應用結構-過程-結果架構評估遠距居家照護支援系統效果：實地實驗法

Applying Structure-Process-Outcome Framework to Evaluate the Effectiveness of a Tele-Homecare Support System: A Field Experiment

周歆凱(Hsin-Kai Chou)

指導教授 ： 洪新原

國立中正大學/管理學院/資訊管理學系/博士(2014年)

摘要

無資料

關鍵字

實地實驗 ； 遠距居家照護支援系統 ； 結構過程結果理論 ； 醫療資訊 ； 失智症照護

並列摘要

Background: Applying web-based information and communication technology to care for patients has been implemented in various countries for many years. Most Telecare research focuses on information engineering, such as hardware development, information platform design, and system construction.
Purposes: There is much less research into the use of information technology to support dementia care and the effects on caregiver mental health and quality of life. To address this gap, the objectives of this research are:
(1) To evaluate the quantitative effectiveness of technology adaptability between disease severity and a Tele-Homecare Support System;
(2) To explore Mediators and Moderators which affect the effectiveness of technology adaptability between disease severity and a Tele-Homecare Support System;
(3) To evaluate the subjective perception of system usage by caregivers (system users).
Method: A Tele-Homecare Support System specific to dementia caregivers is first proposed in this research, and then a Structure-Process-Outcome (SPO) framework is applied to conduct a field experiment to objectively test the quantitative effectiveness of the adaptability on a Tele-Homecare Support System (THSS). In addition, the qualitative effectiveness of the prototype system is explored by interviewing the users to collect their perceptions of Ease of Use and Usefulness.
Results and Discussions: The results of THSS usage show that the property exit sensor (averaging at 81.17 times per household) triggered more frequently than the bed occupation sensor (59.13 times) and the fall detector (4.67 times). The problem of the patient getting lost outside is currently the major burden for caregivers. The possibility of having someone or some organization to take over or share the burden of care were at the top of their wish list. The Tele-homecare Support System is a web-based interactive platform/interface that provides a 24/7 platform to support patients by monitoring their safety, caregivers by offering them helpful instructions' and medical staff by giving them access to information crucial to making related care decisions. This research found the different adaptability between disease severity and care-aided tool would significantly improve the caregiver’s depression and quality of life overall, and in the domains of satisfaction with overall health, physical health, psychological health, social relations and environment. The difference in effectiveness showed that the fit group predictably experienced a greater increase in quality than the unfit group. The mean depression score for the fit group was also lower than that of the unfit group. Furthermore, there was a moderating effect so that the adaptability of the system would significantly affect the care support effectiveness when the age of caregiver is 65 years or under. Applying the Structure-Process-Outcome (SPO) theory, it can be concluded that the mediating effect little occur in the relationship between the technology adaptability and care support effectiveness. That is, the adaptability of THSS would directly affect the caregiver's medical utilization and mental health.
Conclusions: In summary, this research is an empirical study looking at the concrete benefits of a technological intervention in dementia care. Data from the caregivers’ quantitative assessment and qualitative perspective for Tele-Homecare Support Systems were collected and analyzed. The findings of this research make a meaningful contribution to dementia care and could make a real difference in the lives of primary caregivers by alleviating their mental pressure.

並列關鍵字

Field Experiment ； Tele-Homecare Support System ； Structure-Process-Outcome framework ； Medical Informatics ； Dementia Care

參考文獻

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