Browsing by Author "Hunter I"
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- ItemEnabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study(JMIR Publications, 2022-11-04) Hunter I; Lockhart C; Rao V; Tootell B; Wong SBackground: Telehealth is often suggested to improve access to health care and has had significant publicity worldwide during the COVID-19 pandemic. However, limited studies have examined the telehealth needs of underserved populations such as rural communities. Objective: This study aims to investigate enablers for telehealth use in underserved rural populations to improve access to health care for rural older adults. Methods: In total, 7 focus group discussions and 13 individual interviews were held across 4 diverse underserved rural communities. A total of 98 adults aged ≥55 years participated. The participants were asked whether they had used telehealth, how they saw their community’s health service needs evolving, how telehealth might help provide these services, and how they perceived barriers to and enablers of telehealth for older adults in rural communities. Focus group transcripts were thematically analyzed. Results: The term telehealth was not initially understood by many participants and required an explanation. Those who had used telehealth reported positive experiences (time and cost savings) and were likely to use telehealth again. A total of 2 main themes were identified through an equity lens. The first theme was trust, with 3 subthemes—trust in the telehealth technology, trust in the user (consumer and health provider), and trust in the health system. Having access to reliable and affordable internet connectivity and digital devices was a key enabler for telehealth use. Most rural areas had intermittent and unreliable internet connectivity. Another key enabler is easy access to user support. Trust in the health system focused on waiting times, lack of and/or delayed communication and coordination, and cost. The second theme was choice, with 3 subthemes—health service access, consultation type, and telehealth deployment. Access to health services through telehealth needs to be culturally appropriate and enable access to currently limited or absent services such as mental health and specialist services. Accessing specialist care through telehealth was extremely popular, although some participants preferred to be seen in person. A major enabler for telehealth was telehealth deployment by a fixed community hub or on a mobile bus, with support available, particularly when combined with non–health-related services such as internet banking. Conclusions: Overall, participants were keen on the idea of telehealth. Several barriers and enablers were identified, particularly trust and choice. The term telehealth is not well understood. The unreliable and expensive connectivity options available to rural communities have limited telehealth experience to phone or patient portal use for those with connectivity. Having the opportunity to try telehealth, particularly by using video, would increase the understanding and acceptance of telehealth. This study highlights that local rural communities need to be involved in designing telehealth services within their communities.
- ItemReality vs expectations: An exploratory study of New Zealand nurses' perceptions of HR measures(2018-03-13) Tretiakov A; Hunter I; Tootell B; Wilson S; Toulson PWhen nurses believe that human resources (HR) measures used to record data describing their work are inappropriate, it may result in low engagement in the measurement process and in higher on-the-job stress, and it may be indicative of problems in the HR system. The purpose of the present study is to explore nurses' views on which HR measures are most appropriate for use in the healthcare sector and their perceptions of the current practice at their organisations. A cross-sectional survey of registered nurses in New Zealand was conducted, resulting in N=916. The respondents rated commonly used HR measures for importance and indicated whether they are used in their organisations. The data were analysed by using graphical representations of descriptive statistics to identify patterns in the relationship between perceived importance and perceived use of HR measures. Patient satisfaction and nurses' competencies measures were seen as both highly important and in use. However, a group of measures related to nurses' job satisfaction and empowerment stood out as, from nurses' perspectives, highly important but relatively unused. The results suggest that in healthcare organisations in New Zealand there is a divergence between nurses' ideas about the best HR measurement practice and their perceptions of the current practice. We argue that to address the underlying causes of the divergence and to mitigate its negative effects, healthcare organisations should involve nurses in making decisions regarding the use of HR measures.
- ItemSurvey protocol for exploring video and phone use in Aotearoa New Zealand general practice: considerations for future telehealth(BMJ Publishing Group Ltd and BCS, the Chartered Institute for IT, 2021-03-22) Day K; Hunter I; Rao V; Russell G; Roskvist R; Moir F; Gill E; van der Werf BIntroduction Telehealth became the most practical option for general practice consultations in Aotearoa New Zealand (NZ) as a result of the national lockdowns in response to the COVID-19 pandemic. What is the consumer experience of access to telehealth and how do consumers and providers perceive this mode of care delivery going forward? Methods and analysis A national survey of general practice consumers and providers who used telehealth services since the national lockdowns in 2020 will be distributed. It is based on the Unified Theory of Acceptance and Use of Technology framework of technology acceptance and the access to care framework. The data will be statistically analysed to create a foundation for in-depth research on the use of telehealth services in NZ general practice services, with a specific focus on consumer experiences and health outcomes. Ethics and dissemination Ethics approval was granted by the Auckland Health Research Ethics Committee on 13/11/2020, reference AH2539. The survey will be disseminated online.
- ItemTelehealth at Home: Co-Designing a Smart Home Telehealth System(IOP Press BV, 2021-04-19) Hunter I; Elers P; Lockhart C; Guesgen H; Whiddett D; Singh A; Maeder AJ; Higa C; van den Berg MEL; Gough CIncreasing life expectancy and rates of chronic conditions place increasing demands on aged care health and support services. One response preferred by older adults and seen as cost effective is aging in place, whereby older people remain in their own homes and avoid aged residential care. For this to take place, it is crucial that older people maintain effective relationships with support networks and that older adults and these networks have adequate information to support patient centred health and wellness care at home. This study explored how smart home telehealth, a form of telehealth where health care is provided at a distance using smart home digital technology (sensors), could assist older people to age in place and enhance their health and wellbeing. It was a two-phase project, preceded by a workshop with experts:1) 41 interviews with older adults and their informal support networks, seven focus groups with 44 health providers working with older adults, which informed 2) a pilot implementation of a co-designed telehealth system, addressing key barriers identified in Phase 1. The system used low cost, easily accessible, and commercially available sensors, transferring information via email and/or text messaging. It was successfully piloted with five older adults and twelve of their respective support networks for six months, who reported an increased feeling of security and improved interpersonal communication. The findings indicate that smart home telehealth could assist aging in place, and the study provides insights into successful co-design of smart home telehealth services at scale that could be implemented and deployed in contexts wider than aged care.