Characterising adoption of assistive technology for people with high tetraplegia: a qualitative study

PURPOSE: This study characterises at-home assistive technology adoption by people with high cervical spinal cord injury (HCSCI), identifying what technologies are used, what is valued, and where unmet needs and barriers to adoption remain. MATERIALS AND METHODS: Semi-structured interviews with 10 people with HCSCI and six caregivers discussing their at-home use of assistive technologies. RESULTS: Key findings reveal that low-level physiological and safety needs are not met by assistive technology and are still heavily dependent on caregiver assistance. High-level needs are facilitated by independently used technology, such as smart home devices or computer usage. Barriers to assistive technology adoption and sustained use included limited information and training, integration and reliability challenges, and restrictive funding pathways. This constrained whether technology could reduce caregiver dependence and support higher-order needs. CONCLUSION: The application of Maslow's Hierarchy of Human Needs provides a lens to understand and address these unique needs and explore the dynamic caregiving relationships of people with HCSCI.