Department of Social Work, Umeå University, Umeå, Sweden.
Centre for Demography and Ageing Research (CEDAR), Umeå University, Umeå, Sweden.
Scand J Caring Sci. 2021 Dec;35(4):1322-1331. doi: 10.1111/scs.12953. Epub 2021 Jan 14.
BACKGROUND: The aim of this article is to describe older people's perceptions of caring relations in the context of rural eHealth, as well as to explore how such relations can facilitate engagement in digital primary health care. There is an ongoing implementation of eHealth in Western health care, and rural areas and older people are specifically targeted. eHealth is said to be a solution to emergent problems and a technology that will facilitate people's opportunities to achieve good and equal health. From this perspective, it is crucial that older people engage in eHealth services, but there are barriers for use, and care providers need to adapt to the preferences of older people. METHODS: Semi-structured interviews with 19 individuals aged 61-85 were conducted. The participants were using digital services at two primary healthcare centres located in northern Sweden. Qualitative content analysis was used. An important theoretical tenet was that older people's perceptions of and engagements in eHealth are affected by the specific rural conditions. Ethical approval for the study has been obtained. RESULTS: The analysis rendered a total of three themes: in-person interaction was central to people's perceptions of good caring relations; patient-nurse relations were particularly emphasised; and caring relations in rural eHealth appeared to be multi-directional and fuelled by a shared sense of rural community. Altogether, this facilitated participants' engagement in local eHealth initiatives. CONCLUSIONS: eHealth is an opportunity for primary health care and for rural communities. However, the results provide insight into matters that can affect the quality, access, and equality of rural primary health care. Participants' engagement in eHealth was almost always facilitated by close caring relations with local Registered Nurses. Digital care needs to be approached as a combination of digital and in-person presence. Separating digital and physical task assignments among different personnel could make older people refrain from seeking health care.
背景：本文旨在描述老年人在农村电子健康背景下对关怀关系的看法，并探讨这些关系如何促进他们参与数字初级卫生保健。西方医疗保健领域正在持续实施电子健康计划，农村地区和老年人是特别关注的对象。据说电子健康是解决新出现问题的一种手段，也是促进人们实现良好和公平健康的一种技术。从这个角度来看，老年人参与电子健康服务至关重要，但使用电子健康服务存在障碍，护理提供者需要适应老年人的偏好。
方法：对 19 名年龄在 61-85 岁之间的个体进行了半结构化访谈。这些参与者正在位于瑞典北部的两个初级保健中心使用数字服务。采用了定性内容分析方法。一个重要的理论前提是，老年人对电子健康的看法和参与受到特定农村条件的影响。该研究已获得伦理批准。
结果：分析得出了三个主题：面对面互动是人们对良好关怀关系看法的核心；医患关系特别受到强调；农村电子健康中的关怀关系似乎是多向的，并由对农村社区的共同感所推动。总的来说，这促进了参与者参与当地的电子健康计划。
结论：电子健康为初级卫生保健和农村社区提供了机会。然而，研究结果揭示了可能影响农村初级卫生保健质量、可及性和平等性的因素。参与者参与电子健康的积极性几乎总是受到与当地注册护士密切关怀关系的促进。数字护理需要被视为数字和面对面存在的结合。将数字和物理任务分配给不同的人员可能会使老年人不愿意寻求医疗保健。
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