Gibson Grant, Dickinson Claire, Brittain Katie, Robinson Louise
School of Applied Social Sciences, Colin Bell Building, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
Institute of Health & Society, Newcastle Biomedical Research Building, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
BMC Geriatr. 2015 Jul 24;15:89. doi: 10.1186/s12877-015-0091-3.
Assistive Technology (AT) has been suggested as a means by which people with dementia can be helped to live independently, while also leading to greater efficiencies in care. However little is known about how AT is being used by people with dementia and their carers in their daily routines. This paper reports on a qualitative study exploring the everyday use of AT by people with dementia and their families.
The research employed a qualitative methodology. Semi structured interviews took place with 39 participants, 13 people with dementia and 26 carers. Key themes were identified using thematic analysis and the constant comparative method.
Three categories of AT use in everyday settings were identified; formal AT, accessed via social care services, 'off the shelf AT' purchased privately, and 'do it yourself' AT, everyday household products adapted by families to fulfil individual need in the absence of specific devices. Access to AT was driven by carers, with the majority of benefits being experienced by carers. Barriers to use included perceptions about AT cost; dilemmas about the best time to use AT; and a lack of information and support from formal health and social care services about how to access AT, where to source it and when and how it can be used.
It has been argued that the 'mixed economy' landscape, with private AT provision supplementing state provision of AT, is a key feature for the mainstreaming of AT services. Our data suggests that such a mixed economy is indeed taking place, with more participants using 'off the shelf' and 'DIY' AT purchased privately rather than via health and social care services. However this system has largely arisen due to an inability of formal care services to meet client needs. Such findings therefore raise questions about just who AT in its current provision is working for and whether a mixed market approach is the most appropriate provider model. Everyday technologies play an important role in supporting families with dementia to continue caring; further research is needed however to determine the most effective and person-centred models for future AT provision.
辅助技术(AT)已被视为一种帮助痴呆症患者独立生活的手段,同时还能提高护理效率。然而,对于痴呆症患者及其护理人员在日常生活中如何使用辅助技术,我们知之甚少。本文报告了一项定性研究,探讨痴呆症患者及其家人对辅助技术的日常使用情况。
本研究采用定性研究方法。对39名参与者进行了半结构化访谈,其中包括13名痴呆症患者和26名护理人员。使用主题分析和持续比较法确定了关键主题。
确定了日常环境中辅助技术使用的三类情况;通过社会护理服务获得的正规辅助技术、私人购买的“现成辅助技术”以及“自己动手制作”的辅助技术,即家庭对日常家用产品进行改造以满足个人在没有特定设备时的需求。辅助技术的获取由护理人员推动,大多数益处由护理人员体验到。使用障碍包括对辅助技术成本的看法;关于使用辅助技术最佳时机的困境;以及正规健康和社会护理服务在如何获取辅助技术、从何处获取以及何时以及如何使用方面缺乏信息和支持。
有人认为,以私人辅助技术供应补充国家辅助技术供应的“混合经济”格局是辅助技术服务主流化的关键特征。我们的数据表明,这种混合经济确实正在发生,更多参与者使用私人购买的“现成”和“自己动手制作”的辅助技术,而不是通过健康和社会护理服务。然而,这种体系很大程度上是由于正规护理服务无法满足客户需求而产生的。因此,这些发现引发了关于当前辅助技术供应究竟是为谁服务以及混合市场模式是否是最合适的供应模式的问题。日常技术在支持痴呆症患者家庭继续护理方面发挥着重要作用;然而,需要进一步研究以确定未来辅助技术供应最有效和以个人为中心的模式。