Navigating change for occupational wellbeing: Pediatricians' perspectives on tele-homecare integration in an Italian pediatric hospital

Background: Telemedicine holds the promise of reshaping conventional medicine, offering a more sustainable practice for healthcare systems and patients. However, the implementation process entails changes in healthcare professionals’ knowledge, skills and working practices, potentially undermining their occupational wellbeing. Under a project assessing the economic, organizational, and psychological impact of a telehomecare service in an Italian pediatric hospital, this study was conducted to investigate pediatricians' expectations regarding benefits, concerns, and changes associated with the integration of telehomecare into their practice. Methods: All pediatricians involved in the study (N=13) participated in semi-structured interviews. Data were analysed using thematic analysis. Findings: Although participants anticipated numerous benefits in patients' experiences and healthcare structures, they expressed concerns about the risk of losing key clinical information and potential difficulties for parents in using the device correctly. Anticipated changes in their working practice included a potential increase in workload and the need for adequate spaces and resources. Furthermore, participants expected alterations in their relationships with patients and parents, recognizing the relevance of personal characteristics, such as the ability to engage patients and parents. Discussion: By identifying how pediatricians preconceived the adoption of telehomecare in their working practice, this study contributes to telemedicine literature and provides valuable insights into designing programs to assist clinicians in managing the changes related to the adoption of telehomecare service. As change is widely recognized as a potential source of work-related stress, providing effective support to pediatricians is crucial to sustain their occupational health and ensuring the successful integration of telemedicine.