Association of Technology-Related Skills and Self-Efficacy With Willingness to Participate in Heart Failure Telemonitoring: Cross-Sectional Observational Study

Abstract

Background: The adoption of telemonitoring in patients with heart failure (HF) is influenced by technology-related skills and self-efficacy, as well as psychological, clinical, and demographic factors. However, the relative importance of these factors with regard to willingness to use telemonitoring is insufficiently understood. Objectives: This cross-sectional observational study examines the extent to which technology-related skills and self-efficacy are related to willingness to participate in telemonitoring in patients with HF. Methods: Patients completed questionnaires during hospitalization. Associations of technological skills and self-efficacy with willingness to participate in telemonitoring (dichotomous and continuous scale) were examined using regression models. Mediation-moderation analyses were used to investigate the role of self-efficacy in the association of technological skills with willingness to participate. Results: This study recruited 61 patients admitted for decompensated HF (mean age 79.9, SD 9.5 years; 24 women). Higher levels of technological skills were associated with higher willingness to participate in telemonitoring (odds ratio [OR] 1.073 per scale unit, 95% CI 1.031-1.117). Technological self-efficacy and learnability were also related to willingness to participate (OR 1.141, 95% CI 1.039-1.252; OR 1.029, 95% CI 1.006-1.052) but did not mediate the association of technological skills with willingness to participate in telemonitoring. Psychological factors (anxiety, depressive symptoms, and perceived social support), age, and cognitive and physical functioning did not moderate the association of technological skills with willingness to participate in telemonitoring. Conclusions: Technological skills, self-efficacy, and learnability are interrelated factors that need to be considered in patients with HF who are eligible for telemonitoring. Future intervention studies that target these factors could increase patients' willingness and competence in using telemonitoring after admission for HF.