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
Oversat titel
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
Forfattere
Christensen, Trine Søby ; Petersen, Ida Munk
Semester
4. semester
Udgivelsesår
2015
Afleveret
2015-06-23
Antal sider
106
Abstract
Telesundhed forventes at effektivisere og højne kvaliteten i sundhedsvæsenet, hvor borgernes oplevede kvalitet måles som tilfredshed. At evaluere og dokumentere tilfredshed kan styrke evidensen i klinisk praksis og understøtte en national implementering af telesundhed. Dette speciale havde til formål at evaluere og dokumentere forhold, der kan påvirke borgeres tilfredshed og oplevelse af virtuelt besøg via skærm sammenlignet med fysisk besøg i forbindelse med hjælp til medicin i kommunal hjemmepleje/-sygepleje. Metode: Model for ASsessment of Telemedicine (MAST) blev anvendt som overordnet ramme. En Mixed Methods-tilgang (Convergent Design) kombinerede logfiler, manuelle data, spørgeskemaer, fokusgruppeinterview og individuelle interviews for at forklare og forstå borgernes tilfredshed og oplevelser. I alt deltog 32 borgere fra Viborg Kommune (16 i hver gruppe). Resultater: Den samlede tilfredshed var høj, og mere end to tredjedele angav stor tilfredshed. Der var ingen signifikant forskel mellem de to grupper. Flere forhold sås at påvirke tilfredsheden: behov for fysiologisk stabilitet, tryghed og sikkerhed samt social kontakt med medarbejdere. Borgere med fysiske besøg forventede høj faglighed, medinddragelse og ønskede en tættere relation til medarbejderne. Borgere med virtuelle besøg lagde vægt på, at skærmen fungerede, og at opkaldene kom til tiden for at give mere frihed. Trods signifikant kortere leveret tid end visiteret tid oplevede de, at varigheden var passende. I begge grupper spillede personlige og kulturelle forhold også en rolle. Diskussion: Opfyldelse af grundlæggende behov i medicinadministration kan med Maslows behovsteori forklare den høje tilfredshed. Faglighed og medinddragelse var også til stede i virtuelle besøg. Fund om varighed og rettidighed tydede på, at det fysiske besøg ofte blev opfattet som målestok, mens det virtuelle blev set som et middel; dette kan hænge sammen med, at gruppen med fysiske besøg havde en signifikant højere alder end gruppen med skærmløsning. Konklusion: Tilfredsheden ved både fysiske og virtuelle besøg blev delvist formet af borgernes behov, forventninger, præferencer og oplevelser af medicinadministration, suppleret af personlige og kulturelle forhold. Samlet set resulterede disse parametre i en høj grad af tilfredshed blandt borgerne i Viborg Kommune.
Telehealth is expected to improve efficiency and quality in healthcare, where the quality experienced by citizens is often measured as satisfaction. Evaluating and documenting satisfaction can strengthen evidence in clinical practice and support national implementation of telehealth. This thesis aimed to evaluate and document factors that may influence citizens’ satisfaction and their experience of a virtual screen-based visit compared with a physical visit for medication support in municipal home care/nursing. Methods: The Model for ASsessment of Telemedicine (MAST) provided the overall framework. A mixed-methods approach (Convergent Design) combined log files, manual data, questionnaires, focus group interviews, and individual interviews to explain and understand satisfaction and experiences. In total, 32 citizens from Viborg Municipality participated (16 in each group). Results: Overall satisfaction was high, with more than two thirds reporting high satisfaction. There was no significant difference between the two groups. Several factors appeared to shape satisfaction: the need for physiological stability, feelings of safety and security, and social interaction with staff. Citizens receiving physical visits expected professional expertise and involvement and sought a deeper relationship with staff. Citizens receiving virtual visits emphasized screen functionality and timely calls to gain greater freedom. Despite significantly less delivered time than the time allocated, they perceived the call duration as appropriate. In both groups, personal and cultural factors also influenced satisfaction. Discussion: Meeting basic needs during medication administration, interpreted through Maslow’s hierarchy, may explain the high overall satisfaction. Professionalism and user involvement were also present in virtual visits. Findings on duration and timeliness suggested that physical visits were often seen as the benchmark, with virtual visits viewed as a means to achieve goals; this may relate to the significantly higher age in the physical-visit group compared with the screen-solution group. Conclusion: Satisfaction with both physical and virtual visits was partly shaped by citizens’ needs, expectations, preferences, and experiences of medication administration, along with personal and cultural factors. Together, these parameters led to a high level of satisfaction among citizens in Viborg Municipality.
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