Sociotechnical Influences on Outcomes in Telehomecare

DESCRIPTION (provided by applicant): The purpose of this research is to examine the relationship of elderly patients', caregivers', and nurses' needs, technology integration, and quality outcomes in telehomecare. Telehomecare is defined as monitoring patients via telephone interactive video transmission as a substitute for face-to-face home visits. Use of telehomecare changes the balance of patient/caregiver and nurse practices. As patients and caregivers take on responsibility for managing technology in the home and for independent self-monitoring, they transition from recipients of care to full participation in the care process. Together, the patient, caregiver and nurse create a new social subsystem linked by technology. The degree of technology integration into common care practices is measured from the perspectives of the social subsystem members. The proposed research provides a new framework based on the sociotechnology systems theory that examines the influence of patient, caregiver and nurse subsystem needs on use of technology and subsequent patient and nurse outcomes. Patient, nurse and caregiver needs consist of motivation and attitudes and expectation about the use of technology. Patient quality outcomes include symptom management, self-care and satisfaction. The nurses' quality outcomes are satisfaction and control over nursing practice. Correlation techniques and multiple regressions are used to test relationships in the theoretical model. Causal modeling can then be used to test for causation among the framework variables.