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Table 1 Characteristics of included studies

From: Informal carers’ experience of assistive technology use in dementia care at home: a systematic review

Qualitative studies
No Authors
Date
Country Participants Age range Study Design Theoretical Framework Assistive Technology Data collected from
 1 Altus DE et al. [52]
2000
USA 2- Spouses
(2 men)
Not reported Interviews Case study GPS tracker/Mobile locator Participant reflections and diary of incidents
 2 Cahill S [46]
2007
Ireland 20 – Spouses + Children + Sibling + Daughter-in-law + Friend
(5 men; 15 women)
34–79 Semi-structured interviews Thematic Analysis Automatic night and day calendar; lost item locator; automatic night lamp; gas cooker device; picture button telephone; Participant reflections
 3 Starkhammar S et all [53]
2008
Sweden 14 Spouses + Daughters
(5 men; 9 women)
Not reported Interviews and Observations Grounded Theory Stove timer Participant reflections
 4 Faucounau V et al. [54]
2009
France 1 – Spouse
(1 woman)
68 Interviews Single dyad case study GPS tracker Participant reflections
 5 Spring HJ [40]
2009
USA 14 – Spouses + Daughters + Grand daughter
(1 men; 13 women)
38–86 Semi-structured interviews Full conceptual description- grounded theory In-home night time monitoring system Participant reflections
 6 Landau R et al. [55]
2010
Israel 36 – Spouses + Children
(12 men; 24 women)
Not reported Focus groups Thematic framework approach GPS electronic tracking device Participant reflections on vignettes
 7 Powell J et al. [41]
2010
England 34 – Spouses + Children + Grandchildren + Friend
(12 men; 22 women)
23–91 Semi-structured interviews Framework approach Movement sensors; cameras; automatic water and gas switch off devices; tracking devices Participant reflections on vignettes
 8 White EB et al. [56]
2010
England 10 – Spouses + Son+ Daughter
(4 men; 6 women)
44–73 Interviews and survey Grounded Theory GPS tracker Participant reflections and Machin carer strain scale (modified)
 9 Rosenberg L et al. [57]
2011
Sweden 4 – Son +Daughters +Neighbour
(1male; 3 women)
55–78 Observations and In-Depth interviews Grounded Theory Night and Day Calendar, Forget-Me-Not Calendar, Memory Message, MeDose watch Participant reflections
 10 Olsson A et al. [58]
2012
Sweden 14 Spouses
(6men; 8 women)
62–89 Interviews Not reported Safety alarm, bed alarm, door alarm, passage sensor, electronic tracking device, cooker monitors, talking cazette, picture button telephone, memory aid, special remote control Participant reflections
 11 Rosenberg L et al. [59]
2012
Sweden 16 – Spouses + Son +Daughter+ Neighbour
(5 men; 11 women)
45–78 Interviews and Focus groups Grounded Theory GPS monitor, electronic pill dispenser Participant reflections
 12 Martin S et al. [60]
2013
Northern Ireland 8
(Gender not reported separately)
Not reported Semi-structured interviews Phenomenological approach NOCTURNAL - Sensors, communication devices, tablet PC Participant reflections
 13 Nijhof N et al. [61]
2013
Netherlands 14 – Spouses + Family + Friends (Gender not reported) Not reported Semi-structured interviews Not reported ADLife - gateway with alarm button, sensors Participant reflections
 14 Olsson A et al. [62]
2013
Sweden 5 Spouses (2men; 3 women) 62–68 Participant Observation Ethnographic approach Passive Positioning Alarm Participant experience
 15 Riikonen M et al. [47]
2013
Finland 25 – Spouses + Daughters + Brothers + Son-in-law + Niece
(12 men; 13 women)
Less than 65 Unstructured interviews and participant observations Thought entity Cameras, movement detectors, electronic medication reminder, photo memory telephone Participant reflections
 16 Hastall MR et al. [63]
2014
Germany 17 - Spouses + Children
(4 men; 13 women)
38–91 Semi-structured interviews Thematic Analysis Information retrieval system; Video communication system; sensors Participant reflections on vignettes
 17 Jentoft R et al. [64]
2014
Norway 9 – Son + Spouses +Daughters +Mother
(4 men; 5 women)
19–89 In-depth interviews and Observations Social situated learning Simple remote control for TV Participant reflections
 18 Meiland F et al. [65]
2014
Netherlands and Germany 13
(Gender not reported separately)
