers of the participants, many follow-up questions

and trigger questions are used. As the interview is semi-structured, the researcher is

able to adjust some questions in the process of interview. In considering of the fact

that some participants have low English language ability, the interview instrument

have both English version and English-Chinese version (which is the native language

of the participants), both of these two interview instruments are in the appendix

(Appendix 1 and Appendix 2).

33

The first part of the interview instrument is mainly about some general information

of the participants. Question 1 gets the non-identifying information of the

participants, such as age, gender, education background. That does NOT include

your name and other identification information. Question 2 and 3 mainly intend to

know their general understanding about SHCS and their experience in using smart

facilities.

Section 2 is about the barrier and expectations of the participants in using SHCS.

The questions involve the barriers in their general opinion and in the field of some

potential widely concerned problems such as privacy, reliability, cost, functions and

emergency assistance service and so on. The detailed questions are shown in the

interview instrument. As has been explained, during the interview of this part, some

new questions are asked by the researcher. However, since these questions differ a

lot from each other, it is hard to summarize these questions.

3.6 Sampling

The research data collected in this study comes from 8 participants of the

interviews. All the 8 participants come from Tianjin of China, which is a large city

with population more than 14.13 million (TianJin Statistical Information Net, 2013).

Among them, there are 5 female interviewees and 3 male interviewees. The

interviewee with the highest age is 77 and the lowest age is 58. In order to identify

the participants, they are anonymized based on the date order of the interview

along with their gender and age. For example, for anonymous information (P1, M,

70), P1 means participant 1, M means his gender is male, 70 means his age is 70.

34

This is mainly used in the discussion of chapter 4, findings. The detail list of the

participants is showed below:

Reference ID Participant ID Gender(M/F) Age

(P1, M, 70) P1 M 70

(P2, F, 58) P2 F 58

(P3, F, 62) P3 F 62

(P4, F, 68) P4 F 68

(P5, F, 62) P5 F 62

(P6, M, 59) P6 M 59

(P7, F, 77) P7 F 77

(P8, M, 63) P8 M 63

As Tianjin is a relatively developed area of China, the participants have good

education background and relatively good economic capacity. At the same time,

Tianjin is one of the 103 cities of 2013 annual Chinese national smart city pilot cities

(Ministry of Housing and Urban-Rural Development of the People Republic of China,

2013). Meanwhile, as introduce in literature review section 2.3.2, Tianjin has an

landmark project of Smart City (Sino-Singapore Tianjin Eco-City), people have a

common sense about the concept of smart city. Therefore, the study can get the

first hand research data about the citizens ’ (who are from a pilot city of “Smart City”

in China) opinion about SHCS. Other more information of the participants (how they

are recruited) will be clarified in section 3.8 Ethical aspects.

35

3.7 Data analysis approach

The research data is first kept as digital sound recording of the telephone interview.

After collecting the research data, the researcher translated these sound recordings

into text transcription. And then the research data collected by semi structured

interview is analysed through a thematic analysis approach. Fereday and Muir-

Cochrane (2008) claim that thematic analysis is a method to process and analyse

research data in the form of themes, which can well fit the demand of analysing

qualitative research data. According to the definition of Braun and Clarke (2006),

there are mainly 5 stages for thematic analysis:

1. Get familiar with the data by the transcription of digital data into textual

data and have carefully and multiple times of review of the data.

2. Code and attach the textual data into codes.

3. Sort codes into potential themes and connect all the relevant codes to the

themes.

4. Review themes and develop concept maps.

5. Report the findings by analysis of the codes regarding to the research

questions and literature.

This study conduct the data analysis mainly based on the guidance of these above

steps. In addition, as pointed out by Boyatzis (1998), the textual data need to be

coded into codes after throughout review of the data and it is the key step to

transform the interview data into codes. The conceptual map which contains all the

themes and its corresponding codes need to be presented (Guest, MacQueen, &

Namey, 2011). In this study, the conceptual map contains the barriers of Chinese

36

elder people to use SHCS and their corresponding expectations of each barrier.

Meanwhile, the cause and consequence of each barrier and expectation are also

included in the conceptual map. The coding scheme and conceptual map are

attached in the appendix.

3.8 Research methodology limitations

As has been mentioned, when conducting the interview, the researcher and the

participants are not in the same location. Although telephone interview has many

benefits which have been discussed above, there are still some drawbacks of

telephone interview compared to traditional interview (Thomas & Burdon, 1994).

Because the researcher cannot see the face of the participants, some of the

participants’ emotion and feeling may not be recorded (for example, whether they

feel confusion in answering a specific question, whether they really like a specific

function).

3.9 Ethical aspects

The research participants are elder people, which are sensitive and vulnerable

group of people. In this case, this study is assessed and assigned as “High Risk”

project. To reduce the potential risk of the participants when they are participating

in this study, the following measures are taken.

First, all the participants are recruited by the personal relationship network of the

researcher. The researcher of this project is a Chinese international student and has

a relatively wide range of personal relationship network (such as family members,

classmates and friends) in Tianjin, China. All the participants recruited are elder

37

people aged around or over 65 who are healthy and have full independent ability.

To ensure their safety, the interview was conducted by telephone. As has been

mentioned, all that the participants need to do is just to stay at home, be

accompanied by their family members and be interviewed through telephone call

by the researcher. As has been clarified in the information sheet/consent form,

participation in this study is voluntary and the potential participants have the right

to withdraw at any time.

The potential participants will be informed about the purpose of the interview and

the informed consent will be sent to them through the researcher’s personal

relationship network. They will be informed that the data will only be used in the

project and only for the research purpose. The interview will not start only after

that the participants clearly understand the details of the interview and agree to

sign the informed consent. The research Ethics application form, information

sheet/consent form, and Certificate of Approval are in the appendices.

38

Chapter 4 Findings

4.1 Introduction

As mentioned in Chapter 3, the research data was collected by using interviews. In

this chapter, after the research data is analysed by a thematic analysis approach,

the findings of this research will be given. The code of all the barriers will be divided

into 4 themes, namely: lack of understanding, price and cost barriers, reliability

barriers and individual differences in demand. As has been explained, except for the

barriers of using SHCS, the research also aims to find out the suitable SHCS

functions and facilities for Chinese elder people. Thus, all the barriers will be

presented below one by one, along with the corresponding expectations at the end

of each theme. The detailed coding scheme and conceptual map will be given in the

appendix.

In addition, the further discussion and conclusion of these findings will be given in

chapter 5.

4.2 Lack of understanding

In this section, the principal barriers about using the SHCS for Chinese elder people

will be discussed. Overall, all the interviewees of this study do not have a good

knowledge and understanding of the detailed functions of SHCS. But all the

interviewees have shown great interest in trying to get more information about

SHCS and are willing to have some user experience if it is possible.

39

4.2.1 Lack of popularization

As pointed out by Kotler (2012), “Reach is most important when launching new

products”. AS we can see from the literature review, currently, SHCS is not a widely

used smart system all over the world. There are researchers in some advanced

research institutions who are conducting relevant study. However, especially in

China, SHCS is far more from having an extensive use by people. When the

interviewees were asked about their understanding of SHCS, they all know very

limited information.

“I do not really understand SHCS. I have ever used step counter: you take it along

with you when walking, it can show how many steps have you walked. I have used

this but I am not sure whether it belongs to SHCS or not. I do not have experience in

using other equipment.”(P2, F, 58)

“Never heard about it. I guess maybe SHCS is something about automated remote

control.”(P7, F, 77)

The interviewees mainly get the information about SHCS from the TV series and

magazine or heard from their friends, and some interviewees do not have direct

contact with such smart systems. Their knowledge about SHCS is limited and they

nearly have no user experience about SHCS features:

“I have ever heard about it, but I do not know some detailed information.” (P4, F, 68)

“I have ever known the elder people can make call to 120(the emergency alarm

telephone call number in Chinese NHS) by only press one button, but I have never

heard who have one in his house nearby.”(P3, F, 62)

40

Furthermore, it is evident that if people want to purchase the facilities or use the

service of SHCS, they should have some common sense about the SHCS. While SHCS

is not a widely known by Chinese people, it seems that more introduction is needed,

to let people know more information about SHCS and have confidence in using this

smart system.

