Beate-Christin Hope Kolltveit1, Sally Thorne2, Marit Graue1,3, Eva Gjengedal3,4, Marjolein M Iversen1,5, Marit Kirkevold1,6. 1. Faculty of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway. 2. School of Nursing, University of British Columbia, Vancouver, BC, Canada. 3. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. 4. Faculty of Health and Social Care, Molde University College, Molde, Norway. 5. Section of Endocrinology, Department of Medicine, Stavanger University Hospital, Stavanger, Norway. 6. Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway.
Abstract
AIMS AND OBJECTIVES: To investigate the application of a telemedicine intervention in diabetes foot ulcer care, and its implications for the healthcare professionals in the clinical field. BACKGROUND: Contextual factors are found to be important when applying technology in health care and applying telemedicine in home-based care has been identified as particularly complex. DESIGN AND METHODS: We conducted field observations and individual interviews among healthcare professionals in home-based care and specialist health care in a diabetes foot care telemedicine RCT (Clin.Trial.gov: NCT01710774) during 2016. This study was guided by Interpretive Description, an inductive qualitative methodology. RESULTS: Overall, we identified unequal possibilities for applying telemedicine in diabetes foot ulcer care within the hospital and home care contexts. Different circumstances and possibilities in home-based care made the application of telemedicine as intended more difficult. The healthcare professionals in both care contexts perceived the application of telemedicine to facilitate a more comprehensive approach towards the patients, but with different possibilities to enact it. CONCLUSIONS: Application of telemedicine in home-based care was more challenging than in the outpatient clinic setting. Introducing more updated equipment and minor structural adjustments in consultation time and resources could make the use of telemedicine in home-based care more robust. RELEVANCE TO CLINICAL PRACTICE: Application of telemedicine in diabetes foot ulcer follow-up may enhance the nursing staff's ability to conduct comprehensive assessment and care of the foot ulcer as well as the patient's total situation. Access to adequate equipment and time, particularly in home-based care, is necessary to capitalise on this new technology.
AIMS AND OBJECTIVES: To investigate the application of a telemedicine intervention in diabetes foot ulcer care, and its implications for the healthcare professionals in the clinical field. BACKGROUND: Contextual factors are found to be important when applying technology in health care and applying telemedicine in home-based care has been identified as particularly complex. DESIGN AND METHODS: We conducted field observations and individual interviews among healthcare professionals in home-based care and specialist health care in a diabetes foot care telemedicine RCT (Clin.Trial.gov: NCT01710774) during 2016. This study was guided by Interpretive Description, an inductive qualitative methodology. RESULTS: Overall, we identified unequal possibilities for applying telemedicine in diabetes foot ulcer care within the hospital and home care contexts. Different circumstances and possibilities in home-based care made the application of telemedicine as intended more difficult. The healthcare professionals in both care contexts perceived the application of telemedicine to facilitate a more comprehensive approach towards the patients, but with different possibilities to enact it. CONCLUSIONS: Application of telemedicine in home-based care was more challenging than in the outpatient clinic setting. Introducing more updated equipment and minor structural adjustments in consultation time and resources could make the use of telemedicine in home-based care more robust. RELEVANCE TO CLINICAL PRACTICE: Application of telemedicine in diabetes foot ulcer follow-up may enhance the nursing staff's ability to conduct comprehensive assessment and care of the foot ulcer as well as the patient's total situation. Access to adequate equipment and time, particularly in home-based care, is necessary to capitalise on this new technology.
Authors: Constantijn E V B Hazenberg; Wouter B Aan de Stegge; Sjef G Van Baal; Frans L Moll; Sicco A Bus Journal: Diabetes Metab Res Rev Date: 2019-12-20 Impact factor: 4.876
Authors: Daniela C Gonçalves-Bradley; Ana Rita J Maria; Ignacio Ricci-Cabello; Gemma Villanueva; Marita S Fønhus; Claire Glenton; Simon Lewin; Nicholas Henschke; Brian S Buckley; Garrett L Mehl; Tigest Tamrat; Sasha Shepperd Journal: Cochrane Database Syst Rev Date: 2020-08-18