DOI: 10.1111/ajag.12139

Research Carers’ perceptions of the impact of home telehealth monitoring on the provision of care and sustainability of use Rachael Wade, Colleen Cartwright and Kelly Shaw ASLaRC Aged Services Unit, Southern Cross University, Coffs Harbour, New South Wales, Australia

Aims: This paper aims to report carers’ perceptions of the impact of home telehealth on the provision of care and the sustainability of home telehealth use. Method: This paper is reporting on a sample of 15 carers who were involved in the telehealth arm of a larger controlled trial. Results: Carers primarily believed that telehealth helped to provide better care. None of the carers had organised, or planned to organise, ongoing telehealth monitoring beyond the study. The main reason given for non-sustained usage was the belief that the person they cared for no longer required, or would benefit from, the monitoring. Conclusion: As the person being cared for was a frail older person with multiple chronic diseases and a history of recent hospitalisation, the non-sustained usage of home telehealth by carers raises questions about what is needed to ensure sustainability of use; this requires further investigation. Key words: carers, frail older adult, home, sustainable use, telehealth.

Introduction Informal, unpaid care, typically provided by family and friends [1], is an important source of care and support for older people [2], and can include domestic assistance, medical care, and the facilitation and coordination of care services provided by formal providers [3,4]. Worldwide, informal care is the dominant form of care provision for people with disability [1]. Given worldwide population ageing and the rate of disability increasing with age, the need for informal care will continue to grow [1]. To meet the increasing demand on health and care services that population ageing brings [5], governments and other relevant agencies are exploring a variety of models to effectively provide such services [5,6], including consideration of the role of informal care to support older people to remain living at home [5]. At an international policy level, the United Nations ‘Madrid International Plan of Action on Ageing’ noted significant challenges to community resources from an Correspondence to: Ms Rachael Ann Wade, Southern Cross University. Tel: +61 2 66593197; Fax: +61 2 6659 3622; Email: [email protected] Australasian Journal on Ageing, Vol 34 No 2 June 2015, 109–114 © 2014 AJA Inc.

bs_bs_banner

ageing population, and noted that informal care can play a role in providing older people with a choice to safely remain living at home [7]. In Australia, the 2011 Australian Government Productivity Commission Inquiry into caring for older Australians reported, among other issues, the challenges an ageing Australian population will place on formal healthcare resources, benefits of older people being supported to remain at home rather than going into residential care and the role of informal care to help achieve this [4]. A flexible range of support services to assist the provision of informal care to older people in the home is important, with telehealth being one such service [8]. The World Health Organization defines telehealth as the provision of medical assistance across locations, through the utilisation of information and communication technologies [9]. Reported benefits of home telehealth in systematic reviews of the telehealth literature include reduced rates of hospital visits and admissions [10,11], improved quality of life [11] and a reduction in carer stress [12]. However, it should be noted that few randomised controlled trials of telehealth involving older people have been undertaken [13,14]. Informal carers are important in the successful implementation of home telehealth. When home telehealth is utilised as part of a care plan for a person who has a carer, the carer is often involved in using the equipment [15], thus reducing reliance on the formal, paid workforce. Factors reported to influence the receptiveness, use and acceptance of home telehealth by caregivers of patients after a cerebrovascular accident include interest in using the technology, the degree of comfort associated with its use, impact of the technology on safety of the client and impact of the technology on burden in caregiving [16]. A recent Australian study exploring factors that impact on the successful implementation of home telehealth with frail older people found no significant difference between groups with and without carers on the rate at which telehealth readings were reliably generated: that is, whether readings were recorded in the agreed time frame and without user error. The study also suggested that factors such as carer burden may impact on carer compliance in using telehealth [17]. A review of technology as a support for frail older people living at home reported several potential benefits to informal carers from home telehealth monitoring, including a reduction in travel time and expense from taking the person cared for to a doctor for routine check-ups. The review concluded that telehealth services should be driven by, and responsive to, service user needs, including an understanding of the issue of sustainability of use [18]. 109

W a d e

In summary, populations around the world are ageing and placing greater demands on health and care services. Informal care is a vital resource to help meet these increasing demands. Home telehealth is a potential service to support the provision of informal care in the home. This paper aims to investigate informal carers’ perceptions of the impact of home telehealth on the provision of care to frail older people, and the sustainability of home telehealth use post-study.

