1.
2.
Grünloh, Christiane, 1980-, et al.
(författare)
"why do they need to check me?" patient participation through ehealth and the doctor-patient relationship : Qualitative study
2018
Ingår i: Journal of Medical Internet Research. - : J M I R Publications, Inc.. - 1438-8871. ; 20:1
Tidskriftsartikel (refereegranskat) abstract
Background: Roles in the doctor-patient relationship are changing and patient participation in health care is increasingly emphasized. Electronic health (eHealth) services such as patient accessible electronic health records (PAEHRs) have been implemented to support patient participation. Little is known about practical use of PAEHR and its effect on roles of doctors and patients. Objective: This qualitative study aimed to investigate how physicians view the idea of patient participation, in particular in relation to the PAEHR system. Hereby, the paper aims to contribute to a deeper understanding of physicians' constructions of PAEHR, roles in the doctor-patient relationship, and levels and limits of involvement. Methods: A total of 12 semistructured interviews were conducted with physicians in different fields. Interviews were transcribed, translated, and a theoretically informed thematic analysis was performed. Results: Two important aspects were identified that are related to the doctor-patient relationship: roles and involvement. The physicians viewed their role as being the ones to take on the responsibility, determining treatment options, and to be someone who should be trusted. In relation to the patient's role, lack of skills (technical or regarding medical jargon), motives to read, and patients' characteristics were aspects identified in the interviews. Patients were often referred to as static entities disregarding their potential to develop skills and knowledge over time. Involvement captures aspects that support or hinder patients to take an active role in their care. Conclusions: Literature of at least two decades suggests an overall agreement that the paternalistic approach in health care is inappropriate, and a collaborative process with patients should be adopted. Although the physicians in this study stated that they, in principle, were in favor of patient participation, the analysis found little support in their descriptions of their daily practice that participation is actualized. As seen from the results, paternalistic practices are still present, even if professionals might not be aware of this. This can create a conflict between patients who strive to become more informed and their questions being interpreted as signs of critique and mistrust toward the physician. We thus believe that the full potential of PAEHRs is not reached yet and argue that the concept of patient empowerment is problematic as it triggers an interpretation of "power" in health care as a zero-sum, which is not helpful for the maintenance of the relationship between the actors. Patient involvement is often discussed merely in relation to decision making; however, this study emphasizes the need to include also sensemaking and learning activities. This would provide an alternative understanding of patients asking questions, not in terms of "monitoring the doctor" but to make sense of the situation.
3.
Monstad, Therese, 1973-, et al.
(författare)
The Communicative Constitution of Organizations in an Era of Re-materialization : A Case Study of Three Organizations
2024. - 1 uppl
Ingår i: Organizational Communication in the Digital Era. - Cham : Springer Nature. - 9783031583063 - 9783031583070 ; , s. 253-272
Bokkapitel (refereegranskat) abstract
This chapter discusses the challenges and opportunities of digital transformation from the perspective of three organizations based on continuous interview and observation data gathered between late 2018 and the end of 2020. The purpose of such a discussion is to understand the importance of spatial co-existence and the significance of spatiality for meaningful organizational interaction. In other words—what happens to organizational members and the constitution, preservation and development of organizations, when the activity of “work” becomes detached from space? Of course, space or location matters more for some than others. For a telemarketer, space might be entirely insignificant, while for the priest and church-goer or the actor and theater-goer, the act of “going” somewhere to experience something is as important as what happens at the location, making the church and stage places that in themselves carry significance. This importance is represented in how churches and theater buildings often are majestic architectural achievements similar to other institutions of cultural, societal or financial importance that are housed in impressive locations such as banks, governments, court houses and universities.To discuss these questions, we draw on theories and perspectives of the communicative constitution of organizations (CCO) (e.g., Brummans et. al., 2014; Cooren, 2006; Putnam & Nicotera, 2009; Schoeneborn et al., 2018; Taylor & Van Every, 2000), and present a Sweden-based multisite case study (Ekström et al., 2021) of digital transformation consisting of three organizations whose common trait is that their core activities have historically speaking been dependent on either a physical location, physical spaces or face-to-face meetings. The three organizations in question are a major European financial institute, a church organization and a city theater—all institutions of traditional architectural and societal importance. As our relationship with these organizations deepened over the course of the pandemic, it allowed us as researchers to glimpse how digitalization has affected each one over time, and how each organization’s perspective of the challenges and opportunities of digitalization shifted and evolved before and throughout the pandemic.
