God vård och användning av digitala hjälpmedel Föreställningar hos äldre och vårdpersonal

Sammanfattning: The overall aim of this thesis was to describe the perceptions about care and the use of digital assistive technology among elderly people and caregivers. Perceptions are continually changing depending on technical and socio-political developments and changes in society. The research presented here consists of data gathered to assess these perspectives, and the subsequent analysis and interpretation. In study I and II, individual interviews were conducted with twelve healthy elderly couples living in their own homes. All participants were 70 years of age or older and none of them received any professional care or social support. The interviews were substantiated by written scenarios considered to be realistic descriptions of imaginary examples of the state of health and wellbeing for themselves in the future. The participants were asked what they believed would be the best solution concerning quality care and the use of assistive technology in each scenario. A qualitative content analysis was used to analyze the text. For study III and IV, a questionnaire was developed to probe the perceptions of a digital photo diary for use by people with dementia. The respondents were employees of the Swedish municipalities in a position to be able to influence the implementation of digital assistive technology for use by people with dementia. The data was analyzed with descriptive statistics, multivariate statistics and qualitative content analysis. The first study revealed that participants tried to maintain their sense of self and desired dignified care. The receipt of care in one’s own home was considered preferable as it enabled partners to remain together; later on, in contrast, the best care was perceived to be that offered by a nursing home with well-trained nursing staff. In study II, the use of assistive technology was perceived to be an asset by participants since it would enable them to continue living a normal life despite having some disabilities. In the absence of a partner or if their cognitive impairment increased, their willingness to use assistive technology would decrease, and the technology was considered to be an obstacle. In both studies there was a pervading concern about the risk of losing a sense of individuality in the absence of meaningful relationships. In study III, perceptions related to the prerequisites for and consequences of using the digital photo diary were investigated. The analysis of factor analysis concerning consequences, revealed four factors; trust, vulnerability, dependency/independency and control. The results interpreted from the qualitative data emphasized the importance of Personalization and the preservation of dignity when using the device. The prerequisite most often specified was the need for digital photo diary to be introduced in an early stage of the disease. In study IV, caregivers’ perceptions on how persons with mild dementia will experience the usage of a digital photo diary were examined. The digital photo diary considered was perceivedto contribute to a Sense of autonomy, Sense of self-esteem and a Sense of trust among people with dementia. These findings highlight the context-dependence of the perceptions about quality care and the use of digital assistive technology for elderly people. An overall understanding of the results emphasizes the importance of personalized and dignified support, and this should be taken into consideration when organizing quality care and implementing new digital assistive technology for use by elderly people.