TY - JOUR
T1 - A systematic concept analysis of 'technology dependent': challenging the terminology
AU - Brenner, M.
AU - Alexander, D.
AU - Quirke, M.B.
AU - Eustace-Cook, J.
AU - Leroy, P.
AU - Berry, J.
AU - Healy, M.
AU - Doyle, C.
AU - Masterson, K.
N1 - Funding Information:
The project is funded by the European Research Council 803051.
Funding Information:
There are an increasing number of children who require medical technology to sustain their life [–] and, in response, an expanding array of medical technology available. This paper analyses the concept of ‘technology dependent’, the term commonly used to refer to these children. The current prevalence and rate of increase in the number of children who are technology dependent is difficult to determine as they depend on a number of interrelated factors including: the prevalence of particular conditions; medical and surgical interventions chosen; and finance and policies for care delivery across and within countries [–]. The term technology dependent stems primarily from the phrase ‘technology dependence’ which was coined 30 years ago by the Office of Technology Assessment (US) [], describing ‘a medical device to compensate for the loss of a vital body function and substantial ongoing nursing care to avert death or further disability’. To the best of our knowledge, this is the first systematic concept analysis to examine the contemporary relevance and utility of this terminology as it is currently portrayed in the literature. This is important for two key reasons: the array of medical technology now available means that the broad term of ‘technology dependent’ has the potential to conjure up a multitude of clinical scenarios; and the objectifying nomenclature does not reflect a child-centric approach. This paper is part of a larger body of research, the TechChild project, funded by the European Research Council. The purpose of this research is to explore influences on the initiation of technology dependence required to sustain a child’s life and to identify more appropriate child-centred terminology in an evidenced-based manner.
Publisher Copyright:
© 2020, The Author(s).
PY - 2021/1/1
Y1 - 2021/1/1
N2 - There are an increasing number of children who are dependent on medical technology to sustain their lives. Although significant research on this issue is taking place, the terminology used is variable and the concept of technology dependence is ill-defined. A systematic concept analysis was conducted examining the attributes, antecedents, and consequences of the concept of technology dependent, as portrayed in the literature. We found that this concept refers to a wide range of clinical technology to support biological functioning across a dependency continuum, for a range of clinical conditions. It is commonly initiated within a complex biopsychosocial context and has wide ranging sequelae for the child and family, and health and social care delivery.Conclusion: The term technology dependent is increasingly redundant. It objectifies a heterogenous group of children who are assisted by a myriad of technology and who adapt to, and function with, this assistance in numerous ways.What is Known:center dot There are an increasing number of children who require medical technology to sustain their life, commonly referred to as technology dependent. This concept analysis critically analyses the relevance of the term technology dependent which is in use for over 30 years.What is New:center dot Technology dependency refers to a wide range of clinical technology to support biological functioning across a dependency continuum, for a range of clinical conditions. It is commonly initiated within a complex biopsychosocial context and has wide-ranging sequelae for the child and family, and health and social care delivery.center dot The paper shows that the term technology dependent is generally portrayed in the literature in a problem-focused manner.center dot This term is increasingly redundant and does not serve the heterogenous group of children who are assisted by a myriad of technology and who adapt to, and function with, this assistance in numerous ways. More appropriate child-centred terminology will be determined within the TechChild project.
AB - There are an increasing number of children who are dependent on medical technology to sustain their lives. Although significant research on this issue is taking place, the terminology used is variable and the concept of technology dependence is ill-defined. A systematic concept analysis was conducted examining the attributes, antecedents, and consequences of the concept of technology dependent, as portrayed in the literature. We found that this concept refers to a wide range of clinical technology to support biological functioning across a dependency continuum, for a range of clinical conditions. It is commonly initiated within a complex biopsychosocial context and has wide ranging sequelae for the child and family, and health and social care delivery.Conclusion: The term technology dependent is increasingly redundant. It objectifies a heterogenous group of children who are assisted by a myriad of technology and who adapt to, and function with, this assistance in numerous ways.What is Known:center dot There are an increasing number of children who require medical technology to sustain their life, commonly referred to as technology dependent. This concept analysis critically analyses the relevance of the term technology dependent which is in use for over 30 years.What is New:center dot Technology dependency refers to a wide range of clinical technology to support biological functioning across a dependency continuum, for a range of clinical conditions. It is commonly initiated within a complex biopsychosocial context and has wide-ranging sequelae for the child and family, and health and social care delivery.center dot The paper shows that the term technology dependent is generally portrayed in the literature in a problem-focused manner.center dot This term is increasingly redundant and does not serve the heterogenous group of children who are assisted by a myriad of technology and who adapt to, and function with, this assistance in numerous ways. More appropriate child-centred terminology will be determined within the TechChild project.
KW - acute-community interface
KW - centered care
KW - child
KW - children
KW - complex care needs
KW - complex needs
KW - concept analysis
KW - family
KW - home-care
KW - implantable cardioverter-defibrillators
KW - intensive-care
KW - long-term ventilation
KW - medical decision-making
KW - quality-of-life
KW - technology dependence
KW - Complex needs
KW - ACUTE-COMMUNITY INTERFACE
KW - Concept analysis
KW - COMPLEX CARE NEEDS
KW - LONG-TERM VENTILATION
KW - QUALITY-OF-LIFE
KW - Child
KW - HOME-CARE
KW - INTENSIVE-CARE
KW - CHILDREN
KW - Technology dependence
KW - Family
KW - IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS
KW - MEDICAL DECISION-MAKING
KW - CENTERED CARE
U2 - 10.1007/s00431-020-03737-x
DO - 10.1007/s00431-020-03737-x
M3 - (Systematic) Review article
C2 - 32710305
SN - 0340-6199
VL - 180
SP - 1
EP - 12
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 1
ER -