title: Attitudes towards the use and acceptance of eHealth technologies: a case study of older adults living with chronic pain and implications for rural healthcare.
abstract: BACKGROUND
  Providing health services to an ageing population is challenging, and in rural areas even more so. It is expensive to provide high quality services to small populations who are widely dispersed; staff and patients are often required to travel considerable distances to access services, and the economic downturn has created a climate where delivery costs are under constant review. There is potential for technology to overcome some of these problems by decreasing or ceasing the need for patients and health professionals to travel to attend/deliver in-person appointments. A variety of eHealth initiatives (for example Pathways through Pain an online course aimed to aid self-help amongst those living with persistent pain) have been launched across the UK, but roll out remains at an early stage.
  
  
  METHODS
  This mixed-methods study of older adults with chronic pain examines attitudes towards, current use of and acceptance of the use of technology in healthcare. A survey (n = 168, 40% response rate) captured broad experiences of the use of technology in health and social care. Semi-structured interviews (four with technology and seven without technology participants) elicited attitudes towards technology in healthcare and explored attributes of personal and social interaction during home visits.
  
  
  RESULTS
  People suffering from chronic pain access healthcare in a variety of ways. eHealth technology use was most common amongst older adults who lived alone. There was broad acceptance of eHealth being used in future care of people with chronic pain, but older adults wanted eHealth to be delivered alongside existing in-person visits from health and social care professionals.
  
  
  CONCLUSIONS
  eHealth has the potential to overcome some traditional challenges of providing rural healthcare, however roll out needs to be gradual and begin by supplementing, not substituting, existing care and should be mindful of individual's circumstances, capability and preferences. Acceptance of technology may relate to existing levels of personal and social contact, and may be greater where technological help is not perceived to be replacing in-person care.
authors.affiliation: Social, Economic & Geographical Sciences, The James Hutton Institute, Craigiebuckler, Aberdeen, AB15 8QH, UK. margaret.currie@hutton.ac.uk.
authors.forename: Margaret
authors.initials: M
authors.lastname: Currie
authors.affiliation: Geography & Environment, School of Geosciences, University of Aberdeen, Elphinstone Road, Aberdeen, AB24 3UF, UK. l.philip@abdn.ac.uk.
authors.forename: Lorna J
authors.initials: LJ
authors.lastname: Philip
authors.affiliation: The Centre for Rural Health, University of Aberdeen, The Centre for Health Sciences, Aberdeen, IV2 3JH, UK. a.roberts@abdn.ac.uk.
authors.forename: Anne
authors.initials: A
authors.lastname: Roberts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001292:Attitude to Computers; D059350:Chronic Pain; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D017216:Telemedicine; D006113:United Kingdom