The Healthcare Innovation Center, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
J Med Internet Res. 2023 Mar 9;25:e41768. doi: 10.2196/41768.
In home care, eHealth implementation requires health care professionals and home care clients to change their behavior because they have to incorporate the use of eHealth into their daily routines. Knowledge of factors that influence the use of eHealth in home care is needed to optimize implementation strategies. However, a comprehensive overview of such factors is lacking.
The aims of this study were to (1) provide insight into the types of eHealth that are used and preferred in home care and (2) identify factors that influence the use of eHealth in home care according to health care professionals and home care clients.
A scoping review and online, cross-sectional survey were conducted sequentially. The survey was conducted among Dutch health care professionals with a nursing background who were working for a home care organization at the time. The capability, opportunity, motivation, behavior (COM-B) model, which posits that for any behavior (B) to occur, a person must have the capability (C), opportunity (O), and motivation (M) to perform the behavior, was used to identify influencing factors. The use of a theoretical model may contribute to a better understanding of how to achieve and sustain behavior change in clinical practice.
We included 30 studies in the scoping review. The most frequently studied type of eHealth was a telecommunication/telemonitoring system. The survey was completed by 102 participants. The most frequently used types of eHealth were electronic health records, social alarms, and online client portals. A health app was the most frequently preferred type of eHealth. We identified 22 factors that influence the use of eHealth in home care according to health care professionals and home care clients. Influencing factors were organized into the components of the COM-B model, namely capability (n=6), opportunity (n=10), and motivation (n=6). We found that there is no single influencing factor that is key to the complexity of eHealth implementation.
Different types of eHealth are used, and many types of eHealth are preferred by health care professionals. The identified factors that influence the use of eHealth in home care relate to all components of the COM-B model. These factors need to be addressed and embedded in implementation strategies of eHealth to optimize the use of eHealth in home care.
在家庭护理中，实施电子健康需要医疗保健专业人员和家庭护理客户改变他们的行为，因为他们必须将电子健康的使用纳入他们的日常生活。需要了解影响家庭护理中电子健康使用的因素，以优化实施策略。然而，缺乏对此类因素的全面概述。
本研究的目的是（1）深入了解家庭护理中使用和偏好的电子健康类型，（2）根据医疗保健专业人员和家庭护理客户确定影响家庭护理中电子健康使用的因素。
我们先后进行了范围界定审查和在线横断面调查。该调查是在当时为家庭护理组织工作的具有护理背景的荷兰医疗保健专业人员中进行的。能力、机会、动机、行为（COM-B）模型假设，对于任何行为（B）的发生，一个人必须具有执行该行为的能力（C）、机会（O）和动机（M）。该模型用于确定影响因素。使用理论模型可能有助于更好地理解如何在临床实践中实现和维持行为改变。
我们在范围界定审查中纳入了 30 项研究。研究最多的电子健康类型是远程通信/远程监测系统。该调查由 102 名参与者完成。使用最多的电子健康类型是电子健康记录、社会警报和在线客户端门户。健康应用程序是最受欢迎的电子健康类型。我们根据医疗保健专业人员和家庭护理客户确定了 22 个影响家庭护理中电子健康使用的因素。影响因素被组织到 COM-B 模型的组件中，即能力（n=6）、机会（n=10）和动机（n=6）。我们发现，没有一个单一的影响因素是电子健康实施复杂性的关键。
不同类型的电子健康被使用，许多类型的电子健康受到医疗保健专业人员的青睐。确定影响家庭护理中电子健康使用的因素与 COM-B 模型的所有组件有关。这些因素需要在电子健康实施策略中加以解决和嵌入，以优化家庭护理中电子健康的使用。
