The psychosocial impact of home use medical devices on the lives of older people: a qualitative study

Abstract

BackgroundIncreased life expectancy and the accompanying prevalence of chronic conditions have led to the focus and delivery of health care migrating from the hospital and into people’s homes. While previous studies have investigated the integration of particular types of medical devices into the home, it was our intention to describe how medical devices are integrated into the lives of older people.MethodsAdopting a qualitative study design, 12 older people, who used medical devices in the home, took part in in-depth, semi structured interviews. In 7 of the interviews participants and their partners were interviewed together. These interviews were recorded, transcribed and analysed thematically.ResultsTwo themes were constructed that describe how medical devices that are used in the home present certain challenges to older people and their partners in how the device is adopted and the personal adaptations that they are required to make. The first theme of 'self-esteem’ highlighted the psychological impact on users. The second theme of 'the social device' illustrated the social impact of these devices on the user and the people around them.ConclusionsWe found that these devices had both a positive and negative psychosocial impact on users’ lives. An improved understanding of these psychological and social issues may assist both designers of medical devices and the professionals who issue them to better facilitate the integration of medical devices into the homes and lives of older people.

The use of advanced medical technologies at home: a systematic review of the literature

“…When it comes to children, they have to learn to incorporate disability, illness and technology actively within their process of growing up [27]. It seems that the use of medical technologies in the home can have both a positive and a negative psychosocial impact on patients and their families, which in turn causes ambivalence in experiences [27, 28]. On the one hand, patients in general gain more independence, an enhanced overall health and a better quality of life [29–34].…”

“…The need to provide emotional support and support with appropriate coping strategies is a key professional role [25, 26, 47]. Insight into the psychosocial effects on those involved can be used to assist designers of medical devices to find strategies to better facilitate the integration of these technologies into the home [28].…”

“…[80]CanadaRetrospective cohort study (all characteristics collected based on identification in electronic records and patient charts) n = 202 (patients)Home hemodialysisEnd-stage renal disease:Diabetes;Glomerulonephritis;Polycystic kidney diseaseThe study describes adverse technical events in a large cohort of home hemodialysis patients.Thomson, R., Martin, J.L., Sharples, S., 2013. [28]UKQualitative study;In-depth semi-structured interview n = 12 (patients)Transcutaneous electrical nerve stimulation device;Oxygen concentrator;Continuous ambulatory peritoneal dialysis;Stair-lift;NebulizerDiabetesThe article describes the psychosocial impact of home use medical devices on the lives of older people and how the devices are integrated into their lives.Toly, V.B., Musil, C.M., Carl, J.C., 2012. [37]USADescriptive, correlational, dross-sectional study;Structured interview, face-to-face, using the Demographic Characteristics Questionnaire, the Functional Status II–Revised Scale, the Center for Epidemiological Studies–Depression Scale, a Normalization Scale subscale, and the Feetham Family Functioning Survey. n = 103 (mothers)Mechanical ventilation;Intravenous nutrition/ medication;Respiratory/ nutritional support;Apnea monitors;Feeding tube;Tracheostomy tube;Supplemental oxygenNeuromuscular;Respiratory conditions;Gastrointestinal conditions;Cardiac conditions;Cystic fybrosis;Metabolic disorders;Renal disordersThe study describes various issues related to family functioning and normalization in mothers of children dependent on medical technology following initiation of home care.Toly, V.B., Musil, C.M., Zauszniewski, J.A., 2014.…”

Enhancement of an Auto-Injector Device for Self-Administration of Etanercept in Patients With Rheumatoid Arthritis Confers Emotional and Functional Benefits

“…As such, increasing a patient's belief in their ability to correctly administer their medication may help increase the level of adherence to that medication [11]. Devices can also impact positively on the self-esteem of elderly patients if they feel they have mastered the device [19]. Addition of the sleeve may therefore have a beneficial effect; the increased confidence and sense of control it gave to patients with resulting impact on confidence in the auto-inject procedure, may boost patient's compliance with treatment.…”

Evaluation and Fault Classification for Service Robot during Sit- to-Stand Movement through Center of Mass

“…A good understanding of psychological issues may help facilitate better integration of medical devices with users. Thomson et al [9] emphasized that medical devices have both positive and negative psychological impacts on users, and simply addressing safety requirements does not guarantee user satisfaction. Because the duty of a service robot is to provide satisfaction with its service, cases where robot fails to meet this need can reasonably be defined as a fault.…”