Decision-making Factors Associated With Telehealth Adoption by Patients With Heart Failure at Home: A Qualitative Study.

ABSTRACT

Telehealth has been reported to be effective in helping patients with heart failure manage their symptoms at home. Despite this, the adoption rate for telehealth among home care patients with heart failure is low, and there is limited research on reasons for this. This study was undertaken to explore factors associated with patients' decisions to adopt telehealth at home. A qualitative descriptive study underpinned by the Unified Theory of Acceptance Use of Technology model was conducted using semi-structured telephone interviews with patients with heart failure (N = 20) referred for telehealth. Interviews were analyzed using a mixture of deductive and inductive coding. Among the theoretical model elements, the perceived usefulness of the technology (performance expectancy), the availability of clinical/technical support (facilitating conditions), and the opinion of other individuals important to the patient (social influence) were associated with telehealth initiation. However, the ease of use (effort expectancy) was not an associated factor. Other factors such as experience, knowledge, confidence, satisfaction, and attitudes were also associated with the decision. Identification of factors related to higher telehealth initiation rates can be used to inform individualized care planning by nurses. Knowledge of such associations can inform referral process to improve the efficiency and utilization of telehealth.