Patients’ and healthcare providers’ perceptions and experiences of telehealth use and online health information use in chronic disease management for older patients with chronic obstructive pulmonary disease: a qualitative study

Abstract

Background Telehealth and online health information provide patients with increased access to healthcare services and health information in chronic disease management of older patients with chronic diseases, addressing the challenge of inadequate health resources and promoting active and informed participation of older patients in chronic disease management. There are few qualitative studies on the application of telehealth and online health information to chronic disease management in older patients. Chronic obstructive pulmonary disease is one of the most common chronic diseases in older adults. Telehealth is widely used in the management of chronic obstructive pulmonary disease. The purpose of this study was to explore the perceptions and experiences of older patients and healthcare providers in the application of telehealth and online health information to chronic disease management of chronic obstructive pulmonary disease. Methods A qualitative descriptive study with data generated from 52 individual semi-structured interviews with 29 patients [Law of the People’s Republic of China on the protection of the rights and interests of older people (2018 Revised Version) = >60 years old] with chronic obstructive pulmonary disease and 23 healthcare providers. The inductive thematic analysis method was used for data analysis. Results Four themes and 16 sub-themes were identified in this study. Four themes included: faced with a vast amount of online health information, essential competencies and personality traits ensuring older patients’ participation and sustained use, user experience with the use of technology, being in a complex social context. Conclusion The ability of patients to understand health information should be fully considered while facilitating access to online health information for older patients. The role of health responsibility and user experience in older patients’ participation and sustained use of telehealth and online health information needs to be emphasised. In addition, the complex social context is a determining factor to be considered, particularly the complex impact of a reliance on offspring and social prejudice on the behaviour of older adults using telehealth and online health information.

Qualitative Research Studies Addressing Patient-Practitioner Communication about Online Health Information

“…However, as the authors reported that they found no talk about online health information in the observational data, the results are focused upon the interview data. Ten studies addressed patient perspectives on the topic of online information in the communication between health personnel and patients [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ] in different medical areas: Patients with chronic disease [ 17 , 18 , 19 ], or gynecologic or breast cancer [ 15 ]; senior citizens [ 16 , 23 ]; parents or mothers to be [ 21 , 24 ]. Additionally, four articles addressed the practitioners’ perspective [ 21 , 23 , 25 , 26 , 27 ] and two articles described interviews from both patients and practitioners’ perspective [ 13 , 17 ].…”

“…Ten studies addressed patient perspectives on the topic of online information in the communication between health personnel and patients [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ] in different medical areas: Patients with chronic disease [ 17 , 18 , 19 ], or gynecologic or breast cancer [ 15 ]; senior citizens [ 16 , 23 ]; parents or mothers to be [ 21 , 24 ]. Additionally, four articles addressed the practitioners’ perspective [ 21 , 23 , 25 , 26 , 27 ] and two articles described interviews from both patients and practitioners’ perspective [ 13 , 17 ]. In the results section, we will present a descriptive overview of the main findings from the patients’ perspectives and the health care practitioners’ perspectives, respectively, on the topic of online health information.…”

“…Others used to search the internet prior to, or after the medical consultation, to meet prepared, or to complement the practitioner’s information, and on rare occasions, to challenge the doctor. Jiang et al, (2022) also reported distrust in practitioners as a reason why patients searched the internet for more information, especially of there was a lack of information, or a hope of wonder medicines [ 17 ]. However, in Lee’s study, patients’ main reasons for online searches were to be more informed and gain knowledge and understanding about their disease.…”

“…Six interview studies concerning practitioners’ attitudes towards online health information were included in our study. Practitioners’ ambivalence towards information introduced by the patient from the Internet was reported by several researchers [ 13 , 17 , 25 , 26 , 27 , 28 ]. Caiata-Zufferey and Schulz [ 28 ] found that practitioners adopted four different strategies when meeting online informed patients: 1.…”

Factors associated with internet use and health information technology use among older people with multi-morbidity in the United States: findings from the National Health Interview Survey 2018

“…This new form of communication provides broader and open access to information and advices on how to maintain or improve health and manage illness. The use of the Internet and health information may be particularly beneficial to older adults seeking health information [ 17 , 18 ]. However, little is known about the proportion of older adults with physical multi-morbidity who use the Internet to search for health information and communicate with health care providers online [ 11 , 19 ].…”