Electronic Business Technologies, Telfer School of Management, University of Ottawa, Ottawa, ON, Canada.
Health Systems Management, Telfer School of Management, Ottawa, ON, Canada.
Health Soc Care Community. 2020 Nov;28(6):1827-1842. doi: 10.1111/hsc.13011. Epub 2020 May 7.
The number of seniors and prevalence of chronic conditions are increasing worldwide, resulting in more pressure on health systems. Health Information Technologies (HIT) present opportunities to support the healthcare needs of seniors. Although prior studies have investigated HIT and seniors, it remains unclear what factors significantly affect the adoption of different HIT by elderly people in the community. A Systematic Review (SR) was conducted between December 2017 and February 2018 (with a search update in 2018-2019) to critically appraise and synthesise existing evidence on HIT adoption factors among seniors. Following the PRISMA guidelines, five major databases were consulted (PubMed, Medline, CINAHL, Scopus and Web of Science). The inclusion criteria consisted of empirical studies, published in English, and reporting impacts of specific factors on HIT adoption among seniors in the community. A total of 41 studies were included in this review, mostly published between 2014 and 2017 in Europe and the US; the level of evidence in these studies was low to moderate. The factors that affect HIT adoption did not differ across types of technologies or age groups. The findings reveal that seniors adopt HIT that are perceived as useful and requiring low effort commitment; price/cost value were reported as adoption barriers. Social influence, facilitating conditions, senior-friendly product design, self-efficacy, Intrinsic Technology Quality, experience/training and technology anxiety may affect HIT adoption by seniors, although the evidence on these impacts remains weak and limited. Mixed and inconclusive evidence was observed on the impacts of socio-demographic variables, health condition, habit and privacy/security. Given the reported low level of HIT adoption among seniors, we call for more rigorous research in this area using a 'senior-centred' approach, which takes into account the discourse/interaction between seniors and their collective environment to better understand the factors that affect their technology adoption and address their needs.
全球范围内老年人的数量和慢性病的患病率都在增加，这给医疗系统带来了更大的压力。健康信息技术（HIT）为满足老年人的医疗保健需求提供了机会。尽管先前的研究已经调查了 HIT 和老年人，但仍不清楚哪些因素会显著影响社区中老年人对不同 HIT 的采用。我们进行了一项系统评价（SR），以批判性地评估和综合现有关于老年人 HIT 采用因素的证据。我们遵循 PRISMA 指南，在五个主要数据库（PubMed、Medline、CINAHL、Scopus 和 Web of Science）中进行了检索（2017 年 12 月至 2018 年 2 月进行了检索，2018-2019 年进行了更新）。纳入标准包括以英语发表的实证研究，报告了特定因素对社区中老年人 HIT 采用的影响。这项综述共纳入了 41 项研究，这些研究主要发表于 2014 年至 2017 年期间，来自欧洲和美国；这些研究的证据水平为低到中等。影响 HIT 采用的因素在不同类型的技术或年龄组之间没有差异。研究结果表明，老年人采用的 HIT 被认为是有用的，且需要投入的努力较少；价格/成本价值被报道为采用障碍。社会影响、促进条件、适合老年人的产品设计、自我效能、内在技术质量、经验/培训和技术焦虑可能会影响老年人对 HIT 的采用，尽管这些影响的证据仍然薄弱且有限。社会人口统计学变量、健康状况、习惯和隐私/安全对 HIT 采用的影响存在混合和不一致的证据。鉴于老年人对 HIT 的采用率较低，我们呼吁在这一领域进行更严格的研究，采用“以老年人为中心”的方法，考虑老年人与其集体环境之间的话语/互动，以更好地理解影响他们技术采用的因素，并满足他们的需求。
