Meta-synthesis of qualitative research on the experience of elderly patients with chronic disease participating in telemedicine

doi:10.3761/j.issn.0254-1769.2022.13.017

Abstract

Abstract:

Objective To systematically review and synthesize the experiences of elderly patients with chronic diseases participating in telemedicine,in order to provide references for improving the accessibility and experience of telemedicine for elderly patients. Methods We searched databases,including PubMed,Embase,Cochrane Library,Web of Science,Scopus,CINIHL,ProQuest,CNKI,WanFang data VIP and SinoMed,for the qualitative research on the attitude and experience of elderly patients with chronic diseases in using telemedicine. The retrieval time limit is from January 2000 to March 2022. We use the standardized qualitative research evaluation tool developed by the Joanna Briggs Institute to evaluate the quality of the literature. Results A total of 22 studies were included. 92 research results were summarized into 12 categories and 3 synthesized findings according to their similarities. The 3 findings are the good experience,poor experience,and the preference and expectation of telemedicine treatment in elderly patients with chronic diseases. Conclusion The adaptive experience of elderly patients with chronic diseases participating in telemedicine treatment is diversified. It is necessary to improve the telemedicine care service system from the perspectives of telemedicine devices,hospitals,communities,families and individuals,and improve the accessibility and experience of elderly patients with chronic diseases using telemedicine care services.

Key words: Aged, Chronic Disease, Telemedicine, Experience, Meta-Synthesis, Evidence-based Nursing

摘要：

目的系统评价老年慢性病患者参与移动医疗照护体验的质性研究,为提高和改善老年患者对移动医疗的可及性提供依据。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、Scopus、CINAHL、ProQuest、中国知网、万方数据库、维普中文生物医学期刊、中国生物医学文献数据库,检索有关老年慢性病患者对使用移动医疗的态度和体验的质性研究,检索时限从2000年1月—2022年3月。使用乔安娜布里格斯研究所质性研究评估工具评价文献质量。结果共纳入22篇研究,提炼出92个明确的研究结果,将相似的研究结果归纳形成12个新类别,综合成3个整合结果：老年慢性病患者参与移动医疗的良好体验、老年慢性病患者参与移动医疗的不佳体验、老年慢性病患者对移动医疗的偏好和期望。结论老年慢性病患者参与移动医疗的适应体验多样化,需要结合患者情况,从移动医疗设备、医院、社区、家庭和个人多层面完善移动医疗照护服务体系,提升老年慢性病患者使用移动医疗照护服务的可及性和体验。

关键词: 老年人, 慢性病, 移动医疗, 体验, Meta整合, 循证护理学

XIONG Jiaming, YU Hongyu, SU Jin, ZHAO Zhuorui, YANG Qiaohong. Meta-synthesis of qualitative research on the experience of elderly patients with chronic disease participating in telemedicine[J]. Chinese Journal of Nursing, 2022, 57(13): 1641-1648.

熊佳铭, 余红雨, 苏瑾, 赵倬睿, 杨巧红. 老年慢性病患者移动医疗照护体验的Meta整合[J]. 中华护理杂志, 2022, 57(13): 1641-1648.

