Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 13, 2023
Date Accepted: Dec 19, 2023
The Patients Representations of Perceived Distance and Proximity to Telehealth: A Qualitative Study in France
ABSTRACT
Background:
Many health technologies, like telehealth, have emerged in recent years, suggesting several social benefits like a greater patient autonomy, an improved communication with physicians and an easier access to care. However, previous research has revealed disparities in acceptance and use of digital health tools. Yet no study has investigated patients’ representations of telehealth, despite their strong connection with attitudes.
Objective:
To provide a conceptual framework of patient’s social representations of perceived proximity and distance to telehealth.
Methods:
The present study has a qualitative design, using in-depth, individual interviews. A total of fourteen interviews were conducted between May and June 2022. In an inductive approach, discourses were analyzed using thematic analysis.
Results:
The two main opposed dimensions of “proximity” and “distance” emerged from interviews as a basic structure for understanding multiple social representations of telehealth. A semiotic square was built, providing a fruitful typology of four categories of contrasted representations of proximity with telehealth. Each category provides a coherent body of social representations explaining in what extent telehealth is perceived and accepted. Finally, due to the dynamic nature these representations, we highlighted two specific journeys of “proximity making process”, through which patients’ acceptance of telehealth may improve.
Conclusions:
This study shows how crucial it is to consider social representations of proximity and distance to better understand the drivers of acceptation (vs rejection) of telehealth. If reducing temporal distance to consultation and enhancing the proximity of access to care may be seen as efficient, telehealth can also be considered of as a destroyer of the human relationship between patient and physician, decreasing the essential relational proximity between them. The patient-oriented value turns out to be key in the future development of digital health tools.
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