Using information and communication technology to support people with serious chronic illness living at home

The overall aim of this licentiate thesis was to describe the experiences of people with serious chronic illness and the points of view and experiences of district nurses concerning the use of information and communication technology in nursing care at home. The study has a qualitative approach. Data were collected by using focus group discussions with 19 district nurses describing their points of view about using information and communication technology in nursing care at home (I). An intervention study with a case study design were performed (II, III) using semi-structured interviews with two people with serious chronic illness living at home and their respective district nurses before, during and after the use of the ICT application. The data were analysed using a thematic content analysis. The findings show the importance of district nurses having the opportunity to influence the design and participate in the introduction to the use of information and communication technology. District nurses saw that the use of this technology in nursing care at home could improve the accessibility of the district nurse for the ill person at home. They saw a possibility for themselves to gain better access to information about ill people living at home, and that its use could both save time, but also take time. The findings revealed that the equipment could be regarded as an encroachment and that the autonomy of the people and their relatives at home could be threatened. Furthermore it appeared that the use of information and communication technology in nursing care at home was not suitable for everyone, and that people cannot be replaced by information and communication technology. The findings in the intervention study indicate that it was difficult to reach the district nurse, and the use of information and communication technology improved accessibility. The messaging program provided a more direct communication between the ill people and their district nurses and facilitated communication with the district nurse, which led to fewer limitations in everyday life for people with serious chronic illness living at home. A feeling of uncertainty was salient in the use of the technology for the participants. The technology was seen as a complement to nursing care at home but not a replacement for traditional home visits. The study indicates that the use of information and communication technology offers a possibility of improving nursing care at home for people with serious chronic illness with increased accessibility, safety and security. It also seemed to mediate a more trusting relationship between the ill person and their district nurse.Godkänd; 2007; 20070220 (ysko