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Towards digital care management and unobtrusive patient monitoring in home-based dementia care: Experiences, expectations and needs of professional caregivers.

Witte, E.R. de (2019) Towards digital care management and unobtrusive patient monitoring in home-based dementia care: Experiences, expectations and needs of professional caregivers.

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Abstract:Introduction: Because of the increasing number of patients with dementia in The Netherlands, a major increase of dementia-care related healthcare costs is expected in the near future. Healthcare must be provided with less healthcare professionals to more patients with dementia, which is why it is important to invest in technological innovations. Carenzorgt is a communication platform which facilitates communication between informal and formal caregivers and enables informal caregivers to read along with reports. Knowledge about its added value from the viewpoint of its users is still incomplete. Also, remote monitoring of patients with dementia can enable more efficient care, but knowledge about the contexts in where it might be advantageous, lacks. The aim of this study lies in collecting user experiences of healthcare professionals with Carenzorgt in home care to patients with dementia, and their needs and expectations towards unobtrusive monitoring systems. The first research question is; ‘What are the user experiences of healthcare professionals of different care teams that deliver home-based care to patients with dementia, with the care management platform Carenzorgt functionalities in ONS?’ The second research question is; ‘What are the expectations, needs and barriers of formal caregivers towards unobtrusive monitoring of persons with dementia in the home situation?’ Methods: A mixed method approach was applied, where a questionnaire and semi-structured interview was used. Positively formulated statements were introduced to respondents via an online questionnaire, where they could score the statements on a scale from 1 to 5. Differences in scores between groups are explored. The questionnaire statements were also integrated in the interview scheme. Results: Healthcare professionals have positive experiences with Carenzorgt when it comes to usability, workflow and quality of care. Carenzorgt does not decrease the burden of care in general. The main advantages of Carenzorgt were the easy communication and improved participation of and cooperation with informal caregivers. Because informal caregivers can read along with reports, miscommunication sometimes occurs. New messages are sometimes missed due to the lack of a notification, and the agenda appeared to be less user-friendly which is why it is barely used. Respondents from smaller teams agreed more to all statements than respondents from larger teams, and significantly more to burden of care statements. The barriers that were expected towards unobtrusive monitoring systems were mainly privacy, suspicion or distress of the patient and an increased workload. Permission of patient and family is very important. Unobtrusive monitoring systems could enable more care provision from a distance, give an increased insight in the patient’s functioning, help healthcare professionals with taking proactive measures and improve tailoring and quality of care. Healthcare professionals would like to have an easy-to-use, integrated system, where data is displayed in a way that is insightful and useful in practice. Discussion: Healthcare professionals might not report certain findings in Carenzorgt to avoid miscommunication, so adding an option to hide certain reports could be a solution. Other recommendations are good training and support for informal caregivers, a notification in case of new messages or agenda appointments and better insight in the agenda. The lower scores on questionnaire statements of respondents from larger teams could be explained by possible poorer team processes that are often found in larger teams. In further research, experiences with different functionalities of Carenzorgt, such as the agenda, could be further explored to gain better insight. While redesigning functionalities, it is very useful to closely involve relevant end users. Privacy is often found as main barrier in studies where expectations of monitoring technologies are explored. Since permission of patient and family is important, shared decision making should be well-facilitated. Also, while in the contextual inquiry, it is important to explore the expectations and needs of patients with dementia. The same goes for development, but involving them can be challenging. Persona-based design would be very useful in the early development phase, and can be used for multiple purposes. The results of this research show that UCD and holistic eHealth development and design remains important during early and later developments of eHealth.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:02 science and culture in general
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/80112
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