Woo Kyungmi, Dowding Dawn W
Author Affiliations: Columbia University School of Nursing (Dr Woo), New York, NY; and Division of Nursing, Midwifery and Social Work, University of Manchester (Dr Dowding), United Kingdom.
Comput Inform Nurs. 2020 Apr;38(4):204-214. doi: 10.1097/CIN.0000000000000589.
Telehealth has been reported to be effective in helping patients with heart failure manage their symptoms at home. Despite this, the adoption rate for telehealth among home care patients with heart failure is low, and there is limited research on reasons for this. This study was undertaken to explore factors associated with patients' decisions to adopt telehealth at home. A qualitative descriptive study underpinned by the Unified Theory of Acceptance Use of Technology model was conducted using semi-structured telephone interviews with patients with heart failure (N = 20) referred for telehealth. Interviews were analyzed using a mixture of deductive and inductive coding. Among the theoretical model elements, the perceived usefulness of the technology (performance expectancy), the availability of clinical/technical support (facilitating conditions), and the opinion of other individuals important to the patient (social influence) were associated with telehealth initiation. However, the ease of use (effort expectancy) was not an associated factor. Other factors such as experience, knowledge, confidence, satisfaction, and attitudes were also associated with the decision. Identification of factors related to higher telehealth initiation rates can be used to inform individualized care planning by nurses. Knowledge of such associations can inform referral process to improve the efficiency and utilization of telehealth.
据报道，远程医疗有助于心力衰竭患者在家中管理症状。尽管如此，心力衰竭家庭护理患者中远程医疗的采用率较低，对此原因的研究也很有限。本研究旨在探讨与患者在家中采用远程医疗决策相关的因素。采用基于技术接受与使用统一理论模型的定性描述性研究，对20名被推荐接受远程医疗的心力衰竭患者进行半结构化电话访谈。访谈采用演绎编码和归纳编码相结合的方式进行分析。在理论模型要素中，技术的感知有用性（绩效期望）、临床/技术支持的可用性（促进条件）以及对患者重要的其他个人的意见（社会影响）与远程医疗的启动有关。然而，易用性（努力期望）不是一个相关因素。经验、知识、信心、满意度和态度等其他因素也与该决策有关。识别与较高远程医疗启动率相关的因素可用于指导护士进行个性化护理计划。了解这些关联可以为转诊过程提供信息，以提高远程医疗的效率和利用率。
