| 1. |
- Hägglund, Maria, Lektor, 1975-, et al.
(author)
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A Nordic Perspective on Patient Online Record Access and the European Health Data Space
- 2024
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In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 26:1
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Journal article (peer-reviewed)abstract
- The Nordic countries are, together with the United States, forerunners in online record access (ORA), which has now become widespread. The importance of accessible and structured health data has also been highlighted by policy makers internationally. To ensure the full realization of ORA’s potential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, informed by our research in a Nordic-led project that carries out the first of its kind, large-scale international investigation of patients’ ORA—NORDeHEALTH (Nordic eHealth for Patients: Benchmarking and Developing for the Future). We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records. In our analysis of the proposal, we have identified five key principles for ORA: (1) the right to access, (2) proxy access, (3) patient input of their own data, (4) error and omission rectification, and (5) access control. ORA implementation today is fragmented throughout Europe, and the EHDS proposal aims to ensure all European citizens have equal online access to their health data. However, we argue that in order to implement the EHDS, we need more research evidence on the key ORA principles we have identified in our analysis. Results from the NORDeHEALTH project provide some of that evidence, but we have also identified important knowledge gaps that still need further exploration.
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| 2. |
- Löscher, Ida, 1988-
(author)
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Aiming at Moving Targets : Applying Cognitive Work Analysis to Work Domains in Transition
- 2020
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Doctoral thesis (other academic/artistic)abstract
- The design of IT systems for complex work environments is essential for workers to be able to operate more effectively and efficiently. To design a system that supports the workers' specific tasks we need to understand the work demands and the context in which the system operates. However, this is a difficult task because of the dynamic nature of complex systems. The thesis investigates how the cognitive work analysis (CWA) framework (Vicente, 1999) can be applied to understand a domain under transformation by (1) developing methods to manage challenges associated with applying CWA to real-world complex systems and (2) investigating how models from the CWA framework can be used to contend with the moving target for development. The studies are carried out within two quite different application domains: long-haul driving and health care. An activity prioritization method was suggested as a useful technique to focus the analyzing efforts during the analysis of tasks and strategies. However, adaption to practical constraints has to be done thoughtfully in order not to lose the value of the analysis. Moreover, workshops were proposed as a means to bridge the gap between the analysis and design by finding design metaphors and possible future work strategies from the domain knowledge of the drivers. Third, a study was done using the abstraction hierarchy (AH) to learn about digitization in health care, which is an example of ongoing change in a work domain. The AH was also adapted to model health IT systems as a means to provide an overview and consistent vision of strategic decisions. Using the AH as an overview of sub-systems that were developed by different organizations or organizational units would make it possible to identify collaboration needs or a lack of connectivity and integration between systems. The AH can therefore be applied to support the development of an IT system that is to be part of a transforming work domain.
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| 3. |
- Bärkås, Annika, et al.
(author)
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Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients : Results from a Nationwide Survey in Sweden
- 2023
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In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 25
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Journal article (peer-reviewed)abstract
- BACKGROUND: Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC. OBJECTIVE: The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups. METHODS: Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square. RESULTS: Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were "very important," but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups. CONCLUSIONS: About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records.
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| 4. |
- Bärkås, Annika
(author)
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Patients’ Access to Their Mental Health Records : Understanding Policy, Access, and Patient Experiences
- 2024
-
Doctoral thesis (other academic/artistic)abstract
- ORA is the concept of patients' access to clinical information, which has become more widespread worldwide. When patients are provided online record access (ORA) to their health records, concerns have been raised by healthcare professionals, especially when it comes to patients with mental health diagnoses. In the general population, positive aspects appear to outweigh the negative, yet limited research has so far explored the impact of ORA in mental healthcare. The overall aim of this thesis was to explore how patients experience ORA in mental healthcare through four studies: 1) a literature review aimed to explore the current literature on the experiences of ORA among mental healthcare patients, care partners, and healthcare professionals, 2) a document analysis combined with key stakeholder email interviews that aimed to explore to what extent ORA in mental healthcare has been implemented in Sweden including national and local policy regulations, 3) an online patient survey study aimed to understand mental healthcare patients' experiences with ORA in Sweden, Estonia, Finland, and Norway, and 4) an online patient survey study aimed to understand if and how patients with mental health conditions experiences of ORA differs from patients in other healthcare settings. More patients reported positive experiences with ORA in mental healthcare than negative experiences. Common benefits of ORA included, among others, a greater sense of control over their care, improved understanding of their mental health diagnosis, and better adherence to appointments. Despite patients' predominant positive experiences, only 17 out of 21 regions in Sweden offered ORA in mental healthcare in 2021. Additionally, many patients experienced errors and omissions and felt offended by the content of their health records. Mental healthcare patients experienced this at a higher rate than patients in other healthcare settings.In conclusion, mental healthcare patients have higher rates of negative experiences of ORA compared to patients in other healthcare settings. However, patients' experiences of ORA are still predominantly positive among both patient groups. Yet, in 2021, only 17 regions offered patients ORA in mental healthcare. Denying mental healthcare patients ORA to protect them from negative experiences could instead increase stigma in this patient group.
