Hechinger Mareike, Hentschel Diana, Aumer Christine, Rester Christian
Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany.
JMIR Aging. 2022 Sep 9;5(3):e34872. doi: 10.2196/34872.
Older adults with chronic illnesses or dependency on care who strive to age in place need support and care depending on their illness. Digital technology has enabled the possibility of supporting older adults in their wishes to age in place. However, current studies have mainly focused on the solitary evaluation of individual technologies or on evaluating technologies for specific illnesses.
This study aimed to synthesize research on the experiences of older people from the Western culture with chronic illnesses or care needs and their families with digital technology for aging in place. From the meta-synthesis, a model was derived that can be useful for the development of assistive devices in old age and that can support health care providers and professionals in their work with affected individuals.
A systematic review and qualitative meta-synthesis was performed using an inductive approach, as proposed by Sandelowski and Barroso. We performed a systematic literature search in 6 databases from 2000 to 2019, with an update in 2021 and, in addition, conducted a hand search in 2 databases, relevant journals, and reference lists. The results of each study were analyzed using initial and axial coding, followed by theoretical coding. A conceptual model was derived.
A total of 7776 articles were identified. Articles were screened independently by 2 authors based on the eligibility criteria. Finally, of the 7776 studies, 18 (0.23%) were included in the meta-synthesis. The derived conceptual model describes older adults with chronic illnesses or dependency on care and their family members in an individual process of reflection and decision-making, starting with the use of a digital device. Older adults live in times of change. They experience stable and unstable times of illness as they are part of a changing digital world. Hence, older adults and their families consider digital technology a solution to their current situation. As they become familiar with a specific digital technology, they refine their needs and demands, gain confidence in its use, and note its advantages and disadvantages. They weigh hopes, needs, demands, and experiences in a process of reflection to decide on convenience and inconvenience. Independent of their decision, they achieve peace of mind either with or without digital technology. This process can restart repeatedly during the illness trajectory of older adults.
This study promotes a differentiated understanding of older adults' experiences with digital technology. The conceptual model can be useful for the development of assistive technology in old age. Moreover, it can guide health care professionals in their work with older adults and their families to provide individual counseling to find the appropriate digital technology for their respective situations.
患有慢性疾病或依赖他人照顾且希望居家养老的老年人，需要根据自身病情获得支持和护理。数字技术使得支持老年人居家养老的愿望成为可能。然而，目前的研究主要集中在对个别技术的单独评估或针对特定疾病的技术评估上。
本研究旨在综合有关西方文化中患有慢性疾病或有护理需求的老年人及其家庭使用数字技术居家养老经历的研究。通过元综合分析，得出一个模型，该模型可用于老年辅助设备的开发，并可支持医疗保健提供者和专业人员与受影响个体的工作。
按照桑德洛斯基和巴罗斯提出的归纳法进行系统评价和定性元综合分析。我们在2000年至2019年期间对6个数据库进行了系统的文献检索，并于2021年进行了更新，此外，还在2个数据库、相关期刊和参考文献列表中进行了手工检索。使用初始编码和轴心编码对每项研究的结果进行分析，随后进行理论编码。得出一个概念模型。
共识别出7776篇文章。由2名作者根据纳入标准独立筛选文章。最后，在7776项研究中，有18项（0.23%）被纳入元综合分析。得出的概念模型描述了患有慢性疾病或依赖他人照顾的老年人及其家庭成员在一个从使用数字设备开始的个人反思和决策过程中。老年人生活在变革的时代。由于他们是不断变化的数字世界的一部分，他们经历着病情稳定和不稳定的时期。因此，老年人及其家庭将数字技术视为解决当前状况的一种方法。随着他们对特定数字技术的熟悉，他们会细化自己的需求，对其使用获得信心，并注意到其优缺点。他们在反思过程中权衡希望、需求、要求和经历，以决定便利和不便之处。无论他们做出何种决定, 有或没有数字技术，他们都能获得内心的平静。在老年人的疾病轨迹中，这个过程可以反复重新开始。
本研究促进了对老年人数字技术体验的差异化理解。该概念模型可用于老年辅助技术的开发。此外，它可以指导医疗保健专业人员在与老年人及其家庭的工作中，提供个性化咨询，以找到适合他们各自情况的数字技术。
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