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Patients' perceptions of a home telecare system.

Int J Med Inform. 2008 Jul;77(7):486-98. Rahimpour M, Lovell NH, Celler BG, McCormick J. Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2052, Australia.

GOAL: To identify any major factors that could affect patients' perceptions of a Home Telecare Management System (HTMS) and use the findings to contribute to development of a theoretical framework for patient acceptance of HTMS.

MATERIALS AND METHODS: Ten Focus Group Interviews (FGIs) were conducted with patients suffering from congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or both, from seven different ethnic groups in Sydney. Six key discussion points were used to conduct the FGIs. The participants were shown a video demonstrating the HTMS and its operation, followed by the demonstration of an HTMS prototype. The participants, who had no prior experience with the HTMS, were then asked questions to access their perceptions in potentially real situations. The discussions were audio-taped and content analysis performed.

RESULTS: Four major themes and 16 sub-themes were identified. The themes were: intention to use the HTMS, the impact of the HTMS on patients' health management, concerns associated with using the HTMS, and the impact of the HTMS on healthcare services.

CONCLUSION: Most participants perceived the system as a useful and convenient mode of health care delivery, expressed positive attitudes toward the HTMS and expressed intent to use the system. However, there were concerns centred on the issues of cost, ease of use, clinical support, low self-efficacy and anxiety related to the use of the HTMS. The findings of this study suggest that HTMS self-efficacy and anxiety are likely to be important constructs in patients' acceptance of home telecare. Therefore, we propose these two factors be included in future HTMS acceptance models. Also it is suggested that in order to develop training programs for patients to use HTMS, tailored training components should aim to reduce 'HTMS anxiety' and improve 'HTMS self-efficacy'. Participants agreed that the HTMS would save cost and time by reducing hospital admissions, emergency department and medical practitioner visits and associated travel. Participants generally agreed that the HTMS could inform patients of their health conditions, thus promoting active participation in their health management and empowering them to perform better self-care. Also, they agreed that the HTMS could improve their health management by their doctors by providing more accurate and up-to-date information, to help them make better decisions. They suggested that the HTMS could have a preventative role in terms of providing early warning when their health conditions were deteriorating, which could lead to on-time appropriate interventions. The latter may result in reducing the use of emergency services and hospital admissions.

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