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利益相关者对加拿大新不伦瑞克省支持就地养老的居家被动远程监测的看法:快速定性调查

Stakeholder Perspectives on In-home Passive Remote Monitoring to Support Aging in Place in the Province of New Brunswick, Canada: Rapid Qualitative Investigation.

作者信息

Read Emily A, Gagnon Danie A, Donelle Lorie, Ledoux Kathleen, Warner Grace, Hiebert Brad, Sharma Ridhi

机构信息

Faculty of Nursing, University of New Brunswick, Moncton, NB, Canada.

Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada.

出版信息

JMIR Aging. 2022 May 11;5(2):e31486. doi: 10.2196/31486.

Abstract

BACKGROUND

The province of New Brunswick (NB) has one of the oldest populations in Canada, providing an opportunity to develop and test innovative strategies to address the unique health challenges faced by older adults. Passive remote monitoring technology has the potential to support independent living among older adults. Limited research has examined the benefits of and barriers to the adoption of this technology among community-dwelling older adults.

OBJECTIVE

This study aimed to explore perceptions of in-home passive remote monitoring technology designed to support aging in place from the perspective of older adults, their family or friend caregivers, social workers, and government decision-makers in the province of NB, Canada.

METHODS

Between October 2018 and March 2020, a rapid qualitative investigation of 28 one-on-one interviews was conducted in person or via telephone. Participants included 2 home support services clients and 11 family or friend caregivers who had used passive remote monitoring technology in their homes; 8 social workers who had worked as case managers for home support services clients; and 7 individuals who were key government decision-makers in the adoption, policy development, and use of the technology in the province of NB. The interviews focused on the following topics: decision to adopt the passive remote monitoring system, barriers to adopting the passive remote monitoring system, benefits of the passive remote monitoring system, impact on client health outcomes, and privacy concerns. The interviews were audio recorded, transcribed, and analyzed by a team of 6 researchers. Data analysis was conducted using a rapid assessment process approach that included matrix analysis.

RESULTS

Participants reported that the use of the remote monitoring system allowed older adults to live at home longer and provided caregiver relief. Stakeholders were invested in meeting the home support (home care) needs of older adults. However, when it came to the use of remote monitoring, there was a lack of consensus about which clients it was well-suited for and the role that social workers should play in informing clients and caregivers about the service (role ambiguity, gatekeeping, and perceived conflicts of interest).

CONCLUSIONS

Our findings highlight many benefits and challenges of the adoption of passive remote monitoring for clients, their family or friend caregivers, and public provincial health and social services systems. Passive remote monitoring is a valuable tool that can provide support to older adults and their family or friend caregivers when it is a good fit with client needs. Further work is needed in NB to increase public and social workers' awareness of the service and its benefits.

摘要

背景

新不伦瑞克省(NB)拥有加拿大最老龄的人口之一,这为开发和测试应对老年人所面临独特健康挑战的创新策略提供了契机。被动式远程监测技术有潜力支持老年人独立生活。有限的研究探讨了社区居住老年人采用该技术的益处和障碍。

目的

本研究旨在从加拿大新不伦瑞克省老年人、其家人或朋友护理者、社会工作者以及政府决策者的角度,探索旨在支持就地养老的家庭被动式远程监测技术的认知情况。

方法

2018年10月至2020年3月期间,通过面对面或电话方式对28人进行了一对一访谈,开展了快速定性调查。参与者包括2名居家支持服务客户和11名在自家使用过被动式远程监测技术的家人或朋友护理者;8名曾担任居家支持服务客户个案经理的社会工作者;以及7名在新不伦瑞克省该技术的采用、政策制定和使用方面担任关键政府决策者的个人。访谈聚焦于以下主题:采用被动式远程监测系统的决定、采用该系统的障碍、该系统的益处、对客户健康结果的影响以及隐私担忧。访谈进行了录音、转录,并由6名研究人员组成的团队进行分析。数据分析采用了包括矩阵分析在内的快速评估流程方法。

结果

参与者报告称,使用远程监测系统使老年人能够更长时间地居家生活,并减轻了护理者的负担。利益相关者致力于满足老年人的居家支持(家庭护理)需求。然而,在远程监测的使用方面,对于该技术适合哪些客户以及社会工作者在向客户和护理者介绍该服务时应扮演的角色(角色模糊、把关以及利益冲突认知)缺乏共识。

结论

我们的研究结果凸显了采用被动式远程监测对客户、其家人或朋友护理者以及省级公共卫生和社会服务系统而言的诸多益处和挑战。当被动式远程监测与客户需求相契合时,它是一种可为老年人及其家人或朋友护理者提供支持的宝贵工具。新不伦瑞克省需要进一步开展工作,以提高公众和社会工作者对该服务及其益处的认识。

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