Sağlık Personellerinin Tele-Sağlık Uygulamalarını Benimsemesinde Kolaylaştırıcılar ve Engeller

Year 2022, Volume: 25 Issue: 3, 168 - 176, 30.09.2022

Ayşegül Karaca , Özlem Örsal , Pınar Duru

https://doi.org/10.5152/JANHS.2022.957610

Cited By: 1

Abstract

Bu sistematik derlemede, tele-sağlık uygulamaları aracılığıyla sunulan sağlık bakım uygulamalarının sağlık personelleri tarafından benimsenmesindeki kolaylaştırıcı faktörler ile engel oluşturan
faktörlerin incelenmesi amaçlanmıştır. Konu ile ilgili literatür taraması PubMed, Cochrane, Science
Direct, Web of Science, ProQuest Central ve Google Scholar veri tabanlarında 01 Mart-01 Mayıs
2021 tarihleri arasında yapılmıştır. Çalışmanın dahil edilme ve dışlanma kriterleri Nüfus, Müdahale,
Karşılaştırma, Sonuçlar ve Çalışma (PICOS) uygun olacak şekilde belirlenmiş, sistematik derlemeye sadece hakemli dergilerde yayınlanan ve tam metnine ulaşılan araştırmalar dahil edilmiştir.
Çalışmaların yanlılık riski değerlendirmesinde, “Randomize çalışmalar için revize edilmiş Cochrane
yanlılık riski aracı (RoB 2)” ve “Bias Risk Değerlendirme Aracı- Kesitsel Araştırmalar (BiRAT-CS)”dan
yararlanılmıştır. Çalışmalar arası farklılıklar söz konusu olduğundan anlatı sentezi kullanılmıştır.
Çalışmaya 9 makale dahil edilmiştir. İncelenen çalışmalardaki toplam katılımcı sayısı 1398 olup,
büyük çoğunluğu hemşirelerden (n=1133) oluşmaktadır. Sağlık personellerinin tele-sağlık uygulamalarını benimsemesinde en fazla vurgulanan ilk 4 kolaylaştırıcı faktörün; hasta izlemini kolaylaştırması, sürekli eğitim fırsatı sunması, sağlık personellerinin performanslarını olumlu olarak
etkilemesi ve teknolojik açıdan ilerleme sağlaması olduğu görülmüştür. Engelleyici faktör olarak ise,
en çok finansal desteklerin yetersiz oluşu ile karşılaşılmakta, bu durumu uygulama kullanımındaki
teknik aksaklıklar ve uygulamayı kullanan kişilerin kişisel farklılıkları takip etmektedir. Gözden geçirilen 9 çalışmada sağlık personellerinin tele-sağlık uygulama kullanım durumlarındaki memnuniyet
düzeyleri ölçülmüş ve 6 çalışmada yüksek olarak değerlendirilmiştir. İlgili çalışmaların sayılarının
artması teknolojik ilerlemelere paralellik sağlamak adına önemlidir.

Keywords

Engel, kolaylaştırıcı, hemşirelik, tele-sağlık

Facilitators and Barriers to Healthcare Professionals’ Adoption of Tele-Health Interventions

Abstract

This systematic review aimed to determine the factors of facilitators and barriers in the adoption of
healthcare interventions offered through telehealth interventions by health personnel. Literature
search on the subject was conducted between March 01 and May 01, 2021, in PubMed, Cochrane,
Science Direct, Web of Science, ProQuest Central, and Google Scholar databases. The inclusion
and exclusion criteria of the study were determined in accordance with Population, Intervention,
Comparison, Outcomes and Study (PICOS) and only studies published in peer-reviewed journals
and whose full text was accessible were included in the systematic review. “A revised Cochrane
risk-of-bias tool for randomized trials (RoB 2)” and “Bias Risk Assessment Tool- Cross-sectional
Studies (BiRAT-CS)” were used in the bias risk assessment of the studies. Since there are differences
between studies, narrative synthesis was used. Nine articles were included in the study. The total
number of participants in the studies reviewed was 1398, and the majority of them were nurses
(n=1133). The first 4 facilitator factors were most emphasized in the adoption of telehealth interventions by healthcare personnel. It has been seen that it facilitates patient follow-up, provides continuous education opportunities, positively affects the performance of health personnel, and provides
technological progress. As a barrier factor, inadequacy of financial support was mostly encountered,
followed by technical problems in the use of the intervention and the personal differences of the
people who use the intervention. In 9 studies reviewed, health personnel's satisfaction levels in telehealth intervention use cases were measured and evaluated as high in 6 studies. The increase in the
number of related studies is important in order to ensure parallelism with technological advances.

