Peek Sebastiaan Theodorus Michaël, Wouters Eveline J M, Luijkx Katrien G, Vrijhoef Hubertus J M
Institute of Allied Health Professions, Chair of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, Netherlands.
J Med Internet Res. 2016 May 3;18(5):e98. doi: 10.2196/jmir.5253.
There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce.
To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations?
Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis.
Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults' needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes).
Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale.
通过部署各类技术(即电子健康、环境辅助生活技术、智能家居技术和老年技术)使老年人能够居家养老,这一做法正引发越来越多的关注。然而,旨在实施这些技术的举措因涉及多个利益相关者群体而变得复杂。利益相关者的目标和动机可能并不总是透明或一致的,但关于利益相关者趋同和分歧立场的研究却很匮乏。
通过回答以下问题,深入了解参与居家养老技术实施的利益相关者群体的立场:利益相关者认为哪些技术是相关的?利益相关者通过实施技术旨在实现什么目标?实现成功实施需要什么条件?
对代表五类利益相关者的29名参与者进行了单学科焦点小组访谈,这五类利益相关者分别是:老年人(6/29,21%)、护理专业人员(7/29,24%)、家庭护理或社会工作组织的管理人员(5/29,17%)、技术设计师和供应商(6/29,21%)以及政策制定者(5/29,17%)。使用主题分析法对访谈记录进行了分析。
利益相关者认为有26种不同类型的技术与实现独立生活相关。26种技术中只有6种(23%)被所有利益相关者群体提及。护理专业人员提及的不同类型技术比其他群体少。所有利益相关者群体都认为,当出现以下情况时,居家养老技术的实施可被视为成功:(1)在技术的开发和部署过程中优先考虑老年人的需求和愿望;(2)该技术被老年人接受;(3)该技术能为老年人带来益处;(4)存在有利于老年人使用技术的先决条件。虽然利益相关者似乎有着相同的目标,但也出现了一些潜在的差异,例如在技术应由谁付费方面。此外,每个利益相关者群体都提到了为实现成功实施需要采取的具体步骤。总体而言,利益相关者认为他们需要实现跨越(即改变态度、改变政策并与其他组织合作);弥合差距(即使技术与个人相匹配并促进跨学科教育);为大众提供便利技术(即致力于支持大规模推广的产品和研究,并培训目标群体如何使用技术);以及花时间进行反思(即评估使用情况和结果)。
利益相关者在他们应该前进的方向上基本达成一致;然而,他们在可采用的技术以及实施这些技术所需的工作方面存在不同观点。这些问题的核心似乎是根据每位居家老年人的具体需求定制一种或多种技术,以及利益相关者为大规模支持此类服务提供所需开展的工作。