1
|
Sia LL, Sharma S, Kumar S, Singh DKA. Physiotherapists' Perception of and Readiness to Use, Telerehabilitation for Musculoskeletal Disorders in Malaysia: A Cross-Sectional Study. Telemed J E Health 2024; 30:2842-2850. [PMID: 39119877 DOI: 10.1089/tmj.2024.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
Introduction: Musculoskeletal ailments exert a significant impact on global populations. To address challenges posed by geographical constraints and financial limitations, physiotherapists have explored and found telerehabilitation to be a viable solution. Despite its proven effectiveness in clinical practice, the integration of telerehabilitation has been sluggish. This cross-sectional survey sought to delve into the perspectives and readiness of physiotherapists in Malaysia regarding telerehabilitation for musculoskeletal disorders. Methods: A customized survey instrument was developed and evaluated for face validity and reliability. The 36-item questionnaire was distributed through the Google Form platform, targeting respondents via social media channels such as Facebook and WhatsApp. Data analysis used descriptive statistics (frequency and percentage). Results: The survey garnered responses from 271 physiotherapists. A majority (76.3%, n = 202) expressed agreement regarding the potential benefits of telerehabilitation in physiotherapy practice. About 77% of the respondents also showcased greater readiness for monitoring client progress through telerehabilitation as opposed to assessment and treatment. Notable benefits identified by respondents included preventing cross-infection (98.5%) and reducing travel time for both clients (94.0%) and physiotherapists (90.6%). Conclusion: The study reveals that physiotherapists in Malaysia exhibit positive attitudes and preparedness for implementing telerehabilitation in managing musculoskeletal conditions.
Collapse
Affiliation(s)
- Lee Lee Sia
- Physiotherapy Program, Centre of Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Physiotherapy Unit, Hospital Miri, Ministry of Health Malaysia, Miri, Malaysia
| | - Shobha Sharma
- Speech Sciences Program, Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Saravana Kumar
- Allied Health and Human Performance Unit, University of South Australia (City East Campus), Adelaide, Australia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program, Centre of Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Abdul Razak I, Kusnin F, Sukeri S. Satisfaction With Virtual Consultation Services and Associated Factors Among Health Care Providers in Government Health Clinics in Selangor, Malaysia. Cureus 2024; 16:e70591. [PMID: 39483605 PMCID: PMC11527495 DOI: 10.7759/cureus.70591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2024] [Indexed: 11/03/2024] Open
Abstract
BACKGROUND In Malaysia, virtual consultation services (VCSs) have been implemented by the Ministry of Health (MOH) since 2019 to complement current healthcare service delivery in government health clinics. Although the services have been proven to benefit patients, little is known about the satisfaction of healthcare providers (HCPs) who run the services. This study utilizes the extended Technology Acceptance Model to evaluate the satisfaction of HCPs with VCS and identify associated factors to further improve these services. OBJECTIVES In this study, we aimed to determine the proportion of HCPs who were satisfied with the VCS and identify factors contributing to this satisfaction. METHODOLOGY A cross-sectional study was conducted among 42 government health clinics in Selangor, Malaysia, using an online survey comprising a validated questionnaire of the extended Technology Acceptance Model. A total of 137 HCPs from various categories responded to the online survey. Data were analyzed using descriptive statistics and logistic regression. RESULT The majority of the respondents (72.3%) were satisfied with the VCSs, with a mean score of 14.47 ± 3.391. Two factors were found to be significantly associated with HCPs' satisfaction: perceived usefulness (adjusted odds ratio = 9.396; 95% confidence interval = 3.196-27.625) and behavioral intention (adjusted odds ratio = 8.311; 95% confidence interval = 2.494-27.694). CONCLUSION Our results indicated a moderately high percentage of HCPs in government health clinics of Selangor who were satisfied with VCS (72.3%). Perceived usefulness and behavioral intention of HCPs were two strong determinants of satisfaction with VCS. Therefore, efforts should be directed toward improving satisfaction with VCS by addressing these factors to ensure the sustainability of these services to best benefit patients.