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| 5. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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Effects of patient accessible electronic health records on nurses' work environment : a survey study on expectations in Sweden
- 2022
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:11
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The introduction of information and communication technology influences the work environment of large groups of employees in healthcare. In Sweden, a national healthcare service providing patient accessible electronic health records (PAEHR) has been deployed, and this paper investigates nurses' expected effects of this implementation.SETTING: Nurses associated with the Swedish Association of Health Professionals working in healthcare such as primary care, hospitals and midwives in Sweden. Before a full-scale national implementation of PAEHR, a web survey study was distributed nationally. The respondents represented all 21 Swedish regions. Questions included five-point Likert scale questions and open questions.PARTICIPANTS: A survey link was distributed via email to 8460 registered nurses, midwives and union representatives in Sweden. The response rate was 35.4% (2867 respondents: registered nurses 84%; midwives 6%; chief position 5%; in projects 2% and other 3%). Three reminders were sent out, all of them increasing the response rate. A majority of the respondents were female (89.9%), 8.4% male, whereas 1.7% did not indicate their gender. 31.4% were under 40 years old, 53.8% 40-59 and 13.7% over 60.RESULTS: Data were analysed using exploratory factor analysis with principal component analysis as the extraction method. The analysis revealed three distinct factors related to nurses' expectations of PAEHR: (1) PAEHR improves the quality of care, (2) PAEHR improves the quality of the work environment and (3) risk and fears concerning patients' well-being. Some interesting results include that more experienced nurses are more favourable to PAEHR. Our analysis also shows that the view of the nurse-patient relationship is an essential underlying factor related to positive or negative expectations.CONCLUSIONS: Results show that the expectations and perceptions of PAEHR vary depending on the nurse's view of who the electronic record belongs to. Younger nurses are somewhat more negative towards PAEHR than older nurses.
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| 6. |
- Cajander, Åsa, 1971-
(author)
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Usability – Who Cares? : The Introduction of User-Centred Systems Design in Organisations
- 2010
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Doctoral thesis (other academic/artistic)abstract
- This thesis analyses the difficulties encountered in the promotion of usability, especially in relation to occupation health issues, when developing IT systems in a public authority. It examines what happens when User-Centred Systems Design (UCSD) approaches are introduced to organisations with in-house systems development for their employees. It studies how stakeholder values affect the outcomes in terms of usability, occupational health, and institutional acceptance. Moreover, new methods are examined and evaluated as potential tools for assisting the adoption of UCSD. These methods are for example Field studies for system developers, Usability coaching for stakeholders and Management views of usability.A stated aim is to influence systems development in practice. Hence an action research paradigm has been employed, carrying out research and change in real life settings, gathering and analysing data using qualitative techniques.This thesis is based on a constructivist perspective, where theories in the areas of learning and organisational change have been used in order to better understand the research questions.The research demonstrates that most people are enthusiastic to, and interested in, UCSD with a focus on the computerised work environment. Many of the stakeholder groups, such as managers, users, project managers and system developers, changed their construct of identity as well as practice when UCSD was introduced.However, this research shows that there are several values that affect systems development and hinder usability work. These include for example value of rationality and objectivity, and differing values and perspectives underpinning descriptions and discourse on work and systems development. Values such as automation, efficiency, and customer satisfaction shape the development of new technology, and ultimately the tasks, work practices integrated in IT systems.Moreover, the results demonstrate that even though many consider usability as important, few take active responsibility for it, as the title of this thesis suggests.
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| 7. |
- Frezza, S., et al.
