Psychosocial outcomes of eCare services use for employed informal carers of older people

Potreba po dolgotrajni oskrbi se je zaradi staranja prebivalstva znatno povečala. Uporaba storitev e-oskrbe ima velik potencial pri reševanju izzivov demografskih sprememb, malo pa je znanega o potencialu storitev e-oskrbe v zvezi s psihosocialnimi učinki pri neformalnih oskrbovalcih starejših. Cilj doktorske disertacije je identificirati pozitivne in negativne psihosocialne učinke uporabe storitev e-oskrbe, se poglobiti v povezave med temi učinki ter ugotoviti, kako različne funkcionalnosti storitev e-oskrbe oblikujejo psihosocialne učinke in kako se sprejemanje teh storitev oblikuje na podlagi opredeljenih psihosocialnih učinkov. Štirimesečna intervencijska študija v Sloveniji je bila izvedena v letih 2018 in 2019 z uporabo kvazi eksperimentalne kvalitativne zasnove raziskave. Med intervencijo so bili zbrani kvantitativni in kvalitativni podatki, vendar je imela temeljno vlogo kvalitativna metodologija z uporabo pristopa utemeljene teorije. Opravljenih je bilo 44 polstrukturiranih intervjujev z 22 neformalnimi oskrbovalci, ki so bili analizirani po postopkih kodiranja utemeljene teorije s pomočjo programske opreme Atlas.ti 9. Rezultati pričujoče doktorske disertacije so pokazali na veliko pozitivnih in izjemno malo negativnih psihosocialnih učinkov uporabe storitev e-oskrbe. Starejši ljudje, ki živijo sami, so lahko izpostavljeni nekaterim tveganjem, ki jih je mogoče uspešno obvladovati z uporabo storitev e-oskrbe, saj zadovoljijo potrebo neformalnih oskrbovalcev po zagotavljanju varnosti starejše osebe. Posledično je bilo zagotavljanje varnosti v disertaciji opredeljeno kot osrednja kategorija, saj se je povezovala z večino kategorij in konceptov. V tem kontekstu je uporaba storitev e-oskrbe neformalnim oskrbovalcem omogočila večji nadzor nad situacijo oskrbe, manj skrbi in zaskrbljenosti zaradi morebitne (ne)varnosti oskrbovanih starejših oseb ter neformalnim oskrbovalcem zagotovila pomirjenost. Vsi navedeni učinki so dodatno vplivali na sprejemanje storitev e-oskrbe pri neformalnih oskrbovalcih. Glede funkcionalnosti storitev e-oskrbe so največ psihosocialnih učinkov povzročili senzorji gibanja, in kontaktni senzorji ter alarmni obesek. Obenem je bil pomemben dejavnik pravilno delovanje vseh funkcionalnosti. Identificirani psihosocialni učinki in povezava med njimi ter njihove povezave s sprejemanjem storitev e-oskrbe so pojasnjeni v konceptualnem modelu. Preučevana tema je lahko koristna za razvijalce ter oblikovalce politike storitev e-oskrbe, da bi razumeli, kako končni uporabniki zaznavajo storitve e-oskrbe in podobne tehnologije preko psihosocialnih učinkov ter kako jih lahko izboljšajo.The current ageing of the population means that the need for long-term care will increase significantly. The use of eCare services holds enormous potential for addressing the challenges of demographic change, yet little is known about the potential of eCare services in relation to psychosocial outcomes among employed informal carers. The aim is to identify positive and negative psychosocial outcomes of eCare services use in the post-implementation phase, explore the relationships between these outcomes, and discover how various functionalities shape psychosocial outcomes and acceptance is shaped by the identified psychosocial outcomes. A 4-month intervention study was conducted in Slovenia in 2018 and 2019 using a quasi-experimental qualitative research design. Although both quantitative and qualitative data were collected during the intervention, the qualitative methodology, where the grounded theory approach was used, played a fundamental role. A total of 44 semi-structured interviews with 22 informal carers was conducted and analysed following grounded theory coding procedures with the help of Atlas.ti 9 software. The results of the doctoral dissertation demonstrated many positive and few negative psychosocial outcomes. Older people living alone may be exposed to certain risks that can be successfully managed through use of eCare services that meet their safety needs by providing those who care for them with a reassurance of safety. Therefore, the core category identified was the reassurance of safety since it was associated with most categories and concepts, where the use of eCare services led the informal carers to have greater control over the care situation, be less worried and anxious about the potential (un)safety of the older person involved and give those who care for them peace of mind, which further impacted their acceptance. In terms of functionalities of eCare services, the motion and contact sensors and the alarm pendant elicited the most psychosocial outcomes, while it was also important that all functionalities worked properly. The identified psychosocial outcomes, their interrelationships, and the relations with acceptance are explained in a substantive conceptual model. The topic studied may be useful for developers, designers, scholars, and policymakers of eCare services to understand how end users perceive their technology through psychosocial outcomes and how they can improve it