4.2.2 Unfamiliar with specific functions

In fact, this barrier is, to some extent, a little similar to the barrier “lack of

popularization”. However, they do have some difference. The “lack of

popularization” of SHCS in China mainly affects their confidence of people to

purchase or use the system. According to the theory of Aronson, E., Wilson, T. D., &

Akert, R. M. (2007), the conformist mentality can have a strong influence when

people make decisions: most of the other people use this system, so I want to try to

use it. Thus, the popularization of SHCS will make people worry less in using it.

Nevertheless, in this part, we will focus on that some specific functions the

interviewees feel useful but do not know they already exist. Participant 1

mentioned:

“I have a friend who is an Alzheimer's patient. One time, he got lost. His family and

the police spent a lot of time to find him, by using the camera in the traffic control

port. They worried about his safety a lot before finally finding him. If there are some

features that can allow his family to know his position at any time, it will be rather

good. But I do not know whether there are such kind of products in China and

whether it needs to be allowed by the police.”(P1, M, 70)

41

This kind of user requirement can be satisfied by using GPS (Global Positioning

System) service. However, the point is, even though the elder people have such kind

of requirement to use this function, they do not know its existence and how to get

this kind of service.

“As the customer and user, we at first need channel to know this function. People

need to know its existence and where to buy it. Both by the introduction of friends or

by advertising should be ok.”(P6, M, 59)

As has been mentioned in chapter 2, Chinese elder people, especially for who are

over 60 years old, do not have a good knowledge of using computer. According to

Zhang (2013), the Chinese elder people over 60 years old accounted for only 0.7%

of the total number of Internet users until November, 2011. Therefore, the elder

people have relatively few sources of getting information in such emerging field like

smart systems.

4.2.3 Corresponding expectations

In this part, the corresponding expectations to this theme of barriers mentioned in

this section (namely “lack of understanding”) will be discussed. Moreover, these

expectations reflect the people’s view to SHCS and what features they think are

suitable for Chinese elder people. The interviewees have some general expectations

and also some very detailed expectations or, more accurately, requirements.

4.2.3.1Willing to experience

Although the interviewees have known limited information about SHCS, they have

shown great interest in experiencing these smart systems. After a short

42

introduction about SHCS by the interviewer, the interviewees consider SHCS is a

useful smart system and have high expectation on it. Participant 1 said:

“I am very confident in SHCS. The main problem is that people have more common

sense about its function, the ordinary people can afford its cost, it should be easy to

maintain, like the radio, not very expensive and can be carried and used easily. I

hope it could be as popular as radio, I am willing to try to use SHCS.”(P1, M, 70)

At the same time, the interviewees also have great confidence in modern

technology. No matter they get information from the TV or newspaper, or no

matter whether they use computer and smart mobile phones or not, they have a

general understanding about it and they believe the y can benefit by using this

modern technology:

“Like computer, it can be accepted by young people relatively quickly. It seems that

the elder people need some longer time to accept it. But once they benefit from

using it, they will know its advantage, and they will accept it. In addition, there will

be a social effect to promote people to accept it. I know now the proportion of older

people in China is improving very quickly, and products specially designed for elder

people are very rare. I think SHCS will have a large market in the near future.”(P5, F,

62)

4.2.3.2 Health caring and first aid

The interviewees are highly concerned about health caring and first aid issues. In

their opinion, the health and safety are the top two important things in their life.

Participant 2(P2, F, 58) explains that she currently considers more about health

43

issues, and has no high demand for other things such as food and clothing. During

the interview, the function of “one button medical alarm” is treated as a very good

and useful function, regardless of the interviewees’ concern about its cost and

reliability, which will be discussed later in this study.

One important cause of this expectation is that the elder people usually have

multiple unhealthy status.

“Such as Heart disease and Cerebral thrombosis, the time from onset to get

treatment is very valuable: people may die of these in a short time. I think for elder

people, the older they are, the more they are feared of death. So they are more

concerned about this kind of accident and emergency cases. They care less about

other services which aims to let life more convenient.”(P4, F, 68)

Another reason is the family structure in China. As mentioned in chapter 2, many

elder people are living separately with their children. Among them, there are some

elder people who live alone. So when they are in emergency, they need a reliable

way to get fast access to the hospital or guardianship agency.

“I will consider purchasing the ‘one button medical alarm’ service, because there are

relatively few family members in my home, only me and my husband. In some

emergency cases we need this to seek for help from the others. Families with few

people need this service very much.”(P7, F, 77)

4.3 Price and cost barriers

In this section, the researcher aims to summarize the participants’ barriers related

to the field of price and cost. As SHCS has not been made extensive use by

44

worldwide people and also its facilities have no mass production, the price and cost

of using SHCS is an important factor to affect the spread of its usage. Besides,

because of the influence of Chinese traditional ethics philosophy, Chinese elder

people treat ‘saving’ as traditional virtue. Thus, the elder people will think over the

price and cost carefully before using SHCS.

4.3.1 Economic capacity is not high

Although the economy of China has met rapid development in the last 50 years,

China is still a developing country. According to the data of International Monetary

Fund (IMF) (2014), the gross domestic product (GDP) per capita of China ranked

only 85 in all the countries all over the world. Therefore, the purchasing power of

Chinese residents is relatively low. Participant 3 claimed:

“The price is very important. If this kind of system is very cheap, people aged like me

can accept it. But if SHCS is expensive and has a high requirement of economic

capacity, we may not accept to use it. Because, after all, our income is still in the

level of wage-earning class, we cannot afford a high economic requirement.”(P3, F,

62)

During the interviews, nearly all the participants kept mentioned that the price

should be reasonable and relatively low, otherwise even the function is rather

useful they might reject to buy. Participant 3 said “If the cost of the system is

around tens of thousands RMB yuan, it will be rather expensive.” When asked by

some questions about private protection and reliability, the participants will still

highlight that the price is an important factor for them to make any decisions.

45

4.3.2 Maintenance and service fees

When considering about price and cost issues, the interviewees are also highly

concerned about the maintenance and service fees. As some features like “one

button medical alarm” must be long-term effective, the maintenance is essential to

keep the facilities effective whenever it is used. Otherwise the equipment failure

can make the reliability of the facilities stays at an untrustworthy level. At the same

time, the medical emergency service like ambulance is not free of charge in China.

No matter an elder people caring agency or the hospital is responsible to response

this kind of alarm signal, the users must pay service fees.

“For example, if I want to install a medical alarm machine, I might only use it once a

year. But I need to invest a lot of money for facilities and service fees. But things like

electrical appliances are still burn-in and ageing even they are not used. The

appliance themselves have a service life for around 8 or 10 years, and they are still in

damage without being used.”(P3, F, 62)

Therefore, the interviewees calculate the maintenance and service fees into the

total cost to install and use SHCS. A high-frequency maintenance and large amount

of service fees will be a barrier for the elder people to use SHCS. In fact, the price

and cost of SHCS is still playing a decisive role: the elder people will consider

whether the systems have high price-performance ratio or not.

4.3.3 Replace the original home facilities

“…I am not sure whether I need to install something or it will make damage to my

original decoration of my house. If the cost is high, I might not accept. If it is not a

46

big change, I can accept. But the premise is that I feel it is very necessary function

and it impress me very much and is very useful.”(P2, F, 58)

This barrier is particularly related to some functions like automatic door and

window. For example, the participants worried about that, to install an automatic

window, they need to replace the original window or add some new facilities .

Nowadays, indoor decoration is rather popular in the houses of Chinese. If the new

installed facilities are not in the same style to their original decoration, the overall

appearance of the indoor decoration might be rather disharmonious. The

interviewees worried whether some part of the Installation of SHCS will make

damage to the original decoration, or even the householder needs redecoration. In

this case, it means the actual cost of SHCS will increase. Meanwhile, the

householder might feel uncomfortable to the new environment.


