When technology enters the home – a systematic and integrative review examining the influence of technology on the meaning of home

Abstract

Aim: To analyse and synthesise the research that has investigated the experience of home in relation to home mechanical ventilation (HMV). Method: Systematic integrative review. Four electronic databases (CINAHL, PubMed, Scopus and ISI Web of Knowledge) were searched between January 2010 and April 2017 as well as reference lists of included studies. Quantitative and qualitative studies meeting the inclusion criteria were critically appraised. Study findings were inductively analysed and synthesised using the integrative approach. Results: Twenty-one studies were included in the review. Two main themes emerged: home and at-homeness and altered interpersonal relationships. The literature suggests that the technology alters the meaning of home through its structural and conceptual reconfiguration. Paradoxically, the space is experienced as both a home and a workplace which creates tensions and ambiguities for HMV users/families and care workers. HMV users and their families attempt to recreate a sense of home and identity while gaining control over space and decision-making. Nevertheless, the home is seen as the preferred place to live and close bonds can develop between the different actors. Conclusions: The literature suggests that the transformation of the meaning of home by the presence of technology and workers poses challenges that are often under-recognised. Healthcare professionals and personal care assistants need preparation for the complexities of working in the home setting in addition to clinical aspects of caregiving. Home adaptations need to be carefully planned and include design principles that retain ‘at-homeness’ while enabling the creation of a safe workplace.