Methods The study was approved by Southern Cross University and Baptist Community Services (BCS) Human Research Ethics Committees. Target group The target group was frail older clients from BCS community-based transition care program (TCP) who were being discharged from hospital to home, had a chronic disease and were at risk of being admitted into residential care. If the client had a primary informal carer, this carer was also invited to take part in the study. The BCS sites were in urban and regional Eastern Australia. Participants This paper reports on a sample of 15 informal carers who were involved in, and completed, the telehealth arm of a controlled telehealth study. See Table 1 for demographic information. See Figure 1 for the flow of study participants through the study. Diagnosis At study commencement, participants with a carer who went on to complete the study had a mean of seven medical diagnoses (range 4–11) as reported in the hospital discharge information. See Table 2 for primary diagnosis summary: 100% of those participants had problems with activities of daily living (ADL) and/or instrumental activities of daily living as reported by the Aged Care Assessment Team (ACAT) at the time of hospital discharge. TCP clients com-

Table 1: Carer demographics Informal carers who used telehealth and completed the study (n = 15)

Gender Female Male Relationship to TCP client Wife Daughter Husband Son Lives with TCP client Yes No Cares for person with cognitive capacity Yes No Age of person cared for

n

%

9 6

60 40

5 4 3 3

33 27 20 20

13 2

87 13

14 1 Range 67–95

93 7 M 82.60

Note: Carers were not asked their age. TCP, transition care program.

110

R ,

C a r t w r i g h t

C ,

S h a w

K

pleted the Barthel index scored out of 100 (a measure of ADL) when they commenced TCP; lower scores indicate lower levels of functional independence. Participants with a carer who completed the study reported a mid-range mild dependency at study commencement (Barthel index mean = 67.5, standard deviation = 14.1). Recruitment Clients assessed by ACAT in hospital as suitable for TCP were referred to the BCS coordinator who set up a TCP care plan and determined the client’s suitability for the telehealth project. Those deemed suitable (and if applicable their informal carer) were provided with project information and had the project explained to them. Clients wanting to participate in the project (and carers if applicable) were visited by a BCS TCP staff member at the client’s home when they returned from hospital and written consent was obtained. A trained BCS staff member visited all participants in their home, installed the equipment, and trained the client and informal carer (if applicable) in its use. Operational proficiency of using the equipment was assessed by a BCS staff member. Participants and carers were also encouraged to phone BCS for additional support if required. The recruitment period was September 2009 to October 2010. Design See Figure 1 for the controlled study design. Client exclusion criteria 1 The client a) lacked capacity to complete surveys and/or operate the equipment and did not have an informal carer to help them, b) had an informal carer who did not wish the client to participate, c) had an informal carer and the client did not want the carer involved, d) had no phone line connected to the house or nowhere suitable to install the equipment that would not be a hazard to the client or potentially damage the equipment, and e) was using other telehealth products before going into hospital and intended to continue using those products. 2 The client’s live-in partner a) was already participating in the project and b) was already using telehealth equipment. Telehealth equipment Participants in groups 2–5 were provided with a Tunstall® home telehealth monitor. They, or their carer, were required to complete 11 questions that were presented on the monitor screen each day, by pressing ‘Yes’ or ‘No’; questions were based on physical functioning, emotional state, care and support and service support. Monitoring also included up to four peripherals measuring weight, blood pressure, heart rate Australasian Journal on Ageing, Vol 34 No 2 June 2015, 109–114 © 2014 AJA Inc.

Te l e h e a l t h

a n d

s u s t a i n a b i l i t y

o f

u s e

Figure 1: Flow of transition care program study participation. Clients who did not participate (n = 82) -Declined to participate (n = 76) -Readmitted to hospital (n = 4) -Withdrew prior to commencement (n = 2)

Eligible TCP clients invited to participate (n = 143)

+TCP clients enrolled in the study and allocated to groups (n = 61) G1 control: Receipt of TCP (n = 16) G2: Receipt of TCP and telehealth (up to 12 weeks) (n = 6) G3: Receipt of TCP and telehealth (as above) plus an additional 12 weeks of telehealth (n = 9) G4: Receipt of TCP/telehealth/pendent alarm (up to 12 weeks) (n = 16) G5: Receipt of TCP/telehealth/pendant alarm (as above) plus an additional 12 weeks of telehealth monitoring/pendant (n = 14)

Clients who completed the study (n = 42) G1 control: (n = 11) G2: (n = 4) G3: (n = 4) G4: (n = 11) G5: (n = 12)

Carers allocated to groups (n = 29) G1 control: (n = 5) G2: (n = 4) G3: (n = 4) G4: (n = 7) G5: (n = 9)

