| 1. |
- Erlingsdottir, Gudbjörg, et al.
(författare)
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eHealth services, patient empowerment and professional accountability - An empirical study on the changing patient-doctor relationship in the digital world
- 2014
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Ingår i: ; , s. 1-21
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Konferensbidrag (refereegranskat)abstract
- In Sweden, as in many other European countries, government and public agencies have promoted the expansion of eHealth over the past years, arguing that this development enhances patient participation, empowerment and cost efficiency. The development is part of a more comprehensive movement, emphasizing patient’s rights including options to make far reaching decisions concerning the patient’s own care and treatment. This study focuses on the deployment of one such eHealth service – the patients’ digital access to their own medical records over the Internet. The use of electronic patient records (EPRs) is reported as being one of the most important services within the development of eHealth services and constitute a prominent part of the movement towards computerization in healthcare overall. In November 2012, the eHealth service “My medical record on the internet” was introduced in Uppsala County Council and the same civic service was introduced in another Swedish county council, Region Skåne, in March 2014. Both launches have caused resistance and, in some cases, strong negative reactions among many of the medical professionals. Simultaneously, the actions of the medical professionals have been discussed as well as criticized by other actors participating in the development process.
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| 2. |
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| 3. |
- Sahlin Åkerstedt, Ulrika, et al.
(författare)
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On threats and violence for staff and patient accessible electronic health records
- 2018
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Ingår i: Cogent Psychology. - : Cogent OA. - 2331-1908. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Does patient accessible electronic health records (PAEHR) result in increased risk of threats and violence? This study was conducted one year after launching PAEHR in Uppsala to examine whether staff whose patients had gained access to the patient portal perceived greater risks of threats and violence, and were exposed to more threats and violence, than those whose patients had not yet gained access. A total of 174 (35%) professionals responded to a web survey. 83 were from the emergency department, whose patients had online electronic health record access, and 91 were from the psychiatric department, whose patients had not. 40% of all participating professionals believed that risks of threats and violence increase after launch. The results did not support a correlation with more incidents of threats and violence, and only one respondent reported that patient access had played any significant negative role in relation to an incident.
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| 4. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Is Access to eHealth Records Important for Patients? : Opinions of Healthcare Personnel
- 2015
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Ingår i: MedInfo 2015. - Amsterdam, Netherlands : IOS Press. - 9781614995647 - 9781614995630 ; , s. 908-908
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Konferensbidrag (refereegranskat)abstract
- Sweden has had significant progress with the the introduction of electronic health records. A pilot county deployed in an eHealth service in 2012, giving access to health records for all of its patients. This eHealth service is, however, a controversial issue. Two surveys were conducted to discover whether healthcare professionals' opinions differ between professionals, and between staff who have had experience with patients using eHealth records and those, to date, who have had none. Experienced nurses found this eHealth service more important for the patients compared to unexperienced nurses outside the pilot county, as well as both semi-experienced physicians.
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| 5. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Is 'patient's online access to health records' a good reform? : Opinions from Swedish healthcare professionals differ
- 2015
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Ingår i: Conference On Enterprise Information Systems/International Conference On Project Management/Conference On Health And Social Care Information Systems And Technologies, Centeris/Projman / Hcist 2015. - Amsterdam, Netherlands : Elsevier BV. ; 64, s. 964-968
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Konferensbidrag (refereegranskat)abstract
- Patients' access to their own electronic health record is a controversial issue. Many care professionals are concerned about negative effects deriving from patients reading their record information without support from clinicians. Patients on the other hand often think their concerns are outweighed by the benefits. In Sweden a pilot county has provided the health record online to its 350 000 patients for 2.5 years. This study highlights one of the most important questions to handle before and during implementation of such public eHealth services; the opinions of the care professionals regarding online records as a good reform. Results from three questionnaires to various care professions show that opinions from healthcare professionals differ not only between the professions but more importantly also between those who have experience from their patients reading their health record online and those who to date have no real experience. The experienced staff was more positive. This study concludes that in order to provide for successful national implementation, it is important to quickly elicit and disseminate opinions of care professionals with real experience to their unexperienced peers. Healthcare professionals should also be more involved in the implementation of Public eHealth services that regard electronic health records and their work processes.
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| 6. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Patient Accessible EHR is Controversial : Lack of Knowledge and Diverse Perceptions Among Professions
- 2017
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Ingår i: International Journal of Reliable and Quality E-Healthcare. - : IGI Global. - 2160-9551 .- 2160-956X. ; 6:1, s. 29-46
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, a national eHealth service providing Patient Accessible Electronic Health Records is now being widely deployed, with 400 000 users in January 2016. Although the Patient Data Act states that patients have a right to take part of their health records, the introduction has been controversial. Results from a pre-deployment questionnaire to record-keeping care professions in a healthcare region indicate that perceptions and knowledge differ not only between the professions but, more importantly, that knowledge about current eHealth development and action plans needs to increase as implementation will affect their work processes. Staff perceptions and knowledge are considered being some of the most important issues to handle during the implementation of eHealth services aiming to provide healthcare information and communication tools for patients and relatives. To cover the gaps, specific training is needed, and all record-keeping professionals need to be more involved in the implementation of such eHealth services.