Collapse
Affiliation(s)
- Ihsan Abdul Razak
- Community Medicine Department, Universiti Sains Malaysia School of Medical Sciences, Kubang Kerian, MYS
| | - Faridah Kusnin
- Primary Health Care Unit, Selangor State Health Department, Shah Alam, MYS
| | - Surianti Sukeri
- Community Medicine Department, Universiti Sains Malaysia School of Medical Sciences, Kubang Kerian, MYS
| |
Collapse
|
3
|
Mabu Shareef S, Prakash Goud B, Domalapally B, Naser Ashraf T. Assessing Telemedicine Competency Among Doctors in a Tertiary Care Hospital: A Questionnaire-Based Cross-Sectional Study. Cureus 2024; 16:e57712. [PMID: 38711686 PMCID: PMC11070893 DOI: 10.7759/cureus.57712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/06/2024] [Indexed: 05/08/2024] Open
Abstract
Background The use of telemedicine in contemporary healthcare has become essential, providing a novel method of delivering care, particularly in rural and underdeveloped areas. This study assesses the telemedicine awareness, knowledge, attitude, skills, and challenges among physicians working in tertiary care hospitals. Methods A cross-sectional study was carried out with 100 doctors from diverse specialties at a tertiary care institution. The questionnaire evaluated five domains: telemedicine awareness and knowledge, telemedicine attitude, telemedicine technology skills, telemedicine utilization patterns, and perceived barriers and educational needs. Results The study indicated that 95% of participants were aware of telemedicine. However, knowledge gaps remained, particularly in legal and ethical concerns (50%) and international rules (40%). Eighty percent of respondents had a favorable opinion of telemedicine, and 85% thought it might improve patient care in rural regions. The proficiency level of telemedicine users was variable: 60% of them had previous experience, and 70% of them rated their proficiency as intermediate or better. According to utilization patterns, 50% of telemedicine users used it at least once a week, primarily for remote monitoring (30%) and video consultations (60%). The study found that 90% of respondents had a high demand for training and educational opportunities. The absence of infrastructure (65%), worries about data security (55%), and patient acceptability (30%) were the main obstacles found. It also highlighted how important it is to have defined policies and collaborate across disciplines. Conclusion The study identifies a good attitude toward telemedicine among doctors as well as a need for improved training and infrastructure. It is essential to tackle these requirements and obstacles in order to successfully incorporate telemedicine into healthcare systems.
Collapse
Affiliation(s)
- Shaik Mabu Shareef
- Department of Pharmacology, Dr. YSR Government Medical College, Pulivendula, IND
| | | | | | | |
Collapse
|
4
|
Nugroho DCA, Adisaputro K, Sigilipoe MA, Triastuti IA, Hutomo S, Septarda AB, Yuwono A, Yusuf CR, Sulistiawan D, Gusbela B, Hsu JC, Su ECY. Exploring disparities of teleconsultation readiness: A comparative analysis of healthcare facilities in Indonesia. Digit Health 2024; 10:20552076241278296. [PMID: 39253693 PMCID: PMC11382234 DOI: 10.1177/20552076241278296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/09/2024] [Indexed: 09/11/2024] Open
Abstract
Objectives To investigate the implementation of teleconsultation and assess the level of readiness for its adoption among various types of healthcare facilities. Methods This cross-sectional study involved medical doctors working in a public hospital, a private hospital, and community health centers in Yogyakarta, Indonesia. We recruited 29 medical specialists from various departments in two hospitals and 27 heads of community health centers. The readiness items were categorized into sections that encompassed various readiness areas such as core, technological, motivational, learning, work culture, and policy readiness. Data were analyzed using a one-way analysis of variance and the Kruskal-Wallis test to evaluate differences in levels of readiness across healthcare facilities. A logistic regression analysis was conducted to further assess factors predicting the implementation of teleconsultation. Results Variations in technological readiness were observed between the community health centers and the public hospital (p = 0.006) and the private hospital (p = 0.007). Differences in learning readiness were found between the public hospitals and private hospitals (p = 0.01). There were also disparities in cultural readiness between the public hospital and the private hospital (p = 0.04) and between public hospital and community health centers (p = 0.01). Logistic regression revealed an association between technological readiness and the use of video teleconsultation (OR = 1.13; p = 0.017). The private hospital was more likely to implement video-based teleconsultation than was the public hospital (OR = 2.68; p = 0.003) or community health centers (OR = 3.13; p ≤ 0.001). Conclusion Significant differences in technology readiness were identified among community health centers, public hospitals, and private hospitals. Future policy implementation should focus on customizing technology use and providing cultural training to help healthcare institutions with different technological readiness levels.
