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- Pesola, Ulla-Maija, 1977-
(författare)
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Crossing Boundaries : Transferring eHealth services across the Northern Periphery
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Health care organisations in Finland, Norway, Scotland and Sweden face similar challenges when it comes to providing health services in the sparsely populated rural areas. Vast distances, centralized health services, harsh climate and limited access to public transport can make accessing health services difficult. In order to provide health services for the population of the Northern Periphery it is necessary to develop health care service models which can address the problems of isolation, remoteness and centralized health services. One way of overcoming these issues is to develop eHealth services that focus on increasing access to health services in the rural areas.As health care organisations’ resources are often limited, the possibilities to develop, test and implement eHealth services can be restricted. Thus, transferring existing eHealth services across organisational and national boundaries can be beneficial, as the services have already been tested in practice. Taking advantage of the knowledge health care organisations in different countries have can support organisations in their drive to develop service provision models that reach out to the population of the Northern Periphery.The main objective of this thesis is to understand how local conditions influence the outcomes of eHealth transfer. In order to do so the transnational implementation of five eHealth services was investigated in five case studies. This research gives insight into how differences in organisational structure, ICT infrastructure and the size of the patient base impact health care organisations’ possibility to transfer and utilize existing eHealth services. In addition, this research offers rich insights into how these factors impact the sustainability of eHealth services. The case studies also illustrate how stakeholder collaboration and knowledge exchange impact the process of transferring eHealth services, and how patients’ and professionals’ level of trust in eHealth services can materialize in practice. In addition, this thesis demonstrates why the benefits obtained with a specific eHealth service may, or may not be duplicable in another organisational context. The research discussed in this thesis also contributes to the understanding of how assessing organisational readiness prior to transferring and eHealth services can facilitate the implementation process.
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| 2. |
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| 3. |
- Waterworth, John, et al.
(författare)
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Special issue : Presence and interaction
- 2012
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Ingår i: Interacting with computers. - : Elsevier. - 0953-5438 .- 1873-7951. ; 24:4, s. 190-192
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Roberts, Anne, et al.
(författare)
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Transnational comparison : A retrospective study on e-health in sparsely populated areas of the Northern periphery
- 2010
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Ingår i: Telemedicine journal and e-health. - : Mary Ann Liebert. - 1530-5627 .- 1556-3669. ; 16:10, s. 1053-1059
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Tidskriftsartikel (refereegranskat)abstract
- Healthcare delivery in the northern periphery of Europe is challenged by dispersed populations, geographical complexities (including mountainous terrain and inhabited islands), ageing populations, and rising patient expectations. It is challenged further by variations in transport networks and information communication technology infrastructure. This article provides an overview of e-health development across the northern periphery areas of four northern European countries (Finland, Sweden, Norway, and Scotland) by summarizing the outcomes of a mixed methods e-health mapping exercise and subsequently identifying service needs and gaps. A total of 148 applications, with a range of applied e-health solutions, were identified and the findings have promoted the sharing and transfer of e-health innovation across the four countries. The supporting telecommunications infrastructure and development of innovative telemedicine appear slower in sparsely populated areas of Scotland in comparison to its northern peripheral counterparts. All four countries have, however, demonstrated a clear commitment to the development of e-health within their remote and rural regions.
