Lu Ju-Fen, Chi Mei-Ju, Chen Ching-Min
College of Nursing, Taipei Medical University, Taipei, Taiwan; Department, of Nursing, Jen-Te Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
J Clin Nurs. 2014 Mar;23(5-6):811-9. doi: 10.1111/jocn.12156. Epub 2013 Jun 25.
To describe use of home telehealth care as an alternative for chronic disease management from users' perspective.
As the population ages, telehealth is increasingly being used to tackle problems related to the fast growing ageing population. Home telehealth care therefore poses challenges and offers opportunities for patients and healthcare providers.
A qualitative approach was adopted with a purposeful sample of 20 patients residing in Taiwan.
Patients who had received the service for three months and were willing to share their experiences were recruited. Data were collected by face-to-face interviews with semi-structured interview guideline (n = 8) and a focus group discussion (n = 12) in 2010. A qualitative content analysis was used.
Four key themes were identified: perceived support and security, enhanced disease self-management, concerned with using the devices and worries about the cost by patients. Most users favoured using the service to control their chronic conditions because of its convenience and accessibility, and their condition could be measured daily to enhance their sense of security. Users could determine and understand changes in their condition and improve medical regimen compliance, and they were empowered to revise their lifestyles for better disease self-management. However, users were concerned about the utility of the service, because they were unfamiliar with the operating procedures and doubted its quality. As the service is still in stage of pilot testing, users worried about possible cost and reimbursement policy changes in the future.
Most users perceived telehealth care was a convenient and useful model for healthcare-delivery. It increased the availability of health care and improved the self-care ability of patients.
To advocate for home telehealth care, nurses must play an active role in providing consumers with proper training and support for any problems when adopting the system to foster patients' willingness to use this service.
从用户角度描述家庭远程医疗保健作为慢性病管理替代方案的使用情况。
随着人口老龄化,远程医疗越来越多地被用于应对与快速增长的老年人口相关的问题。因此,家庭远程医疗保健给患者和医疗服务提供者带来了挑战,也提供了机遇。
采用定性研究方法,对居住在台湾的20名患者进行了有目的抽样。
招募接受该服务三个月且愿意分享其经历的患者。2010年,通过半结构化访谈指南进行面对面访谈(n = 8)和焦点小组讨论(n = 12)收集数据。采用定性内容分析法。
确定了四个关键主题:感知到的支持与安全感、增强的疾病自我管理、对设备使用的担忧以及患者对成本的担忧。大多数用户青睐使用该服务来控制慢性病,因为其方便易用,而且可以每天测量病情以增强安全感。用户能够确定并了解自身病情的变化,提高医疗方案的依从性,并且有能力调整生活方式以更好地进行疾病自我管理。然而,用户担心该服务的实用性,因为他们不熟悉操作程序,并且怀疑其质量。由于该服务仍处于试点测试阶段,用户担心未来可能的成本和报销政策变化。
大多数用户认为远程医疗保健是一种方便且有用的医疗服务提供模式。它增加了医疗服务的可及性,提高了患者的自我护理能力。
为倡导家庭远程医疗保健,护士必须积极发挥作用,在患者采用该系统时为其提供适当培训,并支持解决任何问题,以增强患者使用该服务的意愿。