Jakobsson Elin, Nygård Louise, Kottorp Anders, Malinowsky Camilla
Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
Faculty of Health and Society, Malmö University, Malmö, Sweden.
Scand J Caring Sci. 2019 Jun;33(2):380-389. doi: 10.1111/scs.12634. Epub 2019 Jan 10.
Since health care is facing challenges, with fewer caregivers providing care to more clients, eHealth plays a crucial role. Through eHealth, people are expected to be more involved in their own care. On the part of health care users, eHealth requires use of everyday technology such as telephones and computers, and services through the Internet which might be challenging for older adults with cognitive impairment.
To investigate experiences of using eHealth in contact with health care among older adults with cognitive impairment.
Individual, semi-structured interviews were conducted with nine participants, aged 65-84 years, with cognitive impairments of varying origins. A constructivist Grounded Theory approach was used. Data collection and analysis were performed simultaneously using a constant comparative method.
Ethical approval (Dnr: 2014/906-32) was obtained from the regional ethical committee, Stockholm.
The core category, the eHealth staircase supported by habits, is presented as a model that visualises the result. The model includes three steps showing different ways of being in contact with health care through the use of technological devices and services that mirrors different levels of complexity of eHealth use as follows: (i) Analogue use, (ii) One-way-use and (iii) Interactive use. The participants' location on the eHealth staircase was affected by several aspects described in three categories united by habits; A stable relationship with technology: a prerequisite for use; The importance of interpersonal relationships within health care and Being supported by significant others: a prerequisite in contact with health care.
Older adults with cognitive impairments seemed to prefer common and less complex eHealth when contacting health care. Therefore, it is necessary that health care providers offer different possibilities for patients to contact them, that is, both through the Internet and by personal telephone service.
由于医疗保健面临挑战,照顾者减少而需要照顾的客户增多,电子健康发挥着至关重要的作用。通过电子健康,人们有望更多地参与自身护理。对于医疗保健用户而言,电子健康需要使用电话和电脑等日常技术,以及通过互联网提供的服务,这对于认知障碍的老年人来说可能具有挑战性。
调查认知障碍老年人在与医疗保健接触中使用电子健康的体验。
对9名年龄在65 - 84岁、患有不同病因认知障碍的参与者进行了个体半结构式访谈。采用建构主义扎根理论方法。使用持续比较法同时进行数据收集和分析。
获得了斯德哥尔摩地区伦理委员会的伦理批准(编号:2014/906 - 32)。
以习惯为支撑的电子健康阶梯这一核心类别,被呈现为一个可视化结果的模型。该模型包括三个步骤,展示了通过使用技术设备和服务与医疗保健接触的不同方式,反映了电子健康使用的不同复杂程度,如下:(i)模拟使用,(ii)单向使用,(iii)交互使用。参与者在电子健康阶梯上的位置受到习惯所统一的三个类别中所描述的几个方面的影响;与技术的稳定关系:使用的先决条件;医疗保健中人际关系的重要性;以及得到重要他人的支持:与医疗保健接触的先决条件。
认知障碍的老年人在与医疗保健接触时似乎更喜欢常见且不太复杂的电子健康方式。因此,医疗保健提供者有必要为患者提供不同的联系方式,即通过互联网和个人电话服务。