Demand Analysis of Telenursing for Community-Dwelling Empty-Nest Elderly Based on the Kano Model

Background: In recent years, the increasing number of empty-nest elderly has become a significant global social problem, and the rapid development of medical technology and information technology has improved the feasibility of telenursing. However, few studies have been conducted on needs of telenursing among the empty-nest elderly. The aim of this study is to explore the needs of telenursing for community-dwelling empty-nest elderly who are completely independent in activities of daily living (ADL), or who are mildly disabled, and to provide a reference for improving the remote care quality. Methods: A questionnaire survey aiming to explore telenursing needs of the elderly was conducted among 268 community-dwelling empty-nest elderly who were selected using random sampling and then data were analyzed based on the Kano Model. Results: Chi-square goodness-of-fit test showed that there were significant differences between actual and expected counts for each item of telenursing needs ( p < 0.01 for all), indicating that the sample had specific individual preference for the Kano category. The desired degree of telenursing service ranged from 48.37% to 80.86%, the better values (satisfaction) were between 57.09% and 67.56%, and the worse values (dissatisfaction) were between 11.92% and 37.93%. The items, remote one-button emergency caller and remote emergency assistance arrangement, were considered to be one-dimensional qualities by empty nesters and the rest were attractive qualities. In the quadrant analysis diagram, all the remote care services were categorized as attractive qualities. Discussion: The community-dwelling empty-nest elderly with ADL independence or mild impairment have positive attitudes toward telenursing services, especially the needs of remote first aid nursing. Medical policy makers and nursing managers can provide targeted telenursing services according to empty nesters' requirements, thus improving nursing care quality and satisfaction of the elderly.