| 1. |
- Grünloh, Christiane, 1980-, et al.
(författare)
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"why do they need to check me?" patient participation through ehealth and the doctor-patient relationship : Qualitative study
- 2018
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Ingår i: Journal of Medical Internet Research. - : J M I R Publications, Inc.. - 1438-8871. ; 20:1
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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.
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| 2. |
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| 3. |
- Nordfeldt, Sam, et al.
(författare)
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As Facts and Chats Go Online, What Is Important for Adolescents with Type 1 Diabetes?
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 8:6
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Tidskriftsartikel (refereegranskat)abstract
- Background:Continued refinement of resources for patient information, education and support is needed. Considering the rapid development of new communication practices, the perspectives of young people themselves warrant more attention using a wide research focus. The purpose of this study was to understand information-seeking behaviours, Internet use and social networking online in adolescents with type 1 diabetes (T1DM). This applied to their everyday life, including the context of diabetes and their experiences and need of contact with T1DM peers.Methodology/Principal Findings:Twenty-four adolescents aged 10-17 years with T1DM were recruited from a county hospital in the south-east of Sweden. Qualitative data were obtained using eight focus groups, wherein each participant engaged in a 60-90 minute video/audio-recorded session. The focus group data were transcribed and analysed using qualitative content analysis. Some demographic and medical information was also collected. The three main categories that were identified; Aspects of Security, Updating, and Plainness and their sub-categories gave significant information about how to enhance information retrieval and peer contacts related to T1DM. Regarding the persons' information-seeking behaviour, Internet use, and use of social media some differences could be identified depending on gender and age.Conclusions/Significance:Sensitivity and adaptation to users' needs and expectations seem crucial in the development of future online resources for adolescents with T1DM. To start with, this could mean applying a wider range of already existing information and communication technologies. Health practitioners need to focus on the areas of security of information and communication, frequency of updating, and simplicity of design-less is more. © 2013 Nordfeldt et al.
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| 4. |
- Grünloh, Christiane, et al.
(författare)
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Using Critical Incidents in Workshops to Inform eHealth Design
- 2017
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Ingår i: Human-Computer Interaction - INTERACT 2017. - Cham : Springer. - 9783319677439 - 9783319677446 ; , s. 364-373
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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.
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| 5. |
- Gustavsson, Per M., 1965-, et al.
(författare)
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Machine Interpretable Representation of Commander's Intent
- 2008
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Ingår i: Proceedings of the 13th International Command and Control Research and Technology Symposium (13th ICCRTS).
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Konferensbidrag (refereegranskat)abstract
- The Network-Centric approach envisioned in the Global Information Grid enables the interconnection of systems in a dynamic and flexible architecture to support multi-lateral, civilian and military missions. Constantly changing environments require commanders to plan for missions that allow organizations from various nations and agencies to join or separate from the teams performing the missions, depending on the situation, as missions unfold. The uncertainty within an actual mission, and the variety of potential organizations that support the mission after it is underway, makes Command Intent (CI) a critical concept for the mission team. With new and innovative information technologies, CI can now be made available to the team of organizations in a coalition environment. Using a flexible and linguistically based approach for representing CI allows Intent to be interpreted and processed by all participants – both humans and machines. CI representations need to be able to express mission team’s purpose, the anticipated End-State of the mission and desired key tasks. In this work, the expression of CI is developed to enable the structure and dynamics of collaboration support.
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| 6. |
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| 7. |
- Berner, Jessica, et al.
(författare)
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Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden
- 2015
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Ingår i: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 21:3, s. 237-249
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Tidskriftsartikel (refereegranskat)abstract
- Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.
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| 8. |
- Rexhepi, Hanife, 1984-, et al.
(författare)
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Online electronic healthcare records : Comparing the views of cancer patients and others
- 2020
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Ingår i: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 26:4, s. 2915-2929
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates differences in attitudes towards, and experiences with, online electronic health records between cancer patients and patients with other conditions, highlighting what is characteristic to cancer patients. A national patient survey on online access to electronic health records was conducted, where cancer patients were compared with all other respondents. Overall, 2587 patients completed the survey (response rate 0.61%). A total of 347 respondents (13.4%) indicated that they suffered from cancer. Results showed that cancer patients are less likely than other patients to use online electronic health records due to general interest (p < 0.001), but more likely for getting an overview of their health history (p = 0.001) and to prepare for visits (p < 0.001). Moreover, cancer patients rate benefits of accessing their electronic health records online higher than other patients and see larger positive effects regarding improved communication with and involvement in healthcare.
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| 9. |
- Bäckström, Caroline, et al.
(författare)
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Expecting parents' perceptions of the digital parental support "childbirth journey" constructed as a serious game : an intervention study
- 2022
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Ingår i: Digital Health. - : Sage Publications. - 2055-2076. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore expecting parents’ perceptions of the Childbirth Journey as an intervention that includes medical information for parental support, constructed as a serious game.Methods: In this qualitative study, semi-structured interviews were held with expecting parents in Sweden who were able to talk about specific parts of the Childbirth Journey they appreciated or found difficult to understand. A phenomenographic methodology was employed for data analysis.Results: Participants perceived the Childbirth Journey to be easily accessible and customized with reliable information. The design and features of the intervention were perceived by the expecting parents to enhance the intervention’s usability, appeal, and trustworthiness. When parental couples used the Childbirth Journey together, it gave them an opportunity to discuss and better understand each other’s situation. The participants proposed several changes to the existing version of the game, mostly related to extending practical information and illustrated scenarios but also to the further development of the game’s design and animations. The participants found the Knowledge portal to be the most appealing part of the Childbirth Journey.Conclusions: The Childbirth Journey intervention was concluded to be a valuable digital complement to in-person profes- sional support, especially given the current COVID-19 pandemic restrictions in place in Sweden, which do not allow antenatal visits by partners. However, in its current form, the Childbirth Journey has some deficiencies and would therefore benefit from further development and exploration.
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| 10. |
- Kujala, Sari, et al.
(författare)
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Benchmarking usability of patient portals in Estonia, Finland, Norway, and Sweden
- 2024
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Ingår i: International Journal of Medical Informatics. - : Elsevier. - 1386-5056 .- 1872-8243. ; 181
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Poor usability is a barrier to widespread adoption of electronic health records (EHR). Providing good usability is especially challenging in the health care context, as there is a wide variety of patient users. Usability benchmarking is an approach for improving usability by evaluating and comparing the strength and weaknesses of systems. The main purpose of this study is to benchmark usability of patient portals across countries. METHODS: A mixed-methods survey approach was applied to benchmark the national patient portals offering patient access to EHR in Estonia, Finland, Norway, and Sweden. These Nordic countries have similar public healthcare systems, and they are pioneers in offering patients access to EHR for several years. In a survey of 29,334 patients, both patients' quantitative ratings of usability and their qualitative descriptions of very positive and very negative peak experiences of portal use were collected. RESULTS: The usability scores ranged from good to fair level of usability. The narratives of very positive and very negative experiences included the benefits of the patient portals and experienced usability issues. The regression analysis of results showed that very positive and negative experiences of patient portal use explain 19-35% of the variation of usability scores in the four countries. The percentage of patients who reported very positive or very negative experiences in each country was unrelated to the usability scores across countries. CONCLUSIONS: The survey approach could be used to evaluate usability with a wide variety of users and it supported learning from comparison across the countries. The combination of quantitative and qualitative data provided an approximation of the level of the perceived usability, and identified usability issues to be improved and useful features that patients appreciate. Further work is needed to improve the comparability of the varied samples across countries.
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