Keywords

Barrier, facilitator, nursing, telehealth

References

• 1. Mechanic OJ, Persaud Y, Kimball AB. Telehealth systems. In: StatPearls [Internet]. StatPearls Publishing; 2020.
• 2. Pazar B, Taştan S, İyigün E. Tele-sağlık sisteminde hemşirenin rolü. Bakırköy Tıp Derg. 2015;11(1):1-4.
• 3. Ertek S. Endokrinolojide tele-sağlık ve tele-tıp uygulamaları. Acıbadem Univ Sağlık Bilimleri Derg. 2011;2(3):126-130.
• 4. Olson CA, Thomas JF. Telehealth: No longer an idea for the future. Adv Pediatr. 2017;64(1):347-370. [CrossRef]
• 5. Hoonakker PL, Carayon P, McGuire K, et al. Motivation and job satisfaction of tele-ICU nurses. J Crit Care. 2013;28(3):315.e13-315.e21. [CrossRef]
• 6. De La Torre-Díez I, López-Coronado M, Vaca C, Aguado JS, de Castro C. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: A systematic review. Telemed J E Health. 2015;21(2):81-85. [CrossRef]
• 7. Olson CA, McSwain SD, Curfman AL, Chuo J. The current pediatric telehealth landscape. Pediatrics. 2018;141(3):1-10. [CrossRef]
• 8. Tuckson RV, Edmunds M, Hodgkins ML. Telehealth. N Engl J Med. 2017;377(16):1585-1592. [CrossRef]
• 9. Demirci Ş, Uğuroğlu Ö. Dijital pazarlama kanalları: Özel sağlık kuruluşlarına yönelik bir inceleme. Pamukkale Univ Sosyal Bilimler Enstitüsü Derg. 2020;39:339-351.
• 10. Öz F. Sağlık Alanında Temel Kavramlar. 2. Baskı. Mattek Matbaacılık; 2010:44-48.
• 11. Joos O, Silva R, Amouzou A, et al. Evaluation of a mhealth data quality intervention to improve documentation of pregnancy outcomes by health surveillance assistants in Malawi: A cluster randomized trial. PLoS One. 2016;11(1):e0145238. [CrossRef]
• 12. Kiberu VM, Mars M, Scott RE. Barriers and opportunities to implementation of sustainable e-health programmes in Uganda: A literature review. Afr J Prim Health Care Fam Med. 2017;9(1):e1-e10. [CrossRef]
• 13. Webster P. Virtual health care in the era of COVID-19. Lancet. 2020;395(10231):1180-1181. [CrossRef]
• 14. American Medical Association. Digital health study physicians’ motivations and requirements for adopting digital clinical tools. Available at: https://www.ama-assn.org/media/11681/download. (Accessed: 31.05.2021)
• 15. Amoakoh HB, Klipstein-Grobusch K, Amoakoh-Coleman M, et al. The effect of a clinical decision-making mhealth support system on maternal and neonatal mortality and morbidity in Ghana: Study protocol for a cluster randomized controlled trial. Trials. 2017;18(1):157. [CrossRef]
• 16. Lin CCC, Dievler A, Robbins C, Sripipatana A, Quinn M, Nair S. Telehealth in health centers: Key adoption factors, barriers, and opportunities. Health Aff (Millwood). 2018;37(12):1967-1974. [CrossRef]
• 17. Baird MB, Whitney L, Caedo CE. Experiences and attitudes among psychiatric mental health advanced practice nurses in the use of telemental health: Results of an online survey. J Am Psychiatr Nurs Assoc. 2018;24(3):235-240. [CrossRef]
• 18. Moreau JL, Alexsander S, Cordasco KM, et al. The use of telemental health to meet the mental health needs of women using department of veterans affairs services. Women's Health Issues. 2018;28(2):181-87.
• 19. Topol E. The Patient Will See You Now: The Future of Medicine is in Your Hands. 1st ed. Basic Books; 2015:921-924.
• 20. Woods B. By 2020, 90% of world’s population aged over 6 will have a mobile phone [report]. The Next Web 2014. Available at: https://thenextweb.com/news/2020-90-worlds-population-aged-6-willmobile-phone-report. (Accessed: 31.05.2021)
• 21. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906. [CrossRef]
• 22. Amir-Behghadami M, Janati A. Population, intervention, comparison, outcomes and study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews. Emerg Med J. 2020;37(6):387. [CrossRef]
• 23. JBI. Checklist for Randomized Controlled Trials. Critical Appraisal Tools for Use in JBI Systematic Reviews. Joanna Briggs Instıtue; 2020. https://jbi.global/critical-appraisal-tools. (Accessed: 31.05.2021)
• 24. JBI. Checklist for Analytical Cross Sectional Studies. Critical Appraisal Tools for Use in JBI Systematic Reviews. Joanna Briggs Instıtue; 2020. https://jbi.global/critical-appraisal-tools. (Accessed: 31.05.2021)