This part will mainly focus on the corresponding expectations to price and cost

barriers of the elder people. Along with general expectations, there are some

detailed approaches that the interviewees think can reduce their economic burden

in using the SHCS, which are more acceptable in their opinion. The expectation of

High Price–performance ratio is in a more general and common level shared by all

the interviewees. The next 2 expectations followed are in a more detailed level. In

fact, the willing to ensure a high Price–performance ratio service is the reason why

the interviewees have the following 2 detailed expectations.

47

4.3.4.1 High Price–performance ratio

To summarize the interviewees’ general expectation in the field of price and cost,

high price-performance ratio comes first as a basic requirement. Although the usage

of SHCS does not spread widely all over the world, the interviewees, as the

potential users of SHCS, still have some evaluation criteria in their mind:

“I will consider the cost of purchase facilities as well as the cost when using the

systems and the price-performance ratio should be high. For example, some elder

people need to be accompanied by others. If he can take care of himself, then he

does not need the company by others, merely a monitoring system can satisfy his

need for being safety. Then he will compare the fees between human monitoring

and SHCS monitoring.”(P6, M, 59)

The elder people have different requirements depend on different conditions,

which will be discussed in section 4.6. However, high Price–performance ratio of the

system is a common requirement. Participant 3 argued that “If you want me to

install SHCS, I might still not accept as long as the economic requirement is high.

However good the function is, I need to consider its cost performance ratio.”

4.3.4.2 Pay fees separately

Similar to the purpose of making payment by installments, the participants intend

to reduce the money they paid in a short period. As most of the elder people get

income from pension insurance or salary, they have relatively stable income every

month. By pay fees separately, their economic pressures of purchasing SHCS is

reduced. This expectation contains the means of paying by instalments and other

means. As participant 8 said:

48

“I prefer to pay a part of the facilities fees first and then to pay long-term

maintenance and service fees. This will be better because the elder people can have

relatively lighter economic burden. Also, some approaches such as leasing service

will be easily accepted. Long-term paid service fees can reduce the purchasing

pressure of users.”(P8, M, 63)

By paying the fees separately, the users can be more independent to make

decisions. One advantage is that the users can stop the service whenever they find

the function is not really useful. Since the users do not pay all the money when they

start to use the system, their loss of abandoning using the system will be

significantly reduced. In this way, the elder people are encouraged to experience

SHCS.

4.3.4.3 Free or paid trial service

Trial service is another way to encourage the elder people to experience SHCS, but

it can give more freedom to the elder people. The elder people can get the chance

to try the service which they are interested in. By using the trial product or trial

service, the elder people can get a more intuitive Impression on the functions of the

system and experience its benefit.

“Free trial is certainly acceptable for me. Paid trial is also acceptable based on its

service scope and content, such as facility fees and service fees. If the system can be

effective when I have some problems, even only once (not frequent), I think it is

valuable and worthy of my investment.”(P5, F, 62)

49

Trial service can not only solve the elder people’s worry in the aspects of cost, but

also let the elder people get familiar with the functions of SHCS. Once only when

they benefit from the new product, they will start considering the necessity to buy

it.

4.4 Reliability barriers

In this section, the participants’ barriers in using SHCS, which are related to the field

of reliability of SHCS, will be given. As mentioned in section 4.2, Chinese elder

people do not have a deep understanding of SHCS. Thus, the interviewees have

some doubts both in the reliability of SHCS itself and in the reliability of its functions.

They doubt whether the system is reliable and highly developed, and require that

the system must be able to work as expected when they need to use it. In fact, the

reliability barriers mainly come from the different reliability demands of elder

people.

4.4.1 Hard to find a most reliable way to promote SHCS

The interviewees worry about the reliability of the information source of SHCS. It is

primarily caused by their different trust in the means they get the information of

SHCS. For example, advertising is a widely used method by most enterprises to

promote their products. The aim of advertising is to let customers or potential

customers know an enterprise’s products and believe they are the best (Rossiter &

Percy, 1987). However, as SHCS is not widely used all over the world, people do not

have much confidence in its advertising. Participant 3 explained that:

50

“I do not like advertising. I feel the advertisings in TV are unreliable. … For example,

if a friend tells me this product is extremely good, then I would dare to try it.

Because he has, after all, a relatively better understanding or he has ever used it. It

will be easier for me to accept. I dare not to buy product by watching the advertising.

I have ever been fooled to buy some products, which are not as good as what they

said in the advertising.”(P3, F, 62)

Although getting the information of SHCS from the introduction of friends is

considered as a reliable way by the interviewees, some interviewees have different

opinion. They argued that the most reliable information source of SHCS should be

the recommendation of the government.

“The recommendation of government is still more reliable. Other approaches let

people feel unbelievable.”(P8, M, 63)

“…When I want to buy a SHCS, the recommendation of government is the most

reliable one. But in the early stage of its promotion, advertising is still rather

effective. Finally, when I need to buy it, I will consider the most reliable information

source, intending to be safe and reliable. (P4, F, 68)

In summary, because people have different trust degree in different information

sources of SHCS, it is very hard to find a most reliable way to promote SHCS, which

makes the promotion of SHCS more complex and difficult.


In this section, the research findings related to the reliability expectation will be

given. The expectation about 4.4.2.1 reliability of facilities and service source is in a

51

more general level and 4.4.2.2 “Reliability of real-time monitoring service” is in a

more specific level.

4.4.2.1 Reliability of facilities and service source

The interviewees have reached a consensus unconsciously that the facilities or

service of SHCS must be highly reliable. Especially for some functions like medical

alarm and first aid service, when people need to use it, people are in emergency

and highly demand the facilities play its correct role. To ensure the facilities are

effective and reliable, most of the participants prefer to choose the facilities

produced by large famous brands than new companies, even if the new companies

are more professional in the field of SHCS.

“Overall, I believe more in traditional large famous brands, even though its price

might be more expensive. Especially for this kind of SHCS products, its reliability

must be good. Reliability comes first.”(P1, M, 70)

“I tend to select big brand. Since I have chosen to use it, I will require its high

reliability. Otherwise it is better not to choose it. When I really need to use it, it

should be sensitive and effective.”(P2, F, 58)

When considering the reliability of service supplier, again the participants have

more confidence in the government. The researcher still takes one button medical

alarm as an example. Its service supplier can be 120 Emergency Center (in Chinese

NHS system) or professional elderly caring center. Participant 8 said:

“I think 120 Emergency Center is more reliable. The medical assistance is relatively

more reliable. Currently people who can afford the service of a professional caring

52

center are few. And I do not have too much understanding about professional caring

center. More people can enjoy and benefit from medical insurance.”(P8, M, 63)

Overall, no matter the interviewees choose big famous brands or government

service, they expect to ensure the reliability of the facilities and service source of

SHCS. Reliability and price are two major factors that the elder people will think

over before purchasing and using SHCS. Certainly, the premise is that people find

the function is practical.

4.4.2.2 Reliability of real-time monitoring service

This expectation is a more specific expectation about the people’s demand of real-

time monitoring service. Real-time monitoring service is considered as a very

practical service by the interviewees. As described in the literature review, by using

wireless sensor network, the current technology of SHCS are already able to supply

a real-time monitoring service to ensure the elder people are in a normal condition

when they are staying in the room (Tabar, Keshavarz & Aghajan, 2006). Also there is

a cheaper way to achieve this kind of monitoring: using human monitored Closed-

circuit television (CCTV) camera. However, except for the concerns about privacy,

the interviewees have some more requirements about its reliability:

“The first kind of service is better, because it can monitor all the time, the second

one is intermittent. … I think the semi-automated service is better. As for elder

people, their thought is somehow a little conservative. I feel safer and more reliable

if I can see some people. This kind of alarm is useful when I start to contact outside,

but eventually to see some people is more reliable to me.” (P4, F, 68)

53

The interviewees have more trust in the reliability of monitoring job done by

automated facilities than the job done by human, because smart facilities are less

likely to make error than human (Participant 1). And they require the continuity of

the monitoring and the service to be semi-automated to enable them to finally get

contact with or service from “real” people.