4.
Eriksson, Darek M., et al.
(författare)
A framework for the modelling of tempo-spatial enterprise
2007
Ingår i: International Journal of Applied Systemic Studies. - 1751-0589 .- 1751-0597. ; 1:3, s. 231-247
Tidskriftsartikel (refereegranskat) abstract
A framework for the modelling of enterprise operations is presented, aiming at enabling a conception of enterprise operations in three explicitly aligned perspectives: its what, or morphology; its when, or temporal position; its where, or spatial position. It is derived from the precepts of a General Systems Theory and its General Process Theory. The practical and empirical benefit of this framework is indicated by a real-life case, a so-called 'Transatlantic Shopping Process', where the models constructed enable management of complexities emerging from enterprise operations.
5.
Eriksson, Darek M., et al.
(författare)
Organization information system : extending organizational cognition through intelligent artifacts
1996
Ingår i: Cybernetics and systems. - : Informa UK Limited. - 0196-9722 .- 1087-6553. ; 27:3, s. 235-264
Tidskriftsartikel (refereegranskat) abstract
The question of investigation is, What can intelligent artifacts mean to a command system? By means of a theoretical synthesis of previous works, the present work starts with an epistemological discussion focused on systems thinking. With the organization in focus, an extrospective approach is taken in which a global discussion results in some implications for the organizational system design. This system is considered as a sociotechnological system; consequently, the nature of systems (i.e., complexity) and the nature of human beings (i.e., parts of the systems and who are to be served by the artifacts) are discussed. The result argues that intelligent artifacts can extend the intelligent behavior of organizations. Examples of computer system architecture and software architecture are given.
6.
Asai, Ryoko
(författare)
Social Media Supporting Democratic Dialogue
2013
Ingår i: Ambiguous Technologies. - Lisbon : Autónoma University. ; , s. 36-43
Konferensbidrag (refereegranskat) abstract
The term of “social media” appears in newspapers and magazines everyday and the huge number of people use social media actively in daily life. Nowadays, in the highly Information and Communication Technology (ICT) developed country Japan, Japanese people enroll in social media and evolve a new way of communicating with others based on the “virtual” social distance between them. Among social media, Twitter has been focusing on its strong power as the tool for political change recent years. While Twitter has of-expressed problems as well as the “traditional” social media, it is characterized by the limited number of characters, strong propagation and optional reciprocity. Those characteristics stimulate people’s communication online and bring about opportunities for social interaction and democratic dialogue. On the other hand, in the deluge of information, we need to nurture skills to utilize critical and rational way of thinking through dialogue not only between others also between themselves internally. This study explores characteristics of social media and differences between “traditional” social media and Twitter, and how the difference affects people’s information behavior in Japan.
7.
Grünloh, Christiane, et al.
(författare)
Using Critical Incidents in Workshops to Inform eHealth Design
2017
Ingår i: Human-Computer Interaction - INTERACT 2017. - Cham : Springer. - 9783319677439 - 9783319677446 ; , s. 364-373
Konferensbidrag (refereegranskat) abstract
Demands for technological solutions to address the variety of problems in healthcare have increased. The design of eHealth is challenging due to e.g. the complexity of the domain and the multitude of stakeholders involved. We describe a workshop method based on Critical Incidents that can be used to reflect on, and critically analyze, different experiences and practices in healthcare. We propose the workshop format, which was used during a conference and found very helpful by the participants to identify possible implications for eHealth design, that can be applied in future projects. This new format shows promise to evaluate eHealth designs, to learn from patients’ real stories and case studies through retrospective meta-analyses, and to inform design through joint reflection of understandings about users’ needs and issues for designers.
8.
Huvila, Isto, Professor, 1976-, et al.
