Table 5.
Mapping of overarching themes and subthemes to the normalization process theory and the Implementation Outcomes framework by Proctor.
| Theme and subthemes | Quotes | Normalization process theory construct | Implementation Outcomes construct by Proctor | |
| Making sense of the purpose of TMa | Coherence | Appropriateness | ||
| “We were keeping a log book and it wasn’t consistent but we were still trying to do that...The NP would have me email her the sugar readings. So I would have to transpose all that information into an email... they would review it when we go visit them.” (MCCP0019) | ||||
| Engaging and investing in TM | Cognitive participation | Acceptability | ||
| Comparing the old ways of working to use TM | “We did] nothing. If we felt sick we’ll go to the doctor. We took blood pressure now and again, but not on a regular basis, not like this.” (MCCP0025) | |||
| Connected devices support individual capacity and gain investment for patient buy-in of TM practices | “I think it was we actually really liked that it was connected, because it gave me a peace of mind. At least I know, okay, if something goes wrong, there’s somebody there to call her. Someone is kind of checking on me.” (MCCP0026) | |||
| Accepting the technology | “Yes, it was easy. Yeah it does everything for you. You just have to turn the phone off and press the button the blood pressure cuff or step on the weight scale and it does everything.” (MCCP009) | |||
| Implementing and adopting TM | Collective action | Adoption | ||
| Adjusting routines around TM | “You get up, you put your housecoat on, you go to the bathroom, you get the scale out from under the sink.” (MCCP007) | |||
| Frequent clinical monitoring; reinforced routine adherence | “It’s good. It’s good to know that somebody is out here watching too not negatively. If they were watching to condemn me for what I’m doing – but they’re watching with my best interests.” (MCCP002) | |||
| The support of caregivers and caregiver participation | “Yeah, so it’s one hundred percent good to have help from family members.” (MCCP0019) | |||
| Evaluating perceived usefulness and perceived benefits of TM in CCCsb | Reflexive monitoring | Feasibility and fidelity | ||
| Improvement to ongoing self-care practices | “You don’t know whether it’s good or bad, but with Medley they give that guideline to live with – within” (MCCP002) | |||
| Enabling immediate action on abnormal readings and trends | “I know if the reading comes up in orange—that’s the orange. If it comes up in orange, check. If it gets worse during the course of the day check the clinic. And I know that feels good. I feel good. Yeah, I feel good, so that is very helpful, that is very, very helpful.” (MCCP002) | |||
| Concerns moving forward without TM | “Yeah. I like knowing someone’s keeping an eye on me. Certainly no one else will keep an eye on me now. [After I you mean?] Yes, there’s no one now...I just liked it, that’s all, knowing, they were there looking out for me.” (MCCP0024) | |||
| Symptom questions were not always relevant for patients with CCCs | “There were times [when it was] kind of like a grey area...She’s not always feeling great and you enter the information based on the prompts and some of those prompts alerted the nurse at the hospital and we would get a phone call. And sometimes to me they were kind of unwarranted... Was she dizzy? Well she feels dizzy a lot of times. She’s usually OK.” (MCCP0019’s caregiver) | |||
aTM: telemonitoring.
bCCC: complex chronic condition.