| 1. |
- Baudin, Katarina, et al.
(författare)
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Views of Swedish Elder Care Personnel on Ongoing Digital Transformation : Cross-Sectional Study
- 2020
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Ingår i: Journal of Medical Internet Research. - Toronto : JMIR Publications. - 1438-8871. ; 22:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Swedish municipalities are facing demographic challenges due to the growing number of older people and the resulting increased need for health care services. Welfare technologies are being launched as possible solutions for meeting some of these challenges.Objective: The aim of this study was to explore the perception, experimentation, evaluation, and procurement of welfare technology practices among professionals working in municipal elder care in relation to their gender, age, and profession.Methods: Data for this explorative cross-sectional study were collected from 393 responses to a web-based survey on municipal elder care in Sweden. Chi square tests were performed to determine the associations.Results: The results revealed gender, age, and professional differences in perspectives of municipal elder care workers. Differences were particularly evident in attitudes toward technology, both the use of technology in general and in the workplace, and involvement and participation in decision making regarding the procurement of new welfare technologies. Men (37/53, 70%) expressed a more positive attitude toward and curiosity regarding new technologies than women (157/336, 46.7%) (P=.03). Regarding age, the younger respondents (18-24 years old) perceived the digital transformation in the workplace as "too slow" (4/4, 100%), whereas the majority of older respondents (65-74 years old) perceived it as happening at the "right pace" (4/7, 57%). The elder care personnel felt encouraged by management to explore and experiment with new welfare technologies, but never did so either for management or with patients. Even though the majority of the respondents were women, more men (4/7, 57%) were involved in the procurement process for welfare technology devices and solutions than women (98/336, 29.2%) (P<.001).Conclusions: Personnel working within municipal elder care were generally very positive toward new technologies. However, both gender and age differences may influence these perspectives such as the personnel's resistance to welfare technology and patients' participation in welfare technology usage and deployment. Different levels of participation in the decision-making process regarding new technology deployment may negatively affect the overall digital transformation within municipal elder care.
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| 2. |
- Bonn, Stephanie Erika, et al.
(författare)
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How Valid are Web-Based Self-Reports of Weight?
- 2013
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Ingår i: Journal of Medical Internet Research. - : JMIR PUBLICATIONS, INC. - 1438-8871. ; 15:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many studies rely on self-reported anthropometric data. While paper-based self-reports have been the standard collection mode, the number of studies collecting self-reported data via the Web is increasing rapidly. Although numerous studies have shown good agreement between self-reported and measured weight using paper-based questionnaires, the validity of using the Web to inquire about weight is unknown. Objective: The objective of this study was to validate Web-based self-reports of bodyweight compared to weight measured at the study center. Methods: The validity of weight self-reported via the Web was assessed by comparing self-reports against measurements of weight in a convenience sample of 149 individuals (77.2% women, 115/149), aged 20-65 years. Study participants self-reported their weight via a Web-based questionnaire and thereafter had their weight measured in the research center. Results: The Spearman correlation coefficient between self-reported and measured weight was 0.98 (P<.001). The mean difference between self-reported and measured weight was -1.2 (SD 2.6) kg. There was a statistically significant difference between self-reported and measured weight with the self-reported being lower (P<.001). Subjects with a body mass index (BMI) >= 25 kg/m(2), and subjects >= 30 years of age, under-reported their weight statistically significantly more than subjects with a BMI <25 kg/m(2), and subjects <30 years of age, respectively. Conclusions: Our results show that self-reported weight via the Web can be a valid method of data collection.
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| 3. |
- 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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| 4. |
- Hansson, Kristian, et al.
(författare)
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Issues in Child and Adolescent Inpatient Assessment and Evaluation After Discharge : Protocol for App Development and a Randomized Controlled Trial
- 2018
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Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 7:11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: New methods are needed for collecting data of in- and outpatients and for improving outpatient compliance after discharge. Mobile technologies, such as smartphone apps, have shown promising results, (eg, helping unwell people by offering support and resources). Screening for the condition, including comorbidities, is a vital part of psychiatric care. Comorbid conditions, especially in emergency evaluation, are often missed, leading to inaccurate diagnosis and treatment. One way of improving diagnostic accuracy is to use a structured diagnostic process. Digitalized screening and follow-up have the advantage of making administration and scoring easier and less time consuming, thereby increasing response rate. To address these problems, we decided to create a smartphone app called The Blue App. The Blue App was developed through 6 steps, described in the manuscript. OBJECTIVE: The aim of this paper is to describe (1) the development of The Blue App and (2) 2 planned research studies to evaluate the app. METHODS: Two studies will be performed. Study 1 has a descriptive design, mapping comorbidities before and after the introduction of The Blue App. Study 2 has a randomized controlled design, measuring compliance with outpatient treatments as well as depressive symptoms, rated as changes in Montgomery-Asberg Depression Scale scores during a 1-year follow-up. RESULTS: We have described app development. Data collection for Study 1 started in autumn 2017. Study 2 will start in autumn 2018. We expect to have enrolled the 150 patients in Study 2 by December 2019. Final results will be published in a scientific journal. CONCLUSIONS: A technically advanced and easy-to-use Web-based mobile phone app corresponding to the unit's needs was developed, and 2 studies are planned to evaluate its usefulness. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/10121.
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| 5. |
- Persson, Johanna, et al.
