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“不得不在人生这么晚的时候学习这个……”瑞典老年患者在初级卫生保健中对电子健康的信念、经历、态度和期望。

'Having to learn this so late in our lives…' Swedish elderly patients' beliefs, experiences, attitudes and expectations of e-health in primary health care.

作者信息

Nymberg Veronica Milos, Bolmsjö Beata Borgström, Wolff Moa, Calling Susanna, Gerward Sofia, Sandberg Magnus

机构信息

a Department of Clinical Sciences , Lund University , Malmö , Sweden.

b Center for primary Health Care research Malmö , Malmö , Sweden.

出版信息

Scand J Prim Health Care. 2019 Mar;37(1):41-52. doi: 10.1080/02813432.2019.1570612. Epub 2019 Feb 8.

Abstract

OBJECTIVE

The elderly are an increasing group and large consumers of care in Sweden. Development of mobile information technology shows promising results of interventions for prevention and treatment of chronic diseases. Exploring the elderly patients' beliefs, attitudes, experiences and expectations of e-health services helps us understand the factors that influence adherence to such tools in primary care.

MATERIAL AND METHODS

We conducted focus group interviews with 15 patients from three primary health care centers (PHCCs) in Southern Sweden. Data were analysed with thematic content analysis with codes and categories emerged from data during analysis.

RESULTS

We found one comprehensive theme: 'The elderly's ambivalence towards e-health:  reluctant curiosity, a wish to join and need for information and learning support'. Eight categories emerged from the text during analysis: 'E-health - a solution for a non-existing problem?', 'The elderly's experiences of e-health', 'Lack of will, skills, self-trust or mistrust in the new technology', 'Organizational barriers', 'Wanting and needing to move forward', 'Concerns to be addressed for making e-health a good solution', 'Potential advantages with e-health versus ordinary health care' and 'Need for speed, access and correct comprehensive information'.

CONCLUSIONS

Elderly patients in Sweden described feelings of ambivalence towards e-health, raising concerns as accessibility to health care, mistrust in poor IT systems or impaired abilities to cope with technology. They also expressed a wish and need to move forward albeit with reluctant curiosity. Successful implementation of e-health interventions should be tailored to target different attitudes and needs with a strong focus on information and support for the elderly. Key points Exploring the elderly patients' beliefs, experiences, attitudes and expectations of the fast developing e-health services helps us understand the factors that influence adherence to such tools in primary care. Elderly patients in Sweden reported ambivalence and different experiences and attitudes towards e-health, raising concerns as accessibility to health care, costs and mistrust in poor IT systems or impaired abilities to cope with technology. They also expressed a wish and need to move forward albeit with reluctant curiosity. Successful implementation of e-health interventions should be tailored to target different attitudes and needs with a strong focus on information and support for the elderly.

摘要

目的

在瑞典,老年人数量不断增加,且是医疗护理的大量消费者。移动信息技术的发展显示出对慢性病防治干预措施的良好效果。探究老年患者对电子健康服务的信念、态度、经历和期望,有助于我们理解在初级保健中影响对这类工具依从性的因素。

材料与方法

我们对瑞典南部三个初级卫生保健中心(PHCCs)的15名患者进行了焦点小组访谈。采用主题内容分析法对数据进行分析,分析过程中从数据中提炼出代码和类别。

结果

我们发现了一个综合主题:“老年人对电子健康的矛盾态度:不情愿的好奇、参与意愿以及对信息和学习支持的需求”。分析过程中从文本中提炼出八个类别:“电子健康——解决不存在的问题的方案?”“老年人的电子健康经历”“对新技术缺乏意愿、技能、自信或不信任”“组织障碍”“想要并需要向前发展”“使电子健康成为良好解决方案需解决的问题”“电子健康相对于普通医疗保健的潜在优势”以及“对速度、获取和正确全面信息的需求”。

结论

瑞典的老年患者描述了对电子健康的矛盾态度,对医疗保健的可及性、对糟糕信息技术系统的不信任或应对技术能力受损表示担忧。他们还表达了尽管带着不情愿的好奇但仍有向前发展的愿望和需求。电子健康干预措施的成功实施应针对不同态度和需求进行调整,重点是为老年人提供信息和支持。要点 探究老年患者对快速发展的电子健康服务的信念、经历、态度和期望,有助于我们理解在初级保健中影响对这类工具依从性的因素。瑞典的老年患者报告了对电子健康的矛盾态度以及不同的经历和态度,对医疗保健的可及性、成本以及对糟糕信息技术系统的不信任或应对技术能力受损表示担忧。他们还表达了尽管带着不情愿的好奇但仍有向前发展的愿望和需求。电子健康干预措施的成功实施应针对不同态度和需求进行调整,重点是为老年人提供信息和支持。

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