Collapse
Affiliation(s)
- Daniel Chriswinanto Adityo Nugroho
- Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei
| | | | | | - Ida Ayu Triastuti
- Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia
| | - Suryani Hutomo
- Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia
| | | | - Aryososepti Yuwono
- Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia
| | - Caraka Randi Yusuf
- Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia
| | - Dedik Sulistiawan
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
- School of Public Health, Taipei Medical University, Taipei
| | - Balqis Gusbela
- International PhD Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei
| | - Jason C Hsu
- International PhD Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei
- Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei
- Research Center of Health Care Industry Data Science, College of Management, Taipei Medical University, Taipei
| | - Emily Chia-Yu Su
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei
- Institute of Biomedical Informatics, College of Medicine, National Yang Ming Chiao Tung University, Taipei
| |
Collapse
|
5
|
Khraisat OMA, Al-Bashaireh AM, Alnazly E. Telenursing implications for future education and practice: Nursing students' perspectives and knowledge from a course on child health. PLoS One 2023; 18:e0294711. [PMID: 38011137 PMCID: PMC10681229 DOI: 10.1371/journal.pone.0294711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Technology advancements have altered the standard of nursing care, and education. This suggests the necessity to equip prospective nurses to provide competent care in a highly technical and digital environment via telenursing. AIMS The aim of this study was to assess the perceptions and knowledge of nursing students about telenursing. METHODS Using a descriptive cross-sectional design. A self-reported questionnaire was used. The distribution of 110 questionnaires to nursing students attending two private colleges in Jordan resulted in an 83.6% (n = 92) response rate. Descriptive and inferential statistics were applied. RESULTS The results showed a positive perception toward telenursing practice, as well as the difficulty in precisely defining telenursing. Age, internet usage patterns, and knowledge were all factors considered telenursing predictors. 32% of the variance was explained by the model. Telenursing would be beneficial for future nursing professionals by incorporating telenursing into the curriculum. CONCLUSIONS The learning environment is extends somewhat beyond the classroom, making it is necessary to integrate telenursing into education in order to redefine the future of the nursing practice.
Collapse
Affiliation(s)
| | - Ahmad M. Al-Bashaireh
- Faculty of Health Science, Higher Colleges of Technology, Fujairah, United Arab Emirates
| | - Eman Alnazly
- Nursing Faculty, Al-Ahliyya Amman University, Amman, Jordan
| |
Collapse
|
6
|
Guo J, Dai Y, Gong Y, Xu X, Chen Y. Exploring the telehealth readiness and its related factors among palliative care specialist nurses: a cross-sectional study in China. BMC Palliat Care 2023; 22:82. [PMID: 37370039 DOI: 10.1186/s12904-023-01209-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/22/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUNDS The majority of Chinese people who are nearing the end of their lives prefer to receive home-based palliative care. Telehealth, as a new service model, has the potential to meet the increasing demand for this service, especially in remote areas with limited resources. However, nurse-led telehealth-based palliative care services are still in the pilot implementation phase. Assessing the telehealth readiness among palliative care specialist nurses and identifying associated factors is crucial to facilitate the successful implementation of telehealth services. Therefore, this study aimed to examine TH readiness and its related factors among Chinese palliative care specialist nurses. METHODS Four hundred nine Chinese palliative care specialist nurses from 28 provinces or municipalities participated in this study between July and August 2022. The Chinese version of Telehealth Readiness Assessment Tools (TRAT-C), and Innovative Self-Efficacy Scale (ISES-C) were used to assess the degree of TH readiness and the levels of innovative self-efficacy. RESULTS The total score of the TRAT-C was 65.31 ± 9.09, and the total score of ISES was 29.27 ± 5.78. The statistically significant factors that influenced telehealth readiness were the experience of using telehealth platforms or services, the willingness to provide telehealth to patients, and the level of nurses' innovative self-efficacy. The innovative self-efficacy is positively correlated to telehealth readiness (r = 0.482, P < 0.01). These related factors could explain 27.3% of the difference in telehealth readiness. CONCLUSION The telehealth readiness of Chinese palliative care specialist nurses are at a moderate level. Measures such as providing incentives to promote nurses' innovation self-efficacy by nurse managers, and establishing a comprehensive telehealth training system for palliative care specialist nurses should be taken to facilitate the implementation of telehealth services in the field of palliative care.