Figures/Tables 3

References 35

[1]	黄聪, 谌永毅, 刘翔宇, 等. 移动医疗在护理领域的应用进展[J]. 中华护理杂志, 2019, 54(8):1264-1269. DOI
	Huang C, Chen YY, Liu XY, et al. Review of mobile health in nursing field[J]. Chin J Nurs, 2019, 54(8):1264-1269.
[2]	中国居民营养与慢性病状况报告(2020年)[J]. 营养学报, 2020, 42(6):521.
	Report on nutrition and chronic disease status of Chinese residents(2020)[J]. Acta Nutr Sin, 2020, 42(6):521.
[3]	杜玉慧, 施学忠, 张卫萍, 等. 中国人口老龄化时间空间变化趋势分析[J]. 中国卫生统计, 2018, 35(4):522-526.
	Du YH, Shi XZ, Zhang WP, et al. Exploration on the trend of temporal and spatial distribution of population aging in China[J]. Chin J Heal Stat, 2018, 35(4):522-526.
[4]	Bradford NK, Caffery LJ, Smith AC. Telehealth services in rural and remote Australia:a systematic review of models of care and factors influencing success and sustainability[J]. Rural Remote Health, 2016, 16(4):3808. PMID
[5]	Li JJ, Liu Y, Jiang JJ, et al. Effect of telehealth interventions on quality of life in cancer survivors:a systematic review and meta-analysis of randomized controlled trials[J]. Int J Nurs Stud, 2021, 122:103970. DOI URL
[6]	Conway N, Campbell I, Forbes P, et al. mHealth applications for diabetes:user preference and implications for app development[J]. Health Informatics J, 2016, 22(4):1111-1120. DOI URL
[7]	弓少华, 孙超, 杨姮, 等. 中青年脑卒中患者疾病体验的Meta整合[J]. 中华护理杂志, 2021, 56(6):843-851. DOI
	Gong SH, Sun C, Yang H, et al. The real experience of stroke patients in young and middle-age adults:a qualitative meta-synthesis[J]. Chin J Nurs, 2021, 56(6):843-851.
[8]	Istepanian RSH, Laxminaryan S. UNWIRED,the next generation of wireless and internetable telemedicine systems-editorial paper[J]. IEEE Trans Inform Technol Biomed, 2000, 4:189-194. DOI URL
[9]	余红雨, 杨巧红, 李耀霞, 等. 中青年急性心肌梗死患者社会适应体验的Meta整合[J]. 中华护理杂志, 2021, 56(9):1387-1393.
	Yu HY, Yang QH, Li YX, et al. The psychosocial adaptation experience of young and middle-aged patients with acute myocardial infarction:a qualitative meta-synthesis[J]. Chin J Nurs, 2021, 56(9):1387-1393.
[10]	Fairbrother P, Pinnock H, Hanley J, et al. Exploring telemonitoring and self-management by patients with chronic obstructive pulmonary disease:a qualitative study embedded in a randomized controlled trial[J]. Patient Educ Couns, 2013, 93(3):403-410. DOI PMID
[11]	Fairbrother P, Ure J, Hanley J, et al. Telemonitoring for chronic heart failure:the views of patients and healthcare professionalsa qualitative study[J]. J Clin Nurs, 2014, 23(1/2):132-144. DOI URL
[12]	Fairbrother P, Pinnock H, Hanley J, et al. Continuity,but at what cost? The impact of telemonitoring COPD on continuities of care:a qualitative study[J]. Prim Care Respir J, 2012, 21(3):322-328. DOI URL
[13]	Lyngå P, Fridlund B, Langius-Eklöf A, et al. Perceptions of transmission of body weight and telemonitoring in patients with heart failure?[J]. Int J Qual Stud Health Well-being, 2013, 8:21524. DOI URL
[14]	O’Cathain A, Drabble SJ, Foster A, et al. Being human:a qualitative interview study exploring why a telehealth intervention for management of chronic conditions had a modest effect[J]. J Med Internet Res, 2016, 18(6):e163. DOI URL
[15]	Chang CP, Lee TT, Mills ME. Experience of home telehealth technology in older patients with diabetes[J]. Comput Inform Nurs, 2017, 35(10):530-537.
[16]	Portz JD, Bayliss EA, Bull S, et al. Using the technology acceptance model to explore user experience,intent to use,and use behavior of a patient portal among older adults with multiple chronic conditions:descriptive qualitative study[J]. J Med Internet Res, 2019, 21(4):e11604. DOI URL
[17]	Huniche L, Dinesen B, Nielsen C, et al. Patients’ use of self-monitored readings for managing everyday life with COPD:a qualitative study[J]. Telemed J E Health, 2013, 19(5):396-402. DOI PMID
