Telemedicine follow‐up facilitates more comprehensive diabetes foot ulcer care: A qualitative study in home‐based and specialist health care

Beate‐Christin Hope Kolltveit, Sally Thorne, Marit Graue, Eva Gjengedal, Marjolein M Iversen and Marit Kirkevold

Journal of Clinical Nursing, 2018, vol. 27, issue 5-6, e1134-e1145

Abstract: Aims and objectives To investigate the application of a telemedicine intervention in diabetes foot ulcer care, and its implications for the healthcare professionals in the clinical field. Background Contextual factors are found to be important when applying technology in health care and applying telemedicine in home‐based care has been identified as particularly complex. Design and methods We conducted field observations and individual interviews among healthcare professionals in home‐based care and specialist health care in a diabetes foot care telemedicine RCT (Clin.Trial.gov: NCT01710774) during 2016. This study was guided by Interpretive Description, an inductive qualitative methodology. Results Overall, we identified unequal possibilities for applying telemedicine in diabetes foot ulcer care within the hospital and home care contexts. Different circumstances and possibilities in home‐based care made the application of telemedicine as intended more difficult. The healthcare professionals in both care contexts perceived the application of telemedicine to facilitate a more comprehensive approach towards the patients, but with different possibilities to enact it. Conclusions Application of telemedicine in home‐based care was more challenging than in the outpatient clinic setting. Introducing more updated equipment and minor structural adjustments in consultation time and resources could make the use of telemedicine in home‐based care more robust. Relevance to clinical practice Application of telemedicine in diabetes foot ulcer follow‐up may enhance the nursing staff's ability to conduct comprehensive assessment and care of the foot ulcer as well as the patient's total situation. Access to adequate equipment and time, particularly in home‐based care, is necessary to capitalise on this new technology.

Date: 2018
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