Attitudes towards the use and acceptance of eHealth technologies: a case study of older adults living with chronic pain and implications for rural healthcare

Abstract

BackgroundProviding health services to an ageing population is challenging, and in rural areas even more so. It is expensive to provide high quality services to small populations who are widely dispersed; staff and patients are often required to travel considerable distances to access services, and the economic downturn has created a climate where delivery costs are under constant review. There is potential for technology to overcome some of these problems by decreasing or ceasing the need for patients and health professionals to travel to attend/deliver in-person appointments. A variety of eHealth initiatives (for example Pathways through Pain an online course aimed to aid self-help amongst those living with persistent pain) have been launched across the UK, but roll out remains at an early stage.MethodsThis mixed-methods study of older adults with chronic pain examines attitudes towards, current use of and acceptance of the use of technology in healthcare. A survey (n = 168, 40% response rate) captured broad experiences of the use of technology in health and social care. Semi-structured interviews (four with technology and seven without technology participants) elicited attitudes towards technology in healthcare and explored attributes of personal and social interaction during home visits.ResultsPeople suffering from chronic pain access healthcare in a variety of ways. eHealth technology use was most common amongst older adults who lived alone. There was broad acceptance of eHealth being used in future care of people with chronic pain, but older adults wanted eHealth to be delivered alongside existing in-person visits from health and social care professionals.ConclusionseHealth has the potential to overcome some traditional challenges of providing rural healthcare, however roll out needs to be gradual and begin by supplementing, not substituting, existing care and should be mindful of individual’s circumstances, capability and preferences. Acceptance of technology may relate to existing levels of personal and social contact, and may be greater where technological help is not perceived to be replacing in-person care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0825-0) contains supplementary material, which is available to authorized users.

Factors that influence older people’s engagement with digital health technology

“…Some DHT applications and web sites address this by including interactive components such as quizzes, case studies and informative pictures and videos that enhance learning and are updated regularly (Currie et al 2015, Algeo et al 2017) and these can encourage older people's engagement. Essery et al (2017) found that almost all users who completed a trial of the dizziness management website felt it offered new information and taught new skills, despite some of the users having already completed the same activity using a booklet-based format (Essery et al 2017).…”

“…However, poor internet connection was an ongoing barrier to DHT for older people living in rural locations due to slower download speeds and inability to use videoconferencing software. It is important to consider the appropriateness of DHT design that relies on webbased services when identifying potential users living outside urban areas (Currie et al 2015).…”

“…Middlemass et al (2017) identified that older people with chronic obstructive pulmonary disease perceived an advantage of engagement with DHT through the monitoring of their health trends which enabled detection of the early onset of infections. In another study by Currie et al (2015), older people with chronic pain cited their reduced need to travel for treatment as a perceived benefit of engagement with DHT. These people lived in rural areas but were able to access a number of specialist pain management staff and participate in group sessions via a web-based applications, providing benefits that they may have had difficulty in accessing without DHT (Currie et al 2015).…”

“…In another study by Currie et al (2015), older people with chronic pain cited their reduced need to travel for treatment as a perceived benefit of engagement with DHT. These people lived in rural areas but were able to access a number of specialist pain management staff and participate in group sessions via a web-based applications, providing benefits that they may have had difficulty in accessing without DHT (Currie et al 2015).…”

“…However, it is also important to acknowledge that there are some prevailing attitudes among older people that indicate severity of illness and age are factors in engaging with DHT, with some feeling people need to have a high level of need or be "ill enough" to warrant use of DHT devices (Sanders et al 2012;Doyle et al 2014;Lie et al 2016) and that certain interventions such as web-based programmes are for younger age groups (Currie et al 2015). Such perceptions are important to consider and manage if DHT is to be encouraged among older people.…”