title: Technology dependence and health-related quality of life: a model.
abstract: OBJECTIVE
  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).
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nursing and Patient Care Services Clinical Center, National Institutes of Health, MSC 1506, 2-1339, 10 Center Drive, Bethesda, MD 20892-2178, USA. smarden@nih.gov
authors.forename: Susan F
authors.initials: SF
authors.lastname: Marden
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D020811:Biomedical Technology; D015400:Clinical Nursing Research / Q000379:methods; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011788:Quality of Life; D012737:Sex Factors