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¶ … telehealth in nursing and the ability to provide quality care has received much attention of late and there are several studies that examine the role of telehealth in supporting patients and helping nurses provide quality care.
The study by Geennhalgh, Wherton, Sugarhood, Hinder, Procter et al. (2013) conducts a qualitative phenomenological study on how telehealth and telecare help elderly persons with their assisted living needs. The study finds that these tools are helpful to varying degrees depending on the patients' needs and the nurses' role in providing care.
Gorst, Coates and Armitage (2016) conduct a qualitative study on how patients' beliefs and personal feelings regarding telehealth impact their quality of care. The study employed interviews with 8 patients to find out how patients feel about this type of care: most liked it but most also valued face-to-face time with care givers.
Brewster et al. (2014) use both qualitative and quantitative data (a mixed method systematic review) in order to discern the impact of telehealth on front line operations in nursing. The study finds that most nurses accept it positively but that there are still barriers in terms of support structures that need to be overcome.
The study by Wilson (2016) is another mixed-methods systematic review that is both qualitative and quantitative. It finds that telehealth care in pediatric services raised concerns about where clinical responsibility lay. The study indictes that telehealth may be better applied to senior care than to child care.
Spindler et al. (2014) conducted a quantitative randomized-control trial to measure patient satisfaction when telehealth services were employed. The study showed that telehealth increased patient satisfaction in the VA facility. The study used quantitative surveys and qualitative interviews to obtain data for analysis. The study is helpful in showing that telehealth services help health care providers overcome obstacles and patients to receive better quality care.
Finally, the study by Caffery, Martin-Khan and Wade (2016) used a mixed-methods approach to assess the role of research in understanding telehealth and its uses in nursing and health care. The study shows that both quantitative and qualitative assessments are important in understanding the effects and impacts of telehealth in the health care world.
References
Brewster, L. et al. (2014). Factors affecting front line staff acceptance of telehealth
technologies: a mixed-method systematic review. JAN, 70(1): 21-33.
Abstract: Aim: To synthesize qualitative and quantitative evidence of front-line staff acceptance of the use of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.
Background: The implementation of telehealth at scale...
Identified factors affecting staff acceptance centred on the negative impact of service change, staff -- patient interaction, credibility and autonomy, and technical issues. Studies often contrasted staff and patient perspectives, and data about staff acceptance were collected as part of a wider study, rather than being the focus of data collection, meaning data about staff acceptance were limited.
Conclusion: If telehealth is to be implemented, studies indicate that the lack of acceptance of this new way of working may be a key barrier. However, recommendations have not moved beyond barrier identification to recognizing solutions that might be implemented by front-line staff. Such solutions are imperative if future roll-out of telehealth technologies is to be successfully achieved.
Caffery, L., Martin-Khan, M., Wade, V. (2016). Mixed methods for telehealth research.
Journal of Telemedicine & Telecare, doi:10.1177/1357633X16665684
Abstract: Mixed methods research is important to health services research because the integrated qualitative and quantitative investigation can give a more comprehensive understanding of complex interventions such as telehealth than can a single-method study. Further, mixed methods research is applicable to translational research and program evaluation. Study designs relevant to telehealth research are described and supported by examples. Quality assessment tools, frameworks to assist in the reporting and review of mixed methods research, and related methodologies are also discussed.
Gorst, S., Coates, E., Armitage, C. (2016). "It's sort of a lifeline": Chronic obstructive
pulmonary disease patients' experiences of home telehealth. Health Pyschology, 35(1): 60-68.
Abstract: Objective: Home telehealth can provide considerable benefits to people diagnosed with chronic obstructive pulmonary disease, yet 20% of patients abandon telehealth. Identifying the factors that affect whether or not a patient decides to continue using telehealth is therefore crucial to the goal of mainstreaming telehealth. However, studies to date have only assessed the perceptions of patients who are not currently using telehealth, have used telehealth in experimental sessions, or are enrolled in a trial. The aim of the present…
Wilson, R. (2016). Can telehealth help to deliver sustainable and equitable paediatric
services in Northern Scotland? Rural and Remote Health, 16: 4118.
Abstract: Northern Scotland needs more equitable and sustainable paediatric unscheduled care. Rural hospital emergency departments are primarily staffed by GPs or junior doctors outside normal working hours. Achieving equitable access to paediatric specialist advice is challenging. The Paediatric Unscheduled Care (Puc) Pilot Service was driven primarily by the Scottish Centre for Telehealth and Telecare. The Centre for Rural Health undertook an evaluation of the activity during the first six months. We evaluated the experience of consultations, rates of patient transfers to specialist centres, consultant views, satisfaction with videoconferencing technology and quality of care. The Puc Telehealth Service pilot attempted to provide a single point of consultant led paediatric contact for Rural General or Community hospitals across northern Scotland, by providing non-specialist physicians and families with fast and appropriate access to specialist assessment and support via video conferencing. This pilot aimed to use telehealth as a contribution to integrated care and embed Puc into existing working practice within the rural hospitals. We assessed the progress of the pilot against its objectives, using mixed methods during the evaluation including both quantitative and qualitative data collection, an economic analysis and literature review. Although the Puc model was popular with families and junior physicians, it proved expensive and concerns emerged about where clinical responsibility lay. Recommendations for sustaining equitable paediatric unscheduled care will be made.
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