Access to health care perceived by parents caring for their child at home supported by eHealth—a directed approach introducing aperture

Abstract

Background In recent years a variety of eHealth solutions has been introduced to enhance efficiency and to empower patients, leading to a more accessible and equitable health care system. Within pediatric care eHealth has been advocated to reduce emergency and hospital outpatient visits, with many parents preferring eHealth to physical visits following the transition from hospital to home. Still, not many studies have focused on access from the parental perspective. Therefore, the aim of the study was to analyze access to health care as perceived by parents when caring for their child at home, with conventional care supported by eHealth following pediatric surgery or preterm birth. Methods Twenty-five parents who went home with their child following hospitalization and received conventional care supported by eHealth (a tablet) were interviewed in this qualitative study. Directed content analysis was used, guided by a framework for dimensions of access previously described as: approachability, acceptability, affordability, appropriateness, and availability. Results All dimensions of access were present in the material with the dimensions of approachability, appropriateness and acceptability most frequently emphasized. The dimensions highlighted a strong acceptance of eHealth, which was perceived by the parents as beneficial, particularly access to communication with health care personnel familiar to them. The chat function of the tablet was often mentioned as positive. A new dimension was also identified: “aperture.” It is defined by the pathways by which communication is transmitted in cyberspace, and these pathways are not easily visualized for parents submitting information, therefore generating concerns. Conclusions Parents generally experienced good access to the eHealth-supported health care. Describing access through its dimensions complemented previous descriptions of eHealth in pediatric care and gave new insights. As such, the new dimension of “aperture”, the indeterminate opening of pathways of communication reflecting the uncertainty of not comprehending cyberspace, could be further evaluated. The dimensional framework of access is recommended when evaluating eHealth in the future. Trial registration ClinicalTrials.gov identifier: NCT04150120.

Association between health literacy and satisfaction with health care among parents of long-term ill children: a cross-sectional study

“…Recently, studies have focused on the implications and consequences of eHealth solutions (special apps, mobile tablets, teleconferences) for parents' involvement and satisfaction with children's health care. The studies nd that parents are generally accepting and satis ed with eHealth solutions in the care of their children (24,25). Other studies show high parental satisfaction when using eHealth devices in neonatal and pediatric health care after the hospital discharge (26, 27).…”

Parental Access to Healthcare following Paediatric Surgery—The Precarious Role of Parents as Providers of Care in the Home

“…The data were analysed qualitatively with a directed content analysis [ 13 ]. The method was based on Hsieh and Shannon [ 13 ] and has then been further developed and tested for credibility in a previous study [ 12 ]. The six-dimensional framework [ 12 ] adapted from Levesque et al [ 11 ] was used in order to evaluate accessibility to healthcare as expressed in the data material.…”

“…The method was based on Hsieh and Shannon [ 13 ] and has then been further developed and tested for credibility in a previous study [ 12 ]. The six-dimensional framework [ 12 ] adapted from Levesque et al [ 11 ] was used in order to evaluate accessibility to healthcare as expressed in the data material. In the first step of the analysis, each member of the analysis group did their analysis of the total coded material individually (SN, MH, and RV).…”

“…A sixth dimension, aperture, has recently been added as an important dimension in access to care, particularly as it is related to e-health. Aperture indicates an opening of pathways of communication in cyberspace, and this dimension demonstrates the uncertainty of not adequately comprehending how communication in cyberspace works [ 11 , 12 ].…”

Parental satisfaction with paediatric care with and without the support of an eHealth device: a quasi-experimental study in Sweden

“…High parental satisfaction with using eHealth devices in neonatal and paediatric health care is shown [ 21 ]. Recent studies have indicated that parents of children with long-term illness experience access to and use of an eHealth device positively after discharge from the hospital [ 5 , 22 ]. eHealth in terms of telemedicine is also described as boosting the parents’ sense of self-efficacy, social support, satisfaction, and security [ 23 – 25 ].…”