Not reported Interviews and Focus group Not reported COGKNOW day navigator; sensors and sensor network Participant reflections on development of AT + Vignette
 19 Milne H et al. [66]
2014
Scotland 16 - Spouses + Sister + Son + Daughters + Son-in-law + Daughter-in-law
(7men; 9 women)
Not reported Interviews
(part of observational mixed methods study)
Thematic analysis with constant comparison GPS devices - worn as watches, pendants or carried in pockets and bags Participant reflections
 20 Burstein AA et al. [67]
2015
USA 34 - Spouses + Children + Grandchildren + Friend + Neighbour + Sibling + Niece + Daughter-in-law + Cousin
(6 men; 28 women)
43–76 In-depth interviews Not reported Sensor technology, GPS tracking device. Plus emerging technology - robotic therapy seal, GPS tracking system; social contact system, health monitoring system Participant reflections on awareness of technology
 21 Gibson G et al. [10]
2015
England 26 - Spouses and Daughters
(Gender not reported separately)
49–82 Interviews Thematic analysis, constant comparative method Community alarms and telecare; GPS location monitoring devices, signage, reminiscence tools, clocks to aid orientation, simplified telephones with pictures, pill dispensers Participant reflections
 22 Arntzen C et al. [48]
2016
Norway 14 - Spouses +Children +Parent
Gender not reported)
19–89 In-depth interviews and Observations Phenomenological conception of ‘lived body’ Sensors, timers, tracking device, cooker alarm, timer on coffee machine, automatic day and night calendar, simple remote control for television, electronic door lock, item locator, simple mobile phone, automatic day and date calendar, speaking arm-wrist watch, message box reading out a message when activated, memory clock, medicine dispenser with alarm Participant reflections
 23 Grigorovich A et al. [68]
2016
Canada 20 – Sons + Son-in-law
(20 men)
25–66 Semi-structured interviews Naturalistic enquiry, qualitative descriptive design Cameras, baby monitors, skype Participant reflections
 24 Newton L et al. [69]
2016
England 26
(Gender not reported separately)
49–82 Interviews Not reported Community alarms and telecare; GPS location monitoring devices, signage, reminiscence tools, clocks to aid orientation, simplified telephones with pictures, pill dispensers Participant reflections
 25 Ekstrom A et al. [70]
2017
Sweden 1 – Spouse
(1 male)
Not reported Video recording and observation Talk-in interaction Tablet computer Length and domains of conversation
 26 Evans N et al. [49]
2017
England 6 – Daughters +Spouses +Daughter-in-law
(6 women)
48–62 Interviews and Focus groups Interpretative Phenomenological Analysis Calendar Participant reflections
 27 Hassan L et al. [71]
2017
England 4
(Gender not reported)
Greater than 65 Focus group Not reported Wearable sensors Participant reflections and discussion on vignettes
 28 Holthe T et al. [50]
2017
Norway 13 – Spouses + Daughter + Mother + son
(7 men; 6 women)
19–89 Interviews Epistemology of coping stove timer, timer to coffee machine, GPS, automatic calendar, simple remote control to TV, Electronic door lock, object locator, simple mobile phone, digital calendar with remote control, talking wrist watch, medicine dispenser with alarm, memory clock, message box connected to coffee machine Participant reflections
 29 Lorenz K et al. [72]
2017
England 7 – Sons + other carers
(Gender not reported)
Not reported Email and blog reviews Not reported Baby monitors, talking motion sensors, personalised recorded messages, cameras Reports on personal evaluation of technology
 30 Wang RH et al. [51]
2017
Canada 10 – Spouses + Son + Daughters
(4 men; 6 women)
36–78 Semi-structured interviews Thematic analysis Assistive robot - Ed - personal computer; microphones, LCD screen, speakers and web cameras Participant reflections based on observations
Quantitative studies
No Authors
Date
Country Participants Age range Study Design Assistive Technology Measures Validated measures
 31 Gitlin LN et al. [35]
2010
USA 63/73 [Experimental/Control] – Spouse + Others
(13 Men; 50 women – Experimental group)
Dropouts not reported
53–79 Randomised controlled trial Medication dispensers, video cameras, motion detectors, lost item finders 1. Use of device (yes/no).
