Culture-Specific Observations in a Saudi Arabian Digital Home Health Care Program: Focus Group Discussions With Patients and Their Caregivers

Abstract

Background There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to the aspects of the Saudi Arabian culture that need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for patients who are chronically and terminally ill. Objective This study aims to explore the specific cultural factors related to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home, a connected health program in the Home Health Care department at King Saud University Medical City, Riyadh, Saudi Arabia. Methods A qualitative study design was adopted to conduct a focus group discussion in July 2019 using a semistructured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis. Results A total of 2 categories emerged from the focus group discussion that influenced the experiences of digital health program intervention: first, culture-related factors including language and communication, cultural views on using cameras during consultation, nonadherence to web-based consultations, and family role and commitment and second, caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with patients and their family members may work as a barrier to proper communication through the Remotely Accessible Healthcare At Home program. Conclusions We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving direct family members with the health care providers.

Health Care Professionals’ Experiences and Perspectives on Using Telehealth for Home-based Palliative Care: Scoping Review

“…A frequency table illustrating which papers were included in which descriptive themes was made (Table 1). [66], Scofano et al [67], and Weck et al [68] Easy to use but technological issues undermine confidence 18 Bonsignore et al [69], Collier et al [60], Funderskov et al [49] Hackett et al [70], Helleman et al [71], Oelschlägel et al [62], Read Paul et al [59], Shulver et al [57], Harding et al [52], Whitten et al [56], Hochstenbach et al [50], Lind et al [51], Nguyen et al [48], van Gurp et al [72], Stern et al [55], Haydon et al [66], Scofano et al [67], and Weck et al [68] Adds value but personal and organizational barriers challenge adoption 23 Collier et al [60], Hackett et al [70], Harding et al [52], Hochstenbach et al [50], Lind et al [51], McCall et al [61], Adam et al [54], Funderskov et al [49], Read Paul et al [59], Whitten et al [53], Miyazaki et al [58], Tieman et al [73], van Gurp et al [74], Nguyen et al [48], Whitten et al [56], Oelschlägel et al [62], Shulver et al [57], Alodhayani et al [75], Bhargava et al...…”

“…In all but 1 [68] study, the samples consisted of nurses with various specialties [69][70][71][72][73][74][75]; in 13 studies, physicians were included [47,49,51,52,54,63,64,66,68,70,72,74,75]; and in 3 studies, hospice workers (ie, nurses, physicians, social workers, and spiritual care providers) were included [53,56,64]. Eleven studies had multiprofessional perspectives, including HCPs within rehabilitation, allied health, residential care, and palliative care [57,66]; case managers, coordinators, and respiratory therapists [58]; physician consultants [59]; telehealth providers or technologists [69,75]; and rehabilitation physicians, occupational therapists, physical therapists, speech therapists, dieticians, and social workers [49,62,71]. Three studies included only nurses in their sample [48,67,73], while 1 study included only physicians [68].…”

Female Saudi nursing students’ perspectives on pursuing a career in home healthcare: A qualitative study

“…They could communicate with patients in a common language, which helped them understand their patient's condition and provide better feedback and education. Anecdotal evidence shows that 70% of nurses in the Saudi healthcare system do not speak Arabic or come from different cultures (9,10). This may limit their ability to communicate efficiently with patients.…”

“…Despite global developments in home healthcare, this specialized field still faces major nursing shortages (7). One of the considerable challenges in Saudi Arabia is a shortage of nurses in this field due to poor management, lack of suitable infrastructure, cultural barriers, low salary, inter-professional coordination and cooperation, and job dissatisfaction (10,11). Other contributing factors include a lack of home healthcare equipment, insufficient security measures, and quality indicators (12).…”

“…Other contributing factors include a lack of home healthcare equipment, insufficient security measures, and quality indicators (12). These issues contribute to nurses' stress and burnout (10).…”