4.5 Individual differences in demand

In this section, the study will focus on barriers caused by different demands. As the

condition of elder people differs from each other, the elder people have different

user requirement for the functions and attributes of SHCS. Some of these demands

do not have huge difference. However, some demands have significant difference

between each other. Because the user demands are different and complex, it is

hard to find a widely suitable and applicable system of SHCS. To some extent, this is

a barrier both for the promotion of SHCS and for Chinese elder people to use SHCS.

4.5.1 Different demands in privacy protection

As a very sensitive topic, the privacy protection is treated as an important aspect by

the potential users of SHCS. Privacy rights are important and basic rights of people

(Steiner, Alston & Goodman, 1996) and the violation of privacy is happening

everywhere (Moore, 2010). The interviewees worry about the safety of their privacy

when using some functions like wireless sensor monitoring or CCTV monitoring. The

purpose of these functions is to let the elder caring center or emergency center can

get the alarm of some emergency situations (for example, accidental fall-down and

coma) automatically and as soon as possible. The interviewees have different

opinions about this function.

54

“If I think the monitoring is helpful for me, of course, I want it to be active for 24

hours per day. It will not make damage to my privacy. Because I have not done

anything against the law or what I think should not be known by other people, then I

will not be scared. When the elder people lose self-care ability, on contrast, they will

hope to have someone to monitor his conditions all the time and can help him as

soon as some emergency situation happens, it is his inner need. (P5, F, 62)

The wireless sensor monitoring is regarded as an acceptable function. Because

people do not need to worry about that their action are monitored by some other

people. But for CCTV monitoring, most of the interviewees are opposed or can only

accept it in some specific situations, such as when elder people have no self-care

ability (P1, M, 70) or when the monitoring have a switchable power (P6, M, 59 & P7,

F, 77). In these cases their privacy can be less important or protected. Participant 3

thinks even sound monitoring is unacceptable, because sound can be easily

imitated and be used for purpose of fraud (P3, F, 62). Such kind of daily monitoring

will not be valued too much unless the elder people are in a highly necessary

situation of it. Otherwise the participants reject the risk to expose their privacy.

Participant 8 pointed out that:

“I prefer unmanned monitoring with wireless sensor. In this way the privacy will not

be violated. It is safe, reliable and can contribute to privacy protection. I am afraid

that normally people will not accept CCTV monitoring at home. The problem is that

no one will accept their privacy to be exposed in front of people. Even if the wireless

sensor monitoring is more expensive, I can accept.” (P8, M, 63)

55

In one word, most of the participant cannot accept their privacy to be exposed to

others unless some special constraints can be satisfied. Elder people in different

heath conditions and personal conditions have different demands for their privacy

protection. Meanwhile, even they are in the same situations, they may have

different thoughts about the importance of their privacy: 1, whether the necessity

of using such kind of function can overweight the risk of privacy violation? and 2,

can the risk be avoided? This different demand in privacy protection makes the

privacy issues rather complex during the design of SHCS.

4.5.2 Different demands in functions

In this part, the study will introduce the participants’ different demands in the

functions of SHCS. These demands vary mainly because of the age of the participant.

For participants who are under 65 years old, they are more willing to get to know

and use some functions related to make their life more convenience. They pay less

attention to functions related to emergency assistance.

“Emergency assistance is not practical for my age, and I think facilities which are

intended to make life more convenience will be more useful. I haven’t found some

obvious difficulties in my life.”(P3, F, 58)

On contrast, for participants who are over 65 years old, they think functions such as

one button emergency alarm and first aid are more important and useful. For the

service to make life more convenience (such as automatic door and window,

remote controlled air conditioner and curtains), they think is less important.

56

“(For service to make life more convenience) My personal experience is that it is not

very necessary for me, because elder people have plenty of time. Being retired at

home, I don’t have too much thing to do… …not in hurry to eat dinner and not

sensitive to hot and cold … so I feel that it is not very necessary. … I am more

concerned about medical emergency related functions.”(P4, F, 68)

“Both of these are useful. Emergency assistance is more necessary.”(P7, F, 77)

Surely, there is not a very exact boundary that, among all the elder people, which

age is exactly the age they start to care more emergency assistance issues. However,

the less the elder people’s self-care ability is, the more they need outside help.

According to the interviews, in general, people in higher age have more concerns

about life safety.


As the participants have different individual demands for the functions of SHCS, it is

hard to summarize a system can be completely accurate to satisfy all the elder

people. However, the participants do have some general expectations for the

functions and the system. Meanwhile, although some functions are not treated as

very useful by all the participants, the study will make a brief introduction and

summary of them.

4.5.3.1 Easy to learn and use

Although participant 8 claimed he would like the functions to be more complex and

more variety, the other participants cannot agree. However, as the scale of this

study is relatively small, there are only 8 participants. The opinion of participant 8

57

cannot be ignored. At the same time, in considering of the possibility that maybe

there are some elder people who are very familiar in using smart facilities such as

smart mobile phone and computer, these people may have the demand to have

more functions. Thus, this expectation is sorted into the theme of “Individual

differences in demand”. But as the majority of the participants showed their wish

that SHCS should be easy to learn and use, this expectation is defined as “easy to

learn and use”.

As has been mentioned in section 4.2, most of the participants have relatively

limited experience in using some smart facilities such as smart mobile phone and

personal computers (PCs). And they have many barriers in using the Internet. Thus,

some functions like web-based remote controlled home appliances and windows

are thought to be hard to learn and use. Besides, the participants claimed they have

enough time to do this kind of things. They believe these kinds of functions may be

more suitable for young people.

“Currently, some elder people (in China) have good education, but more of others

are workers, farmers and even illiteracy, their knowledge is limited. It will be better

if SHCS can be easier to use and more practical. Like the smart phone, many elder

people do not know how to use it. It will be more convenient if the function can be

simple.”(P1. M, 70)

The elder people have relatively weak ability to getting familiar with new things. For

elder people, however good the function is, it is meaningless if they cannot use it

properly. Or if they find it is hard to learn how to use the function, they will

58

abandon the usage. If the functions can be realised by press one button or

automatically, they will be highly appreciated by the elder people.

4.5.3.2 Summary of other demands

People have all kinds of requirements for the functions, to get a better promotion

of SHCS, its functions should be comprehensive and can satisfy different demands.

As has been mentioned, some functions are not widely accepted by all the

participants, but the participants do have some comments and good expectations.

However, these expectations are rather detailed and are only suitable for some

particular functions. In this part, the study will do a short and brief summary.

1. The monitoring functions should have good controllability and be switchable. This

function will be particularly useful when people have no self-care ability or when

they are ill and need caring. It is also very useful for elder people who have

Alzheimer's, Hypertension, Heart disease and Thrombosis. It will be ideal if it can

also be used in the prevention of theft. Wireless sensor monitoring is particularly

reliable.

2. The facilities of SHCS can have back-up power in case of accidental power

outages. The smart electrical appliances are able to be power off automatically

when necessary.

3. Healthy caring functions and “One button medical alarm” functions are highly

appreciated by elder people.

4. People can pay services like “One button medical alarm” by the times that they

use the service.

59

5. Global Positioning System (GPS) service is very useful for the advanced ages.

60

Chapter 5 Conclusion and Recommendations

5.1 Introduction

In this chapter, the study will summarize the findings to the conclusion regarding to

the research questions and aims. Meanwhile, the research limitation and

recommendation for further research will be given at last.

5.2 Further discussion and Conclusion

From the above discussion in chapter 4, the barriers of Chinese elder people to use

SHCS in their daily life are presented, along with their corresponding expectations in

the related field of each barrier. The four themes of the barriers are: “Lack of

understanding”, “Price and cost barriers”, “Reliability barriers” and “Individual

differences in demand”. In this section, the study will summarize the barriers and

the participants’ corresponding expectations of each theme to address the research

questions.