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| 7. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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Registered nurses’ opinions of Patient Access to Electronic Health Records in Sweden – a Nationwide Survey
- 2014
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Ingår i: Medicine 2.0'14 congress.
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Konferensbidrag (refereegranskat)abstract
- BACKGROUND: Providing patients online access to their electronic health records (EHR) holds considerable potential to improve care. As a Swedish pilot project, the County Council of Uppsala carries out an EU deployment project, which gives the 350 000 citizens access to their EHR through a national healthcare portal. This pilot project started in 2012 and when it ends in December 2014, the majority of the Swedish county councils are expected to follow the example of providing patients access to health data. Therefore it is of great importance to capture care professionals’, patients and other stakeholders’ opinions about such public eHealth services. The survey presented here is part of a large research project (DOME) on the Deployment of Online Medical records and other eHealth services in Sweden. The overall objective is to disseminate knowledge about adoption and use of public eHealth services aiming at benefits for both patients and healthcare. OBJECTIVE: The objective of this study is to investigate different professionals’ experiences from and opinions about patients having access to their EHRs online. What are the opinions today? Do the opinions differ between different care professionals? Do experiences from the pilot county result in other opinions compared to the regions where the public eHealth services are not yet implemented? METHOD AND MATERIALS: In this survey the respondents are members of Vårdförbundet (the Swedish Association of Health Professionals), the trade union and professional organization of four registered professions; nurses, midwives, biomedical scientists and radiographers. The survey is currently ongoing and during the first week of March, 6300 registered nurses (RN) and midwives throughout Sweden got the questionnaire via their professional email addresses. The questionnaire was constructed from questions used in a pilot study that tested them for reliability (Cronbachs´s-α) and validity (content-validity and face validity). It consisted of eight background questions and five blocks of statements where the magnitudes of agreement were given by answering to a five-graded Likert scale from “not at all”-agreement to “great extent”-agreement”. In the end of each block there was an open question where the respondents could write their experiences or opinions in free text.EXPECTED RESULT: Other studies in DOME have shown that the opinions differ between the professionals and other stakeholders (patients, relatives, managers and politicians). Especially physicians in the county council where the pilot project is taking place have been reluctant to this change and the local union even tried to stop the deployment project. Present study will result in knowledge about the opinions and experiences of other care professionals, in this case RNs and midwives.EXPECTED CONCLUSION: One of the main arguments that physicians had against the eHealth service, before it was launched, was that the EHRs are to be seen primarily as working documents for the healthcare professionals and that patients would not understand them and thus not benefit from reading them on their own. Here is the possibility to evaluate Uppsala healthcare professionals’ opinions after working a year with the new system and analyze current attitudes in the rest of Sweden. Yet to come; the results of this survey are expected to conclude the differences between both professions and regions, which can have implications for the healthcare provided.
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| 8. |
- Ålander, Ture, et al.
(författare)
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Abuse in Women and Men with and without Functional Gastrointestinal Disorders
- 2008
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Ingår i: Digestive Diseases and Sciences. - : Springer Science and Business Media LLC. - 0163-2116 .- 1573-2568. ; 53:7, s. 1856-1864
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to investigate the history of abuse in childhood and adulthood and health-related quality of life (HRQL) in women and men with FGID in the general adult population. A cross-sectional study in a random population sample (n = 1,537, 20-87 years) living in Osthammar municipality, Sweden, in 1995 was performed. Persons with FGID (n = 141) and a group of abdominal symptom-free controls (SSF, n = 97) were selected by means of a validated questionnaire assessing gastrointestinal symptoms (the ASQ). Abuse, anxiety and depression (the HADS) and HRQL (the PGWB) were measured. Women with FGID had a higher risk of having a history of some kind of abuse, as compared with the SSF controls (45% vs.16%, OR = 2.0, 95% CI: 1.01-3.9; SSF = 1), in contrast to men (29% vs. 24% n.s.). Women with a history of abuse and FGID had reduced HRQL 91 (95% CI 85-97) as compared with women without abuse history 100 (95% CI 96-104, P = 0.01, "healthy" = 102-105 on PGWB). Childhood emotional abuse was a predictor for consulting with OR = 4.20 (95% CI: 1.12-15.7.7). Thus, previous abuse is common in women with FGID and must be considered by the physician for diagnosis and treatment of the disorder.
