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- Eldh, Ann Catrine, Docent, 1965-, et al.
(författare)
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Health Care Professionals' Experience of a Digital Tool for Patient Exchange, Anamnesis, and Triage in Primary Care : Qualitative Study.
- 2020
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Ingår i: JMIR Human Factors. - Toronto, Canada : JMIR Publications. - 2292-9495. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care.OBJECTIVE: The objective of our study was to describe health care staff's experience with a digital communication system intended for patient-staff encounters via a digital route in primary care.METHODS: In this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis.RESULTS: While the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient's voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service-at least for a while-if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers.CONCLUSIONS: A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.
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| 2. |
- Nilsson, Evalill, et al.
(författare)
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A Human, Organization, and Technology Perspective on Patients' Experiences of a Chat-Based and Automated Medical History-Taking Service in Primary Health Care : Interview Study Among Primary Care Patients
- 2021
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 23:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of e-visits in health care is progressing rapidly worldwide. To date, studies on the advantages and disadvantages of e-consultations in the form of chat services for all inquiries in primary care have focused on the perspective of health care professionals (HCPs) rather than those of end users (patients). Objective: This study aims to explore patients' experiences using a chat-based and automated medical history-taking service in regular, tax-based, not-for-profit primary care in Sweden. Methods: Overall, 25 individual interviews were conducted with patients in the catchment areas of 5 primary care centers (PCCs) in Sweden that tested a chat-based and automated medical history-taking service for all types of patient inquiries. The semistructured interviews were transcribed verbatim before content analysis using inductive and deductive strategies, the latter including an unconstrained matrix of human, organization, and technology perspectives. Results: The service provided an easily managed way for patients to make written contact with HCPs, which was considered beneficial for some patients and issues but less suitable for others (acute or more complex cases). The automated medical history-taking service was perceived as having potential but still derived from what HCPs need to know and how they address and communicate health and health care issues. Technical skills were not considered as necessary for a mobile phone chat as for handling a computer; however, patients still expressed concern for people with less digital literacy. The opportunity to take one's time and reflect on one's situation before answering questions from the HCPs was found to reduce stress and prevent errors, and patients speculated that it might be the same for the HCPs on the other end of the system. Patients appreciated the ability to have a conversation from almost anywhere, even from places not suitable for telephone calls. The asynchronicity of the chat service allowed the patients to take more control of the conversation and initiate a chat at any time at their own convenience; however, it could also lead to lengthy conversations where a single issue in the worst cases could take days to close. The opportunity to upload photographs made some visits to the PCC redundant, which would otherwise have been necessary if the ordinary telephone service had been used, saving patients both time and money. Conclusions: Patients generally had a positive attitude toward e-visits in primary care and were generally pleased with the prospects of the digital tool tested, somewhat more with the actual chat than with the automated history-taking system preceding the chat. Although patients expect their PCC to offer a range of different means of communication, the human, organization, and technology analysis revealed a need for more extensive (end) user experience design in the further development of the chat service.
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| 4. |
- Nilsson, Sverker, 1958, et al.
(författare)
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Evaluation of a health promotion programme to prevent the misuse of androgenic anabolic steroids among Swedish adolescents
- 2004
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Ingår i: HEALTH PROMOTION INTERNATIONAL. - : Oxford University Press (OUP). - 0957-4824 .- 1460-2245. ; 19, s. 61-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to design an appearance programme in order to prevent the misuse of androgenic anabolic steroids among adolescents and to evaluate the adolescents' perception of this programme. The study was performed in all schools in a primary health care area on the south west coast of Sweden. The intervention targeted all 16- and 17-year-old males and females (n = 921). The intervention and evaluation were completed by 451 boys. The strategy of the appearance programme was to create awareness of and to discuss attitudes towards steroid hormones among these adolescents. Youth leaders and health workers, who discussed these subjects with adolescents over a period of 2 years, carried out the intervention programme. The perception of the programme was analysed anonymously using questionnaires. Effects on the total population of youths were assessed by two cross-sectional surveys. The intervention programme was well received by the adolescents. The misuse of androgenic anabolic steroids had a tendency to decrease after the appearance programme. We demonstrated a method for involving the community in an appearance programme to reduce misuse of anabolic steroids and showed that youth were sensitive to our discussions about appearance and attitudes. This study indicates that drug abuse among adolescents can be decreased by health promotion activities, such as group discussions. Controlled studies are needed before the results of this appearance programme can be generalized. Key words: adolescents; androgenic anabolics; appearance; intervention
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| 5. |
- Nilsson, Sverker, 1958
(författare)
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Misuse of anabolic steroids in youth. Trends, attitudes and evaluation of an intervention programme
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Misuse of androgenic anabolic steroids in US is well known. Less is known about the situation in Sweden and Europe. If there does exist a problem of misuse, it is important to investigate prevalence, risk-factors and attitudes towards anabolics. This knowledge is vital in order to design intervention.Aim:. The aims of this thesis were to investigate the prevalence in a Swedish county, rural and urban areas as well as different points in time; analyse attitudes among users and non-users of androgenic anabolic steroids; assess the importance of self-esteem, appearance and peer pressure among male youths; design And evaluate an intervention programme.Methods: Prevalence studies by questionnaires were performed regularly 1993-2000 to follow trends of the misuse and to study attitudes towards androgenic anabolic steroids. Based on background factors for the drug misuse an intervention programme was designed, implemented and evaluated. To add further to our understanding of youths attitudes and lifestyles a quantitative study with individual and focus-groups interviews were performed. The material was analysed in phenomenological tradition. Results: The first prevalence study verified misuse of anabolics with the prevalence rate of 5.8% among male adolescents. Sports activities were protecting factors. An appearance programme, including group discussions catalysed by specially educated health-workers, was implemented. The programme was well received and the misuse figures remain stable with a possible tendency to decline. The prevalence rates were 3.0% 1995 and 1.2% 2000 among male adolescents. The attitudes among misusers and non-misusers differed risk factors for misuse were immigrant status, smoking, drinking more alcohol including home-distilled alcohol, other drug-misuse and muscular training at gyms. Thewell-trained body was reported as an important factor for self-confidence, respect from other boys and girls, for security in nightlife and in the beach culture.Conclusions: Misuse of anabolics among male adolescents is a threatening problem in the community. This intervention programme based on appearance discussions and self-confidence strengthening seems to be a possible way to prevent misuse of anabolics. These findings would be interesting to implement and evaluate in different settings, with possible modifications, in order to find effective ways to reduce the misuse of androgenic anabolic steroids.
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