5.2.1 Summary of “Lack of understanding”

5.2.1.1 Barriers

From the literature review, although the theory of Smart City is widely accepted and

has attracted the attention of many national leaders and city leaders, SHCS is not

currently widespread used all over the world. Chinese elder people know limited

information about SHCS and generally have no direct contact with it. Thus, Chinese

elder people have no user experience about SHCS. Meanwhile, the elder people

have few sources of getting information about SHCS. It makes them be unaware of

61

the existence of some functions and services. Even if the functions and services are

highly needed, the elder people do not know the approaches to know and get

access to them. Therefore, “lack of understanding” about SHCS is the principal

barrier for Chinese elder people to use SHCS.

5.2.1.2 Corresponding expectations

However, as the functions and services of SHCS are considered to be useful and

highly expected by the participants and Chinese elder people have enough

confidence in current technology, the participants are willing to experience SHCS. In

addition, the services related to “the health caring and first aid” in SHCS are treated

as particular useful because of the multiple unhealthy status of elder people and

living alone or separately from their children. The participants believe that SHCS can

have a good customer market in Chinese elder people.

5.2.2 Summary of “Price and cost barriers”

5.2.2.1 Barriers

As has been mentioned, the GDP per capita of China ranks only number 85 in all the

nations worldwide (IMF, 2014). And as most Chinese elder people get income

mainly from wage and pension insurance, their economic capacity is relatively not

high. The participants required SHCS should have a reasonable and relatively low

price. Also the maintenance and service fees are treated as an important point in

considering. High price-performance ratio is demanded. As to install some facilities

(like automatic window) may damage original decoration of the house and maybe

make indoor decoration disharmonious, which will finally make the total cost

62

increase, the possibility of replacing original home facilities is also concerned by the

participants.


According to the barriers in price and cost issues, the participants have one general

expectation that the system should have high price-performance ratio. In a more

detailed level, they also expect they can pay fees separately and get some free or

paid trial of the service.

5.2.3 Summary of “Reliability barriers”

5.2.3.1 Barriers

Because of the lack of popularization of SHCS in China, the reliability of the systems

is an important problem. It is hard to find a most reliable way to promote SHCS, as

the elder people have different trust degree in different information sources, and in

particular, they have no trust in advertising. There is no unique most reliable

information source and it makes it difficult to promote SHCS. And it also makes

Chinese elder people worry about the reliability of SHCS.


The worries of the participants about the reliability of SHCS are more likely to be

expectations. In order to ensure the facilities are effective when people need to use

them, the participants prefer to choose facilities produced by some big famous

brands and services supplied by the government. In this way, the participants

believe the reliability of facilities and service source can be promised. In particular,

for the widely welcomed real-time monitoring service, the participants believe

63

smart facilities are more error-free than human being, and they will feel safer to see

or get contact with people in emergency situations. Therefore, the participants

require the continuity of the monitoring and prefer semi-automated service.

5.2.4 Summary of “Individual differences in demand”

5.2.4.1 Barriers

As the opinions of the participants about privacy protection vary a lot from each

other, their barrier in using SHCS in privacy field is mainly summarized as different

demands in protection. Some participants have no privacy worries while others

believe their privacy issue is less important only when they lose self-care ability or it

has a switchable power which can be controlled by them. Otherwise they cannot

accept the risk of the violation of privacy. In one word, people have complex

different demands in the privacy issues. Meanwhile, the elder people have different

demand in the functions of SHCS based on their different age. The higher aged elder

people are more interested in the functions about health caring and emergency

assistance while the younger aged elder people prefer to know more about

functions that can make life more convenience.


One general expectation of the participants is that the functions should be easy to

learn and use. The elder people have relatively limited experience of use smart

facilities such as smart phone and computer and they have also many barriers to

use the Internet. At the same time, elder people have relatively weak ability to learn

new things. Thus, they expect the functions should be easy to learn and use,

otherwise they would rather abandon to use the functions to avoid having much

64

trouble in learning its operation method. At the last of this part, the study has done

a short and brief summary of the participants’ other expectations about some

widely concerned functions. To some extent, these expectations are in a very

detailed level but they may be useful for people who are doing researches in the

corresponding field.

5.2.5 Final conclusion

This study have conducted a research about how smart home caring system (SHCS)

can be used to provide better support and caring to elder people in China. By using

semi-structured interview as the data collection method and analysing the data

with thematic analysis approach, the findings are presented in chapter 4 Findings.

The research findings are mainly be summarized as 4 themes of barriers and the

corresponding expectations of each barrier.

For the four research questions:

(1) What kind of smart features and functions are needed by the elder people?

(2) Which ones are perceived to be more important by the elder people?

(3) What are the difficulties and barriers for the elder people to use smart

features and functions?

(4) What kind of possible efforts can be made to help smart home care

systems to do the most benefits to elder people.

Research question 3 is mainly addressed by the 4 themes of barriers and research

questions 1, 2, 4 are mainly answered by the corresponding expectations of each

theme.

In conclusion, although currently SHCS is not widely known or used in China, the

Chinese elder people have strong willing to experience it because of their high

65

demands for the variety of functions of SHCS, in particular, the health caring and

first aid service are treated as highly practical. However, the promotion is SHCS is

not easy. Besides, the price and cost must be relatively low with a high price-

performance ratio. The supplier of its facilities and services must be reliable. The

functions should be easy to learn and use and can satisfy different kinds of

individual demands.

5.3 Research limitation

Firstly, the background of interviewees is a limitation of this study. All the

interviewees are citizens in Tianjin province of China. As Tianjin is one of the four

municipalities in China, the interviewees have relatively a higher economic capacity

and better education background than Chinese elder people who live in the

countryside. Therefore, the data of this study may be affected by the background of

the interviewees.

Secondly, as the participants are mainly Chinese who are aged around 65 or over,

their English language ability is relatively low, thus the interview was conducted in

Chinese. The translation of their sentence might be not very professional.

Thirdly, the research scale is relatively not large. Because of the time limitation of

the research and the practicality of the interview, there are 8 participants and the

interview time for each participant lasts around 30-40 minutes. If the research time

can be longer, more research data can be collected from more interviewees.

At last, as SHCS and Smarty cities are very new areas for Chinese people, there is

relatively few professional literature in this field, people have no general

66

understanding of SHCS. The researcher has to make a general introduction to the

participants before conducting the interview. This introduction might have

influence on their opinions.

5.4 Recommendation for further research

As has been mentioned in the research limitation, the interviewees’ personal

background has important influence on the comprehensiveness of the data. To get

a widely suitable conclusion about the research questions, a research conducted in

more provinces and with more participants is necessary. At the same time, the

conclusion of this study can be used to generate a questionnaire to investigate the

exact support rate of each barriers and expectations. Furthermore, as the

technology of smart facilities is updating very fast, the functions of SHCS can also

have a fast development. Since currently many Chinese families have only one child,

the percentage of elder people in total population are increasing, which will make

the elder people caring issues be more concerned by the whole society. SHCS is

treated as very useful for elder people caring by the interviewees. Thus, the

research about the Chinese elder people’s barriers and demands in SHCS can be a

long-term research project.

Words Count: 14148

67

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Appendix 1 Semi-structured interview instrument

Section 1 general questions

1.1 Please introduce your basic information (only your non-identifying

information, such as age, gender, education background. That does NOT include

your name and other identification information).

1.2 How much do you know about Smart Home Caring System (SHCS)?

Follow-up:

Have you ever used SHCS?

What SHCS facilities or service do you know?

Have you heard that your friends or neighbors have ever used smart home care system?

Trigge questionsr:

What aspects of information do your want to know the most about SHCS?

On what types of facilities of SHCS do you want us to focus our introduction to you the

most?

