Table 2 Barriers and promotors, qualitative and mixed methods literature, N = 23
Author, country, year | n | Design | Certainty of the evidence (GRADE) | Assistive Technology | Barriers | Promotors |
|---|---|---|---|---|---|---|
Arntzen, C., et al., Norway, 2016 [35] | 12 | Phenomenological study | Moderate (60%) | Various ATT | Habitual practices Negative emotions Poor design Not adaptable Not engaging the carer Complexity of ATT | Fit with habitual behaviors Culture Trust user-friendly Adaptability |
Arthanat, S., et al., USA, 2020 [36] | 8 | Focus group interviews | Low (40%) | Socially assistive robot (SAR) | Technology anxiety Effort expectancy Structure and design of the home Value and worth Digital Divide System failures Dual burden | Trust (fidelity) Personalized training Adaptability (tailoring) Engaging the care recipient Humanoid features |
Egan, K. J. And A. M. Pot, USA, Australia, Canada, China, India, Japan, Netherlands, United Kingdom, 2016 [37] | 66 | Qualitative, Focus group interviews | High (80%) | Varied ATT | Stigma Poor accessibility Not accounting for disease progression | Raise awareness Affordability Integrate with existing services Increase collaborative approaches including the PwD |
Evans et al., UK, 2017 [38] | 48 | Mixed methods (qualitative, self-administered questionnaires) | Moderate (71%) | Ipads - games, memoirs, video conference | Benefits and Barriers: Ease of use Convenience and Flexibility Portability Cost | N/A |
Faeo, S.E. et al., Norway, 2020 [39] | 12 | Qualitative, exploratory | Moderate (70%) | Various ATT | Safety with side-effects (unintended consequences) unmet expectations for volunteerism diversity of care and services | A way to broaden PwD everyday environment Ability to have more freedom - walking, out from house Maintained dignity |
Fange, A.M., Norway, 2020 [40] | 9 21 | Qualitative, semi-structured interviews | High (90%) | Sensors | Not having a clear understand of the benefits of ATT Unreliable technology Not fitting into habits Lack of control over an installed device Ethical issues - privacy | Safety for the PwD ATT as a support to make life easier Complemented established care |
Gibson, et al., UK, 2015 [41] | 13 26 | Qualitative, Semi-strctured interviews | High (90%) | DIY ATT, off the shelf solutions | Too little too late from formal care (ATT) Cost | Role of the caregiver as facilitator Easily integrated with current habits/routines |
Gibson, et al., UK, 2018 [42] | 13 26 | Semi-structured interviews | High (80%) | DIY ATT, off the shelf solutions | Inaccessibility Cost No information about technology for PwD “Crisis model” of implementation | Ability to incorporate into habitual practices Informal caregivers as facilitators and bricoleur Off-the-shelf solutions (accessibility and cost) |
Hall A. et al., UK, 2017 [43] | 36 | Multiple-case study with qualitative methods | Moderate (70%) | Sensors, Memory aides | Key stakeholders not involved in implementation process Limited understanding from stakeholders regarding benefits and challenges of ATT | Enhanced safety Personalized training for staff & caregivers |
Heuvel et al., UK, 2012 [44] | 25 | Qualitative, Focus group interviews | High (90%) | Various ATT | Lack of information unknown benefits of use | N/A |
Holthe, T. et al., Norway, 2020 [45] | 24 | Qualitative, Focus group interviews | High (100%) | Various ATT | Unsystematic approaches Contested responsibility Citizen capabilities | Knowledge and training User friendliness |
Holthe, T. et al., Norway, 2018 [46] | 13 | Qualitative, repeated semi-structured interviews | High (100%) | Various ATT | Waiting times Lack of information from public services Untimely information about ATT | Simply designed ATT Committed caregiver Need based provision Incorporation into habitual routines |
Ienca et al., Switzerland Germany Italy, 2018 [47] | 17 | Open-ended qualitative interviews | High (90%) | Various ATT | Mismatch between patients’ needs and ATT Technical limitations Translational problems | See barriers |
Kerssens et al., USA, 2015 [48] | 7 | Feasability study | Moderate (70%) | The Companion - touch screen with Psychosocial interacts for PwD | Not offering a feature counted on Caregivers ignoring or muting shows Recipients ignoring interventions Not having enough time Unwillingness to share experiences Unmet expectation | Relaxation Enjoyment of life Reminisce |
Lindqvist et al., Sweden, 2013 [49] | 17 | Qualitative, semi- structured interviews | High (90%) | Various ATT | N/A | Trust for the ATT Perceived capacity for use Fitting into routines Pre-planning for a decision on which ATT was most appropriate |
Lindqvist et al., Sweden, 2015 [50] | 14 14 | Qualitative, semi-structured interviews | High (90%) | Various - based on interviews with PwD and caregivers | Out of sight-out of mind Non-relevant info Professionals needed for updating features Small buttons Settings easily manipulated by mistake No instructions or feedback | Visibility of the ATT Visualized reminders Customizable features (user) Reminders delivered to mobile phone Personalized buttons Feedback and guidance on display |
Mehrabian et al., France, 2015 [51] | 92 | Mixed methods (semi-structured interviews, self-administered questionnaires) | Moderate (53%) | Various ATT | Complexity Expectation vs. reality Perceptions of need by the caregiver Technology anxiety Costs Limited access to internet in the homes | Security and safety for the user Assisting in case of emergency Enable cognitive stimulation Reminders for meds Improvement in day-to-day living |
Niemeijer, A. R. et al., Netherlands, 2014 [52] | 43 28 | Qualitative, ethnographic field study | High (90%) | Surveillance technology | False alarms Alarm fatigue Not using the technology to full potential Forgetting to take devices off Perception of staff | Vision of safe autonomy Informing of participants (risks and benefits) Instructions and training of staff Willingness to use new technology |
Pino et al., France, 2015 [53] | 25 7 | Mixed method, (focus group interviews, self-administered questionnaires) | Low (41%) | SARs | Negative impact on autonomy Size of SAR Privacy concerns Fear of robots replacing humans/jobs Suitability for level of dementia Negative attitudes Generational gap Perceived usefulness Fear of the future | Cognitive support Communication and companionship Safety and healthcare use Supports independent living Alleviates caregiver stress |
Snyder et al., USA, 2020 [54] | 4 | Qualitative, phenomenological study | High (90%) | Remote monitoring technology | Lack of technical ability Perception of technology as confusing or unclear Ease of use Not tailored to needs Lack of knowledge of benefits of use Ethical issues | Caregiver peace of mind better communication with pwd caregiver confidence caregiver and care recipient independence |
Steils et al., UK, 2021 [55] | 114 | Mixed methods, (semi-structured interviews, case studies, self-administered questionnaires) | High (88%) | Various ATT | Lack of information unknown benefits of use carers level of knowledge of technology | Tailored solutions Involvment of carers |
Thorpe et al., Denmark, 2016 [56] | 10 | Feasibility study | High (80%) | Sony smartwatch 3 and Sony Xperia E4 | Navigation and emergency support | Scheduling features Familiar design Personalization |
Yaddadin et al., Canada, 2020 [57] | 24 | Qualitative, focus group interviews | Moderate (50%) | Various ATT | Complexity of ATT Difficulty adapting Requires a large number of resources (time and costs) Resistance to the use of a technological aid | Learning potential Interdisciplinary collaboration (including the family) Experience Varied features of COOK |