(author)
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Modeling global competencies for computing education
- 2018
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In: ITiCSE 2018 Proceedings of the 23rd Annual ACM Conference on Innovation and Technology in Computer Science Education. - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450357074 ; , s. 348-349
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Conference paper (peer-reviewed)abstract
- This working group contributes to formulating a framework for modeling competencies in the current and future disciplines that comprise computing education. We draw upon the innovative approach taken in the curricular document for information technology (IT2017), curricular competency frameworks, other related documents such as the software engineering competency model (SWECOM), the Skills Framework for the Information Age (SFIA), current research in competency models, and elicitation workshop results from other computing conferences. The outcomes contribute to the Computing Curricula 2020 (CC2020) project, and include the formulation and review of sets of disciplinary-relevant competencies for use in computing education. This work directly informs the CC2020 project sponsored by the Association for Computing Machinery (ACM) and the IEEE Computer Society.
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| 8. |
- Frezza, S., et al.
(author)
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Modelling competencies for computing education beyond 2020 : A research based approach to defining competencies in the computing disciplines
- 2018
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In: Annual Conference on Innovation and Technology in Computer Science Education, ITiCSE. - New York, NY, USA : Association for Computing Machinery. - 9781450362238 ; , s. 148-174, s. 148-174
-
Conference paper (peer-reviewed)abstract
- How might the content and outcomes of tertiary education programmes be described and analysed in order to understand how they are structured and function? To address this question we develop a framework for modelling graduate competencies linked to tertiary degree programmes in the computing disciplines. While the focus of our work is computing the framework is applicable to education more broadly. The work presented here draws upon the pioneering curricular document for information technology (IT2017), curricular competency frameworks, other related documents such as the software engineering competency model (SWECOM), the Skills Framework for the Information Age (SFIA), current research in competency models, and elicitation workshop results from recent computing conferences. The aim is to inform the ongoing Computing Curricula (CC2020) project, an endeavour supported by the Association for Computing Machinery (ACM) and the IEEE Computer Society. We develop the Competency Learning Framework (CoLeaF), providing an internationally relevant tool for describing competencies. We argue that this competency based approach is well suited for constructing learning environments and assists degree programme architects in dealing with the challenge of developing, describing and including competencies relevant to computer and IT professionals. In this paper we demonstrate how the CoLeaF competency framework can be applied in practice, and though a series of case studies demonstrate its effectiveness and analytical power as a tool for describing and comparing degree programmes in the international higher education landscape.
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| 9. |
- Grande, Virginia, 1987-, et al.
(author)
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Making Visible and Modeling the Underrepresented : Teachers' Reflections on Their Role Modeling in Higher Education
- 2022
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In: ITiCSE '22. - New York, NY, USA : Association for Computing Machinery. ; , s. 566-567
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Conference paper (peer-reviewed)abstract
- This work contributes to a better understanding of computing teachers' perceptions of themselves as role models. Role models are described as important to address under-representation, yet there is little in-depth research on how role modeling works and what university teachers in computing can model to broaden participation in the discipline. We will analyze teachers' reflections on how they may, or want to, be perceived by their students, particularly in terms of professional competencies, emotions and attitudes towards well-being. We will use and further develop an already existing framework on role modeling in computing, and we will relate our findings to existing research on computing and science identities. Modeling aspects outside the computing norm can help provide students with a wider notion of what it means to be a computer scientist. Besides developing the theoretical understanding of computing teachers as role models , our work can support various ways of developing computing teachers' competences and departments' teaching culture. The results are one way to contribute to student diversity and equitable access, and more broadly increase the relevance of computing education for sustainability.
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| 10. |
- Grande, Virginia, 1987-, et al.
(author)
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Role Modeling as a Computing Educator in Higher Education : A Focus on Care, Emotions and Professional Competencies
- 2022
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In: ITiCSE-WGR '22. - New York, NY, USA : ACM Digital Library. ; , s. 37-63
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Conference paper (peer-reviewed)abstract
- This paper provides insights into role modeling by educators in computing that is beyond the technical, theoretical and rational perspectives which have historically been described as dominant in computing. Surveying 199 educators in higher education, we have built on frameworks of role modeling, care, emotions, and professional competencies as a lens to see different ways of engaging in computing.Our quantitative and qualitative findings show how educators model ways of caring (for oneself, other humans and living species, technology, and the planet), emotions, professional competencies and other types of role modeling. Examples of contexts within computing and reasons why an educator can(not) model these aspects bring new light to research on care and emotions being shown in computing.This work contributes to a better understanding of computing educators as potential role models, particularly in terms of displaying emotions and various types of care. Our work can support ways of developing the professional competences of computing educators and the teaching culture of computing departments. Our findings may inspire other educators to think about their own display of emotions and care, and what this transmits to their students. Thus, the work also contributes to the discussion of ways to increase diversity among students and equitable access to computing education.
