On social side: Understanding the influence of other people
High-tech home care involves more than simply moving a particular device out of the hospital into a new location. In addition to the effects place has on patients’ use of technology, we need to consider the influence of other people. More precisely, we need to understand how technology is woven into human relationships – some intimate and some professional, but all of them influential.
The private and public places in which health technology is used involve patients in interactions with two main sets of individuals and groups:
Informal caregivers (e.g., family members and friends)
Professional caregivers (e.g., nurses)
These people can empower patients to use their devices in an optimal manner. They can also, however, constrain such use, thereby limiting technology’s effectiveness.
The technological-fix approach
Despite their best intentions, designers and engineers often take a “technological-fix” approach when they are planning home care devices. In part, this means there’s a tendency among designers and engineers to look only at the function of a piece of equipment. Doing so means they often don’t consider and factor in to their work the economic, political, and social elements that shape the lives of people who use their devices.
The social aspects of home care technology
"Friends and family, not those who are close but cousins, leave me out. At family get-togethers during holidays, they say: We would invite you over, but you don’t eat! Yes, I don’t eat but I’m not a leper! I’m not contagious. I have the right to share conversations with people too."
Spoken by a woman who uses peritoneal dialysis (PD), these words offer a small but vivid glimpse of the fact that many people who use home care devices are themselves much more than machines. For the most part they are – and want to continue being – social creatures.
Understanding how home care technology is used in the real world therefore requires going beyond function to consider the social aspects of health. In our research on intravenous (IV) therapy, oxygen therapy, parenteral nutrition (PN), and PD we found lots of evidence showing that patients’ quality of life, autonomy, mobility, and health were deeply affected by how other people viewed and treated them.
At the level of the health care system, there are several key elements that comprise the social aspects of health:
Providers’ perceptions and behaviour
Clinical and psychosocial services
Information and support
Home care policies
At the level of the patient, we need to take stock of the following:
Cognitive, psychosocial, and financial resources
Age and gender
Several of the patients we interviewed expressed opinions that are completely in line with hospitals’ and governments’ support for increased home care. They were glad to take on extra tasks and they felt their health was, in fact, safeguarded by not being in germ-infested hospitals.
Even among those who said home care technology had empowered them, however, there was an awareness that undertaking treatment at home upgrades the importance of personal caregivers such as family members and friends as well as, at times, community-based social services. Delegating life’s “normal” activities (e.g., cooking, cleaning, shopping) is, for many patients, just part of the home care package.
Summary and recommendation
The impact of home care technology on patients’ quality of life, autonomy, mobility, and health is determined, at least in part, by the beliefs and actions of patients themselves as well as those of other people. Further, our research has shown that moving technology from the hospital to the home potentially involves significant changes to the relationships patients’ have with other people.
We recommend, therefore, that designers, engineers, health professionals, and policy-makers devote more time and energy to understanding and factoring in the social side of health technology both as it pertains to individual patients and to the home care arena in general.
|Based on :||Lehoux, P., J. Saint-Arnaud, & L. Richard. (2004)|
|Adapted by :||Morgan Holmes, Ph.D.|
Lehoux, P., J. Saint-Arnaud, & L. Richard. (2004). The use of technology at home: What patient manuals say and sell vs. what patients face and fear. Sociology of Health & Illness 26.5: 617-644.