Striking a balance between in-person care and the use of eHealth to support the older rural population with chronic pain

Abstract

New and existing information communication technologies (ICT) are playing an increasingly important role in the delivery of health and social care services. eHealth1 has the potential to supplement in-person home visits for older, rural adults with chronic pain. The Technology to support Older Adults' Personal and Social Interaction project—TOPS—examines interactions between older people and their health/social care providers and considers how eHealth could play a part in enhancing the life experiences of older people with chronic pain, who live in remote/rural areas. This paper reports findings from the TOPS study, drawing upon observations of health/social care home visits to chronic pain patients and interviews with patients and health/social care providers in rural Scotland. Patients and care professionals believe in-person care promotes the general well-being of older people with pain. However, our findings show that the potential recipients of eHealth are open to the use of such technologies and that although they cannot be expected to replace existing models of care, eHealth may provide opportunities to sustain and enhance these interactions.

A systematic review of observational studies of adult home care

“…Social behaviours of interest included participants’ duration of speech, with and without eye contact, both when speaking and when spoken to. The social and personal interaction schedule recorded types of interactions that took place, such as ‘humour’ and ‘reassurance touch’, as well as whether these interactions were instigated by home‐care worker or client (Roberts et al, ).…”

“…Ethical considerations: Seven studies reported having obtained ethical approval from an appropriate ethics committee (Casado‐Mejía & Ruiz‐Arias, ; Cataldo et al, ; Kalman & Andersson, ; Roberts et al, ; Sundler et al, ; Swedberg et al, , ). Two studies did not require ethical approval to carry out their observations (Glasdam et al, ; Nielsen & Jørgensen, ), although the authors from one of these studies described following the principles of the Helsinki Declaration which outline the codes of conduct for nursing research (Glasdam et al, ).…”

“…Validating and triangulating findings: One study included home‐care worker participants in the analysis of findings (Casado‐Mejía & Ruiz‐Arias, ). In another study, three independent raters conducted the initial coding of transcripts (Roberts et al, ). None of the other studies explicitly reported involving a rater other than the observer in the evaluation and analysis of field notes or observation data.…”

“…Researchers were able to observe and capture the voices and experiences of care from clients who may have been too unwell or unable to take part in formal research interviews:

When we got there, the mother was just sitting in front of the house… with no energy to do anything except the most basic movements (Uys, , p. 3)For some older adults with chronic pain, opportunities to socialise… or leave the home and interact with others were very limited. For these individuals, the home visit provided personal contact that would otherwise be missing from their lives (Roberts et al, , p. 7)

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“…For some older adults with chronic pain, opportunities to socialise… or leave the home and interact with others were very limited. For these individuals, the home visit provided personal contact that would otherwise be missing from their lives (Roberts et al, , p. 7)…”