Page 53 - Handbook of Electronic Assistive Technology

40 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

person toward the technology, which, in turn, influences their intention to use it and its
eventual uptake. Venkatesh et al. (2003) added to TAM in the Unified Theory of Acceptance
and Use of Technology, the users’ expectation about their performance, expectation about
the effort required to successfully use the technology, their social influencers (e.g., family
members who might encourage their use) and facilitating conditions in the environment
(e.g., needing to learn technology for work). These factors have been found to reliably
predict users’ intention to use the technology in the future, as well as their actual use of
that technology. While Venkatesh et al.’s (2003) model was not developed through work
in people with cognitive difficulties, or those using assistive technologies, the principal
findings do offer some insights into what is likely to impact EAT use by people with cogni-
tive impairments. For example, perceived usefulness and perceived need have been men-
tioned in several studies gathering stakeholders’ attitudes toward EAT (McGee-Lennon
et al., 2011; Jamieson et al., 2015; Baldwin et al., 2011; Dawe, 2006), and these two con-
cepts map into the problems arising from poor self-awareness. Facilitating conditions and
social supports that encourage the use of technology have also been noted as important
(Gibson et al., 2014; Hart et al., 2003). Some studies have also noted that anxiety and nega-
tive feelings around one’s own ability to use everyday technologies can prevent engage-
ment with EAT (Jamieson et al., 2017; Nygård and Starkhammar, 2007). A study has found
that frustration and negative emotional reactions to making mistakes with technology are
more prominent in people with cognitive impairments (de Joode et al., 2012).
Given the costs associated with producing, providing and training people with EAT, and
the potential cost-benefit of successful implementation of EAT in clinical practice (Oddy
and Ramos, 2013), it is understandable that there is a great deal of interest in what influ-
ences uptake, continued use and acceptance. There has been work investigating people
with cognitive impairments and their use of EAT. This has mostly been focused on the
use of devices to compensate for cognitive impairments (Scherer et al., 2005; Hart, 2009;
de Joode et al., 2010; Maynard et al., 2015). However, there is some work that has looked
at the uptake of EAT to support difficulties not primarily caused by cognitive impairment
among people with cognitive impairments which are comorbid to the impairments tar-
geted by EAT (Cullen et al., 2008; van den Berg et al., 2012). Other studies have investigated
the use of everyday technologies by people with cognitive impairment (Carey et al., 2005;
Gell et al., 2013). There are also relevant contributions from the literature investigating
telecare and assistive technology for older people in the general population that can help
with understanding the use of EAT in situations where cognitive impairment is a factor
(McGee-Lennon et al., 2011; Clark et al., 2011). In this section we will summarise some of
the themes that arose consistently in these studies, and discuss some of the implications
for practitioners.

Seeing a Benefit
Perceived usefulness is a key component of TAM, and this has also been found to be vital
in the uptake of EAT. When studying older people’s attitudes to supporting technology