1.3 Do you often use some smart facilities such as smart phones or computer?

79

Section 2 The barriers and expectations to use smart home caring systems

2.1 What do you think are your barriers in using SHCS? Why? Among them, which is the

biggest barrier for you?

Follow-up:

2.1.1 Do not have basic understanding about it?

2.1.2 Do not know how to use it?

2.2 You prefer some sample functions can be realised by one or two button or some

complex functions?

Trigger questions:

For example, you can get more functions by using smart phone to do some little bit

complex operation, and you can get more options and stronger function, do your prefer

this or just easy operated and sample functions by only press one button?

2.2 From where get the information of SHCS do you feel most reliable? For example, the

recommendation of government, business advertising, the introduction of friends, etc.

2.3 Are you willing to have a free or paid trial of SHCS?

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2.4 Are you concerned about the cost of SHCS? Do you have some requirements on its

cost?

Follow-up:

Do you prefer long-term investment or short-term investment? Why?

2.5 Do you have some concerns about the reliability of SHCS and the portential risk of

using it?

2.5 For medical emergency alarm service, which do you think is more reliable, 120

emergency center or professional elder caring center?

Trigger questions:

How to make it more reliable?

2.6 Do you have some concerns about privacy protection in using SHCS? For example, can

u accept the CCTV camera monitoring?

2.7 For the facilities of SHCS, do you prefer automatic or semi-automatic facilities?

81

2.8 For the reliability of the facilities provider, do you prefer traditional famous brands or

emerging professional brands?

2.9 Which part of the following aspects of SHCS facilities do you want to know or use

more? 1. Emergency assistance facilities (For example, one button medical alarm) 2.

Facilities to make life more convenient (for example, smart door and window, remote

controlled appliances).

For example, fall-down monitoring alarm, automatic sound controlled facility, etc.

2.10 What aspects do you think the biggest daily home life inconvenience and risk comes

from?

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(Considering the fact that some participants have low English language ability, the inform consent will have both English version and Chinese version (which is the native language of the participants), here is the Chinese version).

Appendix 2 Semi-structured interview instrument

Chinese and English version

半结构式访谈问题提纲中英文版

Section 1 general questions 第一部分基本问题

1.1 Please introduce your basic information (only your non-identifying

information, such as age, gender, education background. That does NOT include

your name and other identification information).

1.1 您的基本信息（仅限于非标识化信息，例如年龄，性别，教育程度等，即不包括

姓名等标识化信息）

1.2 How much do you know about Smart Home Caring System (SHCS)?

1.2 您对智能家庭关爱系统的概念了解有多少？

Follow-up:

跟进问题：

Have you ever used SHCS?

您使用过智能家庭关爱系统么？

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What SHCS facilities or service do you know?

您知道哪些智能家庭关爱系统的设备或者服务？

Have you heard that your friends or neighbors have ever used smart home care system?

您听说过周围朋友或者邻居有使用过智能家庭关爱系统的么？

Trigger questions:

触发问题：

What aspects of information do your want to know the most about SHCS?

您对智能家庭关爱系统最想了解哪些方面的信息？

On what types of facilities of SHCS do you want us to focus our introduction to you the

most?

您最希望我们向您重点介绍哪些类型的智能家庭关爱设备？

1.3 Do you often use some smart facilities such as smart phones or computer?

1.3 您平时经常智能手机或者电脑这种智能化设备么？

Section 2 The barriers and expectations to use smart home caring systems

第二部分使用智能家庭关爱系统的阻碍和期望

2.1 What do you think are your barriers in using SHCS? Why? Among them, which is the

biggest barrier for you?

2.1 您觉得使用智能家庭关爱系统阻碍是什么？为什么？其中，什么是最大的阻碍呢？

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Follow-up:

跟进问题：

2.1.1 Do not have basic understanding about it?

2.1.1 缺乏基本了解？

2.1.2 Do not know how to use it?

2.1.1 不知道如何使用？

2.2 You prefer some sample functions can be realised by one or two button or some

complex functions?

您更喜欢一个两个按键就能实现的简单功能的还是说喜欢功能复杂一些？

Trigger questions:

触发问题：

For example, you can get more functions by using smart phone to do some little bit

complex operation, and you can get more options and stronger function, do your prefer

this or just easy operated and sample functions by only press one button?

比如，你可以通过智能手机进行一些稍微复杂一些的操作，更多一些的选项，可

能功能会更强大，还是更倾向于壹个按钮就可以解决，只需要最基本的功能？

2.2 From where get the information of SHCS do you feel most reliable? For example, the

recommendation of government, business advertising, the introduction of friends, etc.

您觉得最希望从哪些方面获得这类信息（最值得信任）：如政府推广实施，商

家宣传，朋友介绍等

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2.3 Are you willing to have a free or paid trial of SHCS?

您愿意无偿或者有偿试用么？

2.4 Are you concerned about the cost of SHCS? Do you have some requirements on its

cost?

您有对于智能家庭关爱系统的价格的担心么？你对它的成本有什么要求么？

Follow-up:

跟进问题：

Do you prefer long-term investment or short-term investment? Why?

您更倾向于长期性投入还是短期性投入?为什么？

2.5 Do you have some concerns about the reliability of SHCS and the portential risk of

using it?

您对智能家庭关爱系统的可靠性以及潜在使用危险有什么担忧么？

2.5 For medical emergency alarm service, which do you think is more reliable, 120

emergency center or professional elder caring center?

对于医疗急救报警服务，你觉得 120 急救中心还是专业老年人监护中心更可信？

86

Trigger questions:

触发问题：

How to make it more reliable?

如何增加可信度?

2.6 Do you have some concerns about privacy protection in using SHCS? For example, can

u accept the CCTV camera monitoring?

使用智能家庭关爱系统时，你对隐私方面有什么担忧么？比如你可以接受摄像头监控

么？

2.7 For the facilities of SHCS, do you prefer automatic or semi-automatic facilities?

您更相信无人化全自动的设备还是半人工半自动化的设备？

2.8 For the reliability of the facilities provider, do you prefer traditional famous brands or

emerging professional brands?

2.8 对于设备供应商的可靠度，您更信任传统著名品牌还是新兴专业品牌?

2.9 Which part of the following aspects of SHCS facilities do you want to know or use

more? 1. Emergency assistance facilities (For example, one button medical alarm) 2.

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Facilities to make life more convenient (for example, smart door and window, remote

controlled appliances).

For example, fall-down monitoring alarm, automatic sound controlled facility, etc.

2.9 您最希望了解或者使用哪方面的智能家庭关爱设备？ 1 紧急救助方面（一键报警）

2 使日常生活更方便化的设施（智能门窗，远程家电控制）如摔倒监控报警，自动声

控设施等.

2.10 What aspects do you think the biggest daily home life inconvenience and risk comes

from?

