Distributed Digital Care Work in Remote Patient Monitoring: A Qualitative Study of Older Adults with Multimorbidity, Family Caregivers and Clinicians in Indonesia
DOI:
https://doi.org/10.61919/jnanpe50Keywords:
multimorbidity; older adults; remote patient monitoring; digital care work; family caregivers; qualitative researchAbstract
Background: Remote patient monitoring is increasingly incorporated into chronic-disease care, but its usefulness for older adults with multimorbidity depends on the practical, cognitive, relational, and professional work required to generate, interpret, and respond to remotely collected information. How this work is distributed among patients, family caregivers, and clinicians remains insufficiently understood. Objective: To explore how older adults with multimorbidity, unpaid family caregivers, and clinicians experienced, organised, and negotiated digital care work associated with remote patient monitoring in Medan, Indonesia. Methods: A qualitative descriptive study with an interpretive orientation was conducted between January and May 2026. Twelve participants—six older adults, three family caregivers, and three clinicians—were purposively recruited using maximum-variation sampling. Semi-structured individual interviews were analysed using reflexive thematic analysis, with Normalisation Process Theory and burden of treatment theory used as sensitising perspectives after initial coding. Results: Six interrelated themes were developed: reassurance through data but not certainty; monitoring as an additional treatment regimen; caregivers as digital intermediaries and moral safety nets; clinical visibility constrained by workflow and fragmented responsibility; relational negotiation of autonomy, surveillance, and trust; and the need for adaptive, human-supported care. Monitoring was perceived as valuable when data were interpretable and connected to credible clinical responses, whereas rigid routines, hidden caregiver labour, technological problems, and unclear responsibility increased burden. Conclusion: Remote monitoring redistributed rather than eliminated care work. Person-centred implementation requires adaptable monitoring demands, negotiated caregiver involvement, clear clinical accountability, continuing human support, and accessible non-digital alternatives
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Copyright (c) 2026 Liu Zhanyuan, Linda Chiuman, Muhammad Faridz Syahrian (Author)
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