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远程医疗设备有效性的定性分析(二)远程医疗设备使用的障碍

A qualitative analysis of the effectiveness of telehealthcare devices (ii) barriers to uptake of telehealthcare devices.

作者信息

Campling Natasha C, Pitts David G, Knight Paul V, Aspinall Richard

机构信息

Faculty of Health Sciences Building 67, University of Southampton, Southampton, UK.

Cranfield Biotechnology Centre, Cranfield University, Bedford, UK.

出版信息

BMC Health Serv Res. 2017 Jul 6;17(1):466. doi: 10.1186/s12913-017-2270-8.

Abstract

BACKGROUND

Monitoring health and care needs through the use of telehealthcare devices has been proposed to help alleviate funding concerns in a climate of limited budgets. As well as improving cost effectiveness, such an approach could be used to help individuals live at home for longer. In practice however, these devices often go unused. A qualitative study was carried out to determine the barriers to uptake of these devices from both the perspective of the end user and from key players in the healthcare supply chain.

METHODS

A qualitative approach was used involving focus groups and interviews. Two UK-based focus groups were held with users and potential users, to assess their views on the wide array of devices available. 27 individuals were involved in the groups, all over the age of 60. Additionally 27 telephone interviews were conducted with key supply chain players to ascertain their views on the barriers to uptake of these devices. A semi-structured interview guide was used. All data were audio-recorded, transcribed verbatim and analysed using a thematic approach.

RESULTS

Users were generally unaware of the wide array of devices available and when shown a selection, were often unclear as to their purpose. The interviews revealed extensive barriers to uptake due to lack of awareness, unfamiliar terminology, complex supply routes and costs, resistance from professionals to device usage and lack of expertise.

CONCLUSIONS

Public and professional awareness campaigns are required with appropriate funding mechanisms for users to gain access to devices. The numerous barriers identified require systematically addressing, so that device usage is better promoted, enabling individuals to live at home successfully for longer.

摘要

背景

有人提议通过使用远程医疗设备来监测健康和护理需求,以帮助缓解预算有限情况下的资金担忧。除了提高成本效益外,这种方法还可用于帮助个人在家中居住更长时间。然而在实际中,这些设备常常未被使用。开展了一项定性研究,从终端用户和医疗供应链关键参与者的角度确定采用这些设备的障碍。

方法

采用定性方法,包括焦点小组和访谈。与用户和潜在用户进行了两个英国境内的焦点小组讨论,以评估他们对现有各类设备的看法。27人参与了这些小组讨论,均为60岁以上。此外,还对供应链关键参与者进行了27次电话访谈,以确定他们对采用这些设备的障碍的看法。使用了半结构化访谈指南。所有数据都进行了录音、逐字转录,并采用主题分析法进行分析。

结果

用户通常不了解现有的各类设备,当展示一些设备时,他们往往不清楚其用途。访谈揭示了由于缺乏认识、术语不熟悉、供应路线复杂和成本、专业人员对设备使用的抵触以及缺乏专业知识等原因导致的广泛采用障碍。

结论

需要开展公众和专业宣传活动,并为用户提供适当的资金机制以获取设备。需要系统地解决所确定的众多障碍,以便更好地推广设备使用,使个人能够成功地在家中居住更长时间。

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本文引用的文献

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State of Telehealth.
N Engl J Med. 2016 Jul 14;375(2):154-61. doi: 10.1056/NEJMra1601705.

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