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A sense of belonging: A meta-ethnography of the experience of patients with chronic obstructive pulmonary disease receiving care through telemedicine.

AIM
To synthesise the qualitative research in the literature addressing how patients with COPD experience care received by telemedicine.


DESIGN
Meta-ethnography.


DATA SOURCES
Twelve studies, published from 2013 - 2018, were identified by a search of relevant systematic databases in June 2017, including updated searches performed to June 2018.


REVIEW METHODS
The studies were reviewed and critically appraised independently by three researchers. The review followed the seven steps of meta-ethnography developed by Noblit and Hare, including a line-of-argument synthesis.


RESULTS
The synthesis revealed three second-order constructs: presence, transparency and ambivalence. Using a line-of-argument synthesis, a model was developed that showed patients' experience of a sense of belonging when receiving care by telemedicine.


CONCLUSION
This meta-ethnography contributes to the existing and contradictory evidence base of telemedicine to COPD patients. It addresses and adds renewed understanding of who would benefit from TM and why, by illustrating the interrelationship between the conditions of telemedicine care, the severity of COPD and the need for connectedness and emphasises that the need to belong in telemedicine care increases with the progression of illness burden and severity.


IMPACT
The present study endorses the view that the patients with a severe illness burden are likely to benefit the most when receiving care by telemedicine. However, the benefits rely on the fact that the telemedicine interventions involve emotional, social and clinical support, including regular contact with health care professionals, to meet the requirements to belong. This article is protected by copyright. All rights reserved.