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| 11. |
- Huvila, Isto, Professor, 1976-, et al.
(author)
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Technological and informational frames : explaining age-related variation in the use of patient accessible electronic health records as technology and information
- 2021
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In: Information Technology and People. - : Emerald. - 0959-3845 .- 1758-5813.
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Journal article (peer-reviewed)abstract
- Purpose Data from a national patient survey (N = 1,155) of the Swedish PAEHR "Journalen" users were analysed, and an extended version of the theory of technological frames was developed to explain the variation in the technological and informational framing of information technologies found in the data.Design/methodology/approach Patient Accessible Electronic Health Records (PAEHRs) are implemented globally to address challenges with an ageing population. However, firstly, little is known about age-related variation in PAEHR use, and secondly, user perceptions of the PAEHR technology and the health record information and how the technology and information-related perceptions are linked to each other. The purpose of this study is to investigate these two under-studied aspects of PAEHRs and propose a framework based on the theory of technological frames to support studying the second aspect, i.e. the interplay of information and technology-related perceptions.Findings The results suggest that younger respondents were more likely to be interested in PAEHR contents for general interest. However, they did not value online access to the information as high as older ones. Older respondents were instead inclined to use medical records information to understand their health condition, prepare for visits, become involved in their own healthcare and think that technology has a much potential. Moreover, the oldest respondents were more likely to consider the information in PAEHRs useful and aimed for them but to experience the technology as inherently difficult to use.Research limitations/implications The sample excludes non-users and is not a representative sample of the population of Sweden. However, although the data contain an unknown bias, there are no specific reasons to believe that it would differently affect the survey’s age groups.Practical implications Age should be taken into account as a key factor that influences perceptions of the usefulness of PAEHRs. It is also crucial to consider separately patients’ views of PAEHRs as a technology and of the information contained in the EHR when developing and evaluating existing and future systems and information provision for patients.Social implications This study contributes to bridging the gap between information behaviour and systems design research by showing how the theory of technological frames complemented with parallel informational frames to provide a potentially powerful framework for elucidating distinct conceptualisations of (information) technologies and the information they mediate. The empirical findings show how information and information technology needs relating to PAEHRs vary according to age. In contrast to the assumptions in much of the earlier work, they need to be addressed separately.Originality/value Few earlier studies focus on (1) age-related variation in PAEHR use and (2) user perceptions of the PAEHR technology and the health record information and how the technology and information-related perceptions are linked to each other.
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| 12. |
- Hägglund, Maria, Lektor, 1975-, et al.
(author)
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The NORDeHEALTH 2022 Patient Survey : Cross-Sectional Study of National Patient Portal Users in Norway, Sweden, Finland, and Estonia
- 2023
-
In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 25
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Journal article (peer-reviewed)abstract
- BACKGROUND: Although many surveys have been conducted on patients accessing their own health records in recent years, there is a limited amount of nationwide cross-country data available on patients' views and preferences. To address this gap, an international survey of patient users was conducted in the Nordic eHealth project, NORDeHEALTH. OBJECTIVE: We aimed to investigate the sociodemographic characteristics and experiences of patients who accessed their electronic health records (EHRs) through national patient portals in Norway, Sweden, Finland, and Estonia. METHODS: A cross-sectional web-based survey was distributed using the national online health portals. The target participants were patients who accessed the national patient portals at the start of 2022 and who were aged ≥15 years. The survey included a mixture of close-ended and free-text questions about participant sociodemographics, usability experience, experiences with health care and the EHR, reasons for reading health records online, experience with errors, omissions and offense, opinions about security and privacy, and the usefulness of portal functions. In this paper, we summarized the data on participant demographics, past experience with health care, and the patient portal through descriptive statistics. RESULTS: In total, 29,334 users completed the survey, of which 9503 (32.40%) were from Norway, 13,008 (44.35%) from Sweden, 4713 (16.07%) from Finland, and 2104 (7.17%) from Estonia. National samples were comparable according to reported gender, with about two-thirds identifying as women (19,904/29,302, 67.93%). Age distributions were similar across the countries, but Finland had older users while Estonia had younger users. The highest attained education and presence of health care education varied among the national samples. In all 4 countries, patients most commonly rated their health as "fair" (11,279/29,302, 38.48%). In Estonia, participants were more often inclined to rate their health positively, whereas Norway and Sweden had the highest proportion of negative health ratings. Across the whole