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| 9. |
- Ålander, Ture, et al.
(författare)
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Experiences of Healthcare Professionals to the Introduction in Sweden of a Public eHealth Service : Patients' Online Access to their Electronic Health Records
- 2015
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Ingår i: Studies in Health Technology and Informatics. - Amsterdam, Netherlands : IOS Press. - 0926-9630 .- 1879-8365. ; 216, s. 153-157, s. 153-157
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Tidskriftsartikel (refereegranskat)abstract
- Patients' increasing demands for medical information, the digitization of health records and the fast spread of Internet access form a basis of introducing new eHealth services. An international trend is to provide access for patients to health information of various kind. In Sweden, access by patients to their proper electronic health record (EHR) has been provided in a pilot county since November 2012. This eHealth service is controversial and criticism has arised from the clinical professions, mainly physicians. Two web surveys were conducted to discover whether the opinions of healthcare professionals differ; between staff that have had experience with patients accessing their own EHR and those who have no such expericence. Experienced nurses found the EHR more important for the patients and a better reform, compared to unexperienced nurses in the rest of the country. Similarly, physicians with their own experience had a more positive attitude compared to non-experienced physicians. The conclusion of this study is that healthcare professionals must be involved in the implementation of public eHealth services such as EHRs and that real experiences of the professionals should be better disseminated to their inexperienced peers.
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| 10. |
- Ålander, Ture
(författare)
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Functional gastrointestinal disorders : co-morbidity and non-somatic aspects
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims of the thesis: The first aim, (Study I) of this thesis was to compare co-morbidity of the reported symptoms and its relation to healthcare seeking behaviour among non-patients who had persistent functional gastro-intestinal disorders (FGID) or who were strictly GI symptom free (SSF). The second aim (study II) was to compare FGID sufferers primary health care consumption, as registered in their medical records. The third aim (study III) was to investigate the occurrence of a history of abuse, and the possible association with consultation rate, and the fourth aim (study IV) was to investigate the possible influence of a negative parental rearing experienced during childhood. Methods: The Abdominal symptom questionnaire (ASQ) was mailed to a random sample of 1537 adults aged 20-87 years from the municipality of Östhammar, Sweden (n= 21,545 in 1995). From the obtained response and by integrating results from previous studies performed in 1988 and 1989, 244 subjects with FGID (e.g. FD and/or IBS) and 219 SSF subjects were invited to their local health centers for completing the ASQ again in addition to a set of other questionnaires. From the results in the ASQ, 141 subjects with persistent FGID and 97 SSF subjects formed the study groups of the studies I, III and IV. A subgroup living in the eastern part of Östhammar constituted the study groups in study II. The used questionnaires were; Complaint score questionnaire (CSQA), Psychological General Well-Being (PGWB), Hospital Anxiety and Depression Scale (HADS), Sexual, physical and emotional abuse (ABQ), Coping strategies questionnaire (CSQ), Social support (ISSI), and the Multidimensional Health locus of control scale (MHLC). Results: In study I: Non-patients with FGID have a higher risk of psychological illness (OR 8.4, CI95: 4.0-17.5) than somatic illness (OR 2.8, CI95: 1.3-5.7) or ache and fatigue symptoms (OR 4.3, CI95:2.1-8.7). Patients with FGID have more severe GI symptoms than healthy controls. In study II: of the FGID patients, 97% had a non-GI diagnosis, compared to 100% of SSF (ns). The mean number of consultations, prescriptions, diagnoses as well as anxiety level and depression were all statistically significantly higher (p<0.05) in FGID compared to SSF, whereas the number of referrals and sick leave were not. Besides a GI diagnosis, there was no significant difference (p>0.05) in the spectrum of morbidity in terms of ICD-9 subgroup classification, except an increased proportion of older SSF subjects with circulatory disorders and hypertension. In study III: Women with FGID had a higher risk of having a history of some kind of abuse, as compared with the SSF controls (45% vs.16%), in contrast to men (29% vs. 24% n.s.). Women with a history of abuse and FGID had reduced HRQoL as compared with women without abuse history. In study IV: Neuroticism and a parental rejective rearing style were identified as risk factors for FGID. FGID consulters reported an increased parental rejection and reduced health-related quality of life. Moreover, consulters had a higher exposure to abuse in childhood, a lower availability of social attachment and less adequacy of social interaction than non-consulters. Conclusions: FGID is related to an increased demand on primary health care due to an increased overall co-morbidity. Women with longstanding FGID often have a history of physical, emotional or sexual abuse which is associated with a poor HRQoL and increased health care seeking. Negative parental upbringing represents an aggravating factor in FGID. The treatment of FGID should involve assessment of psychological distress.
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