(författare)
Differences in Health Information Literacy Competencies Among Older Adults, Elderly and Younger Citizens
2019
Ingår i: Information Literacy in Everyday Life. - Cham : Springer. - 9783030134716 - 9783030134723 ; , s. 136-143
Bokkapitel (refereegranskat) abstract
To address the research gap on age-based differences in health information literacy (HIL), we investigated how younger (born 1960–) and older adults (1946–1960), and elderly citizens (–1945) differed from each other by their HIL competencies. Data were collected with an online survey of patients using the Swedish national electronic health record system. Altogether, 2,587 users responded. One-way ANOVA with post hoc tests revealed several differences between the groups: younger adults were less likely to value health information than older adults; older adults and elderly were least likely to compare information from multiple sources and had trouble in determining health information needs; older adults were most likely to have trouble understanding health terminology and the elderly to have difficulties in understanding medicinal package labels. The study shows that HIL is not necessarily improving or declining but adapting to challenges of advanced age. © 2019, Springer Nature Switzerland AG.
9.
Rexhepi, Hanife, et al.
(författare)
Do you want to receive bad news through your patient accessible electronic health record? : A national survey on receiving bad news in an era of digital health
2020
Ingår i: Proceedings of the 18th International Symposium for Health Information Management Research. - Kalmar : Linnaeus University, University of Sheffield. - 9789189081093 ; , s. 169-178
Konferensbidrag (refereegranskat) abstract
Despite the fact that patient accessible electronic health records (PAEHRs) have been around for many years in several countries, there is a lack of research investigating patient preferences for receiving bad news, including through PAEHRs. Little is also known about the characteristics of the patients who prefer to receive bad news through the PAEHR in terms of e.g. medical diagnosis, age and educational level. This study, based on a national patient survey in Sweden (N=2587), investigated this. Results show that, generally, receiving bad news by reading in the PAEHR is still among the least preferred options. Additionally, a higher proportion of men want to receive bad news in the PAEHR compared to women (p=0.001), and the same goes for those who are not working/have worked in healthcare (p=0.007). An effect of disease groups was also found, showing that diabetes patients in particular, want to receive bad news through the PAEHR.
10.
Huvila, Isto, Professor, 1976-, et al.
(författare)
Technological and informational frames : explaining age-related variation in the use of patient accessible electronic health records as technology and information
2021
Ingår i: Information Technology and People. - : Emerald. - 0959-3845 .- 1758-5813.
Tidskriftsartikel (refereegranskat) abstract
Purpose Data from a national patient survey (N = 1,155) of the Swedish PAEHR "Journalen" users were analysed, and an extended version of the theory of technological frames was developed to explain the variation in the technological and informational framing of information technologies found in the data.Design/methodology/approach Patient Accessible Electronic Health Records (PAEHRs) are implemented globally to address challenges with an ageing population. However, firstly, little is known about age-related variation in PAEHR use, and secondly, user perceptions of the PAEHR technology and the health record information and how the technology and information-related perceptions are linked to each other. The purpose of this study is to investigate these two under-studied aspects of PAEHRs and propose a framework based on the theory of technological frames to support studying the second aspect, i.e. the interplay of information and technology-related perceptions.Findings The results suggest that younger respondents were more likely to be interested in PAEHR contents for general interest. However, they did not value online access to the information as high as older ones. Older respondents were instead inclined to use medical records information to understand their health condition, prepare for visits, become involved in their own healthcare and think that technology has a much potential. Moreover, the oldest respondents were more likely to consider the information in PAEHRs useful and aimed for them but to experience the technology as inherently difficult to use.Research limitations/implications The sample excludes non-users and is not a representative sample of the population of Sweden. However, although the data contain an unknown bias, there are no specific reasons to believe that it would differently affect the survey’s age groups.Practical implications Age should be taken into account as a key factor that influences perceptions of the usefulness of PAEHRs. It is also crucial to consider separately patients’ views of PAEHRs as a technology and of the information contained in the EHR when developing and evaluating existing and future systems and information provision for patients.Social implications This study contributes to bridging the gap between information behaviour and systems design research by showing how the theory of technological frames complemented with parallel informational frames to provide a potentially powerful framework for elucidating distinct conceptualisations of (information) technologies and the information they mediate. The empirical findings show how information and information technology needs relating to PAEHRs vary according to age. In contrast to the assumptions in much of the earlier work, they need to be addressed separately.Originality/value Few earlier studies focus on (1) age-related variation in PAEHR use and (2) user perceptions of the PAEHR technology and the health record information and how the technology and information-related perceptions are linked to each other.