sample, most patients received some care in the last 2 years (25,318/29,254, 86.55%). Mental health care was more common (6214/29,254, 21.24%) than oncological care (3664/29,254, 12.52%). Overall, most patients had accessed their health record "2 to 9 times" (11,546/29,306, 39.4%), with the most frequent users residing in Sweden, where about one-third of patients accessed it "more than 20 times" (4571/13,008, 35.14%). CONCLUSIONS: This is the first large-scale international survey to compare patient users' sociodemographics and experiences with accessing their EHRs. Although the countries are in close geographic proximity and demonstrate similar advancements in giving their residents online records access, patient users in this survey differed. We will continue to investigate patients' experiences and opinions about national patient-accessible EHRs through focused analyses of the national and combined data sets from the NORDeHEALTH 2022 Patient Survey.
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| 13. |
- Nurgalieva, Leysan, et al.
(author)
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‘I do not share it with others. No, it’s for me, it’s my care’ : On sharing of patient accessible electronic health records
- 2020
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 26:4, s. 2554-2567
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Journal article (peer-reviewed)abstract
- This study explores patients’ perspectives on sharing their personal health data, which is traditionally shared through discussions with peers and relatives. However, other possibilities for sharing have emerged through the introduction of online services such as Patient Accessible Electronic Health Records (PAEHR). In this article, we investigate strategies that patients adopt in sharing their PAEHR. Data were collected through a survey with 2587 patients and through 15 semi-structured interviews with cancer patients. Results show that surprisingly few patients share their information, and that older patients and patients with lower educational levels share more frequently. A large majority of patients trust the security of the system when sharing despite the high sensitivity of health information. Finally, we discuss the design implications addressing identified problems when sharing PAEHR, as well as security and privacy issues connected to sharing.
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| 14. |
- Peters, Anne-Kathrin, et al.
(author)
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Care ethics to develop computing and engineering education for sustainability
- 2020
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In: 2020 IEEE Frontiers in Education Conference (FIE). - : IEEE. - 9781728189611 - 9781728189628
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Conference paper (peer-reviewed)abstract
- The aim of this special session is to connect researchers interested in computing and engineering education for sustainability. We will explore the use of care and care ethics as a theoretical perspective to develop sustainability education. Theoretical discussions in environmental and sustainability education (ESE) research and feminist research will be introduced to develop an understanding of care for education. Those theories will be illustrated and motivated based on concrete examples in computing and computing education. The participants get to choose among four different topics of discussion in the session, 1) the role of education to prepare for care, 2) theoretical discussions of care as a concept to develop education and education research, 3) pedagogical methods to foster care, 4) care and responsibility in the curriculum. The outcome of this session is two-fold: The participants will gain new ways of conceiving education for human and planetary well-being and they will get to know researchers and educational developers with an interest in and experiences with sustainability education.
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| 15. |
- Premanandan, Shweta, et al.
(author)
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Design Suggestions for a Persuasive E-coaching Application : A Study on Informal Caregivers' Needs
- 2023
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In: Digital Health. - : Sage Publications. - 2055-2076. ; 9, s. 1-12
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Journal article (peer-reviewed)abstract
- Objective: Informal caregivers such as relatives or close friends of patients are essential for caregiving at home. However, caregiving is a complex experience that may affect the caregivers’ well-being. Therefore, there is a need to provide support for caregivers, which we address in this article by proposing design suggestions for an e-coaching application. This study identifies the unmet needs of caregivers in Sweden and provides design suggestions for an e-coaching application using the persuasive system design (PSD) model. The PSD model offers a systematic approach to designing IT interventions.Methods: A qualitative research design was used, and semi-structured interviews were conducted with 13 informal caregivers from different municipalities in Sweden. A thematic analysis was performed to analyze the data. The PSD model was used to map the needs emerging from this analysis to propose design suggestions for an e-coaching application for caregivers.Results: Six needs were identified, and based on them, we proposed design suggestions for an e-coaching application using the PSD model. These unmet needs are monitoring and guidance, assistance to avail formal care services, access to practical information without being overwhelmed, feeling of community, access to informal support, and grief acceptance. The last two needs could not be mapped using the existing PSD model, resulting in an extended PSD model.Conclusion: This study revealed the important needs of informal caregivers based on which design suggestions for an e-coaching application were presented. We also proposed an adapted PSD model. This adapted PSD model can be further used for designing digital interventions in caregiving.
