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Chronic Illness
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Understanding factors that inhibit or promote the utilization of telecare in chronic lung disease

Frances S. Mair

Division of Community Based Sciences, University of Glasgow, 1 Horselethill Road Glasgow G12 9LX, UK, fm46c{at}clinmed.gla.ac.uk

Julia Hiscock

National Primary Care Research and Development Centre, University of Manchester 5th Floor, Williamson Building, Manchester M13 9PL, UK

Susan C. Beaton

Mersey Primary Care R&D Consortium, Division of Primary Care/Liverpool PCT 2nd Floor, Whelan Building, University of Liverpool, Liverpool L69 3GB, UK

Objectives: To perform a process evaluation of a randomized controlled trial (RCT) of home telecare for the management of acute exacerbations of chronic obstructive pulmonary disease (COPD), using the normalization process model (NPM) as an explanatory framework.

Methods: Semi-structured interviews were carried out with patients (n = 9) and nurses (n = 11) participating in a RCT. A framework approach to data analysis was used.

Results: The telecare service did not provide an interactional advantage for the nurses providing this service and did not fit with the nurses' views of the most appropriate or preferred use of their skills. The telecare service seemed unlikely to become normalized as part of routine healthcare delivery, because the nursing team lacked confidence that it was a safe way to provide healthcare in this context and it was not perceived as improving efficiency.

Discussion: The NPM effectively mapped onto the study findings and explained those factors that inhibited the routine delivery of COPD services by telecare.

Key Words: Lung disease • Normalization process model • Telecare

Chronic Illness, Vol. 4, No. 2, 110-117 (2008)
DOI: 10.1177/1742395308092482
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