Evaluering og dokumentation af telesundhed i kommunal hjemmepleje/-sygepleje: Et Mixed Methods-studie om borgeres tilfredshed samt oplevelse af virtuelt besøg via skærmløsning sammenlignet med fysisk besøg ved medicinadministration i Viborg Kommune

Abstract

Introduktion Telesundhed forventes at effektivisere og øge kvaliteten i det danske sundhedsvæsen, hvor borgeroplevet kvalitet angivet ved tilfredshed er mål. Evaluering og dokumentation af tilfredshed kan kvalificere og evidensbasere klinisk praksis samt danne grundlag for implementering af telesundhed nationalt. Formålet med specialet var at evaluere og dokumentere parametre, som kan have betydning for borgeres tilfredshed samt oplevelse af virtuelt besøg via skærmløsning sammenlignet med fysisk besøg ved medicinadministration i kommunal hjemmepleje/-sygepleje. Metode Model for ASsessment of Telemedicine (MAST) anvendtes som overordnet ramme. Logfiler, manuelle data, spørgeskemaer, fokusgruppeinterview og individuelle interviews anvendtes til at forklare og skabe forståelse for borgernes tilfredshed samt oplevelse af besøgene via Mixed Methods Research (Convergent Design). 32 borgere (16 i hver gruppe) i Viborg Kommune deltog. Resultater Samlet tilfredshedsscore viste, at mere end to tredjedele af borgerne angav høj tilfredshed. Der var ikke signifikant forskel mellem de to grupper. Resultater viste parametre med nuancer, der kunne have betydning for tilfredsheden. Parametrene var behov for fysiologisk stabilitet, tryghed og sikkerhed samt social interaktion med medarbejdere. Borgerne, der modtog fysisk besøg, udtrykte forventninger om faglighed og medinddragelse samt ønske om en dybere relation med medarbejderne. Borgerne, som modtog virtuelt besøg, udtrykte forventninger om funktionalitet af skærmen og rettidighed af opkald for at opnå større frihed. De udtrykte tilpas varighed af opkald trods signifikant mindre leveret tid sammenlignet med visiteret tid. I begge grupper fremkom personlige og kulturelle parametre, der kunne have betydning for tilfredsheden. Diskussion Opfyldelse af grundlæggende behov ved medicinadministration kunne med Maslows behovsteori forklare den høje samlede tilfredshedsscore. Faglighed og medinddragelse fandtes implicit i virtuelt besøg. Varighed og rettidighed viste, at fysisk besøg blev anset som mål og virtuelt besøg som middel. Dette kunne forklares med signifikant højere alder hos borgerne, som modtog fysisk besøg, sammenlignet med borgerne, der havde skærmløsning. Konklusion Parametre, der havde betydning for borgernes tilfredshed ved fysisk og virtuelt besøg, var delvist indeholdt i behov, forventninger, præferencer samt oplevelse af medicinadministration. Personlige og kulturelle parametre havde ligeledes betydning for borgernes tilfredshed samt oplevelse af besøgene. Parametrene resulterede i høj grad af tilfredshed hos borgerne i Viborg Kommune.

Introduction Telehealth is expected to lead to higher efficiency as well as increased quality within the Danish healthcare system, where service quality in the form of user satisfaction, as experienced by the citizens, is used as target. Evaluation and documentation of satisfaction may help qualify and evidence base clinical practice as well as form a basis for the implementation of telehealth on a national scale. The purpose of the thesis was to evaluate and document which parameters may influence citizen satisfaction as well as their experience with virtual visits using a screen solution in comparison with physical visits in relation to administration of medicine in the municipality home healthcare system. Methods Model for ASsessment of Telemedicine (MAST) was used as an overall framework. Using Mixed Methods Research (Convergent Design), log files, manual data, questionnaires, a focus group interview and individual interviews were used to explain and understand citizen satisfaction as well as their experience with visits. 32 citizens (16 in each group) from the Municipality of Viborg participated. Results The combined satisfaction score showed that more than two thirds of the citizens indicated a high degree of satisfaction. No significant difference between the two groups was identified. The results revealed parameters amended with small details, which could have impact on the satisfaction. These parameters were; need for physiological stability, comfort and security as well as social interaction with employees. Citizens receiving physical visits indicated expectations concerning professional competence and involvement as well as a wish for a deeper relation with employees. Citizens receiving virtual visits indicated expectations concerning the functionality of the screen solution and timeliness in calls to achieve a higher degree of freedom. The citizens expressed approval of the duration of the calls despite significant shorter durations compared to time used for physical visits. In both groups personal and cultural parameters with impact on satisfaction were revealed. Discussion Fulfillment of basic needs in relation to administration of medicine could, on basis of Maslow’s "theory of needs", explain the high combined satisfaction score. Professional competence and involvement were implicit in virtual visits. Duration and timeliness showed that physical visits were considered to be objectives and virtual visits to be means. This could be explained by the significant higher age in the group of citizens receiving physical visits in comparison with the group receiving virtual visits. Conclusion Parameters with influence on citizens’ satisfaction in relation to physical and virtual visits were in part included in needs, expectations, preferences as well as experience with administration of medicine. Personal and cultural parameters were also found to influence citizens' satisfaction as well as the experience of the visits. The parameters resulted in a high degree of satisfaction among the citizens in the Municipality of Viborg.

A master thesis from Aalborg University

Evaluering og dokumentation af telesundhed i kommunal hjemmepleje/-sygepleje: Et Mixed Methods-studie om borgeres tilfredshed samt oplevelse af virtuelt besøg via skærmløsning sammenlignet med fysisk besøg ved medicinadministration i Viborg Kommune

[Evaluation and documentation of telehealth in the municipality home health care: A Mixed Methods study of citizens' satisfaction and experience of virtual visits using a screen solution compared to physical visits in relation to administration of medicine in the Municipality of Viborg]