2. Extent to which helpful (1 = not helpful, 2 = somewhat helpful, 3 = very helpful)
No
 32 Rowe MA et al. [36]
2009
USA 26/27 [Experimental/control] – Spouses + Daughter + Son + Granddaughter
(7/4 men; 19/23 women).
Dropouts = 10 in each group
38–86 Pre test-Post test repeated measures Randomised pilot study Night Monitoring System 1. System reliability.
2. Satisfaction with the NMS.
3. Nighttime injuries.
4. Unattended exits from home.
5. Mechanisms to manage nightime activity.
6. Baseline variables including short version of Zarit Burden Interview; The neuropsychiatric Inventory
1–5 = No.
6. Zarit Burden Interview = Yes;
Quebec User Evaluatio of Satisfaction with Assistive Technology Questionnaire = Yes
 33 Rowe MA et al. [37]
2010
USA 26/27 [Experiemental/control] – Spouses + Daughters + Sons
(6/3 Men; 18/22 Women).
Dropouts = 4 in each group
38–86 Pre test-Post test Controlled Clinical Trial Night Monitoring System 1. Caregiver distress about night time activity
2. Sleep diary
3. actigraphy
1. Generated for this study (10-point Likert-type scale.
2. Subjective 5-point scale
3. Analysis of sleep-wake cycles
 34 Olsson A et al. [73]
2015
Sweden 3 – Spouses
(3 women)
72–74 Three - Experimental single case studies (A1B1A2B2) Passive Positioning Alarm 1. Percentage of days with independent outdoor activities.
2. Spouse’s worry concerning PwD’s independent outdoor activities (1–10 not worried at all to extremely worried).
3. General well-being for spouses (0–10 not well-being at all to extremely good).
4. Caregiver burden scale (1 not at all to 4 often).
1–3 = No;
4 = published for stroke patients
 35 Pot AM et al. [74]
2012
Netherlands 33- Spouses + Children
(2 Men; 26 Women)
Incomplete = 5
> 63 Pre test-Post test Trial GPS tracking device 1. overall global impression of device from 1 to 10.
2. Structured questions for use of the device from totally agree, totally disagreem agree and disagree.
3. Accepatability using Agree, neutral, disagree.
4. Self-perceived pressure from informal care scale
1–3 = No;
4 = published
 36 Kinney J M et al. [38]
2004
USA 19 – Spouses + Son + Daughter + Sister + Great Niece.
(8 men; 11 women).
Incomplete = 6.
36–82 Survey and exit interview Smart home management system (Xanboo); cameras and sensors, cell phone 1. Family obligation, competence, role captivity, loss of self, overload, expressive support in caregiving.
2. Retrospective time budget.
3. Exit interview questions
No
 37 Duff P et al. [75]
2007
Ireland, England, Finland, Lithuania Norway 127
(Gender not reported)
Incomplete = 47
Not reported Before and After Survey Calendar, Lamp, Gas cooker monitor, locator, picture telephone, medicine reminder 1. Usefulness.
2. Levels of satisfaction.
3. Recommend device to a friend.
4. Willing to pay for device.
5. Carer wellbeing score
1-4 = No.
