Liz Brewster1, Gail Mountain2, Bridgette Wessels3, Ciara Kelly4, Mark Hawley5. 1. Department of Health Sciences, University of Leicester - Social Science Applied to Healthcare Improvement Research (SAPPHIRE) Group, UK. 2. University of Sheffield - School of Health and Related Research, UK. 3. University of Sheffield - Sociology, UK. 4. University of Sheffield - Psychology, UK. 5. University of Sheffield - Health and Related Research, UK.
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 is a governmental priority in countries including the UK, USA and Canada, but little research has been conducted to analyse the impact of implementation on front-line nursing staff. DATA SOURCES: Six relevant data bases were searched between 2000-2012. DESIGN: Mixed-method systematic review including all study designs. REVIEW METHODS: Centre for Reviews and Dissemination approach with thematic analysis and narrative synthesis of results. RESULTS: Fourteen studies met the review inclusion criteria; 2 quantitative surveys, 2 mixed-method studies and 10 using qualitative methods, including focus groups, interviews, document analysis and observations. 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.
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 is a governmental priority in countries including the UK, USA and Canada, but little research has been conducted to analyse the impact of implementation on front-line nursing staff. DATA SOURCES: Six relevant data bases were searched between 2000-2012. DESIGN: Mixed-method systematic review including all study designs. REVIEW METHODS: Centre for Reviews and Dissemination approach with thematic analysis and narrative synthesis of results. RESULTS: Fourteen studies met the review inclusion criteria; 2 quantitative surveys, 2 mixed-method studies and 10 using qualitative methods, including focus groups, interviews, document analysis and observations. 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.
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