Patients' experiences with a welfare technology application for remote home care: A longitudinal study

Abstract

Aims and Objectives:To explore the longitudinal experiences using an application named remote home care for remote palliative care among patients with cancer living at home. Background:Introducing welfare technology in home-based care for patients with cancer in the palliative phase is internationally suggested as a measure to remotely support palliative care needs. However, little is known about the experiences of patients utilising welfare technology applications to receive home-based care from healthcare professionals in a community care context. Although living with cancer in the palliative phase often presents rapidly changing ailments, emotions and challenges with patients' needs changing accordingly, no studies exploring the longitudinal experiences of patients were found.Design: A qualitative study with a longitudinal, exploratory design. Methods: Data were collected through individual interviews with 11 patients over 16 weeks. The data were analysed using qualitative content analysis. The COREQ checklist guided the reporting of the study.Results: Three themes were identified: (1) potential to facilitate self-governance of life-limiting illness in daily life, (2) need for interpersonal relationships and connections, and (3) experiences of increased responsibility and unclear utility of the Remote Home Care. Conclusion:The results showed that remote home care facilitated patients' daily routines, symptom control and improved illness-management at home. Interpersonal relationships with healthcare professionals were considered pivotal for satisfactory follow-up. Infrastructural glitches regarding data access, information sharing and lack of continuous adjustments of the application represented major challenges, with the potential to impose a burden on patients with cancer in the palliative phase.

Implementation of remote home care: assessment guided by the RE-AIM framework

“…The assessment was based on qualitative data obtained from individuals, focus group interviews with patients, and HCPs; and is part of a project exploring patients’ and HCPs’ experiences with using RHC in palliative homecare. Comprehensive explanations of RHC intervention and setting and participant recruitment details were published in two recent studies [ 4 , 26 ]. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guided the reporting for this study [ 27 ].…”

“…However, only two agreed to participate, thus we decided not to include family members in the study. The sample consisted of 11 patients in the palliative phase of cancer and 8 interdisciplinary HCPs employed by the RHC service team [ 4 , 26 ].…”

“…The data from the patients and HCPs used in this study were previously analyzed separately by a qualitative content analysis [ 29 ]. Results from these analyses are published in two separate publications that focus on patient and HCP experiences using RHC in palliative homecare [ 4 , 26 ]. To assess RHC implementation specifically for supporting palliative care and to explore areas of particular importance for sustainability of welfare technologies for palliative homecare care, the transcribed data material from the patients and HCPs were imported to NVivo 12 for a secondary analysis.…”

“…The sample size was determined using the theoretical model of information power suggested by Malterud et al [ 30 ]. Information concerning the sample size of the relevant datasets are available in two recently published studies [ 4 , 26 ].…”