The experiences of using telehealth in older adults in Thailand : a mixed-methods study
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Objective: This study aimed to explore factors that influenced the intent to use telehealth and describe the experience of using telehealth among older adults in Thailand. Methods: An explanatory sequential mixed methods design was used to study a convenient sample of 105 participants from the seven communities located in the same district in Bangkok, Thailand. Quantitative data included the participants' characteristics, the adapted Technology Acceptance Model Questionnaire, and the eHealth Literacy Scale. Multiple regression was used to investigate the factors affecting the intention to use telehealth. Qualitative data were obtained from 7 individual interviews which were purposefully selected from the participants in quantitative phase and analyzed the data by using thematic analysis. Results: Mean age was 68.18 [plus or minus] 4.86 years. More than half of the participants were female (67.6 percent). Most participants received telehealth services from public hospitals and used telehealth services for home isolation during COVID-19 and for monitoring chronic diseases. Participants had a high level of perceived usefulness, ease of use, and intention to use, while they had low digital health literacy level. The results from multiple regression showed that the digital health literacy level was related to more ease of use ([beta]=0.23, t=4.26, p[less than]0.001); while the ease of use was related to more usefulness ([beta]=0.37, t=5.28, p[less than]0.001). Additionally, digital health literacy has a statistically significant influence on intention to use telehealth ([beta]=0.23, t=3.31, p=0.001), whereas the perceived usefulness and ease of use was not significant influence on intention to use. Seven themes emerged from the qualitative analysis: 1) experiences using telehealth; 2) perceived usefulness; 3) perceived ease of use; 4) social influence; 5) intention to use telehealth; 6) prefer in-person visits; and 7) concerns regarding using telehealth. Data integration was discussed to provide a deeper understanding of the quantitative results. Conclusion: This study found that digital health literacy was the main factor affecting the intention to use telehealth among older adults, however, they had low digital health literacy. Mobile-based telehealth intervention via phone calls and text messages is appropriate among this population. Additionally, educating on the benefits of telehealth could enhance knowledge and potentially enhance usage. Thus, these findings contribute to the literature on telehealth usage in older adults and the need for educational interventions for older adults in low-income settings in Thailand aimed to enhance accessibility of services and achieve optimal health outcomes.
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Ph. D.