2.10 您觉得日常家居生活中最大的不便以及风险来源于哪些方面？

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Appendix 3 Coding Scheme

Code Definition

Lack of understanding Texts about Chinese elder people are lack of understanding about SHCS

Lack of popularization Texts about the SHCS are Lack of popularization in China

Limited information Texts about Chinese elder people know relatively l imited information about SHCS

No direct contact Texts about Chinese elder people have no direct contact with SHCS

Lack of an extensive use Texts about SHCS are lack of an extensive use

No user experience Texts describe Chinese elder people have no user experience about SHCS

Unfamiliar with specific functions Texts describe Chinese elder people are unfamiliar with specific functions of SHCS

Unaware the existence of the function Texts describe Chinese elder people are unaware of the existence of the function

of SHCS

Unaware the access of the service Texts describe Chinese elder people are unaware of how to get access of the

service of SHCS

Few sources of getting information Texts about Chinese elder people have few sources to get the information of SHCS

Wi l ling to experience Texts about Chinese elder people are willing to experience SHCS

Useful and highly expected Texts about Chinese elder people think SHCS are useful and have high

expectations

confidence in current technology Texts about Chinese elder people have confidence in current technology

Health caring and first aid Texts about Chinese elder people value health caring and fi rs t aid functions of

SHCS very much

Multiple unhealthy status Texts describe elder people usually have multiple unhealthy status

Elderly people living alone Texts about there are many Chinese elder people who are living alone or

separately from their children

Economic capacity is not high Texts describe the economic capacity of Chinese elder people is not high

Low purchasing power Texts about Chinese elder people has relatively low purchasing power

Wage-earning class Texts about most Chinese elder people get income from wage and pension

Insurance

Reasonable and relatively low price Texts about elder people require the reasonable and relatively low price of SHCS

Maintenance and service fees Texts about Maintenance of facilities and service fees of SHCS

Long-term effective service Texts about long-term effective service in SHCS

Maintenance is essential Texts about elder people think the maintenance of facilities is essential

Replace the original home facilities Texts about Chinese elder people worry about the install of new SHCS facili ties will

need to replace the original home facilities

Damage original decoration Texts about Chinese elder people worry about the install of new SHCS facili ties will

damage original decoration

Disharmonious indoor decoration Texts about Chinese elder people worry about the install of new SHCS will make

their indoor decoration to be disharmonious

Demand High Price–performance ratio Texts about Chinese elder people demand the SHCS should have High Price –

performance ratio

89

Pay fees separately Texts about people want to pay fees separately

Free or paid trial service Texts about Chinese elder people want to get free or paid trial service of SHCS

Hard to find a most reliable way to promote

SHCS

Texts about Hard to find a most reliable way to promote SHCS

Do not believe advertising Texts about Chinese elder people do not believe advertising

di fferent trust degree in different

information sources

Texts about Chinese elder people have different trust degree in di fferent

information sources

No unique most reliable information

sources

Texts describe there is no unique most reliable information sources for people.

Di fficult to promote SHCS Texts describe it is difficult to promote SHCS

Rel iability of facilities and service source Texts about the reliability of facilities and service source

Ensure facilities effective Texts describe people want to ensure the facilities are effective

Choose big famous brands Texts describe Chinese elder people prefer to choose big famous brands when

buying SHCS facilities

Choose government service Texts describe Chinese elder people prefer to choose government service when

choosing SHCS service

Rel iability of real-time monitoring service Texts describe Chinese elder people’s expectation to ensure the reliability of real -

time monitoring service

Smart facilities are more error-free Texts describe Chinese elder people believe smart facilities are more error-free

Feel safer to see people Texts describe Chinese elder people will feel safer to see people when they are in

emergency situations

require the continuity of the monitoring Texts describe Chinese elder people require the continuity of the monitoring

Prefer semi-automated service Texts describe Chinese elder people prefer semi-automated service

Di fferent demands in privacy protection Texts describe Chinese elder people have different demands in privacy protection

No privacy worries Texts describe some participants have no privacy worries

Lose self-care ability Texts describe when some people have no self-care ability

Switchable power Texts describe some people demand the monitoring system should have

switchable power

Complex privacy issues Texts describe the complex privacy i ssues of SHCS

Di fferent demands in functions Texts describe the participants have Different demands in functions

Demands of different age Texts describe the elder people have different demands in different age

Easy to learn and use Texts about the elder people demand SHCS should be easy to learn and use

l imited experience of use smart facilities Texts about elder people have limited experience of use smart facilities

Many barriers to use Internet Texts about elder people have many barriers to use Internet

Weak ability to learn new things Texts about elder people have weak ability to learn new things

Summary of other demands Texts about Summary of other demands of the participants

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Appendix 4 Conceptual Map 1

Lack of understanding

Lack of popularization

Unfamiliar with specific

functions

No direct contact

Lack of an extensive

use

limited information

no user experience

Unaware the existence of the function

Unaware the access of the

service

few sources of getting

information

Willing to experience

Health caring and

first aid

Useful and highly

expected

confidence in current

technology

Multiple unhealthy

status

Elderly people living

alone

91


price and cost barriers

Economic capacity is not

high

Low purchasing

power

wage-earning class

Reasonable and relatively

low price

Maintenance and service

fees

maintenance is essential

long-term effective service

Demand high price-performance

ratio

Replace the original home

facilities

Disharmonious indoor decoration

Damage original

decoration

Demand High Price–

performance ratio

Pay fees separately

Free or paid trial service

92


Reliability barriers

Hard to find a most reliable

way to promote SHCS

Reliability of facilities and

service source

Reliability of real-time monitoring

service

different trust degree in different

information sources

No unique most reliable

information sources

Difficult to promote SHCS

Ensure facilities effective

Choose big famous brands

Choose government service

Smart facilities are more error-free

Do not believe

advertising

Feel safer to see people

require the continuity of

the monitoring

Prefer semi-automated

service

93


Individual differences in demand

Different demands in

privacy protection

No privacy worries

Lose self-care ability

switchable power

Complex privacy issuesDifferent

demands in functions

Demands ofDifferent age

Easy to learn and use

limited experience of use smart

facilities

Many barriers to use Internet

Weak ability to learn new things

Summary of other

demands

94

Appendix 8 Research Ethics Approval Letter

95

Appendix 9 Proposal for Research Ethics Review

102

Appendix 10 Ethics Information/Consent form

The University of Sheffield. Information School

How smart home caring systems can be used to provide better support and caring to elder people in China?

Researchers

Rong Yin, E-mail: [email protected] Purpose of the research

The aims of this project are to explore the suitable features of a smart home care system for the elder people, to find out the difficulties and barriers for elder people to use smart home care systems and to give a possible suggestion on how smart home care systems for the elder people can be widely accepted and do the most benefits to elder people in China. Who will be participating?

Elder people aged around or over 65 in Tianjin, China. The interview is voluntary. What will you be asked to do?

We will ask you to participate in an interview (about 30-40 minutes) by telephone

about smart home caring systems. The interview will be conducted at the suitable time chosen by you. During the interview, all you need to do are staying in a safe and comfortable environment (for

example, at your home with your family members nearby) and being interviewed by the researcher over the telephone. What are the potential risks of participating?

The risks of participating are the same as your telephone call experienced in everyday life. During the interview, if you feel uncomfortable physically or mentally, or even without any reason, you have right to pause or end the interview at any time. What data will we collect?

Through the interview, we will collect qualitative data regarding your views and opinions towards potential usage of smart home caring system. We will only audio record the interviews.

103

What will we do with the data?

The interview will be recorded by a voice recorder first and then transferred to the

researcher’s personal computer. Then the recording in the voice recorder will be deleted immediately. The computer is protected by both complex login password

and anti-virus software. The digital audio recording file will be added with complex password. We will be analyzing the data for inclusion in my master’s dissertation. After that point, the audio records will be destroyed. The interview transcription with no indication of the original interviewee will be kept for future research purposes. Will my participation be confidential?

The data will be anonymized and no identifying information will be retained. The

data is only accessible to the researcher and will only be used in his master’s dissertation. If the participant stops participating at all time, all his/her data will be

purged.

The researcher will conduct the telephone interview in a personal room without any unrelated persons nearby. The interview will be recorded by a voice recorder first

and then transferred to the researcher’s personal computer. Then the recording in the voice recorder will be deleted immediately. The computer is protected by both complex password and anti-virus software. The digital audio recording file will be added with complex password. And the computer will be in careful control by the researcher, for example, it will be used only in safe environment and will be shut down whenever the researcher is not in front of screen. What will happen to the results of the research project?

The results of this study will be included in my master’s dissertation which will be publicly available. I will send a Chinese version of my dissertation to you and you can also contact the School in six months to get its English version.

