Gjestsen Martha Therese, Wiig Siri, Testad Ingelin
Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway.
Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
J Med Internet Res. 2020 Jan 2;22(1):e12797. doi: 10.2196/12797.
The use of electronic health (eHealth) interventions is suggested to help monitor and treat degenerative and chronic diseases through the use of sensors, alarms, and reminders and can potentially prevent hospitalizations for home-dwelling older persons receiving community care. It is increasingly recognized that the health care personnel's acceptance of a technological application remains a key challenge in adopting an intervention, thus interventions must be perceived to be useful and fit for purpose by the actual users.
The aim of this study was to identify and explore the perspectives of managers and health care personnel in community care regarding the use of eHealth interventions in terms of prevention of hospitalizations for home-dwelling older persons receiving community care.
A case study with a qualitative approach was carried out in community care in a Norwegian municipality, comprising individual interviews and focus group interviews. A total of 5 individual interviews and 2 focus group interviews (n=12) were undertaken to provide the health care personnel's and managers' perspective regarding the use of eHealth interventions, which could potentially prevent hospitalizations for home-dwelling older persons receiving community care. Data were analyzed by way of systematic text condensation, as described by Malterud.
The data analysis of focus group interviews and individual interviews resulted in 2 categories: potential technological applications and potential patient groups. Discussions in the focus groups generated several suggestions and wishes related to technical applications that they could make use of in their day-to-day practice. The health care personnel warranted tools and measures to enhance and document their clinical observations in contact with patients. They also identified patient groups, such as patients with chronic obstructive pulmonary disease or dehydration or urinary tract infections, for whom hospitalizations could potentially have been prevented.
We have shown that the health care personnel in community care warrant various technological applications that have the potential to improve quality of care and resource utilization in the studied municipality. We have identified needs and important matters in practice, which are paramount for acceptance and adoption of an intervention in community care.
建议使用电子健康(eHealth)干预措施,通过传感器、警报和提醒来帮助监测和治疗退行性疾病和慢性病,并有可能防止接受社区护理的居家老年人住院。人们越来越认识到,医护人员对技术应用的接受程度仍然是采用干预措施的关键挑战,因此实际用户必须认为干预措施有用且符合目的。
本研究的目的是确定并探讨社区护理中的管理人员和医护人员对于使用eHealth干预措施预防接受社区护理的居家老年人住院的看法。
在挪威一个市镇的社区护理中采用定性方法进行了一项案例研究,包括个人访谈和焦点小组访谈。共进行了5次个人访谈和2次焦点小组访谈(n = 12),以了解医护人员和管理人员对使用eHealth干预措施的看法,这些措施有可能防止接受社区护理的居家老年人住院。数据采用Malterud描述的系统文本浓缩法进行分析。
焦点小组访谈和个人访谈的数据分析产生了两类结果:潜在的技术应用和潜在的患者群体。焦点小组讨论提出了一些与他们在日常实践中可以使用的技术应用相关的建议和愿望。医护人员需要工具和措施来加强并记录他们与患者接触时的临床观察。他们还确定了一些患者群体,如慢性阻塞性肺疾病患者、脱水患者或尿路感染患者,住院本有可能被预防。
我们已经表明,社区护理中的医护人员需要各种技术应用,这些应用有可能提高所研究市镇的护理质量和资源利用效率。我们已经确定了实践中的需求和重要事项,这对于在社区护理中接受和采用干预措施至关重要。