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| 5. |
- Sandlund, Marlene, 1972-
(författare)
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Motion interactive games for children with motor disorders : motivation, physical activity, and motor control
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- As motion interactive games have become more widespread the interest in using these games in rehabilitation of children with motor disorders has increased among both clinical professionals and the families of these children. The general aim of this thesis was to evaluate the feasibility of using interactive games in rehabilitation of children to promote motivation for practice, physical activity, and motor control. A systematic review of published intervention studies was conducted to obtain an overview of existing research and the current levels of evidence for using interactive games in motor rehabilitation of children. Sixteen studies met the inclusion criteria, out of these three were randomized controlled trials while half were case series or case reports. Thirteen studies presented positive findings, which indicated a promising potential. However, more convincing research is needed. Commercially available motion interactive games have only been used in a few studies on motor control, and in none of these home based practice was provided. Moreover, no earlier studies have evaluated if these games may increase motivation for training and daily physical activity among children with disabilities. To address these issues a feasibility intervention including 15 children in the ages 6-16 years and with mild to moderate cerebral palsy was conducted. Each child was provided with a Sony PlayStation2â and the EyeToyâ games in Play3, and was recommended to practice with the provided games for at least 20 minutes/day during four weeks. The intervention was evaluated with gaming diaries, physical activity monitors (SenseWear Armband), interviews with the parents, and the clinical motor tests Movement Assessment Battery for Children-2 (mABC-2), Bruininks-Oseretsky Test of Motor Proficiency subtest 5:6, and the 1 Minute Walk Test. In addition, 3D motion analysis was used to evaluate effects on quality of goal-directed arm movements towards virtual and real objects, respectively. Motivation for practice and compliance of training were high, although declining somewhat during the course of the four weeks. The children’s physical activity increased significantly during the intervention. However, four children were excluded from this analysis due to lack of complete data from the physical activity monitors. According to mABC-2 the children’s motor performance improved, but there were both floor and ceiling effects, indicating a low sensibility of this test. The two additional motor tests showed only non-significant progress. Results from the 3D motion analysis suggest that the children improved movement precision when playing the games, movement smoothness when reaching for real objects, and used a more economic reaching strategy with less trunk involvement. In the interviews the parents expressed the view that motion interactive games promote positive experiences of physical training and add elements of social interaction to the training. They also experienced less urge to take on a coaching role. The training provided by the games was considered unspecific and there was a desire for individualized games to better address the unique rehabilitative need of each child. In conclusion, it is feasible to use motion interactive games in home rehabilitation for children with cerebral palsy to promote short term motivation for practice and general physical training. Specific effects on motor control need to be further explored and there is also a need for reliable tests that are adequate and sensitive enough to capture changes in movement control. In future development of interactive games for rehabilitation purposes, it is a challenge to preserve the motivational and social features of games while at the same time optimizing an individualized physical training.
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| 6. |
- Sandlund, Marlene, et al.
(författare)
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Motion interactive video games in home training for children with cerebral palsy : parents' perceptions
- 2012
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Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 34:11, s. 925-933
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore parents' perceptions of using low-cost motion interactive video games as home training for their children with mild/moderate cerebral palsy.Method: Semi-structured interviews were carried out with parents from 15 families after participation in an intervention where motion interactive games were used daily in home training for their child. A qualitative content analysis approach was applied.Results: The parents' perception of the training was very positive. They expressed the view that motion interactive video games may promote positive experiences of physical training in rehabilitation, where the social aspects of gaming were especially valued. Further, the parents experienced less need to take on coaching while gaming stimulated independent training. However, there was a desire for more controlled and individualized games to better challenge the specific rehabilitative need of each child.Conclusions: Low-cost motion interactive games may provide increased motivation and social interaction to home training and promote independent training with reduced coaching efforts for the parents. In future designs of interactive games for rehabilitation purposes, it is important to preserve the motivational and social features of games while optimizing the individualized physical exercise.
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| 7. |
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| 8. |
- Winge, Monica, et al.
(författare)
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Need for a New Care Model - Getting to Grips with Collaborative Home Care
- 2010
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Ingår i: MEDINFO 2010. - : IOS Press. - 9781607505877 - 9781607505884 ; 160:Pt 1, s. 8-12
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Konferensbidrag (refereegranskat)abstract
- In this paper we discuss the fact that more and more patients are treated in their homes by a set of organizations, sometimes with different ownership, and how this fact places new and severe demands on health care and home service staff to communicate and collaborate. We point to the need for managers in different organizations to agree on ways of communicating and collaborating on the operational level and how this aspect needs to be considered during procurement of home care services. Most importantly, by reasoning around a set of problematic areas, we derive a set of related problems and suggest solutions for dealing with them. The solutions are a mix of organizational/administrative measures and IT support for communication and coordination.
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