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| 16. |
- Premanandan, Shweta, et al.
(author)
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Designing a Mobile e-Coaching App for Immigrant Informal Caregivers : Qualitative Study Using the Persuasive System Design Model
- 2023
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In: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 11
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Journal article (peer-reviewed)abstract
- Background: Informal caregivers are vital in caring for their family and friends at home who may have illnesses or disabilities. In particular, the demands for caregiving can be even more challenging for those with limited resources, support systems, and language barriers, such as immigrant informal caregivers. They face complex challenges in providing care for their relatives. These challenges can be related to sociocultural diversity, language barriers, and health care system navigation. Acknowledging the global context of the increasing number of immigrants is essential in designing inclusive mobile health apps.Objective: This study aims to investigate the needs of immigrant informal caregivers in Sweden and discuss the application of the Persuasive System Design Model (PSDM) to develop an e-coaching prototype. By addressing the unique challenges faced by immigrant informal caregivers, this study will contribute to the development of more effective and inclusive mobile health apps.Methods: The participants were considered immigrants and included in the study if they and their parents were born outside of Sweden. Through various channels, such as the National Association of Relatives, rehabilitation departments at municipalities, and immigrant groups, we recruited 13 immigrant informal caregivers. These immigrant informal caregivers were primarily women aged 18 to 40 years. Most participants belonged to the Middle Eastern region whereas some were from North Africa. However, all of them spoke Arabic. We used semistructured interviews to gather data from the participants in Arabic, which were translated into English. Data were analyzed using thematic analysis and discussed in relation to the extended PSDM. The needs of the caregivers were compared with the description of persuasive design principles, and a design principle was chosen based on the match. The PSDM was extended if the need description did not match any principles. Several brainstorming and prototyping sessions were conducted to design the mobile e-coaching app.Results: Immigrant informal caregivers have various needs in their caregiving role. They reported a need for training on the illness and future caregiving needs, assistance with understanding the Swedish language and culture, and help with accessing internet-based information and services. They also required recognition and appreciation for their efforts, additional informal support, and easy access to health care services, which can be important for their mental health. The PSDM was adapted to the informal caregiving context by adding “facilitating conditions” and “verbal encouragement” as additional persuasive design principles. This study also presents the subsequent mobile e-coaching app for immigrant informal caregivers in Sweden.Conclusions: This study revealed important immigrant informal caregivers’ needs based on which design suggestions for a mobile e-coaching app were presented. We also proposed an adapted PSDM, for the informal caregiving context. The adapted PSDM can be further used to design digital interventions for caregiving.
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| 17. |
- Premanandan, Shweta, et al.
(author)
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Designing a Persuasive E-Coaching Application for Informal Caregivers
- 2023
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In: Caring is Sharing. - : IOS Press. - 9781643683898 - 9781643683881 ; , s. 922-926
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Conference paper (peer-reviewed)abstract
- Being an informal caregiver is not easy, and might cause physical and psychosocial burden, especially in the long run. However, the formal health care system has little support for informal caregivers who experience abandonment and lack information. Mobile health can potentially be an efficient and cost-effective way of supporting informal caregivers. However, research has shown that mHealth systems often have problems with usability, and people do not use the systems for more than a short period. Therefore, this paper explores the design of an mHealth app using Persuasive Design, an established design framework. This paper presents the design of the first version of the e-coaching application using the persuasive design framework and unmet needs of informal caregivers from the literature. This prototype version will be updated based on interview data from informal caregivers in Sweden.
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| 18. |
- Premanandan, Shweta, et al.
