Factors influencing the adoption of home telecare by elderly or chronically ill people: a national survey

Aims and objectives. The primary aim is to provide insight into client characteristics and characteristics of home telecare contacts, which may influence the adoption of home telecare. Secondary aim is to examine the applicability of four perceived attributes in Rogers’ diffusion of innovations theory, which may influence the adoption: relative advantage, compatibility, complexity and observability. Background. Western countries face strongly increasing healthcare demands. At the same time, a growing nursing shortage exists. The use of home telecare may be instrumental in improving independence and safety and can provide support to older and chronically ill people, but a precondition for its uptake is that clients consider it as a useful and helpful technological tool. Design. A survey conducted among clients of seven home care organisations in the Netherlands connected to a home telecare system. Methods. In 2007, a postal questionnaire was distributed to 468 older or chronically ill clients: 254 responded (54%). The data were analysed by regression techniques, employing a theoretical model. Results. This study showed that clients’ perceived attributes – relative advantage, compatibility, complexity and observability – have a significant effect on adoption of home telecare explaining 61% of the variance. The chance of adoption is higher when a client already receives long‐term personal and/or nursing care, he/she lives alone and when there are fixed daily contacts via the home telecare system. The perception of possible benefits can still be enhanced. Conclusions. The concept of perceived attributes, derived from Rogers’ diffusion of innovation theory, has been useful to explain clients’ adoption of home telecare. Relevance to clinical practice. Home care organisations can best focus on clients already in care and people living alone, in offering home telecare. Nurses, who aim to enhance the client’s adoption of home telecare, have to take into account clients’ perceived attributes of such new technology.