Technology Dependence in Home Care: Impact on Patients and Their Family Caregivers

Winkler, Marion F.; Ross, Vicki M.; Piamjariyakul, Ubolrat; Gajewski, Byron J.; Smith, Carol E.

doi:10.1177/0115426506021006544

Cited by 48 publications

(48 citation statements)

References 106 publications

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“…25 Having a clear understanding of the goals and expectations of HPN also contributes to a person's acceptance of a technology-dependent therapy. 30 The need for home infusions and nutrients is often due to physical or absorptive loss of the small intestine. This new dependence on HPN requires a chronic indwelling catheter to infuse the solutions, along with the potential for life-threatening, infectious, and metabolic complications.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Long-Term Home Parenteral Nutrition on the Patient and the Family

Winkler

Smith

2015

Journal of Infusion Nursing

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Home parenteral nutrition (HPN) is a technologically complex, life-sustaining therapy for individuals who have intestinal failure. Accepting an invasive lifelong therapy like HPN is challenging for patients and their family caregivers. There is a desire to maintain a sense of normalcy in life and to carry on as usual. Using qualitative methodology, the authors explored and described the lived experience of HPN-dependent adults and identified normalization as a repeating and strong theme. Understanding how individuals adapt, cope, or experience this complex therapy provides insight into how they manage their lives in as normal a way as possible. By understanding the perspective of normalization, home infusion nurses and nutrition support clinicians can embrace caregiving strategies and tools consistent with the changing social environment in which the HPN experience is lived.

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Section: Discussionmentioning

confidence: 99%

The Impact of Long-Term Home Parenteral Nutrition on the Patient and the Family

Winkler

Smith

2015

Journal of Infusion Nursing

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“…Professionals can also reinforce adherence to daily IV aseptic care routines that can reduce catheter infections and complications [21]. We have previously published, and other research has replicated our results indicating that our IVhomeCare interventions for infection prevention and mood and emotion monitoring have resulted in reducing incidents of IV catheter infections and decreasing clinically significant depression [22-24]. Also our intervention for problem solving partnerships with healthcare professionals and for short daily restorative naps result in greater patient problem-solving skills, reduced daytime fatigue, and improved quality of life [20].…”

Section: Related Workmentioning

confidence: 59%

A Clinical Trail of Translation of Evidence Based Interventions to Mobile Tablets and Illness Specific Internet Sites

Smith

Piamjariyakul

Werkowitch

et al. 2015

Sensor Netw Data Commun

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This article describes a method to translate an evidence based health care intervention to the mobile environment. This translation assisted patient participants to: avoid life threatening infections; monitor emotions and fatigue; keep involved in healthy activities. The mobile technology also decreased costs by reducing for example travel to visit health care providers. Testing of this translation method and its use by comparison groups of patients adds to the knowledge base for assessing technology for its impact on health outcome measures. The challenges and workflow of designing materials for the mobile format are described. Transitioning clinical trial verified interventions, previously provided in person to patients, onto tablet and internet platforms is an important process that must be evaluated. In this study, our evidence based guide’s intravenous (IV) homeCare interventions (IVhomeCare) were delivered via Apple iPad mini™ tablet audiovisual instruction / discussion sessions and on a website. Each iPad audiovisual session (n = 41), included three to five families, a mental health specialist, and healthcare professionals. Patients and their family caregivers readily learned to use the wireless mobile tablets, and the IVhomeCare interventions, as described here, were successfully translated onto these mobile technology platforms. Using Likert scale responses on a questionnaire (1 = not helpful and 5 = very helpful) participants indicated that they gained problem solving skills for home care through iPad group discussion (M = 4.60, SD = 0.60). The firewall protected videoconferencing in real time with multiple healthcare professionals effectively allowed health history taking and visual inspection of the patient’s IV insertion site for signs of infection. Supportive interactions with peer families on videoconferencing were documented during discussions. Discussion topics included low moods, fatigue, infection worry, how to maintain independence, and need for support from others with their same lifelong IV experiences. The visual family interactions, discussions with professionals, and the iPad internet links were highly rated. Mobile distance care delivery can result in saved time and money for both healthcare professionals and families.

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“…The literature has tended to focus on that of the role of 'family caregiver’, an individual who lives with or close to the ill person who provides unpaid assistance with social and medical care [24]. Studies that have looked at spousal carers of individuals suffering from chronic diseases have noted the impact of role change as the role of husband/wife is eroded and is absorbed in to that of carer [25].…”

Section: Discussionmentioning

confidence: 99%

The psychosocial impact of home use medical devices on the lives of older people: a qualitative study

Thomson

Martin

Sharples

2013

BMC Health Serv Res

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BackgroundIncreased life expectancy and the accompanying prevalence of chronic conditions have led to the focus and delivery of health care migrating from the hospital and into people’s homes. While previous studies have investigated the integration of particular types of medical devices into the home, it was our intention to describe how medical devices are integrated into the lives of older people.MethodsAdopting a qualitative study design, 12 older people, who used medical devices in the home, took part in in-depth, semi structured interviews. In 7 of the interviews participants and their partners were interviewed together. These interviews were recorded, transcribed and analysed thematically.ResultsTwo themes were constructed that describe how medical devices that are used in the home present certain challenges to older people and their partners in how the device is adopted and the personal adaptations that they are required to make. The first theme of 'self-esteem’ highlighted the psychological impact on users. The second theme of 'the social device' illustrated the social impact of these devices on the user and the people around them.ConclusionsWe found that these devices had both a positive and negative psychosocial impact on users’ lives. An improved understanding of these psychological and social issues may assist both designers of medical devices and the professionals who issue them to better facilitate the integration of medical devices into the homes and lives of older people.

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Technology Dependence in Home Care: Impact on Patients and Their Family Caregivers

Abstract: More research is needed to address effective interventions to reduce patient and caregiver burdens and to improve outcomes for technology-dependent individuals. A greater level of preparedness for managing home technology and technology-related problems may improve quality of life.

Cited by 48 publications

References 106 publications

The Impact of Long-Term Home Parenteral Nutrition on the Patient and the Family

The Impact of Long-Term Home Parenteral Nutrition on the Patient and the Family

A Clinical Trail of Translation of Evidence Based Interventions to Mobile Tablets and Illness Specific Internet Sites

The psychosocial impact of home use medical devices on the lives of older people: a qualitative study

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