The psychosocial impact of home use medical devices

Abstract

Recent increases in life expectancy, combined with the rise of chronic diseases, have led to a rise in the use of medical devices to monitor and treat illnesses in people’s homes. To date, however, little attention has been paid to understanding the impact that these devices have on the home environment, the users of these devices and their partners. This thesis presents three studies investigating the physical, personal and social issues faced by people using home medical devices. The first study consisted of qualitative interviews with 12 device users and seven partners and investigated their experiences of home use medical devices. Analysed thematically, this study described how medical devices can foster or threaten people’s experience of the physical, personal and social aspects of the home environment when medical devices are integrated into their homes. In study two, a questionnaire was developed to investigate the attitudes of healthcare professionals and patients about the relative importance of different medical device characteristics. Different groups of healthcare professionals involved with the provision of medical devices were included (doctors, nurses, pharmacists) as well as medical device users and non-users. The results showed that practical factors (user testing, clear instructions, clinical trials, reducing appointments, training and cost effectiveness) are viewed as more important by professional groups than factors that relate to the home environment (choice and appearance). This indicates a lack of a whole person approach to patient care and the selection of home medical devices. In the third study longitudinal interviews were carried out with four couples, where one of the couple had been diagnosed with Chronic Obstructive Pulmonary Disease (COPD) and prescribed an oxygen concentrator to use at home. The aim of this study was to discover how couples experience the process of being given a medical device to use at home over time. The interviews identified that being given an oxygen concentrator can be the source of an acute episode of uncertainty for some couples and the process of coping was mediated by the expectations that they had prior to being given the device. This research has provided a valuable insight into the poorly understood impact that medical devices have on people’s experience of the home environment