Carers who completed the study (n = 19) G1 control: (n = 4) G2: (n = 1) G3: (n = 1) G4: (n = 5) G5: (n = 8)

Client non-completion (n = 19) -Admitted to hospital (n = 9) -Client no longer wanted to be involved (n = 5) -Carer no longer wanted to be involved (n = 3) -Went into residential care (n = 2) Notes: Some clients who wanted to participate in the study were either already in possession of a Baptist Community Services (BCS) care call pendant (as would be used in groups 4 and 5) prior to commencing the study, or were assessed by BCS as needing one as part of their transition care program (TCP) package. Because of safety considerations, it was decided that if clients were already in possession of a care call pendant or were assessed as needing one for TCP, they were not be excluded from the project. To accommodate a stratified sample utilising random numbers table was incorporated into the methodology. Participants who were assessed as either needing a BCS care call pendant or already had a BCS care call pendant were allocated to the next random table number of groups 1, 4 or 5. Those that were assessed as not needing a care call pendant were allocated to the next random table number of 2 or 3. If a person's general practitioner did not wish to be in the study, the person was automatically allocated to 1.

Table 2: Primary diagnosis of clients Diagnosis Orthopaedic Mobility impairment or falls Cardiovascular Neurological Respiratory Renal Malignancy Infective

N (%) of cases* 4 (26) 3 (20) 3 (20) 2 (13) 1 (7) 0 (0) 1 (7) 1 (7)

*N, number of participants.

and oxygen that were completed daily. Peripherals utilised by individual participants, and the ideal range for their peripheral readings, were determined by the client’s general practitioner (GP) prior to study commencement. The telehealth data (question responses and peripheral data) were sent from the telehealth equipment via the Australasian Journal on Ageing, Vol 34 No 2 June 2015, 109–114 © 2014 AJA Inc.

Internet to a Tunstall Data Monitoring Centre, which, in turn, forwarded the data to the BCS nurse, again via the Internet. If a reading went outside the parameters set by the client’s GP, a copy of the reading was faxed to the GP and the BCS nurse would attempt to contact the client, their GP, informal carer (if applicable) and/or (depending on the situation) an ambulance. At the end of the study, the telehealth equipment was removed by BCS staff and brief information was provided to the client advising them that they could receive, at their own expense, ongoing access to home telehealth. The research team was told by the BCS nurse that specific details such as education on the potential benefits of ongoing monitoring, where to access services, and associated costs were not provided as part of this information. Telehealth study questionnaires Participants and their informal carers completed a telehealth questionnaire prior to being trained in and using the equipment, at completion of TCP (up to 12 weeks of telehealth 111

W a d e

R ,

C a r t w r i g h t

C ,

S h a w

K

N

Strongly agree % (n)

Agree % (n)

Neutral % (n)

Disagree % (n)

Strongly disagree % (n)

15

53 (8)

40 (6)

0 (0)

6 (1)

0 (0)

15

53 (8)

40 (6)

0 (0)

6 (1)

0 (0)

15

53 (8)

27 (4)

13 (2)

6 (1)

0 (0)

15

53 (8)

27 (4)

13 (2)

6 (1)

0 (0)

15

53 (8)

27 (4)

0 (0)

0 (0)

20 (3)

Table 3: Carer response perceived usefulness statements Perceived usefulness statements Technology Acceptance Questionnaire Using the telehealth equipment improved access to regular testing of the health condition of the person I care for. Using the telehealth equipment made it easier to do regular testing for the person I care for. Using the telehealth equipment saved me time in assisting the person I care for having their health condition regularly tested. I found the telehealth equipment useful in the regular testing of the health condition of the person I care for. Other The telehealth equipment helped me to provide better care for the person I care for. Note: Not all % add up to 100 due to rounding.

usage), and 12 weeks post-TCP completion. This paper reports the carer end-of-study data for the perceived impact of the equipment on the provision of care, and the likelihood of future use. See Appendix I and Table 3 for the full list of questions reported in this paper. Data analysis For the relevant survey responses frequencies on closed responses were analysed using SPSS 17, and a thematic analysis was undertaken on relevant open-ended questions.

