Subjective Reasons for Using versus not Using Assistive Technologies in Aging Population: A Meta-Synthesis of Qualitative Studies

The number of older people with limitations of activities of daily living in
developing countries is predicted to increase by a factor of four between
2015 and 2050. One possibility to overcome such limitations is to promote
the use of assistive technologies (ATs) in the aging population. Despite
evident benefits of ATs in this context, the use rate is still low. To find out
why this is the case, we performed systematic literature searches in
PsycINFO, MEDLINE, and Google Scholar databases about subjective
reasons of older people for use and non-use of these devices. We then
performed a meta-synthesis of the relevant studies in order to arrive at a
comprehensive view of older people’s reasons for the use or non-use of
ATs. Beliefs about ease to use and reliability of AT use as well as
perceived suggestion by significant others to use ATs were important
reasons for using them. Beliefs about insecurity, uselessness and other
attributes of ATs as well as desires to avoid burden for others were major
reasons for not using of ATs. We systematized the identified subjective
reasons for using versus not using as referring to (1) situation of need and
demand for an AT, (2) suggestion by significant others, (3) act of using,
and (4) consequences of AT use. Most of the reasons were reasons for
non-use such as beliefs about negative attributes of ATs, and the
consequences of their use. In contrast, desires were only rarely mentioned
as reasons for use or non-use of ATs. Comparing subjective reasons of
our meta-synthesis with predictors in ATs use models, we found that only 5
out of 25 identified subjective reasons have already been considered in
these models. Thus, these models appear not yet to be sufficiently
comprehensive. We suggest integrating the identified subjective reasons
from our meta-synthesis as additional predictors in a comprehensive AT
use model with an improved predictive power.