Perspectives of Patients with Comorbidity on the Use of eHealth Technology for Self-Management at Kenyatta National Hospital

Perspectives of Patients with Comorbidity on the Use of eHealth Technology for Self-Management at Kenyatta National Hospital by Dorcas Waithira Maina MScN University of Nairobi, 2007 BScN, Moi University, 2002 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Public Health Walden University May 2019 Abstract Health care systems still focus on single disease management and ignore the complexities of multiple conditions management. Though self-management is the focus of chronic disease management, patients with comorbidities face challenges in meeting their selfmanagement goals. The purpose of this study was to explore the perspectives of patients with comorbid conditions on the use of eHealth technology to promote self-management.Health care systems still focus on single disease management and ignore the complexities of multiple conditions management. Though self-management is the focus of chronic disease management, patients with comorbidities face challenges in meeting their selfmanagement goals. The purpose of this study was to explore the perspectives of patients with comorbid conditions on the use of eHealth technology to promote self-management. The research was grounded on the technology acceptance model. I sought to explore the participants‘ understanding of self-management, the challenges to self-management and their perspectives on the use of eHealth for self-management. In this phenomenological study, 10 interviews were conducted from a purposeful sample of those with two or more comorbid conditions. The collected data were audio recorded and transcribed verbatim. Prolonged engagement, member checks, and triangulation were used to ensure trustworthiness. Self-reports and observation augmented the interviews. Data collection continued until saturation was reached, then analyzed iteratively and organized according to themes. The results showed that the participants managed their conditions at home by taking prescribed drugs, attending clinics, and following a special diet. However, they faced financial constraints, struggled with symptom control, and took too many drugs. The results also showed that technology could be used for people living with comorbidity as a source of information, to remind patients to take drugs or attend clinics, to increase awareness of symptoms, and to assist in the management of disease. This study is expected to help in understanding (a) the challenges faced by patients with comorbidities, and (b) how the use of technology promotes self-management in this growing group. Perspectives of Patients with Comorbidity on the Use of eHealth Technology for Self-Management at Kenyatta National Hospital by Dorcas Waithira Maina MScN, University of Nairobi, 2007 BScN, Moi University, 2002 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Public health-Epidemiology Walden University January 2019 Acknowledgments I am grateful to Dr. Egondu for guiding me throughout the process. I am also thankful to Dr. Connors for her continuous guidance in the dissertation process. I also acknowledge the roles played by Dr. Tammy Root as the research coordinator and Dr. Dr. Nancy Rea the program director. I am also grateful to my family for their support and patience.