(författare)
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Why are digital health care systems still poorly designed, and why is health care practice not asking for more? Three paths toward a sustainable digital work environment
- 2021
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 23:6
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Forskningsöversikt (refereegranskat)abstract
- Knowledge of how to design digital systems that are ergonomically sound, high in usability, and optimized for the user, context, and task has existed for some time. Despite this, there are still too many examples of new digital health care systems that are poorly designed and that could negatively affect both the work environment of health care staff and patient safety. This could be because of a gap between the theoretical knowledge of design and ergonomics and the practical implementation of this knowledge in procuring and developing digital health care systems. Furthermore, discussions of digitalization are often at a general level and risk neglecting the nature of direct interaction with the digital system. This is problematic since it is at this detailed level that work environment and patient safety issues materialize in practice. In this paper, we illustrate such issues with two scenarios concerned with contemporary electronic health care records, based on field studies in two health care settings. We argue that current methods and tools for designing and evaluating digital systems in health care must cater both to the holistic level and to the details of interaction and ergonomics. It must also be acknowledged that health care professionals are neither designers nor engineers, so expectations of them during the development of digital systems must be realistic. We suggest three paths toward a more sustainable digital work environment in health care: (1) better tools for evaluating the digital work environment in the field; (2) generic formulations of qualitative requirements related to usability and for adaptation to the user, context, and task, to be used in procurement; and (3) the introduction of digital ergonomics as an embracing concept capturing several of the ergonomic challenges (including physical, cognitive, and organizational aspects) involved in implementing and using digital systems.
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| 6. |
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| 7. |
- Thorén, Elisabet, et al.
(författare)
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Internet Access and Use in Adults With Hearing Loss
- 2013
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Ingår i: Journal of Medical Internet Research. - : Journal of Medical Internet Research / JMIR Publications, Inc.. - 1438-8871. ; 15:5, s. e91-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The future rehabilitation of adults with hearing loss is likely to involve online tools used by individuals at home. Online tools could also be useful for people who are not seeking professional help for their hearing problems. Hearing impairment is a disability that increases with age, and increased age is still associated with reduced use of the Internet. Therefore, to continue the research on online audiological rehabilitative tools for people with hearing loss, it is important to determine if and to what extent adults with hearing loss use the Internet.OBJECTIVE:To evaluate the use of the Internet and email in a group of adults with hearing loss and to investigate if their use of Internet and email differed between genders, among different age groups, and how it compared with the general population in Sweden.METHODS:Questionnaires containing multiple-choice questions about Internet access, email use, and educational level were mailed to individuals with hearing loss, who were registered as patients at a hearing aid clinic. Out of the 269 invited participants, 158 returned a completed questionnaire, which was a response rate of 58.7%.RESULTS:The results showed that 60% (94/158) of the participants with hearing loss used computers and the Internet. The degree of hearing loss in the group of participants did not explain the level of Internet usage, while factors of age, gender, and education did (P<.001). More men than women used the Internet (OR 2.54, 95% CI 1.32-4.91, P<.001). Use of the Internet was higher in the youngest age group (25-64 years) compared to the oldest age group (75-96 years, P=.001). A higher usage of the Internet was observed in the participants with hearing loss, especially the elderly, when compared with the general population of Sweden (OR 1.74, 95% CI 1.23-3.17, P=.04).CONCLUSIONS:We conclude that the use of computers and the Internet overall is at least at the same level for people with hearing loss as for the general age-matched population in Sweden, but that this use is even higher in specific age groups. These results are important for the future work in developing and evaluating rehabilitative educational online tools for adults with hearing loss.
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| 8. |
- Wetterholm, Madeleine, et al.
(författare)
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Validation of Two Automatic Blood Pressure Monitors With theAbility to Transfer Data via Bluetooth
- 2019
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 21:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with chronic diseases are in need of regular health controls. Diabetes mellitus type 2 is currently the mostprevalent chronic metabolic disease. A majority of diabetic patients have at least one comorbid chronic disease, where hypertensionis the most common. The standard for blood pressure (BP) measurement is manual BP monitoring at health care clinics.Nevertheless, several advantages of self-measured BP have been documented. With BP data transfer from an automatic BPmonitor via Bluetooth to software, for example, a smartphone app, home measurement could effectively be integrated into regularcare.Objective: The aim of this study was to validate two commercially available automatic BP monitors with the ability to transferBP data via Bluetooth (Beurer BM 85 and Andersson Lifesense BDR 2.0), against manual BP monitoring in patients with type2 diabetes.Methods: A total of 181 participants with type 2 diabetes were recruited from 6 primary care centers in Stockholm, Sweden.BP was first measured using a manual BP monitor and then measured using the two automatic BP monitors. The mean differencesbetween the automatic and manual measurements were calculated by subtracting the manual BP monitor measurement from theautomatic monitor measurement. Validity of the two automatic BP monitors was further assessed using Spearman rank correlationcoefficients and the Bland-Altman method.Results: In total, 180 participants, 119 men and 61 women, were included. The mean age was 60.1 (SD 11.4) years and themean body mass index was 30.4 (SD 5.4) kg/m2. The mean difference between the Beurer BM 85 and the manual BP monitorwas 11.1 (SD 11.2) mmHg for systolic blood pressure (SBP) and 8.0 (SD 8.1) mmHg for diastolic blood pressure (DBP). Themean difference between the Andersson Lifesense BDR 2.0 and the manual BP monitor was 3.2 (SD 10.8) mmHg for SBP and4.2 (SD 7.2) mmHg for DBP. The automatic BP measurements were significantly correlated (P<.001) with the manual BPmeasurement values (Andersson Lifesense BDR 2.0: r=0.78 for SBP and r=0.71 for DBP; Beurer BM 85: r=0.78 for SBP andr=0.69 for DBP).Conclusions: The two automatic BP monitors validated measure sufficiently accurate on a group level, with the AnderssonLifesense BDR 2.0 more often falling within the ranges for what is acceptable in clinical practice compared with the Beurer BM85.
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