Understanding factors that inhibit or promote the utilization of telecare in chronic lung disease.
OBJECTIVE
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.


CONCLUSIONS
The NPM effectively mapped onto the study findings and explained those factors that inhibited the routine delivery of COPD services by telecare.
Mair
Frances S
FS
Division of Community Based Sciences, University of Glasgow, Glasgow, UK. fm46c@clinmed.gla.ac.uk
Hiscock
Julia
J
Beaton
Susan C
SC
D001291:Attitude of Health Personnel; D003144:Communication Barriers; D004867:Equipment Design; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008962:Models, Theoretical; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D010342:Patient Acceptance of Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*; D036301:Qualitative Research; D012803:Sick Role; D017216:Telemedicine / Q000295:instrumentation / Q000706:statistics & numerical data*