(author)
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Designing and Evaluating IT Applications for Informal Caregivers : Protocol for a Scoping Review
- 2023
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In: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 12
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Research review (peer-reviewed)abstract
- Background: A growing number of informal caregivers in many countries are important for effective functioning of health care in our society. Hence, they must receive the required support and services to continue providing care. IT applications can be used to support informal caregivers in their caregiving activities. However, evidence-informed guidelines for developing such IT applications and their evaluation are scarce. Hence, this scoping review can aid researchers and designers by providing design recommendations for IT apps for caregivers and potentially improve the design of IT applications for caregivers to meet their needs better.Objective: This study aims to describe the proposal for a scoping review of current practices and recommendations in designing and evaluating IT applications for informal caregivers. The scoping review will also discuss the opportunities and challenges in designing these IT applications.Methods: We will use a 5-step scoping review methodology to map relevant literature published as follows: (1) identify the research question, (2) identify relevant studies, (3) select relevant studies for review, (4) chart the data from selected literature, and (5) summarize and report results. A structured search will be conducted in PubMed, Scopus, IEEE digital library, Web of Science, and ACM Digital Library databases. In addition, hand searches of reference lists and keyword searches in Google Scholar will also be conducted. Inclusion criteria will be researched (journal and conference) articles focused on IT applications designed for use by informal caregivers and study type to be qualitative studies. Two reviewers will independently identify articles for review and extract data. Conflicts will be discussed, and a third reviewer will be consulted if a consensus cannot be reached. These data will be analyzed using thematic analysis.Results: The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. Uppsala University first initiated this scoping review protocol in December 2021 as part of the European Union–funded project ENTWINE. This work was also supported by the Swedish Research Council and the Swedish Cancer Society. The results will be presented in August 2023 and will be disseminated through a report to the European Union and a peer-reviewed journal publication. In addition, the team plans to share its findings on various public platforms, including social media, blog posts, and relevant conferences and workshops.Conclusions: This is, to our knowledge, the first study to map the literature on the design and evaluation of IT applications for informal caregivers. The scoping review’s results will detail the requirements, design suggestions, and user preferences, as well as the usability criteria and features of IT applications for informal caregivers. A mapping of studies could inform the design and implementation of future IT applications for informal caregivers.
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| 19. |
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| 20. |
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| 21. |
- Rexhepi, Hanife, 1984-, et al.
(author)
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Cancer patients’ information seeking behavior related to online electronic healthcare records
- 2021
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 27:3, s. 1-12
-
Journal article (peer-reviewed)abstract
- Patients’ online access to their EHR together with the rapid proliferation of medical information on the Internet has changed how patients use information to learn about their health. Patients’ tendency to turn to the Internet to find information about their health and care is well-documented. However, little is known about patients’ information seeking behavior when using online EHRs. By using information horizons as an analytical tool this paper aims to investigate the information behavior of cancer patients who have chosen to view their EHRs (readers) and to those who have not made that option (non-readers). Thirty interviews were conducted with patients. Based on information horizons, it seems that non-reading is associated with living in a narrower information world in comparison to readers. The findings do not suggest that the smallness would be a result of active avoidance of information, or that it would be counterproductive for the patients. The findings suggest, however, that EHRs would benefit from comprehensive linking to authoritative health information sources to help users to understand their contents. In parallel, healthcare professionals should be more aware of their personal role as a key source of health information to those who choose not to read their EHRs.
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| 22. |
- Rexhepi, Hanife, et al.
(author)
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Cancer patients' information seeking behaviour related to online electronic healthcare records
- 2020
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In: Proceedings of the 18th International Symposium for Health Information Management Research. - 9789189081093 ; , s. 53-61
-
Conference paper (peer-reviewed)abstract
- Patients' online access to their EHR together with the rapid proliferation of medical information on the Internet has changed the way patients use the information to learn about their health. It is well documented that patients often turn to the Internet to find information about their health and care. However, little is known about patients’ information seeking behaviour when using online EHRs. By using information horizons as an analytical tool this paper aims to investigate the information behaviour of cancer patients who have chosen to view their EHRs (readers) and to those who have not made that option (non-readers). Thirty interviews were conducted with patients. Based on information horizons, it seems that non-reading is associated with living in a narrower information world in comparison to readers. The findings do not suggest that the smallness would be a result of an active avoidance of information, or that it would be counterproductive for the patients.
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| 23. |
- Wang, Bo, et al.
