Remote Patient Monitoring: The Role of and Impact on the Older Spouse

Abstract

Aims and objectives: This master thesis examines the topics of Welfare Technology and Family Caregiving. The Welfare Technology in focus is Remote Patient Monitoring. The aim of the study is to obtain better knowledge and understanding of the role of and the impact on the older spouse when their chronically ill partner receives Remote Patient Monitoring as a municipal service. Background: Welfare technology and family caregiving are given central roles by the Norwegian Government in the building of a sustainable care model for the future. Family caregivers are also defined as important stakeholders in welfare technology. Furthermore, in the implementation of Remote Patient Monitoring in the Norwegian health care context, positive outcomes for family caregivers are sought and mentioned in policy- and project documents. However, the impact of this welfare technology on family caregivers is rarely addressed in empirically informed research. Design: The study has a qualitative research design based on a conceptual, thematical framework developed as a part of this study. This framework is the foundation of the research questions, the data collection and the data analysis. Method: This study applies a two-tier methodological approach. First a systematic document analysis was conducted to identify aspects relevant to examine when investigating the role of and impact on Remote Patient Monitoring on older spouses. The range of identified aspects were categorised into four main themes, forming this study’s thematical framework consisting of the following categories: 1) Role, Responsibility and Competence, 2) Care Burden, 3) Impact on Relationship and 4) Quality of life related aspects. The framework subsequently provided the following research questions: 1) What are the roles and the responsibilities of the spouse in Remote Patient Monitoring and do they have the needed competence?, 2) How does remote patient monitoring impact the care burden of the spouse?, 3) What is the impact of Remote Patient Monitoring on the relationship between the spouses? and 4) How does remote patient monitoring impact quality of life related aspects for the spouse?. Secondly, semi-structured interviews were conducted with 7 informants. Five interviews were conducted with older spouses of recipients of Remote Patient Monitoring services. Two interviews were conducted with municipal health care personnel with first-hand experience with Remote Patient Monitoring. Results and conclusion: At the point of introduction and entry into the remote patient monitoring service, the roles of the spouses appear to be considerable and is characterized by rationality and positivity. At the operational stage there are individual differences in the roles of the spouses. Some describe their involvement as limited to none, while others may be seen to be main operators in the domestic sphere. A wide range of different responsibilities and tasks the spouses may acquire was identified. In this study, all spouses acquired some form of task or responsibility related to the Remote Patient Monitoring. The contributions of the spouses appear to be aligned with their competences and is not found to add a burden. Reduced care burden and increased security are the most prominent impacts on the spouses. In both instances this is expressed to be a result of the sharing of responsibility for the ill spouse with the health care personnel at the response centres, and also the feeling of increased and improved medical follow-up of their partner. Among the other quality of life related aspects, this study has not found any distinct impacts on the sense of freedom or social and physical activity due to Remote Patient Monitoring. Some experienced a lower level of worry. In regard to mastery, knowledge and control was found to increase, but independence and self-management showed a less distinct change. To conclude, this study has found that the older spouses play an important role in the initial stage of the service. They are also contributors in the operational stage and may hold tasks that are critical to the sustainability of the service, regardless of the magnitude of their role. The main impacts experienced by the spouse as a result of Remote Patient Monitoring were increased security and care burden relief. Both impacts notably found to arise as a result of the professional, human constituents of the service, and not as much by the technology itself.