5 = Yes
 38 Rialle V et al. [76]
2008
France 350 – Spouses + Siblings + Relatives + Other
(89 men; 181 women)
Incomplete = 80
54–98 Cluster sample survey Smart home technologies - fall sensor; oral call identification; video surveillance; tracking device; robot care; video conferencing 1. Questionnaire in three sections
a. general information;
b. Current skills and practice and viewpoints on specific technologies;
c. Economical effort and support. (not at all, little, moderately, very much).
Included ‘mini’ Zarit score
No
 39 Landau R et al. [77]
2009
Germany and Israel 69 – Spouses + Sons + Daughters + Other family members
(16 men; 53 women)
Not reported Survey GPS tracking device 1. Attitude towards use of electronic tracking questionnaire - 31 items on 4-point Likert scale from do not agree at all to very much agree.
2. Who should make decisions regarding use of GPS device - 4-point Likert scale.
3. Six Items adapted from Quebec User Evaluation of Satisfaction with Assistive Technology scale
No
 40 Chen Y-C et al. [78]
2012
Taiwan 3 – Spouses
(1 man; 2 women)
28–86 Survey Electronic GPS 1. Lost seeking devices used.
2. Wandering behaviour.
3. Functions in lost seeking devices.
4. Faults in lost seeking devices.
5. Importance of the information
6. importance of purchase consideration.
No
 41 Alwin J et al. [79]
2013
Sweden 47 – Spouses + Children
(16 men; 31 women)
46–77 Survey Easy-to-use telephones, door alarms, alarms and emergency transmitters 1. Carers of Older People in Europe (COPE index).
2. Patient perspective on Care and Rehabilitation process instrument (POCR).
3. How do you value the significance of the intervention? (1 = of no significance, 5 = of greatest possible significance)
1 = published. 2 = Published but modified for this study.
3 = No
 42 Lim F S et al. [80]
2013
Australia 24 – Family + Friend
(3 men; 21 women)
Dropouts = 3
34–85 Before, during and after survey iPad 1. Previous experience of use of technology.
2. PwD using device independently.
3. Carer’s perspectives on usefulness of the device.
No
 43 McKenzie B et al. [81]
2013
USA 60
(7 men; 53 women)
incomplete = 1
Not reported Before and after survey Motion sensor with remote alarm, wireless camera with handheld liquid crystal display night vision, proximity range alarm, wireless home security system, medication organiser, locating technologies, bed occupancy sensor, touchpad key locks, window alerts, water detector alert 1. Safety assessment Scale.
2. Caregiver Vigilance Scale.
3. Peace of Mind scale.
4. Sleep Disorders inventory
Yes
 44 Schulz R et al. [39]
2016
USA 512 – Spouses + Sons +Daughters + Other family members + Friends
(251 men; 261 women)
Incomplete = 75
18–64 Survey Emergency response system; sensors; 1. General technology attitudes −10-point scale. No
 45 Kamimura T [82]
2017
Japan 5 – Spouse + Daughter + Daughter-in-law
(Gender not reported)
52–65 Survey Automatic Medication Dispenser 1. Carer Burden (1 = no burden; 2 = little burden; 3 = mild burden; 4 = moderate to severe burden). No
 46 Korchut A et al. [83]
2017
Poland Spain 81-
(26 men; 54 women)
incomplete = 1
Not reported Survey Robotic assistants 1. Social acceptance.
2. human-robot interaction
No
 47 Megges H et al. [84]
2017
Germany 18 – Spouses + daughters
(10 men; 8 women)
Dropout = 1
41–78 Before and after survey Mobile locating system with GPS 1. Zarit burden interview.
2. General self-efficacy scale.
3. User diary.
4. How satisfied they were with the prototype (1 = not at all satisfied to 4 = very satisfied)
1,2 = Yes.
3,4 = No
Mixed Methods Studies
No Authors
Date
Country Participants Age range Study Design Assistive Technology Measures Validated measures
 48 Topo P et al. [85]
2007
Lithuania
Norway
Ireland
United Kingdom
Finland
50 - Spouses + Children + Grandchildren + Friends.