104

I confirm that I have read and understand the description of the research project, and that I have had an opportunity to ask questions about the project. I understand that my participation is voluntary and that I am free to withdraw at any time without any negative consequences. I understand that I may decline to answer any particular question or questions, or to do any of the activities. If I stop participating at all time, all of my data will be purged. I understand that my responses will be kept strictly confidential, that my name or identity will not be linked to any research materials, and that I will not be identified or identifiable in any report or reports that result from the research. I give permission for the research team members to have access to my anonymised responses. I give permission for the research team to re-use my data for future research as specified above. I agree to take part in the research project as described above. Participant Name (Please print) Participant Signature

Researcher Name (Please print) Researcher Signature Rong Yin Date Note: If you have any difficulties with, or wish to voice concern about, any aspect of your participation in this study, please contact Dr. Angela Lin, Research Ethics Coordinator, Information School, The University of Sheffield ([email protected]), or to the University Registrar and Secretary.

mailto:[email protected]

105

Appendix 11 Ethics Information/Consent form

English and Chinese version

(Considering the fact that some participants have low English language ability, the inform consent will have both English version and Chinese version (which is the native language of the participants), here is the Chinese version).

谢菲尔德大学

信息学院 The University of Sheffield. Information School

如何使用智能家庭关爱系统来给中国的老年人提供更

好的帮助和关爱？ How smart home caring systems can be used to provide better support and caring to elder people in China?

研究人员 Researchers

殷容电子邮箱: [email protected] Rong Yin, E-mail: [email protected]

研究目标 Purpose of the research

本项目研究目标在于探索适用于老年人的智能家庭关爱系统功能，发现老年人

使用智能家庭关爱系统的困难和障碍，给予针对老年人的智能家庭关爱系统如

何被中国老年人广泛接受并最大化获益的可能的建议。 The aims of this project are to explore the suitable features of a smart home care system for the elder people, to find out the difficulties and barriers for elder people to use smart home care systems and to give a possible suggestion on how smart home care systems for the elder people can be widely accepted and do the most benefits to elder people in China.

谁会参加？Who will be participating?

这个访谈是针对中国天津的 65 岁左右或以上老人的自愿性访谈。 Elder people aged around or over 65 in Tianjin, China. The interview is voluntary.

你会被要求做什么？What will you be asked to do?

我们会请你参加一个长约 30-40 分钟的关于智能家庭关爱系统的电话访谈。


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你可以选择任何你方便的时间来进行这个访谈。在访谈进行中，所有你需要做

的事是呆在一个安全舒适的环境（比如，在你家里，由家人陪伴）并接受电话

访谈。 We will ask you to participate in an interview (about 30-40 minutes) by telephone about smart home caring systems. The interview will be conducted at the suitable time chosen by you. During the interview, all you need to do are staying in a safe and comfortable environment (for example, at your home with your family members nearby) and being interviewed by the researcher over the telephone.

参加的潜在风险是什么？What are the potential risks of participating?

参加这个访谈的风险跟你日常生活中打电话的风险一样。在这个访谈中，如果

你感觉身体或者精神上不舒服，你有权在任何时候暂停或者终止访谈，甚至没

有任何理由的情况下。 The risks of participating are the same as your telephone call experienced in

everyday life. During the interview, if you feel uncomfortable physically or mentally, or even without any reason, you have right to pause or end the interview at any

time. 我们会收集什么数据？What data will we collect?

通过访谈，我们会收集你对于使用只能家庭关爱系统的观点和建议的定性数据。

我们只会对谈话进行语音记录。

Through the interview, we will collect qualitative data regarding your views and opinions towards potential usage of smart home caring system. We will only audio

record the interviews. 我们会对这些数据做什么？What will we do with the data?

访谈会首先被语音记录器记录，然后传送到研究者的电脑上。然后语音记录器

中的录音会被立刻删除。研究者的电脑设有复杂的登陆密码和杀毒软件保护。电子录音文件会被添加一个复杂的密码。我们将分析数据用以纳入我的硕士毕

业论文。在这之后，这些录音将被销毁。不包含标识原受访者的访谈文字转录

将会被保存以供将来进一步研究使用。

The interview will be recorded by a voice recorder first and then transferred to the researcher’s personal computer. Then the recording in the voice recorder will be

deleted immediately. The computer is protected by both complex login password and anti-virus software. The digital audio recording file will be added with complex

password. We will be analyzing the data for inclusion in my master’s dissertation. After that point, the audio records will be destroyed. The interview transcription with no indication of the original interviewee will be kept for future research purposes.

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我的参加会被保密么？Will my participation be confidential?

这些数据将被匿名并且不会保留任何标识信息。只有本项目研究者会有权接触

这些数据，同时这些数据只会被用在研究者的硕士论文里。如果参加者在任何

时候停止参加，所以他/她的数据会被清除。 The data will be anonymized and no identifying information will be retained. The

data is only accessible to the researcher and will only be used in his master’s dissertation. If the participant stops participating at all time, all his/her data will be

purged.

研究者将会在一个没有任何无关人员在周围的个人房间进行电话访谈。访谈会

首先被电子录音器记录然后传送给研究者的电脑。此时电子录音器中的录音将

被立即删除。研究者的电脑设有复杂的登陆密码和杀毒软件保护。电子录音文

件会被添加一个复杂的密码。这个电脑会被研究者善加控制，比如说，只会在

安全环境下使用并且当研究组不在屏幕前时会被关闭。 The researcher will conduct the telephone interview in a personal room without any unrelated persons nearby. The interview will be recorded by a voice recorder first

and then transferred to the researcher’s personal computer. Then the recording in the voice recorder will be deleted immediately. The computer is protected by both

complex password and anti-virus software. The digital audio recording file will be added with complex password. And the computer will be in careful control by the

researcher, for example, it will be used only in safe environment and will be shut down whenever the researcher is not in front of screen.

这个研究项目的结果会怎样？What will happen to the results of the research project?

这项研究的结果将会纳入我的硕士论文中，这篇论文将会是公开的。我会发送

给您一个论文的中文版本同时你也可以在六个月内联系学院来获取英文版。 The results of this study will be included in my master’s dissertation which will be publicly available. I will send a Chinese version of my dissertation to you and you

can also contact the School in six months to get its English version.

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我确认我阅读并理解了这个研究项目的描述，同时我也有询问关于这个项目的

问题的机会。 I confirm that I have read and understand the description of the research project, and that I have had an opportunity to ask questions about the project.

我明白我的参与是自愿的同时我可以在任何时间放弃参加并没有任何负面后果。 I understand that my participation is voluntary and that I am free to withdraw at any time without any negative consequences.

我明白我可以拒绝回答任何特定的问题，或者拒绝做任何活动。如果我在任

何时候停止参加，所有我的数据会被清除。 I understand that I may decline to answer any particular question or questions, or to do any of the activities. If I stop participating at all time, all of my data will be purged.

我明白我的回答会被严格保密，我的名字或者标识不会被链接到任何研究材料

里，同时我也不会被任何来自于这个研究的报告所标识。 I understand that my responses will be kept strictly confidential, that my name or identity will not be linked to any research materials, and that I will not be identified or identifiable in any report or reports that result from the research.

我允许研究小组成员接触我的匿名答复。 I give permission for the research team members to have access to my anonymised responses.

如上所述，我允许研究小组在将来的进一步研究中再次使用我的数据。 I give permission for the research team to re-use my data for future research as specified above.

我同意参加如上所述的研究项目。 I agree to take part in the research project as described above.

参加者姓名（请打印）Participant Name (Please print)

参加者签名 Participant Signature

研究者姓名（请打印）Researcher Name

(Please print)

研究者签名 Researcher Signature

殷容 Rong Yin 日期 Date

注：如果你有任何困难存在于或者希望关注任何方面涉及你在这个研究中的参与，请联系安吉拉 .林博

士（ Dr. Angela Lin ），研究伦理协调员，信息学院，谢菲尔德大学

（ [email protected] ），或者联系学校登记和秘书处（ University Registrar and

Secretary.）。


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Note: If you have any difficulties with, or wish to voice concern about, any aspect of your participation in this study, please contact Dr. Angela Lin, Research Ethics Coordinator, Information School, The University of Sheffield ([email protected]), or to the University Registrar and Secretary.


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Appendix 12 Access to Dissertation

september 2014 - university of...

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