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eHomecare – for safety and communication in everyday life: The perspectives of older users, relatives and care managers
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (PriLiv)ORCID iD: 0000-0002-8360-9529
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to examine how eHomecare affects the daily lives of older users and their relatives, with a focus on safety and communication. A further aim was to explore care managers’ perspectives, expectations and experiences of eHomecare and its implementation. Methods: Participants in study one and two were older people with granted eHomecare and eight relatives and, care managers in study three and four. Data were collected through four qualitative studies, using individual interviews in the first and second studies before the introduction and after six months’ use of eHomecare, by individual vignette-based interviews in the third study, and with focus-group interviews in the fourth study. Data were analysed using different qualitative content analyses. Results: The participants described safety as a part of everyday life. eHomecare was found to facilitate a ‘new safety’ for older people and a ‘re-established safety’ for relatives, yet its use raised concerns about ethical considerations and reduced human contact. Participants could attain feelings of togetherness and affection through communication, although this was also considered a vulnerable activity due to physical changes and loss of other people. Used correctly, eHomecare increased communication and thus closeness and participation for the participants. For older participants unable to use the technology as hoped, eHomecare led to disappointment. Care managers expressed that eHomecare can increase older peoples’ everyday life-quality if they receive the right tools at the right time. Care managers, however, have difficulties with eHomecare’s management process. While they struggle with their own attitudes, lack of time and high workloads, their decisions are also influenced by surrounding organisations and the older people’s relatives. Care managers’ own organisations, work situations, relevant stakeholders and society in general can hinder them in managing eHomecare as a new homecare service. Widespread information about eHomecare and opportunities for relevant stakeholders to participate in its implementation are good preconditions for fulfilling the mission of care managers. Conclusions: The findings describe eHomecare from the perspectives of its older users, their relatives and the care managers responsible for managing the service. Used correctly, eHomecare increases possibilities for communication and provides safety. However, care managers have a complex mission when managing the service and they express a need for support and knowledge. The findings can be used clinically to develop older peoples’ utilization of eHomecare and to develop support for the fulfilment of care managers’ mission.

Keywords: care managers, content analysis, communication, eHomecare, experiences, information and communication technology, older people, participation, perceptions, relatives, safety, welfare technology

Place, publisher, year, edition, pages
Västerås: Mälardalen University , 2017.
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 241
Keywords [en]
care managers, content analysis, communication, eHomecare, experiences, information and communication technology, older people, participation, perceptions, relatives, safety, welfare technology
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-36717ISBN: 978-91-7485-352-0 (print)OAI: oai:DiVA.org:mdh-36717DiVA, id: diva2:1148369
Public defence
2017-11-24, Beta, Mälardalens högskola, Västerås, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2017-10-11 Created: 2017-10-10 Last updated: 2017-11-03Bibliographically approved
List of papers
1. eHomecare and safety: The experiences of older patients and their relatives
Open this publication in new window or tab >>eHomecare and safety: The experiences of older patients and their relatives
2018 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, no 2, p. 178-185Article in journal (Refereed) Published
Abstract [en]

The study's aim was to extend descriptions of how older patients with granted eHomecare and their relatives understand safety, and further to describe how they experience safety in everyday life. The study was conducted in Sweden. The participants were 12 older patients who had been provided with eHomecare and 8 relatives. Data were collected by semi-structured individual interviews. A conceptual framework of safety was used and a qualitative content analysis was conducted in a deductive and an inductive phase. The deductive results are presented in predefined categories: perceived sense of safety, disturbance and threats, re-establishing safety, and new safety. The inductive analysis resulted in two main categories: safety as part of everyday life and eHomecare as safety. The results show that eHomecare can promote safety for older patients and their relatives. Existing doubts and ethical concerns about the service can be minimized by providing adequate information.

Keywords
eHomecare, information and communication technology, older patients, relatives, safety
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-36711 (URN)10.1016/j.gerinurse.2017.08.004 (DOI)000431606800008 ()28988833 (PubMedID)2-s2.0-85030539695 (Scopus ID)
Projects
Doktorand projekt
Available from: 2017-10-10 Created: 2017-10-10 Last updated: 2019-11-17
2. eHomecare – experiences of communication
Open this publication in new window or tab >>eHomecare – experiences of communication
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-36715 (URN)
Projects
Doktorandprojekt
Available from: 2017-10-10 Created: 2017-10-10 Last updated: 2017-12-22Bibliographically approved
3. Care managers’ perceptions of eHomecare: a qualitative interview study
Open this publication in new window or tab >>Care managers’ perceptions of eHomecare: a qualitative interview study
2019 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, no 4, p. 634-646Article in journal (Refereed) Published
Abstract [en]

To implement information and communication technology (ICT) in elderlycare can be a challenge for healthcare organisations. In Sweden, caremanagers (CMs) are responsible for offering ICT as a new part ofhomecare, i.e. eHomecare. The aim of this study was to focus on CMs’perspectives and describe their perceptions of eHomecare. The studyhas a qualitative approach. Semi-structured interviews based onvignettes were conducted with 12 CMs in a medium-sized municipalityin central Sweden. Data were analysed using qualitative analysis. Thefindings showed that CMs are influenced by surrounding organisationsand relatives in their decision to grant eHomecare. There were alsodifficulties in CMs’ management of eHomecare. Furthermore, eHomecarewas perceived to improve the quality of everyday life for older. It isunderstood that the management of eHomecare is a challenging taskfor CMs and a complex mission. Interactions among CMs, relatives, careproviders, and other factors as for example CMs’ own attitudes have animpact on CMs’ decisions.

Keywords
Care managers; eHomecare; elderly care; information and communication technology; vignette method, biståndshandläggare; eHemtjänst; informationsoch kommunikationsteknik; vignettmetod; äldreomsorg
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-36709 (URN)10.1080/13691457.2017.1366893 (DOI)000470879000009 ()2-s2.0-85028556551 (Scopus ID)
Projects
Doktorandprojekt
Available from: 2017-10-10 Created: 2017-10-10 Last updated: 2019-06-27Bibliographically approved
4. Care managers' expected and experienced hindrances and preconditions when eHomecare is implemented: A Qualitative Focus Group Study.
Open this publication in new window or tab >>Care managers' expected and experienced hindrances and preconditions when eHomecare is implemented: A Qualitative Focus Group Study.
(English)In: Journal of gerontological social work, ISSN 0163-4372, E-ISSN 1540-4048Article, review/survey (Refereed) Submitted
Abstract [en]

In Sweden, information and communication technology has been introduced into home care services for older people, i.e., eHomecare. In this study, we explore social workers’ (care managers, [CM]) expected orexperienced hindrances and preconditions affecting their role and missionin eHomecare implementation. Four focus group interviews were conducted with participants from four municipalities in central Sweden during thespring of 2015. One focus group consisted of CMs with experiences of eHomecare and the other three groups of CMs without eHomecare experience. The study found that several hindrances may occur when eHomecare is implemented as part of home care, which in turn affect CMs´mission. CMs need a society that is well-informed in general aboute Homecare and requires relevant stakeholders to participate in the implementation process. CMs need an organization that is clear about their mission and a work situation that gives them the right circumstances for professionally managing eHomecare. It is also understood that older people must be given the right circumstances to adopt the technology, thus facilitating the CMs’ mission. Knowledge and time are assumed to be preconditions for CMs when managing eHomecare.

National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-36712 (URN)
Projects
Doktorand projekt
Available from: 2017-10-10 Created: 2017-10-10 Last updated: 2019-11-17

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Åkerlind, Charlotta

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