There is an ongoing implementation of digital health technology – so-called eHealth – in western healthcare, and it specifically targets rural areas and older people. eHealth is said to be a solution to emergent problems and a technology that will facilitate people’s opportunities to achieve good and equal health. Therefore, it is crucial that older people engage in rural eHealth services, but there are barriers to its use, and care providers need to adapt to the preferences of older people.
Previous research on rural eHealth has addressed benefits as well as barriers for patients. However, caring relations (e.g. the relationship between nurses and patients) and their effects have been scarcely explored. The aim of this article by Jens Lindberg, Robert Bhatt and Anton Ferm from Umeå University is to describe older people’s perceptions of caring relations in the context of rural eHealth, as well as to explore how such relations can facilitate engagement in digital primary healthcare. Qualitative interviews were conducted for the study with individuals aged 61-85 who were using digital services at primary healthcare centres located in northern Sweden.
The analysis of the interviews rendered a total of three themes:
- In-person interaction was central to people’s perceptions of good caring relations.
- Patient-nurse relations were particularly emphasized.
- Caring relations in rural eHealth appeared to be multi-directional and fuelled by a shared sense of rural community.
Altogether, this facilitated participants’ engagement in local eHealth initiatives, both initially and more long-term.
Based on the results of this study, eHealth remains a source of opportunity for primary healthcare and for rural communities. Importantly though, the results also provide insights into matters of quality, access and equality in rural primary healthcare, specifically in relation to older people. Because in-person relations are essential for older people’s engagement in digital care interventions, digital care should be approached as a combination of digital and in-person presence. Lack of physical and emotional presence, or the separation of digital and physical task assignments among different personnel, could make older people refrain from seeking healthcare. Thus, it is important for care staff to be able to be just as supportive when providing digital care. To be able to increase the quality and equality in healthcare and other welfare organisations, there is a need for professionals on different levels – political, managerial and practical – to recognise how engagements in e-based services are enabled not only by connectivity and digital innovation but different modes of presence by staff in everyday practice.