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Table 4 Feasibility evaluation of distance interview method by participants and nurses

From: Evaluating the effectiveness and feasibility of nurse-led distant and face-to-face interviews programs for promoting behavioral change and disease management in patients with diabetic nephropathy: a triangulation approach

CategoriesDistance interview method
Development of trust relationship, engagement, and motivation for changeParticipants
- They understood the severity of their diseases and necessity of self-management, but they felt difficulties to see the methods of self-monitoring of blood pressure measurement and palpating edema by screen (without hand-on demonstration).
- They felt secure and firmly attached to the nurses and adequately guided.
- Delayed voice transmission and small screen hindered communication.
- Because of the small screen, one was not sure if the nurse understood him.
- Physical and facial expression technique (such as widely nodding the head, lowering voice tone, and consciously making interpose) were needed to clearly communicate.
- It was difficult to build a trust relationship without having direct eye contact and touching body parts such as foot care.
- One felt insecure in constraining the patient to behavior modification because she was not sure of the participant’s facial expression.
Participants in direct face-to-face interview method
- It was emotionally easy to communicate, and they felt very close to the nurses.
- They felt easy to understand the methods of self-monitoring because the nurses demonstrate directly to them.
- All nurses, except one, felt no differences in both groups in behavior modification as long as nurses followed motivation interview techniques.
- Physical contact in a direct face-to-face interview made better engagement and trust relationships.
Getting accurate information needed for health assessmentParticipants
- One felt unsure that the nurse understood his physical condition and facial expression.
- It was difficult to see the participants’ lab data sheets.
- It was difficult to grasp the whole body (overall impression) at a glance by a small screen.
- Visual inspection of the images without body palpation could not allow the nurses to assess the participants’ conditions.
Participants in direct face-to-face interview method
- It was easy to share detailed information.
Operability of the device for the distance interviewParticipants
- For tablet computer users, operating the tablet was not difficult, but for the first user or older user, it took time to get used to it. (An operation manual was useful, and the nurse explained before starting was helpful.)
- (Some had reduced visual acuity associated with aging and/or diabetic retinopathy, but no one had difficulty of watching the screen.)
- Clarity of images or sound depended on transmission condition of participants’ homes. Some participants had difficulties in using the device and needed to use additional devices such as earphones and bright lightning.
- It was difficult to teach the participants how to use it. However, nurses prepared an easy instruction and troubleshooting manual.
Privacy protectionParticipants in both groups
- Both felt protected (because the nurses explained to have an interview in a private room.)
Additional benefitsNurses
- Nurses were able to observe inside of participants’ houses. Participants were open to show their homes. Family members, such as a spouse and children, could easily join the meeting. Therefore, family members learned and shared the education.