Results Perceived usefulness questions The majority of carers ‘strongly agreed’ or ‘agreed’ that the telehealth equipment had been useful in the provision of informal care (Table 3). The perceived impact of the telehealth equipment on care provision The majority of carers were very positive about the impact of the telehealth equipment on care provision, including that it had provided ‘peace of mind’; another felt that although the person they cared for did not have an adverse health incident while being monitored, ‘it would be a great warning system if there had been any problems’. Some concerns about the safety of the equipment were raised, including issues of accuracy and reliability. One carer reported that ‘sometimes it did not work properly’. Another felt that ‘the equipment needs to be reviewed as far as accuracy’. Continued telehealth usage post-study None of the 15 carers who completed the study had organised another monitor for the person they cared for since returning the study monitor. When asked if another would be organised post-study 73% (n = 11) reported ‘no’, and 27% (n = 4) said that they were ‘not sure’. Of the 11 carers who reported that they would not organise another monitor, 10 (91%) stated that the equipment was no longer necessary after the research study was completed, mainly because they perceived that the person they cared for was not unwell enough to require it (n = 8): 112

Mum is becoming more and more mobile and enjoys health so at this stage I don’t feel it is necessary. My wife has improved to the position a monitor is not necessary at present. Added security at the beginning but realised that it was not necessary as time went on. or that the monitor was no longer necessary as service providers would provide the ongoing support rather than the equipment (n = 2): ‘weekly visit by community nurse’ and ‘regular visit to the doctor’. For the four carers who stated that they were ‘unsure’ if they would organise another monitor post-study, three (75%) reported a lack of service support as the reason for this response, that is no one had advised them that the continued use of the equipment would be necessary and/or that it was possible to organise another beyond the research project: I don’t know if it is possible. It has not been discussed. This has not been suggested as available or necessary. If another offered we would accept it. Despite the majority of carers not looking to organise another monitor for the person they provided care for, 93% (n = 14) of ‘completing’ carers reported that they would recommend the telehealth monitor to another person; 7% (n = 1) said that they would not.

Discussion Perceptions of the majority of carers on the impact of home telehealth for care provision to frail older clients of TCP were positive, a factor that has been associated with telehealth uptake and usage [17,18], but no one had organised or planned to organise another monitoring unit beyond the study. Reasons given for this included a lack of information/ service support about accessing another unit and a belief that the person they cared for was no longer unwell enough to require or benefit from the telehealth monitoring, despite feedback from GPs indicating that telehealth information was relevant to the patient’s ongoing care [19]. Australasian Journal on Ageing, Vol 34 No 2 June 2015, 109–114 © 2014 AJA Inc.

Te l e h e a l t h

Barriers to successful uptake and sustained usage of home telehealth are noted in the literature. These can include associated costs [20–22] and the need for perceived value in using the equipment [18,23]. Investigation of 35 telehealth services that operated in Australia between 1998 and 2007 noted that only 28% remained sustainable beyond a 2-year time frame; barriers to sustained usage included problems with the technology, insufficient funding and lack of service support [24]. In this current study, inadequate information provision by service provider staff was also a potential barrier. This finding highlights the ongoing need for services to clearly communicate to carers if telehealth monitoring services are available, how to access them and other factors such as associated costs. As noted in the literature, service infrastructure must align itself to support telehealth usage; otherwise, the service can become another barrier to the successful implementation of home telehealth [20,23]. Additionally, a belief that the equipment was no longer necessary post-study, or that usual care would be sufficient, was reported by a number of carers who completed the study. These beliefs are potential barriers to the sustainable usage of home telehealth monitoring. A lack of literature specifically addressing the sustainable usage of telehealth monitoring by carers of frail older adults restricts discussion of how this result relates to previous findings. However, the result does add to the debate about sustained usage of home telehealth, particularly by carers of frail older adults. Additionally, a potential usage barrier of a gap in carer perceptions of the health risk, versus the actual health risk, in the frail older person they were caring for was highlighted. This raises questions about how this perceptual gap may influence telehealth monitoring outcomes, and if this lack of insight should be, or can be, modified to improve compliance with treatment. This finding suggests that for sustained home telehealth usage the carer must perceive the equipment as having current value, also noted in the literature as a facilitator of usage [18,23]. Fairhall et al. [25] highlighted the importance of screening and assessment when implementing interventions with frail older adults, and recommended the assessment of potential psychological and social barriers at each stage of an intervention (implementation, uptake and compliance). The results of this current study support this framework with the social factors of carer perceptions of frailty and lack of service support about accessing another unit identified as potential negative influences to ongoing telehealth usage. These uptake barriers were recorded only at the end of the study, and future research would benefit from assessment of barriers throughout the intervention. With worldwide population ageing and a growing demand for care and support services [4], new approaches to cope with demand and reduce reliance on facility-based beds for delivering care are being sought [4,9]. If telehealth enables people to safely stay at home, and reduces the need for Australasian Journal on Ageing, Vol 34 No 2 June 2015, 109–114 © 2014 AJA Inc.