Collapse
Affiliation(s)
- Junchen Guo
- Department of Palliative care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
- School of Nursing, University of South China, No.28, Changsheng West Road, Hengyang, 421001, Hunan, China
| | - Yunyun Dai
- Health Services Research Institute, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Youwen Gong
- School of Nursing, University of South China, No.28, Changsheng West Road, Hengyang, 421001, Hunan, China
- Department of Nursing, The First People's Hospital of Changde City, Changde, China
| | - Xianghua Xu
- Department of Palliative care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
| | - Yongyi Chen
- Department of Palliative care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China.
| |
Collapse
|
7
|
Telehealth Readiness of Healthcare Providers during COVID-19 Pandemic in Saudi Arabia. Healthcare (Basel) 2023; 11:healthcare11060842. [PMID: 36981499 PMCID: PMC10048154 DOI: 10.3390/healthcare11060842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
Objective: This study aimed to assess and explore the telehealth readiness of healthcare providers in Saudi Arabia. Methods: This descriptive cross-sectional survey was conducted in a government healthcare facility in Saudi Arabia between August and October 2020. The Telehealth Readiness Assessment (TRA) tool was used. Results: A total of 372 healthcare providers participated in this study. Their mean age was 35.5 years (SD = 10.46). The majority of respondents were female (65.6%), nurses (68.0%), married (60.2%), and non-Saudi nationals (64.2%). The analysis shows that healthcare providers generally had moderate-to-high telehealth readiness. Of the five domains, financial contributions had the lowest rating among nurses and physicians, 63.4% and 66.1%, respectively. Gender (β = 7.64, p = 0.001), years of experience in the organization (β = 11.75, p = 0.001), and years of experience in the profession (β = 10.04, p = 0.023) predicted the telehealth readiness of healthcare providers. Conclusion: The telehealth readiness of healthcare providers in Saudi Arabia showed moderate to high levels. The COVID-19 pandemic poses a catastrophic threat to both patients and healthcare providers. Assessing telehealth readiness should include both patients and healthcare provider factors. A better understanding of the factors of organizational readiness, particularly healthcare providers, could help avoid costly implementation errors.
Collapse
|
8
|
Mensah NK, Adzakpah G, Kissi J, Boadu RO, Lasim OU, Oyenike MK, Bart-Plange A, Dalaba MA, Sukums F. Health professional's readiness and factors associated with telemedicine implementation and use in selected health facilities in Ghana. Heliyon 2023; 9:e14501. [PMID: 36945351 PMCID: PMC10022178 DOI: 10.1016/j.heliyon.2023.e14501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023] Open
Abstract
Background Telemedicine, which is the practice of medicine using technology to deliver health care remotely, has a low adoption rate in low- and middle-income countries (LMICs). However, the advent of coronavirus disease 2019 (COVID-19) has forced healthcare systems in these settings to begin implementing telemedicine programs. It is unknown how prepared health professionals and the healthcare system are to adopt this technology. Therefore, this study aimed to assess the readiness of health professionals and explore factors associated with telemedicine implementation in Ghana. Methods A cross-sectional study was conducted in six health facilities between March and August 2021. Convenience sampling was used to select the six health facilities, and the participants were selected randomly for the study. Questionnaires were self-completed by participants. Data was exported into STATA 15.0 for analysis, and appropriate statistical methods were employed. All statistical tests were performed at a significance level of p < 0.05. Results Of the 613 health professionals involved in the study, about 579 (94.5%) were comfortable using computers, and the majority, 503 (82.1%) of them, had access to computers at the workplace. Health professionals agreed that the measures outlined by the health facilities supported their readiness to use telemedicine for healthcare services. Analysis revealed a statistically significant positive relationship between health facilities' core readiness and health professionals' readiness, with a correlation coefficient (r) of 0.5484 and a p-value<0.0001. Of the factors associated with health professionals' readiness towards telemedicine implementation, facility core readiness, engagement readiness, staff knowledge and attitude readiness showed a statistically significant relationship with health professionals' readiness. Conclusion The study revealed that health professionals are ready to adopt telemedicine. There was a statistically significant relationship between health facilities' core readiness, engagement readiness, staff knowledge and attitude readiness, and health professionals' readiness. The study identified factors facilitating telemedicine adoption.
