“We are too old to learn new things”: - eHealth literacy and empowerment? A qualitative study of app testing among AMD patients

Introduction: Digital strategies in health care are seen as a solution to the demographic challenges with a growing older population and shortage of staff in the care sector. The interreg project NorDigHealth (2019-2021) sought to test several health-related technologies, seen from the perspective of patients and health professionals. A qualitative study of the testing of apps measuring AMD progression among older patients with the aim of home use, is presented here.
Material and methods: The empirical material consists of 18 interviews with and observations of AMD-patients in Denmark and Germany. Themes were inductively generated in a hermeneutical process, involving four researchers; two had produced the empirical material, and two were otherwise involved in NorDigHealth.
Results: Six interconnected themes were generated: Level of digital competences and access to equipment, General worries, Patients’ relatives, The importance of treatment and seeing the doctor, App functionality and user friendliness, Understanding of the apps and results.
Conclusions: Older patients with AMD had great challenges in using the apps and understanding the results of the tests, partly due to a low degree of digital health literacy, partly due to multimorbidity and general weakening. Shaking fingers, impaired memory, and worries to do things wrong formed hinderances for the use. However, patients tried to minimize their difficulties to seem competent. They expressed a strong need to see the doctor face-to-face. Several were dependent on relatives for helping with digital technologies. The technology did not provide empowerment for patients and the testing was closed.