a n d

s u s t a i n a b i l i t y

o f

u s e

facility-based care, this will assist policy-makers in meeting population demand for care and support. From a policy development perspective, the findings suggest several issues that add to the debate surrounding the successful diffusion and use of in-home telehealth equipment. These include carer perception that the person being cared for no longer required monitoring by the equipment despite the fact that the person was a frail older person with multiple chronic diseases and a history of recent hospitalisation, and communication issues between service providers and service users in relation to sustained access of the equipment. If telehealth is to be successfully incorporated into ‘ageing in place’ policies, then further investigation needs to be undertaken into the barriers to the successful diffusion of this technology and strategies developed to overcome them. Based on the results of this study, this may include examining the impact of educating carers about the benefits of continued use of the technology. A number of limitations of the study should be noted, in particular the small sample size. The strict exclusion criteria were essential, both to maximize participant safety and to ensure reliable readings. This, in turn, resulted in low eligibility and participation rates, which limits the representativeness of this sample and the generalisability of the findings. Also, as the sample was drawn from a larger controlled study, different study groups were included (see Figure 1). The small sample size does not allow for investigation of how this may have impacted on the findings; however, future research in this area may benefit by examining how different usage conditions impact on sustainability of telehealth use. A total of 19 participants did not complete the study; 11 went into hospital or residential care and 8 (5 participants and 3 carers) no longer wanted to be part of it (see Figure 1). Information on why those carers no longer wanted to be part of the study was not provided to the research team, a further limitation of the study. Finally, the short follow-up period post-study constrains interpretation of the results. Strengths include that this study was rolled out through an existing service and therefore has potential for translation into practice. Additionally, as the findings relate to the direct application and sustainable usage of home telehealth, they add to the literature in this developing area. In conclusion, this paper reports carer perception of the impact of home telehealth monitoring on the provision of care, and explores sustained home telehealth usage poststudy. As this study was rolled out through an existing TCP service, it has the potential for translation into practice. However, the study results are constrained by the previously stated limitations. The results indicate that although the majority of carers reported positive perceptions about their experiences with the telehealth equipment, none had organised, or planned to organise, ongoing home telehealth monitoring beyond the study. The implications of this are important. If carers of frail older adults do not intend to utilise home telehealth, the suggested benefits to individuals and the community will be limited. 113

W a d e

13

Acknowledgements This study was conducted in conjunction with Baptist Community Services, NSW and ACT. Funding for the study was provided by the Australian Government Department of Health and Ageing.

14 15 16 17

Key Points • Although the majority of carers reported positive perceptions about their experiences with the telehealth equipment, none had organised, or planned to organise, ongoing home telehealth monitoring beyond the study. • As the person being cared for was a frail older person with multiple chronic diseases and a history of recent hospitalisation, the non-sustained usage of home telehealth by carers raises questions about what is required to ensure sustainability of use. • If carers of frail older adults do not intend to utilise home telehealth, the suggested benefits to individuals and the community will be limited.

18 19

20 21 22 23 24 25

References 1 2 3 4 5

6 7 8 9

10 11

12

114

World Health Organization. Key Policy Issues in Long Long-Term Care. Switzerland: World Health Organization, 2003. Carers Australia. The Economic Value of Informal Care in 2010. Canberra: Access Economics Pty, 2010. Australian Bureau of Statistics. Measures of Australia's Progress 2010. Canberra: Australian Bureau of Statistics, 2010. Australian Government Productivity Commission. Caring for Older Australians: Productivity Commission Inquiry Report No.53. Canberra: Australian Productivity Commission, 2011. Australian Government Department of Health and Ageing. Outcome – 4 Aged Care and Population Ageing Outcome Strategy. 2012. [Cited 20 June 2013.] Available from URL: http://www.health.gov.au/internet/ budget/publishing.nsf/Content/2009-2010_Health_PBS_sup1/$File/ Outcome%204%20-%20Aged%20Care%20and%20Population%20 Ageing.pdf Bookman A. Innovative models of aging in place: Transforming our communities for an aging population. Community, Work and Family 2008; 11: 419–438. United Nations. Political declaration and Madrid international plan of action on ageing. Proceedings of the 2nd World Assembly on Ageing; 8–12 Apr 2002, New York. Stroetmann K, Kubitschke L, Robinson S, Stroetmann V, Cullen K, McDald D. How can telehealth help in the provision of integrated care? World Health Organisation Policy Brief 13. 2010. World Health Organisation. Telemedicine: Opportunities and Developments in Member States. Report on the Second Global Survey on E-health. Global Observatory for E-health Series, Vol. 2. Switzerland: World Health Organization, 2010. Polisena J, Tran K, Cimon K et al. Home telehealth for chronic obstructive pulmonary disease: A systematic review and meta-analysis. Journal of Telemedicine and Telecare 2010; 16: 120–127. Inglis SC, Clark RA, McAlister FA et al. Structured telephone support programmes for telemonitoring programmes for patients with chronic heart failure (review). Cochrane Library. 2010; (8): CD007228. doi: 10 .1002/14651858.CD007228.pub2. Powell J, Chiu T, Eysenbach G. A systematic review of networked technologies supporting carers of people with dementia. Journal of Telemedicine and Telecare 2008; 14: 154–156.