Collapse
Affiliation(s)
- Nathan Kumasenu Mensah
- Department of Health Information Management, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Godwin Adzakpah
- Department of Health Information Management, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Jonathan Kissi
- Department of Health Information Management, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Richard Okyere Boadu
- Department of Health Information Management, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Obed Uwumbornyi Lasim
- Department of Health Information Management, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Martha Khainde Oyenike
- Department of Health Information Management, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | - Abigail Bart-Plange
- Department of Health Information Management, School of Allied Health Science, University of Cape Coast, Cape Coast, Ghana
| | | | - Felix Sukums
- Muhimbili University of Health and Allied Sciences, Box 65001, Dar es Salaam, Tanzania
| |
Collapse
|
9
|
Liu Y, Su Y, Li X. Analyzing the Spatial Equity of Walking-Based Chronic Disease Pharmacies: A Case Study in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:278. [PMID: 36612596 PMCID: PMC9819594 DOI: 10.3390/ijerph20010278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/17/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Chronic diseases place a substantial financial burden on both the patient and the state. As chronic diseases become increasingly prevalent with urbanization and aging, primary chronic disease pharmacies should be planned to ensure that patients receive an equitable distribution of resources. Here, the spatial equity of chronic disease pharmacies is investigated. In this study, planning radiuses and Web mapping are used to assess the walkability and accessibility of planned chronic disease pharmacies; Lorenz curves are used to evaluate the match between the service area of the pharmacies and population; location quotients are used to identify the spatial differences of the allocation of chronic disease pharmacies based on residents. Results show that chronic disease pharmacies have a planned service coverage of 38.09%, an overlap rate of 58.34%, and actual service coverage of 28.05% in Wuhan. Specifically, chronic disease pharmacies are spatially dispersed inconsistently with the population, especially the elderly. The allocation of chronic disease pharmacies is directly related to the standard of patients' livelihood. Despite this, urban development does not adequately address this group's equity in access to medication. Based on a case study in Wuhan, China, this study aims to fill this gap by investigating the spatial equity of chronic disease medication purchases.
Collapse
Affiliation(s)
- Yue Liu
- School of Natural and Built Environment, Queen’s University Belfast, Belfast BT9 5AG, UK
| | - Yuwei Su
- School of Urban Design, Wuhan University, Wuhan 430072, China
| | - Xiaoyu Li
- Department of Landscape Architecture & Urban Planning, Texas A&M University, College Station, TX 77843, USA
| |
Collapse
|
10
|
Karnehed S, Erlandsson LK, Norell Pejner M. Nurses' perspectives on an electronic medication administration record in home healthcare: Qualitative interview study (Preprint). JMIR Nurs 2021; 5:e35363. [PMID: 35452400 PMCID: PMC9077506 DOI: 10.2196/35363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/21/2022] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background eHealth is considered by policy makers as a prerequisite for meeting the demands of health care from the growing proportion of older people worldwide. The expectation about what the efficiency of eHealth can bring is particularly high in the municipal home health care sector, which is facing pressure regarding resources because of, for example, earlier discharges from hospitals and a growing number of patients receiving medications and treatments at home. Common eHealth services in home health care are electronic medication administration records (eMARs) that aim to communicate delegated tasks between professionals. However, there is an extensive gap in the research on how technology affects and is experienced by home health care professionals. Objective The objective of this paper is to shed light on how home care nurses experience eMARs in a Swedish municipality. Methods This qualitative interview study was conducted among home health care nurses using eMARs to facilitate communication and signing of delegated nursing tasks. The analysis of the interviews was performed using constructivist grounded theory, according to Charmaz. Results Of the 19 day-employed nurses in the municipality where an eMAR was used, 16 (84%) nurses participated in the study. The following two categories were identified from the focus group interviews: nurses become monitors and slip away from the point of care. The nurses experienced that they became monitors of health care through the increased transparency provided by the eMAR and the measurands they also applied, focusing on the quantitative aspects of the delegated nursing tasks rather than the qualitative aspects. The nurses experienced that their monitoring changed the power relations between the professions, reinforcing the nurses’ superior position. The experience of the eMAR was regarded as transitioning the nurses’ professional role—away from the point of care and toward more administration—and further strengthened the way of managing work through delegation to health care assistants. Conclusions Previous analyses of eHealth services in health care showed that implementation is a complex process that changes health care organizations and the work of health care professionals in both intended and unintended ways. This study adds to the literature by examining how users of a specific eHealth service experience its impacts on their daily work. The results indicate that the inscribed functions in an eHealth service may affect the values and priorities where the service is in use. This presents an opportunity for future research and for health care organizations to assess the impacts of specific eHealth services on health care professionals’ work and to further examine the effects of inscribed functions in relation to how they may affect actions and priorities at individual and organizational levels.
Collapse
Affiliation(s)
- Sara Karnehed
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | | |
Collapse
|