(4 men; 21 women).
Incomplete = 25
29–84 1. Burden of care questionnaire
2. Interviews
Night and Day Calendar 1. The need for care and treatment.
2. Use of services and quality of life.
3. Greene’s Relative Stress Scale
1,2 = No.
3 = Published
 49 Meiland F et al. [86]
2012
Netherlands
Ireland
Sweden
41 – Spouses + Children
(25 men; 16 women)
23–79 Pre test-Post test Questionnaires
2. Semi-structured interviews.
3. Diary.
4. Observations
COGKNOW Day Navigator (CDN) - touchscreen, mobile device, home based sensors, actuators 1. Short Sense of Competence Questionnaire.
2. One question regarding overall judgement on QoL of the carer
1 = Yes.
2 = No.
 50 Nijhof N et al. [87]
2013
Netherlands 16 – Spouses + Sons + Daughters
(6 men, 10 women)
35–79 1. Log file of system use.
2. Interviews
PAL4 BV - Agenda for the day, diary, two-way video contact, memory games to play, Music and movies, information on dementia and the village they live in 1. Log files - number of clicks and buttons pressed on the touch screen.
2. interviews on uptake and impact with carers
No
 51 Mehrabian S et al. [88]
2014
France 30 – Spouses + Children
(10 men; 20 women)
54–74 1. Survey
2. Semi-structured interviews.
Telecare system - sensors, videoconferencing, detecting emergencies, cognitive stimulation exercises. Medicines and task reminders 1. Questionnaire on use and usefulness.
2. Interview questions
No
 52 Lewis V et al. [89]
2015
Australia 59 – Spouses + Others
(16 men; 35 women). Incomplete = 8
30–70 1. Pre test-Post test self-report questionnaire.
2. Diary.
3. Semi-structured phone interviews.
MP3 player 1. Kessler-10 measure of psychological distress −1 = none of the time to 5 = all of the time.
2. General health question-one item.
3. Life satisfaction questions - 1 = very dissatisfied to 11 = very satisfied.
4. Family caregiver self-efficacy scale - 1 = not at all certain to 10 = very certain.
5. Caregiving and stress measure.
6. Self-care and healthy behaviours.
Yes
 53 Hattink B J et al. [90]
2016
Germany
Netherlands
Belgium
17/15 [Experiemental/Control] – Spouses + Children + Other
(7/6 men; 10/8 women)
Dropouts = 9/9
29–85 1. Pre test-Post test control group design with matched groups (Netherlands, Belgium). Randomised Controlled Trial (Germany).
2. Focus Groups
Integrated Rosetta system: Elderly Day Navigator + The early Detection System + Unattended autonomous surveillance system 1. Usefulness and user-friendliness. 2. Short sense of competence questionnaire. 1 = No.
2 = yes
 54 Navarro R F et al. [91]
2016
Mexico 3 – Spouses + Daughter
(3 women)
43–66 1. Questionnaires
2. Diary.
3. interviews
Assisted cognition system - touchscreen reminders for the day, current date and time, tracking 1. Caregiver burden - Zarit Burden Interview. 2. Caregiver self-efficacy - revised Scale for caregiving Self-Efficacy Yes
 55 Liu L et al. [92]
2017
Canada 46 - Spouses + Children + Friend + Daughter-in-law
(11 men; 35 women)
41–71 1. Pre test-Post test questionnaires2. Focus groups GPS 1. Questionnaire - 1 = strongly disagree to 5 = strongly agree.
2. Zarit Burden Scale. 3. Focus groups.
No
 56 Tyack C et al. [42]
2017
England 12
(2 men, 10 women)
48–77 1. Quasi-experimental repeated measures. Questionnaire.
2. Semi-structured interviews
Tablet Computer 1. Quality of Life - Alzheimer’s Disease (QoL-AD) scale.
2. Semi-structured interviews
Yes
Thematic analysis