Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo 0130, Norway.
Department of Health Sciences, Faculty of Medicine, Lund University, Lund 221 00, Sweden.
Biomed Res Int. 2019 Mar 6;2019:9196729. doi: 10.1155/2019/9196729. eCollection 2019.
Cognitive impairments (CI), associated with the consequences of Alzheimer's disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.
认知障碍（CI）与阿尔茨海默病和其他痴呆症的后果相关，在老年人中越来越普遍，导致他们的自我护理、行动能力和人际关系恶化。创新的辅助技术（IAT），如电子提醒和监控系统，被认为是促进这一人群及其照顾者独立性的越来越重要的工具。本研究旨在综合知识，了解认知障碍患者及其照顾者对接受和使用 IAT 的促进因素和障碍。本系统评价包括具有定量、定性或混合方法设计的原始论文。在以下数据库中检索到 2007 年至 2017 年期间以英文发表的相关同行评议文章：CINAHL；PubMed；Inspec；和 PsycINFO。使用混合方法评估工具（MMAT）进行质量评估。我们检索了 30 项研究，共包括来自欧洲、美国/加拿大、澳大利亚和亚洲的 1655 名参与者，他们在自己的家中、护理院、日托中心或生活实验室中参与研究。三分之二的研究测试了集成家庭传感器和可穿戴设备的技术，用于护理和监测 CI 症状。接受和坚持使用 IAT 的主要促进因素包括对技术的熟悉度和使用动机、对有效性的直接感知（例如，增加安全感知）以及低技术要求。确定的障碍包括年龄较大、IAT 不够成熟、一般技术经验不足、缺乏个性化和支持。超过 2/3 的研究符合 MMAT 的 80%质量标准。IAT 的低接受度和使用率，无论是独立使用还是与照顾者一起使用，仍然是一个重大问题。更多关于医疗保健和社会服务客户使用 IAT 的促进因素和障碍的知识，对于成功实施旨在利用创新技术提高认知障碍老年人独立性的创新计划至关重要。
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