通过健康信息技术促进家庭外护理：对非正式护理人员当前做法、兴趣和感知障碍的调查。

Facilitating out-of-home caregiving through health information technology: survey of informal caregivers' current practices, interests, and perceived barriers.

作者信息

Zulman Donna M, Piette John D, Jenchura Emily C, Asch Steven M, Rosland Ann-Marie

机构信息

Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA 94025, United States.

出版信息

J Med Internet Res. 2013 Jul 10;15(7):e123. doi: 10.2196/jmir.2472.

DOI:10.2196/jmir.2472

PMID:23841987

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3713893/

Abstract

BACKGROUND

Many patients with chronic conditions are supported by out-of-home informal caregivers-family members, friends, and other individuals who provide care and support without pay-who, if armed with effective consumer health information technology, could inexpensively facilitate their care.

OBJECTIVE

We sought to understand caregivers' use of, interest in, and perceived barriers to health information technology for out-of-home caregiving.

METHODS

We conducted 2 sequential Web-based surveys with a national sample of individuals who provide out-of-home caregiving to an adult family member or friend with a chronic illness. We queried respondents about their use of health information technology for out-of-home caregiving and used multivariable regression to investigate caregiver and care-recipient characteristics associated with caregivers' technology use for caregiving.

RESULTS

Among 316 out-of-home caregiver respondents, 34.5% (109/316) reported using health information technology for caregiving activities. The likelihood of a caregiver using technology increased significantly with intensity of caregiving (as measured by number of out-of-home caregiving activities). Compared with very low intensity caregivers, the adjusted odds ratio (OR) of technology use was 1.88 (95% CI 1.01-3.50) for low intensity caregivers, 2.39 (95% CI 1.11-5.15) for moderate intensity caregivers, and 3.70 (95% CI 1.62-8.45) for high intensity caregivers. Over 70% (149/207) of technology nonusers reported interest in using technology in the future to support caregiving. The most commonly cited barriers to technology use for caregiving were health system privacy rules that restrict access to care-recipients' health information and lack of familiarity with programs or websites that facilitate out-of-home caregiving.

CONCLUSIONS

Health information technology use for out-of-home caregiving is common, especially among individuals who provide more intense caregiving. Health care systems can address the mismatch between caregivers' interest in and use of technology by modifying privacy policies that impede information exchange.

摘要

背景

许多慢性病患者由家庭外非正式照料者提供支持，这些照料者包括家庭成员、朋友及其他无偿提供照料和支持的个人。若能掌握有效的消费者健康信息技术，他们就能以低成本促进患者的护理。

目的

我们试图了解照料者对用于家庭外照料的健康信息技术的使用情况、兴趣及感知到的障碍。

方法

我们对全国范围内为患有慢性病的成年家庭成员或朋友提供家庭外照料的个人样本进行了两项连续的基于网络的调查。我们询问了受访者在家庭外照料中对健康信息技术的使用情况，并使用多变量回归分析来研究与照料者在照料中使用技术相关的照料者和受照料者特征。

结果

在316名家庭外照料者受访者中，34.5%（109/316）报告在照料活动中使用了健康信息技术。照料者使用技术的可能性随着照料强度（以家庭外照料活动的数量衡量）的增加而显著增加。与极低强度照料者相比，低强度照料者使用技术的调整优势比（OR）为1.88（95%CI 1.01-3.50），中等强度照料者为2.39（95%CI 1.11-5.15），高强度照料者为3.70（95%CI 1.62-8.45）。超过70%（149/207）未使用技术的受访者表示未来有兴趣使用技术来支持照料。照料中使用技术最常被提及的障碍是限制获取受照料者健康信息的卫生系统隐私规则，以及对促进家庭外照料的项目或网站不熟悉。