Ginger Chu PhD, Carla Silva GDip MtlHith, Kelly Adams BN, Bobby Chacko MD, John Attia PhD, Nicole Nathan PhD, Rhonda Wilson PhD
{"title":"探索影响家庭透析患者参与远程医疗辅助家访的因素：混合方法研究。","authors":"Ginger Chu PhD, Carla Silva GDip MtlHith, Kelly Adams BN, Bobby Chacko MD, John Attia PhD, Nicole Nathan PhD, Rhonda Wilson PhD","doi":"10.1111/jorc.12475","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Technology, such as telehealth, is increasingly used to support home dialysis patients. The challenges patients and carers face when home dialysis nursing visits are provided via telehealth have yet to be explored.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To explore patients' and carers' perspectives as they transition to telehealth-assisted home visits and identify the factors influencing their engagement in this modality.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>A mixed-methods approach, guideed by the behaviour change wheel using the capability, opportunity, motivation-behaviour model to explore individual's perceptions of telehealth.</p>\n </section>\n \n <section>\n \n <h3> Partcipants</h3>\n \n <p>Home dialysis patients and their carers.</p>\n </section>\n \n <section>\n \n <h3> Measuruements</h3>\n \n <p>Suveys and qualitative interviews.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A mixed-methods approach was undertaken, combining surveys and qualitative interviews. It was guided by the Behaviour Change Wheel using the Capability, Opportunity, Motivation- Behaviour model to explore individuals' perceptions of telehealth.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Thirty-four surveys and 21 interviews were completed. Of 34 survey participants, 24 (70%) preferred face-to-face home visits and 23 (68%) had previously engaged in telehealth. The main perceived barrier identified in the surveys was knowledge of telehealth, but participants believed there were opportunities for them to use telehealth. Interview results revealed that the convenience and flexibility of telehealth were perceived as the main advantages of telehealth. However, challenges such as the ability to conduct virtual assessments and to communicate effectively between clinicians and patients were identified. Patients from non-English speaking backgrounds and those with disabilities were particularly vulnerable because of the many barriers they faced. These challenges may further entrench the negative view regarding technology, as discussed by interview participants.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study suggested that a blended model combining telehealth and face-to-face services would allow patient choice and is important to facilitate equity of care, particularly for those patients who were unwilling or had difficulty adopting technology.</p>\n </section>\n </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12475","citationCount":"0","resultStr":"{\"title\":\"Exploring the factors affecting home dialysis patients' participation in telehealth-assisted home visits: A mixed-methods study\",\"authors\":\"Ginger Chu PhD, Carla Silva GDip MtlHith, Kelly Adams BN, Bobby Chacko MD, John Attia PhD, Nicole Nathan PhD, Rhonda Wilson PhD\",\"doi\":\"10.1111/jorc.12475\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Technology, such as telehealth, is increasingly used to support home dialysis patients. The challenges patients and carers face when home dialysis nursing visits are provided via telehealth have yet to be explored.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To explore patients' and carers' perspectives as they transition to telehealth-assisted home visits and identify the factors influencing their engagement in this modality.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>A mixed-methods approach, guideed by the behaviour change wheel using the capability, opportunity, motivation-behaviour model to explore individual's perceptions of telehealth.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Partcipants</h3>\\n \\n <p>Home dialysis patients and their carers.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Measuruements</h3>\\n \\n <p>Suveys and qualitative interviews.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A mixed-methods approach was undertaken, combining surveys and qualitative interviews. 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Exploring the factors affecting home dialysis patients' participation in telehealth-assisted home visits: A mixed-methods study
Background
Technology, such as telehealth, is increasingly used to support home dialysis patients. The challenges patients and carers face when home dialysis nursing visits are provided via telehealth have yet to be explored.
Objectives
To explore patients' and carers' perspectives as they transition to telehealth-assisted home visits and identify the factors influencing their engagement in this modality.
Design
A mixed-methods approach, guideed by the behaviour change wheel using the capability, opportunity, motivation-behaviour model to explore individual's perceptions of telehealth.
Partcipants
Home dialysis patients and their carers.
Measuruements
Suveys and qualitative interviews.
Methods
A mixed-methods approach was undertaken, combining surveys and qualitative interviews. It was guided by the Behaviour Change Wheel using the Capability, Opportunity, Motivation- Behaviour model to explore individuals' perceptions of telehealth.
Results
Thirty-four surveys and 21 interviews were completed. Of 34 survey participants, 24 (70%) preferred face-to-face home visits and 23 (68%) had previously engaged in telehealth. The main perceived barrier identified in the surveys was knowledge of telehealth, but participants believed there were opportunities for them to use telehealth. Interview results revealed that the convenience and flexibility of telehealth were perceived as the main advantages of telehealth. However, challenges such as the ability to conduct virtual assessments and to communicate effectively between clinicians and patients were identified. Patients from non-English speaking backgrounds and those with disabilities were particularly vulnerable because of the many barriers they faced. These challenges may further entrench the negative view regarding technology, as discussed by interview participants.
Conclusion
This study suggested that a blended model combining telehealth and face-to-face services would allow patient choice and is important to facilitate equity of care, particularly for those patients who were unwilling or had difficulty adopting technology.
期刊介绍：
The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA).
The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given.
The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.
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