Division of Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
JMIR Mhealth Uhealth. 2020 Jun 3;8(6):e16343. doi: 10.2196/16343.
Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is growing interest in how electronic health (eHealth) can be used to provide efficient health care. Telemonitoring, where the patient's health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. A successful implementation of telemonitoring systems into clinical practice requires in-depth knowledge of the users' preferences.
The aim of this study was to explore perceptions of the use of a home telemonitoring system among patients with COPD.
Semistructured individual interviews were carried out with 8 women and 5 men who were participants in a project aimed at developing and evaluating a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms, and oxygen saturation. Participants were interviewed after having used the system for 2-4 months. Interview transcripts were analyzed with qualitative content analysis.
The analysis resulted in the theme A transition toward increased control and security and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants reported various perceptions of using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and in terms of their disease. However, the practical management of the telemonitoring system became easier with time; the participants gradually gained confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized.
This study captured a transition among the participants from being insecure and experiencing technical concerns to acquiring technical confidence and improving disease management. Telemonitoring can be a valuable complement to health care, leading to increased self-knowledge, a sense of security, and improved self-management. Suggestions to improve the further development and implementation of telemonitoring systems include better patient education and the involvement of end users in the technical development process. Additional research is needed, particularly in the design of user-friendly systems, as well as in developing tools to predict which patients are most likely to find the equipment useful, as this may result in increased empowerment, improved quality of life, reduced costs, and a contribution to equity in health.
慢性阻塞性肺疾病（COPD）是一个全球性的主要健康问题和经济负担。人们越来越关注电子健康（eHealth）如何用于提供高效的医疗保健。远程监护，即将患者的健康相关数据传输给医疗保健提供者，可以用于检测恶化的早期迹象。成功将远程监护系统实施到临床实践中需要深入了解用户的偏好。
本研究旨在探讨 COPD 患者对家庭远程监护系统使用的看法。
对 8 名女性和 5 名男性进行了半结构化的个人访谈，他们是一个旨在开发和评估远程监护系统的项目的参与者。基于网络的远程监护系统测量了肺功能、主观症状和氧饱和度。参与者在使用该系统 2-4 个月后接受了访谈。对访谈记录进行了定性内容分析。
分析结果得出了一个主题，即向增强控制和安全性转变，以及四个类别：使用时的（不）安全感、影响技术关注或信心、提供便捷的医疗保健以及增加对疾病的控制。参与者报告了使用远程监护系统的各种看法。他们最初对操作系统和疾病都感到不安，但随着时间的推移，远程监护系统的实际管理变得更加容易；参与者逐渐获得了信心，并改善了自我管理。新技术被视为现有医疗保健的重要补充，但强调了在现实生活中或通过远程监护系统保持人际联系的重要性。
本研究捕捉到参与者从不安和技术问题到获得技术信心和改善疾病管理的转变。远程监护可以作为医疗保健的有益补充，带来更多的自我认识、安全感和更好的自我管理。改善远程监护系统的进一步开发和实施的建议包括更好的患者教育和让终端用户参与技术开发过程。需要进一步研究，特别是在设计用户友好型系统以及开发工具以预测哪些患者最有可能发现设备有用方面，这可能会增强赋权、提高生活质量、降低成本，并有助于实现健康公平。
