Currie Margaret, Philip Lorna J, Roberts Anne
Social, Economic & Geographical Sciences, The James Hutton Institute, Craigiebuckler, Aberdeen, AB15 8QH, UK.
Geography & Environment, School of Geosciences, University of Aberdeen, Elphinstone Road, Aberdeen, AB24 3UF, UK.
BMC Health Serv Res. 2015 Apr 16;15:162. doi: 10.1186/s12913-015-0825-0.
BACKGROUND: Providing health services to an ageing population is challenging, and in rural areas even more so. It is expensive to provide high quality services to small populations who are widely dispersed; staff and patients are often required to travel considerable distances to access services, and the economic downturn has created a climate where delivery costs are under constant review. There is potential for technology to overcome some of these problems by decreasing or ceasing the need for patients and health professionals to travel to attend/deliver in-person appointments. A variety of eHealth initiatives (for example Pathways through Pain an online course aimed to aid self-help amongst those living with persistent pain) have been launched across the UK, but roll out remains at an early stage. METHODS: This mixed-methods study of older adults with chronic pain examines attitudes towards, current use of and acceptance of the use of technology in healthcare. A survey (n = 168, 40% response rate) captured broad experiences of the use of technology in health and social care. Semi-structured interviews (four with technology and seven without technology participants) elicited attitudes towards technology in healthcare and explored attributes of personal and social interaction during home visits. RESULTS: People suffering from chronic pain access healthcare in a variety of ways. eHealth technology use was most common amongst older adults who lived alone. There was broad acceptance of eHealth being used in future care of people with chronic pain, but older adults wanted eHealth to be delivered alongside existing in-person visits from health and social care professionals. CONCLUSIONS: eHealth has the potential to overcome some traditional challenges of providing rural healthcare, however roll out needs to be gradual and begin by supplementing, not substituting, existing care and should be mindful of individual's circumstances, capability and preferences. Acceptance of technology may relate to existing levels of personal and social contact, and may be greater where technological help is not perceived to be replacing in-person care.
背景:为老龄化人口提供医疗服务具有挑战性,在农村地区更是如此。为广泛分散的小群体提供高质量服务成本高昂;工作人员和患者常常需要长途跋涉才能获得服务,而且经济衰退使得服务提供成本不断受到审视。技术有可能通过减少或消除患者和医疗专业人员亲自前往就诊/提供面对面预约的需求来克服其中一些问题。英国各地已经推出了各种电子健康倡议(例如“疼痛之路”,这是一门旨在帮助慢性疼痛患者进行自助的在线课程),但推广仍处于早期阶段。 方法:这项针对患有慢性疼痛的老年人的混合方法研究,考察了他们对医疗保健中技术的态度、当前使用情况以及对使用技术的接受程度。一项调查(n = 168,回复率40%)收集了在健康和社会护理中使用技术的广泛经验。半结构化访谈(4名有技术使用经验的参与者和7名无技术使用经验的参与者)引出了对医疗保健中技术的态度,并探讨了家访期间个人和社交互动的特点。 结果:患有慢性疼痛的人通过多种方式获得医疗保健服务。电子健康技术的使用在独居老年人中最为普遍。人们广泛接受在慢性疼痛患者的未来护理中使用电子健康,但老年人希望电子健康能与健康和社会护理专业人员现有的面对面就诊相结合。 结论:电子健康有潜力克服提供农村医疗保健的一些传统挑战,然而推广需要循序渐进,首先是补充而非替代现有护理,并且应考虑到个人情况、能力和偏好。对技术的接受可能与个人和社交接触的现有水平有关,在技术帮助不被视为取代面对面护理的情况下,接受程度可能更高。
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