• 25. Sterne JAC, Savović J, Page MJ, et al. RoB 2: A revised tool for assessing risk of bias in randomized trials. BMJ. 2019;366:l4898. [CrossRef]
• 26. Yıldız F. Gözlemsel Sağlık Araştırmalarında Yan Tutma (Bias) Kontrolü Aracı Geliştirme: Metodolojik Bir Çalışma. (Danışman: P Okyay), Aydın Adnan Menderes Üniversitesi Tıp Fakültesi, Halk Sağlığı Anabilim Dalı, Uzmanlık Tezi, 2020.
• 27. Hobson E, Baird W, Bradburn M, et al. Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre. BJM Open. 2019;9(10):e028526.
• 28. Morony S, Weir KR, Bell KJL, et al. A stepped wedge cluster randomised trial of nurse-delivered teach-back in a consumer telehealth service. PLoS One. 2018;13(10):e0206473. [CrossRef]
• 29. Serwe KM. The provider’s experience of delivering an education-based wellness program via telehealth. Int J Telerehabilitation. 2018;10(2):73-80. [CrossRef]
• 30. Alonso R, Carvajal R, Boaventura M, Galleguillos L. Experience of South American MS and/or NMOSD experts in practice during the covid-19 pandemic: Focus on telemedicine. Mult Scler Relat Disord. 2021;48:102702. [CrossRef]
• 31. Banks J, Corrigan D, Grogan R, et al. Love in a time of covid: Clinician and patient experience using telemedicine for chronic epilepsy management. Epilepsy Behav. 2021;115:107675. [CrossRef]
• 32. Bashir A, Bastola DR. Perspectives of nurses toward telehealth efficacy and quality of health care: Pilot study. JMIR Med Inform. 2018;6(2):e35. [CrossRef]
• 33. Brunelli VN, Fox JA, Langbecker DH. Disparity in cancer survivorship care: A cross-sectional study of telehealth use among cancer nurses in Australia. Collegian. 2021;28(5):498-505. [CrossRef]
• 34. Dietzen A, Ide W, Pavone L. Telehealth in pediatric rehabilitation medicine: a survey of clinician reported utilization and experience. J Pediatr Rehabil Med. 2020;13(3):281-288. [CrossRef]
• 35. Van Houwelingen CTM, Ettema RGA, Kort HSM, Ten Cate O. Hospital nurses' self-reported confidence in their telehealth competencies. J Contin Educ Nurs. 2019;50(1):26-34. [CrossRef]
• 36. Haveland S, Islam S. Key considerations in ensuring a safe regional telehealth care model: A systematic review. Telemed Health. 2021.
• 37. McCaughan AK. Home telehealth: improving care and decreasing costs. In: Harris M D, ed. Handbook of Home Health Care Administration. PA: Jones and Bartlett Publishers; 2010:175-185.
• 38. Langabeer JR, Champagne-Langabeer T, Alqusairi D, et al. Costbenefit analysis of telehealth in pre-hospital care. J Telemed Telecare. 2017;23(8):747-751. [CrossRef]
• 39. Hoque MR. An empirical study of mhealth adoption in a developing country: The moderating effect of gender concern. BMC Med Inform Decis Mak. 2016;16(1):51. [CrossRef]
• 40. Ustamehmetoğlu G. Akıllanan dünyada yaşlı bakım uygulamaları. Fenerbahçe Univ Sağlık Bilimleri Derg. 2021;1(1):53-61.
• 41. Çapacı M, Özkaya S. COVID-19 pandemi döneminde tele-tıp uygulamaları. Anadolu Kliniği Tıp Bilimleri Derg. 2020;25:260-262.
• 42. Cooper SB. Opinion leaders’ perspective of the benefits and barriers in telemedicine: A grounded theory study of telehealth in the midwest. Q Rev Distance Educ. 2015;16(1):25.
• 43. Carroll K. Transforming the art of nursing: Telehealth technologies. Nurs Sci Q. 2018;31(3):230-232. [CrossRef]
• 44. Clarke M, Fursse J, Brown-Connolly NE, Sharma U, Jones R. Evaluation of the national health service (NHS) direct pilot telehprogram: Cost-effectiveness analysis. Telemed J E Health. 2018;24(1): 67-76. [CrossRef]
• 45. Gunter RL, Chouinard S, Fernandes-Taylor S, et al. Current use of telemedicine for post-discharge surgical care: A systematic review. J Am Coll Surg. 2016;222(5):915-927. [CrossRef]
• 46. Hwa K, Wren SM. Telehealth follow-up in lieu of postoperative clinic visit for ambulatory surgery: Results of a pilot program. JAMA Surg. 2013;148(9):823-827. [CrossRef]
• 47. Chase HP, Pearson JA, Wightman C, Roberts MD, Oderberg AD, Garg SK. Modem transmission of glucose values reduces the costs and need for clinic visits. Diabetes Care. 2003;26(5):1475-1479. [CrossRef]
• 48. McGrowder DA, Miller FG, Vaz K, et al. The utilization and benefits of telehealth services by health care professionals managing breast cancer patients during the COVID-19 pandemic. In: Healthcare (Basel). 2021;9(10):1401. [CrossRef]