How do elderly people adapt to and accept nursing technology?

Table of Contests

Summary

Introduction

Method

Theory
Can education make it easier for the elderly person to accept technology?
Are ethical aspects taken into consideration when the use of nursing technology is discussed?

Conclusion

Perspectives to the nursing profession

Literature
Books:
Internet links:

Literature strategy

Summary

Aim: The aim of this assignment is to find out if the elderly’s Sense of Coherence has an impact in the way they accept and adapt to nursing technology.

Method: In this assignment qualitative and quantitative research has been used. The use of both methods helped to get a broader understanding of the technologies impact on elderly people. A phenomenological hermeneutical method was used to understand and analyse the articles that were chosen. Aaron Antonovsky's theory Sense of Coherence gave the opportunity to find out how the elderly people cope with the use of technology.

Analysis: Throughout the analysis four different articles are used to bring in different aspects on nursing technology, how the elderly adapt the technology and the importance of ethical aspects. The Sense of Coherences effect on the adaption to nursing technology is illuminated.

Conclusion: Nursing technology seems to be an ambivalent but effective tool in caring for elderly. Health professionals and elderly people need education to handle the technology and to take advantage of the benefits. It is important for nurses to focus on elderly’s Sense of Coherence to make it easier to accept and adopt to the technology. It is important for the nurse to take into consideration the ethical aspects of safety, dignity and rights of people when working with nursing technology.

Perspective: The future development of nursing technology and its impact on nurses and elderly people is considered. More research in this area is needed.

Introduction

At the beginning of module 9 we visited the Carelab in Forskerparken, Odense, (CareLab 2014) where we were introduced to new technologies in nursing. Seeing the different technologies in a research setting was interesting and we talked about our concerns as health professionals. We are still wondering how the elderly patients will adapt and embrace the technology in their own home. We need to know more about their experience and if they see benefits in using health care technology for them.

Problem area

At present and in the future the health care system has to deal with a globally ageing world population. As the United Nation (UN) reported in 2013, the number of people over 60 years old will increase from 841 million to over 2 billion older persons in 2050 (UN 2013, xii). According to the UN this ageing population brings consequences on a social, political as well as economic level and it is a big task for the future social security system (ibid., xii-1).

The general public believes that technology will improve health care safety, quality, efficiency and cost. Nursing technology is very complex and it is transforming the way nursing care is perceived and delivered (Patterson et al. 2008). Before application of technology nurses were dependent of their senses, smell, touch, sight and hearing to monitor the patients’ condition. Patterson et al. state that the nurse’s senses have been replaced by technologies which are designed to detect physical changes (ibid.).

The technology is optimally designed to minimize errors and avert the consequences of failure. Patterson et al. mean that this can be done by: eliminating mistakes and adverse events, reduce the incidence of failures, reveal the error early - before the damage is done, and reduce the effects of errors after they occur to minimize damage. This would be the perfect world where the result would be positive outcomes on nursing, patient and organizations (ibid.).

Technology has the potential to improve care, but it is not without risks. It is part of the problem and of the solution for safer health care. Observers are concerned that nurses will be too focused on technology and forget their professionalism (ibid.). According to Sävenstedt et al., the use of technology in caring for people is seen as a duality. Technologies impact on both users and carers is needed to be discussed more in an ethical aspect and could be seen as both inhuman and human care when it comes to the question of dignity (Sävenstedt et al. 2006, 17).

According to Sävenstedt et al. and Peeters et al. an increasing shortage of nurses exists in the western society. They conclude that this will be an even larger problem in the future due to the increase in ageing population and their need of care (Peeters et al. 2012, 3183; Sävenstedt et al. 2006, 18). It is known that in the near future the use of communication technologies will be more and more common (Sävenstedt et al. 2006, 23). For this reason older people have to deal with challenges and the ever-evolving technology (Roupa et al. 2010, 118 - 119).

According to these different authors there are both positive and negative impact of the use of nursing technology and the way the elderly experience the use of technology. Could the use of nursing technology be needed and helpful as Peeters et al. says (Peeters et al. 2012, 3184)? Will the elderly be able to adapt the nursing technology or does the nurses need to help them cope by using coping strategies?

Problem statement

Nursing technology seems to be more and more used now and in the future due to shortage of nurses and the ongoing process of technology development. Does the elderly’s sense of coherence have an effect on how they adapt to and accept the nursing technology?

