Technology, home health care, and heart failure: a qualitative analysis with multiple stakeholders
Technology, home health care, and heart failure: a qualitative analysis with multiple stakeholders
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技术、家庭医疗保健和心力衰竭：与多个利益相关者的定性分析
DOI：
10.1145/3314344.3332487
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Nicola Dell
中科院分区：
文献类型：
--
作者：
F. Okeke;Emily Tseng;Benedetta Piantella;Mikaela Brown;H. Kaur;M. Sterling;Nicola Dell
家庭健康助理（HHA）越来越多地被心力衰竭成人用于长期援助和住院后护理。尽管大量参与心力衰竭管理的许多方面，但大多数HHA没有接受过心力衰竭培训。当他们有临床问题时，他们也很难与监督护士或护理团队的其他成员取得联系，这可能导致不必要的急诊室就诊。此外，尽管HHA是患者卫生系统的骨干，但他们大多是妇女和少数民族，是一线护理人员中的边缘化和弱势群体，长期就业不稳定，工资低，歧视和高度倦怠。虽然数字技术可以帮助解决HHA面临的许多挑战，但人们对技术对HHA工作实践的影响知之甚少。为此，我们在纽约市进行了一项多利益相关者的定性研究，38名参与者使用半结构化访谈和焦点小组。我们揭示了技术的使用方式，支持心力衰竭护理的复杂社会技术因素，以及利益相关者对技术如何改善HHA工作的建议。基于这些见解，我们为有兴趣开发工具的研究人员和设计人员综合了设计机会，这些工具支持为患有危及生命的疾病（如心力衰竭）的患者提供家庭医疗保健。
Home health aides (HHAs) increasingly being used by adults with heart failure for long-term assistance and post-hospitalization care. Despite being heavily involved in numerous aspects of heart failure management, most HHAs have not received heart failure training. They also struggle to get in touch with supervising nurses or other members of the care team when they have clinical questions, which may result in unnecessary visits to the emergency room. In addition, despite serving as a backbone in the health system for patients, HHAs, who are mostly women and minorities, are a marginalized and vulnerable group of frontline caregivers, enduring erratic employment, low wages, discrimination, and high levels of burnout. Although digital technologies could help to address many of the challenges HHAs face, little is known about the current impact of technology on HHAs work practices. To this end, we conducted a multi-stakeholder qualitative study with 38 participants in New York City using semi-structured interviews and focus groups. We uncover the ways in which technology is used, the complex socio-technical factors that underpin heart failure care, and stakeholder suggestions for how technology could improve HHAs work. Building on these insights, we synthesize design opportunities for researchers and designers interested in developing tools that support the delivery of home health care for patients suffering from life-threatening diseases like heart failure.