Lindahl Berit, Kirk Sue
Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, Borås, Sweden.
Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK.
Scand J Caring Sci. 2019 Mar;33(1):43-56. doi: 10.1111/scs.12615. Epub 2018 Oct 15.
To analyse and synthesise the research that has investigated the experience of home in relation to home mechanical ventilation (HMV).
Systematic integrative review. Four electronic databases (CINAHL, PubMed, Scopus and ISI Web of Knowledge) were searched between January 2010 and April 2017 as well as reference lists of included studies. Quantitative and qualitative studies meeting the inclusion criteria were critically appraised. Study findings were inductively analysed and synthesised using the integrative approach.
Twenty-one studies were included in the review. Two main themes emerged: home and at-homeness and altered interpersonal relationships. The literature suggests that the technology alters the meaning of home through its structural and conceptual reconfiguration. Paradoxically, the space is experienced as both a home and a workplace which creates tensions and ambiguities for HMV users/families and care workers. HMV users and their families attempt to recreate a sense of home and identity while gaining control over space and decision-making. Nevertheless, the home is seen as the preferred place to live and close bonds can develop between the different actors.
The literature suggests that the transformation of the meaning of home by the presence of technology and workers poses challenges that are often under-recognised. Healthcare professionals and personal care assistants need preparation for the complexities of working in the home setting in addition to clinical aspects of caregiving. Home adaptations need to be carefully planned and include design principles that retain 'at-homeness' while enabling the creation of a safe workplace.
分析和综合研究家庭机械通气（HMV）相关家庭体验的研究。
系统综合评价。检索了2010年1月至2017年4月期间的四个电子数据库（CINAHL、PubMed、Scopus和ISI Web of Knowledge）以及纳入研究的参考文献列表。对符合纳入标准的定量和定性研究进行严格评价。采用综合方法对研究结果进行归纳分析和综合。
该评价纳入了21项研究。出现了两个主要主题：家庭与归属感以及人际关系的改变。文献表明，该技术通过其结构和概念的重新配置改变了家的意义。矛盾的是，这个空间既被体验为家，又被体验为工作场所，这给HMV使用者/家庭以及护理人员带来了紧张和模糊感。HMV使用者及其家人试图在获得对空间和决策的控制权的同时，重新营造一种家的感觉和身份认同感。尽管如此，家仍被视为首选的居住场所，不同行为者之间可以建立紧密的联系。
文献表明，技术和工作人员的存在对家的意义的转变带来了挑战，而这些挑战往往未得到充分认识。除了护理的临床方面，医疗保健专业人员和个人护理助理还需要为在家中工作的复杂性做好准备。家庭改造需要精心规划，并包括在保留“归属感”的同时能够创建安全工作场所的设计原则。
