The implementation of telemedicine in wound care: a qualitative study of nurses' and patients' experiences

Kjersti Marie Blytt; Beate-Christin Hope Kolltveit; Marit Graue; Mari Robberstad; Thomas Ternowitz; Siri Carlsen; Marjolein Memelink Iversen

doi:10.1186/s12913-024-11620-w

The implementation of telemedicine in wound care: a qualitative study of nurses' and patients' experiences

BMC Health Serv Res. 2024 Sep 29;24(1):1146. doi: 10.1186/s12913-024-11620-w.

Authors

Kjersti Marie Blytt¹, Beate-Christin Hope Kolltveit², Marit Graue², Mari Robberstad³, Thomas Ternowitz⁴, Siri Carlsen³, Marjolein Memelink Iversen^{2

3}

Affiliations

¹ Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O. Box 7030, Bergen, 5020, Norway. Kjersti.blytt@hvl.no.
² Department of Health and Caring Sciences, Western Norway University of Applied Sciences, P.O. Box 7030, Bergen, 5020, Norway.
³ Department of Medicine, Section of Endocrinology, Stavanger University Hospital, Stavanger, Norway.
⁴ Department for Dermatology, Stavanger University Hospital, Stavanger, Norway.

Abstract

Background: The increasing use of telemedicine (TM) represents a major shift for health workers and patients alike. Thus, there is a need for more knowledge on how these interventions work and are implemented. We conducted a qualitative process-evaluation alongside a larger randomized controlled trial designed to evaluate a telemedicine follow-up intervention for patients with a leg- or foot-ulcer, who either have or do not have diabetes. Accordingly, the aim of this study was to explore how both health care professionals and patients experienced the implementation of TM follow-up in primary care.

Methods: The intervention comprised an interactive TM platform facilitating guidance and counselling regarding wound care between nurses in primary care and nurses in specialist health care in Norway. Nurses and patients from seven clusters in the intervention arm were included in the study. We conducted 26 individual interviews (14 patients and 12 nurses) in primary care between December 2021 and March 2022. Thematic analyses were conducted.

Results: The analyses revealed the following themes: (1) enhancing professional self-efficacy for wound care, (2) a need to redesign the approach to implementing TM technology and (3) challenging to facilitate behavioral changes in relation to preventive care. As to patients' experiences with taking part in the intervention, we found the following three themes: (1) experience with TM promotes a feeling of security over time, (2) patients' preferences and individual needs on user participation in TM are not met, and (3) experiencing limited focus on prevention of re-ulceration.

Conclusions: TM presents both opportunities and challenges. Future implementation should focus on providing nurses with improved technological equipment and work on how to facilitate the use of TM in regular practice in order to fully capitalize on this new technology. Future TM interventions need to tailor the level of information and integrate a more systematic approach for working with preventive strategies.

Clinical trial registration: NCT01710774. Registration Date 2012-10-17.

Keywords: Diabetes; Foot ulcers; Interview; Telemedicine; Thematic analysis; Wound care.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Aged
Female
Humans
Interviews as Topic
Male
Middle Aged
Norway
Nurses / psychology
Primary Health Care
Qualitative Research*
Telemedicine*

Associated data

ClinicalTrials.gov/NCT01710774