Deciding about the use of a Personal Safety Alerting Device-The need for a legitimation process: A qualitative study.

Aims To explore reasons, thoughts, motives, and influencing factors regarding the use or non-use of Personal Safety Alerting Devices (PSADs) in the daily lives of community-dwelling older persons. Design A qualitative descriptive study design was used. Methods Six focus groups were conducted with a total of 32 older persons between February-August 2016. Data analysis followed the Qualitative Analysis Guide of Leuven. Results The participants described the use or non-use of PSADs as a decision resulting from a "legitimation process". This process implies that a person needs to perceive the necessity for a PSAD and then determine the right moment at which to start using it. During this process, each person weighs her or his "ageing self" and "perception of technology" then decides whether to start using a device or to delay its use. "Critical events" initiate this process, compelling the person to consider their own safety and their possible need for assistance. Conclusion The legitimation process suggests that the initiation of PSAD use represents a turning point in life. Using a PSAD is not simply a matter of obtaining one. It is a complex decision-making process establishing legitimation for its use, which is interwoven with one's individual ageing, self-perception, and the meaning attributed to the device. Impact Older persons need to be supported; in particular, they require time to go through the legitimation process for PSAD use. Nurses can empower them in this process, such that they perceive using a PSAD as a means to restore their frailty balance and feel enabled to (re)gain control over their own life and thus to preserve their independence.