[18]	Brickwood KJ, Williams AD, Watson G, et al. Older adults’ experiences of using a wearable activity tracker with health professional feedback over a 12-month randomised controlled trial[J]. Digit Health, 2020, 6:2055207620921678.
[19]	Akenine U, Barbera M, Beishuizen CR, et al. Attitudes of at-risk older adults about prevention of cardiovascular disease and dementia using eHealth:a qualitative study in a European context[J]. BMJ Open, 2020, 10(8):e037050.
[20]	Poppe L, Crombez G, de Bourdeaudhuij I, et al. Experiences and opinions of adults with type 2 diabetes regarding a self-regulation-based eHealth intervention targeting physical activity and sedentary behaviour[J]. Int J Environ Res Public Health, 2018, 15(5):E954.
[21]	Hägglund E, Strömberg A, Hagerman I, et al. Theory testing of patient perspectives using a mobile health technology system in heart failure self-care[J]. J Cardiovasc Nurs, 2019, 34(6):448-453. DOI PMID
[22]	Hanley J, Fairbrother P, McCloughan L, et al. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes[J]. BMJ Open, 2015, 5(12):e008896. DOI URL
[23]	Woo K, Dowding DW. Decision-making factors associated with telehealth adoption by patients with heart failure at home:a qualitative study[J]. Comput Inform Nurs, 2020, 38(4):204-214.
[24]	Bond CS, Worswick L. Self management and telehealth:lessons learnt from the evaluation of a Dorset telehealth program[J]. Patient, 2015, 8(4):311-316. DOI URL
[25]	Alkawaldeh MY, Jacelon CS, Choi J. Older adults’ experiences with a tablet-based self-management intervention for diabetes mellitus type Ⅱ:a qualitative study[J]. Geriatr Nurs, 2020, 41(3):305-312. DOI PMID
[26]	Lundell S, Modig M, Holmner Å et al. Perceptions of home telemonitoring use among patients with chronic obstructive pulmonary disease:qualitative study[J]. JMIR Mhealth Uhealth, 2020, 8(6):e16343. DOI URL
[27]	Ladin K, Porteny T, Perugini JM, et al. Perceptions of telehealth vs in-person visits among older adults with advanced kidney disease,care partners,and clinicians[J]. JAMA Netw Open, 2021, 4(12):e2137193. DOI URL
[28]	蓝春晗, 邱小芩, 沈茂, 等. 心力衰竭移动医疗App接受意愿低患者真实体验的质性研究[J]. 中国临床新医学, 2021, 14(12):1238-1241.
	Lan CH, Qiu XQ, Shen M, et al. The low receiving willingness and real experience of patients with heart failure using mobile medical App:a qualitative study[J]. Chin J New Clin Med, 2021, 14(12):1238-1241.
[29]	O’Shea O, Woods C, McDermott L, et al. A qualitative exploration of cardiovascular disease patients’ views and experiences with an eHealth cardiac rehabilitation intervention:the PATHway project[J]. PLoS One, 2020, 15(7):e0235274. DOI URL
[30]	Hanley J, Fairbrother P, Krishan A, et al. Mixed methods feasibility study for a trial of blood pressure telemonitoring for people who have had stroke/transient ischaemic attack(TIA)[J]. Trials, 2015, 16:117. DOI PMID
[31]	Vatnøy TK, Thygesen E, Dale B. Telemedicine to support coping resources in home-living patients diagnosed with chronic obstructive pulmonary disease:Patients’ experiences[J]. J Telemed Telecare, 2017, 23(1):126-132. DOI URL
[32]	Leonardsen AL, Hardeland C, Helgesen AK, et al. Patient experiences with technology enabled care across healthcare settings- a systematic review[J]. BMC Health Serv Res, 2020, 20(1):779. DOI URL
[33]	Zhang YT, Fang Y, Xu Y, et al. Adherence with blood pressure monitoring wearable device among the elderly with hypertension:the case of rural China[J]. Brain Behav, 2020, 10(6):e01599.
[34]	Zhou M, Zhao LD, Kong N, et al. Factors influencing behavior intentions to telehealth by Chinese elderly:an extended TAM model[J]. Int J Med Inform, 2019, 126:118-127. DOI PMID
[35]	Alsswey A, Naufal I, Bervell B. Investigating the acceptance of mobile health application user interface cultural-based design to assist Arab elderly users[J]. Ijacsa, 2018, 9(8):144-152.