Purpose

Technology is becoming a much more integrated part of nursing. The aim of this assignment is to find out if the elderly’s Sense of Coherence (SoC) has an impact in the way they accept and adapt to nursing technology.

This assignment could be interesting for health professionals working with nursing technologies when caring for elderly people. Analyzing different articles and combining it with Antonovsky’s theory of SoC a conclusion of its impact on the adaption to nursing technology can be made.

Key concepts

Nursing technology: We have chosen to use nursing technology as a general term which covers different technologies like;

Assistive technology: for example haemodialysis or peritoneal dialysis apparatus, ventilator and oxygen therapy device as described by Fex et al. (Fex et al. 2012).

Telecare: application of information and communication technologies in health care encompassing curative, preventive and promotional aspects and to interact between patient and doctor (Bos et al. 2008).

Information and communication technology: Home telecare is an audio-visual connection between a home-dwelling client and remote healthcare professionals, using communication technologies (Peeters et al. 2012, 3184). It could also be applications like video-phones, telemedicine or remote consultations (Sävenstedt et al. 2006, 18).

Elderly people or older person: is a person who is 60 years or older as described by the UN (UN 2013, xii).

Sense of Coherence (SoC): A coping strategy developed by Aaron Antonovsky, see the paragraph on theory for further information.

Method

The first literature search was made on the library database. Here we started searching general knowledge about technology and the technologies impact in the future. When our topic was decided an unstructured search was started to get an impression of the available literature about technology’s impact on the elderly in the future. We searched in CHINAL, PubMed, Google Scholar and Cochrane with the words “technology”, “nursing”, “future”, “elderly”, “coping” and “nursing technology”. A part of our literature search was found using chain search. We read the literature from the module 9 compendium – which gave us a good basic knowledge.

Our systematic search was based on our final problem statement. Our limitations were that the articles were not allowed to be older than year 2000, the articles had to be in English and full text was available, since we have limited time to complete the project. In the selection of articles we started by looking at the title. If the title sounded relevant, we read the abstract – and then decided if the article could be used. See search strategy in Appendix 1.

We used the Critical Appraisal Skills Programme (CASP) checklists (CASP 2014 a) for qualitative and quantitative studies to find out if the articles are evidence based and if we could include or exclude them. “Critical Appraisal Skills enable you to assess the trustworthiness, relevance and results of published papers so that you can decide if they are believable and useful” (CASP 2014 b).

The articles were chosen to examine the positive and negative aspects of the experiences elderly persons when using nursing technology in their daily life. The articles try to describe the influence coping strategies have on acceptance and adaptation of nursing technology in their own home. To cover different aspects of our problem statement we found and used both qualitative and quantitative studies.

Qualitative research seeks to understand by means of exploration, human experiences, perceptions, motivations, intentions and behavior (Parahoo 2014, 56-57). The essential features for qualitative approaches are the methods it is using to understand perceptions and actions of participants in which are used to find out about the experiences of technology for elderly persons (ibid., 56-57).

Quantitative research deals with quantity and numbers, and the aim of the research is to produce 'hard evidence' by objective and subjective measures (ibid., 53). The main purpose is to measure concepts or variables objectively and examine the relationships between elderly persons and technology by numerical and statistical procedures (ibid., 42-43).

Quantitative research is limited in researching after meaning, experience and behavior while qualitative research is criticised for being biased, subjective and lacking in reliability, validity and generalisability (ibid., 79). This means that researchers sometimes has to use a variety of mixed methods and approaches, sometimes singly and sometimes in combination. By using a combination of the two methods we will bring different aspects into our study and help answering our problem statement (ibid., 80-92).

In health care research there is developed a phenomenological hermeneutical method which is used to reveal meanings of experiences of health-illness transition in the present context (Fex et al. 2011, 255). Phenomenology aims to explore the individuals' interpretation of their experiences and the ways they are expressing them (Parahoo 2014, 60-61). This can be used to find answers to our problem statement. The phenomenological hermeneutical method offers possibilities to understand the deeper meaning of experiences through interviews transcribed into texts (ibid.).

As a phenomenological hermeneutical methods we are using the hermeneutic analysis to understand and analyse the articles we have chosen. The hermeneutic analysis refers to the idea that one's understanding of the whole text is established by referring to individual parts in the text and one's understanding of each individual part refers to the whole text (Harboe 2013, 171).

We are going to include Aaron Antonovsky’s theory Sense of Coherence because it gives us the opportunity to find out how elderly people handle the use of technology.

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