Autonomy, independence, and participation of nursing home habitants addressed by assistive technology: a scoping review.

AbstractContextMethodResultsDiscussion\nIMPLICATION FOR REHABILITATIONAssistive technologies have been identified by researchers and public policies of the Western world to be promising tools to face the challenge of maintaining quality of life of older people, and especially for nursing home habitants. Independence, autonomy, and participation are major determinants of quality of life of nursing homes habitants. Maintaining quality of life is nowadays a priority for public health policies and institutions of the where the population is growing older every year.This PRISMA-ScR review aims to determine which assistive technologies are used to promote autonomy, independence, and social participation of nursing home habitants. An electronic search was conducted for English, French articles to identify research studies using CINAHL, PubMed, Cochrane Library, PsycINFO, and Googlescholar.12 papers published between 2009 and 2023 described 6 assistive technologies: technologies integrated into the environment, monitoring technologies, surveillance technologies, information and communication technology, social assistance robots, virtual reality. Six types of AT are currently used worldwide to maintain autonomy, independence and participation of people living in nursing homes. Their use is mainly perceived as positive by habitants, care and non-care staff, next of kin, and experts despite some concerns regarding ethical, financial, consideration.Nevertheless, their impact on habitant’s autonomy, independence and participation still needs to be measured using suitable tools to understand their real impact on the quality of life of the elderly. Autonomy is a determinant of Quality of life of nursing home habitants that is well identified by habitants, professionals, relatives and public health policies as a major challenge that can be supported by assistive technology (AT).Various technologies are used for which it is assumed that they have an impact on the user autonomy in the context of nursing home. Nevertheless, their impact on habitant’s autonomy, independence and participation is not clear yet because the concepts are not precisely defined leading to a difficulty to assess the phenomenon. It is still needed to define and measure AT impact on autonomy, independence, and participation by using suitable tools that will help to understand their real impact on the elderly’s’ quality of life.There is a lack of knowledge regarding AT effectiveness is lacking in the context of nursing home but in the context of aging in general. Strong methodologies with mixed-method approaches might be relevant to address this gap of knowledge, particularly on elderly level of autonomy, independence of participation.Determinants of AT acceptability by all users (habitants themselves, relatives, care and non-care staff) are largely explored, revealing 3 categories: 1-General principles that can be considered by developers and institution while developing, choosing and deploying AT (affordability, ethical consideration, social Justice); 2-Characteristics that has to be considered during AT conception regarding suitable design and technical reliability (no bugs, failure); 3- Individual anticipated implementation principles taking in account 4 main elements: Considering individual relationship with AT; A space for exchange on representations and fears around AT; Support to learn how to use AT; and Perceived effectiveness of AT.Regarding the complexity of AT acceptation in the context of nursing homes, it seems essential to use collaborative approaches to design and develop AT, bringing diverse stakeholders together who have the same goal: maintaining quality of life of nursing home habitants.Autonomy is a determinant of Quality of life of nursing home habitants that is well identified by habitants, professionals, relatives and public health policies as a major challenge that can be supported by assistive technology (AT).Various technologies are used for which it is assumed that they have an impact on the user autonomy in the context of nursing home. Nevertheless, their impact on habitant’s autonomy, independence and participation is not clear yet because the concepts are not precisely defined leading to a difficulty to assess the phenomenon. It is still needed to define and measure AT impact on autonomy, independence, and participation by using suitable tools that will help to understand their real impact on the elderly’s’ quality of life.There is a lack of knowledge regarding AT effectiveness is lacking in the context of nursing home but in the context of aging in general. Strong methodologies with mixed-method approaches might be relevant to address this gap of knowledge, particularly on elderly level of autonomy, independence of participation.Determinants of AT acceptability by all users (habitants themselves, relatives, care and non-care staff) are largely explored, revealing 3 categories: 1-General principles that can be considered by developers and institution while developing, choosing and deploying AT (affordability, ethical consideration, social Justice); 2-Characteristics that has to be considered during AT conception regarding suitable design and technical reliability (no bugs, failure); 3- Individual anticipated implementation principles taking in account 4 main elements: Considering individual relationship with AT; A space for exchange on representations and fears around AT; Support to learn how to use AT; and Perceived effectiveness of AT.Regarding the complexity of AT acceptation in the context of nursing homes, it seems essential to use collaborative approaches to design and develop AT, bringing diverse stakeholders together who have the same goal: maintaining quality of life of nursing home habitants. 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