Technology dependence and health-related quality of life: a model


  • Susan F. Marden PhD RN

    1. Clinical Nurse Scientist, Nursing and Patient Care Services Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
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Susan Marden,
Mark Hatfield Clinical Research Center,
National Institutes of Health,
2-1339, MSC 1506,
10 Center Drive,
MD 20892-2178,


Aim.  This paper presents a new theoretical model to explain people's diverse responses to therapeutic health technology by characterizing the relationship between technology dependence and health-related quality of life (HRQL).

Introduction.  Technology dependence has been defined as reliance on a variety of devices, drugs and procedures to alleviate or remedy acute or chronic health problems. Health professionals must ensure that these technologies result in positive outcomes for those who must rely on them, while minimizing the potential for unintended consequences. Little research exists to inform health professionals about how dependency on therapeutic technology may affect patient-reported outcomes such as HRQL. Organizing frameworks to focus such research are also limited.

Model.  Generated from the synthesis of three theoretical frameworks and empirical research, the model proposes that attitudes towards technology dependence affect HRQL through a person's illness representations or commonsense beliefs about their illness. Symptom distress, illness history, age and gender also influence the technology dependence and HRQL relationship. Five concepts form the major components of the model: a) attitudes towards technology dependence, b) illness representation, c) symptom distress, d) HRQL and e) illness history.

Conclusion.  The model is proposed as a guide for clinical nursing research into the impact of a wide variety of therapeutic health care interventions on HRQL. Empirical validation of the model is needed to test its generality.