R ,

C a r t w r i g h t

C ,

S h a w

K

Glueckauf RL. Telehealth and older adults with chronic illness: New frontier for research and practice. Clinical Gerontologist 2007; 31: 1–4. Barlow J, Singh D, Bayer S, Curry I. A systematic review of the benefits of home telecare for frail elderly people and those with long-term conditions. Journal of Telemedicine and Telecare 2007; 13: 172–179. Wade R, Shaw K, Cartwright C. Factors affecting provision of successful monitoring in home Telehealth. Gerontology 2012; 58: 371–377. Buckley KM, Tran BQ, Prandoni CM. Receptiveness, use and acceptance of telehealth by caregivers of stroke patients in the home. Online Journal of Issues in Nursing 2009; 9: 9. Wade R, Cartwright C, Shaw K. Factors relating to home telehealth acceptance and usage compliance. Risk Management and Healthcare Policy 2012; 5: 25–33. Magnusson L, Hanson E, Borg M. A literature review study of information and technology as a support for frail older people living at home and their family carers. Technology and Disability 2004; 16: 223–235. Cartwright C, Wade R, Shaw K. The impact of telehealth and telecare on clients of the transition care program report to Baptist Community Services & Commonwealth Dept of Health & Ageing. Coffs Harbour, Australia: ASLaRC Aged Services Unit, Southern Cross University, 2011. Kidd L, Cayless S, Johnston B, Wengstrom Y. Telehealth in palliative care in the UK: A review of the evidence. Journal of Telemedicine and Telecare 2010; 16: 394–402. Eley J. Barriers to the uptake of telemedicine in Australia – a view from providers. Rural and Remote Health 2011; 11: 1581. Goodwin N. The state of telehealth and telecare in the UK: Prospects for integrated care. Journal of Integrated Care; 18: 3–10. Johnston B, Kidd L, Wengstrom Y, Kearney N. An evaluation of the use of Telehealth within palliative care settings across Scotland. Palliative Medicine 2012; 26: 152–161. Wade V, Eliot J, Karnon J, Elshaug A. A qualitative study of sustainability and vulnerability in Australian Telehealth Services. Studies in Health Technology and Informatics 2010; 161: 190–201. Fairhall N, Langron C, Sherrington C et al. Treating frailty – a practical guide. BMC Medicine 2011; 9: 83.

Appendix I Perceived usefulness statements (see Table 3) The Technology Acceptance Model proposes that the construct of perceived usefulness is a significant factor in technology user acceptance and usage. Statements 1–4 are derived from the Technology Acceptance Questionnaire (17). All five questions in this section are rated on a 5-point Likert scale (1 = strongly agree to 5 = strongly disagree). The perceived impact of the telehealth equipment on care provision Q1. Please tell us what difference (if any) did the telehealth equipment make to you and the person you care for? Continued telehealth usage post-study Q1. Since returning the research project telehealth equipment, other telehealth equipment has been organised for the person I care for? Yes/No Q2. If not will another be organised in the future for the person you care for? Yes/No/Not Sure Q3. If no or not sure please tell us why. Q4. Would you recommend using the telehealth equipment to anyone else? Yes/No Q5. If no please tell us why not.

Australasian Journal on Ageing, Vol 34 No 2 June 2015, 109–114 © 2014 AJA Inc.

Carers' perceptions of the impact of home telehealth monitoring on the provision of care and sustainability of use.

This paper aims to report carers' perceptions of the impact of home telehealth on the provision of care and the sustainability of home telehealth use...
170KB Sizes 0 Downloads 11 Views