Older adults’ perspectives on the process of becoming users of assistive technology: a qualitative systematic review and meta-synthesis

Abstract

Purpose: To identify, synthesize, and evaluate existing literature concerning the process of becoming a user of assistive technology (AT).

Method: A systematic review and meta-synthesis were carried out. Five bibliographic databases (MEDLINE via PubMed, CINAHL, Web of Science, PsycINFO and SocINDEX) were systematically searched up to 13^th of March 2017, using two sets of search terms: (i) elderly and synonyms and (ii) assistive technology and similar words, and combined with a qualitative research filter. Articles were screened, read and critically assessed. The meta-synthesis was guided by Ricoeur’s theory of interpretation.

Results: Seventeen out of 4645 articles were included. Five phases emerged relating to the process of becoming a user of AT: phase A: Evaluating need, phase B: Acknowledging need, phase C: Incorporating the AT into daily life, phase D: Using the AT, and phase E: Future use. Three transitions, describing factors essential to moving from one phase to the next, were identified; from phase A–B: Valued activities are threatened, from phase B–C: Obtaining the AT and from phase C–D: Trust in the AT. No transition was identified from phase D–E.

Conclusion: The meta-synthesis led to a deeper understanding of the process of older adults becoming users of AT, by exploring findings across the included articles. The identified phases and transitions in the systematic review serve as an analytical framework for understanding the process from the older adult’s perspective. This review advocates for using a client-centred approach throughout the entire delivery process.

Implications for rehabilitation

• The process of the older adult becoming a user of AT involves an individualized time factor, and this supports the practice of individualized follow-up.

• The process of becoming a user of AT is closely related to self-image; healthcare professionals should support not only the use of AT but also the older adult’s emotional adjustment to a new self-image.

• The process is highly influenced by the older adult’s social context; healthcare professionals should consider involving the client’s social network in the AT delivery process.

Keywords:

• Qualitative systematic review
• assistive technology
• older adults
• meta-synthesis

Note

Acknowledgements

Thank you to information scientists Tove Faber Frandsen and Anne Marie Fiala Carlsen for assisting with the search strategy and Associate Professor Åse Brandt for constructive suggestions on the manuscript. A special thank you to Associate Professor Birthe D. Pedersen for assisting with the development of the Ricoeur-inspired analysis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 To make sure that there was no overlap between findings from the same study, it was decided that themes/subthemes had to be present in more than one study to be included in the current meta-synthesis.

2 The included off-the-shelf products where ex. Doro HandlePlus Mobile phone which is in this review judged as being produced to compensate for declined functioning.

3 Not hearing aids.

Additional information

Funding

This work was supported by University College Lillebaelt and the Danish Association of Occupational Therapists.