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Appears in Collections:Faculty of Social Sciences eTheses
Title: Challenges and possibilities in telecare: Realist evaluation of a Norwegian telecare project
Author(s): Berge, Mari S.
Supervisor(s): Bowes, Alison
McCabe, Louise
Keywords: Telecare
Realist evaluation
Health care innovation
Ambient assistive living
Issue Date: 7-Jun-2017
Publisher: University of Stirling
Abstract: This thesis reports from a telecare evaluation in a Norwegian municipality (2012-2016). The project was established to provide domestic results from a hitherto new field in the country to underpin future policy. This evaluation includes pre- and post-implementation data collection, which has been scarce in telecare. The methodological approach was realist evaluation that seeks to explore how telecare works, for whom, why and in which circumstances – or why it does not work. The research aimed to explore the hypothesis elicited from national policy documents: ‘If telecare is used, then people are enabled to remain safe in their own home for longer’. Various methods were used to gather data from multiple stakeholders as they have different knowledge about how the implementation developed. The methods in this evaluation included literature reviews, observations, and sequential interviews with users and relatives in addition to sequential focus groups with frontline staff. Realist evaluation was particularly suitable in demonstrating how and why telecare is useful to some users but not to others. Telecare had to match users’ abilities and needs for them to benefit from it. Telecare operates in a dynamic context, and therefore requires adjustment according to the user’s current situation, taking into account changes as they occur. This appears to have been often underestimated. Telecare holds a different position from other devices and technologies in people’s everyday life, which also needs to be acknowledged. Correct assessment is significant for users to obtain the intended effect from telecare. When telecare is correctly adjusted to users, it increases safety, which is essential for enabling older people to remain living at home. Several challenges in establishing telecare projects are identified and alternative ways to understand multi-disciplinary partnerships are suggested. By using realist evaluation the findings are nuanced and point to elements that are significant for achieving the intended outcomes.
Type: Thesis or Dissertation

Files in This Item:
File Description SizeFormat 
1- Berge 2017 Thesis Final Edition.pdfThesis2.47 MBAdobe PDFView/Open
2 - Berge 2016 How Do We Understand Partnership Working - Experiences from a Telecare Project.pdfPublication no 1122.41 kBAdobe PDFUnder Permanent Embargo    Request a copy
3 - Berge 2016 Telecare acceptance as sticky entrapment.pdfPublication no 2306.58 kBAdobe PDFView/Open
4- Opening the black box in telecare - Using Realist Evaluation methodology.pdfSubmitted publication - in review1.1 MBAdobe PDFUnder Permanent Embargo    Request a copy
5 -Berge 2017 Telecare - where. when. why and for.pdfPublication no 3261.44 kBAdobe PDFView/Open

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