(author)
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Users’ Experiences With Online Access to Electronic Health Records in Mental and Somatic Health Care : Cross-Sectional Study
- 2023
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In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 25
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Patient-accessible electronic health records (PAEHRs) hold promise for empowering patients, but their impact may vary between mental and somatic health care. Medical professionals and ethicists have expressed concerns about the potential challenges of PAEHRs for patients, especially those receiving mental health care. OBJECTIVE: This study aims to investigate variations in the experiences of online access to electronic health records (EHRs) among persons receiving mental and somatic health care, as well as to understand how these experiences and perceptions vary among those receiving mental health care at different levels of point of care. METHODS: Using Norwegian data from the NORDeHEALTH 2022 Patient Survey, we conducted a cross-sectional descriptive analysis of service use and perceptions of perceived mistakes, omissions, and offensive comments by mental and somatic health care respondents. Content analysis was used to analyze free-text responses to understand how respondents experienced the most serious errors in their EHR. RESULTS: Among 9505 survey participants, we identified 2008 mental health care respondents and 7086 somatic health care respondents. A higher percentage of mental health care respondents (1385/2008, 68.97%) reported that using PAEHR increased their trust in health care professionals compared with somatic health care respondents (4251/7086, 59.99%). However, a significantly larger proportion (P<.001) of mental health care respondents (976/2008, 48.61%) reported perceiving errors in their EHR compared with somatic health care respondents (1893/7086, 26.71%). Mental health care respondents also reported significantly higher odds (P<.001) of identifying omissions (758/2008, 37.75%) and offensive comments (729/2008, 36.3%) in their EHR compared with the somatic health care group (1867/7086, 26.35% and 826/7086, 11.66%, respectively). Mental health care respondents in hospital inpatient settings were more likely to identify errors (398/588, 67.7%; P<.001) and omissions (251/588, 42.7%; P<.001) than those in outpatient care (errors: 422/837, 50.4% and omissions: 336/837, 40.1%; P<.001) and primary care (errors: 32/100, 32% and omissions: 29/100, 29%; P<.001). Hospital inpatients also reported feeling more offended (344/588, 58.5%; P<.001) by certain content in their EHR compared with respondents in primary (21/100, 21%) and outpatient care (287/837, 34.3%) settings. Our qualitative findings showed that both mental and somatic health care respondents identified the most serious errors in their EHR in terms of medical history, communication, diagnosis, and medication. CONCLUSIONS: Most mental and somatic health care respondents showed a positive attitude toward PAEHRs. However, mental health care respondents, especially those with severe and chronic concerns, expressed a more critical attitude toward certain content in their EHR compared with somatic health care respondents. A PAEHR can provide valuable information and foster trust, but it requires careful attention to the use of clinical terminology to ensure accurate, nonjudgmental documentation, especially for persons belonging to health care groups with unique sensitivities.
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| 24. |
- Wiggberg, Mattias, et al.
(author)
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Defining digital excellence: requisite skills and policy implications for digital transformation
- 2022
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In: IEEE Access. - : Institute of Electrical and Electronics Engineers (IEEE). - 2169-3536. ; , s. 1-1
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Journal article (peer-reviewed)abstract
- The skills required to realise the potential of technological transformation to preserve humanity and our fragile world ecosystem in the next decade will centre on the development of digital solutions. This paper discusses the issue of characterising these competencies, since a definition is needed in order to ensure an adequate supply of cutting-edge scholars and a highly educated and agile technological workforce. The paper takes a mixed methods approach combining insights distilled from a rapid literature review, with interviews with leading practitioners and industry leaders. The validity and reliability of the results have been ensured through expert workshops and focus groups. The outcome is a robust definition of what digital excellence entails as well as a road map guiding educational policy and the future supply of digital excellence in national workforces.
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| 25. |
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| 26. |
- Ahmad, Awais, et al.
(author)
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Designing for Human Well-Being : A Case Study with Informal Caregivers of Individuals with Cancer
- 2022
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In: Studies in Health Technology and Informatics. - : IOS Press. - 0926-9630 .- 1879-8365. ; 294, s. 214-218
-
Journal article (peer-reviewed)abstract
- Informal Caregivers such as a spouse, other close relatives or friends of cancer patients can play an essential role in home-based treatment and care. However, the informal caregivers might not be prepared for this responsibility, and they might have several unmet requirements for taking care of patients in the home environment. The informal caregivers’ physical, social and psychological health is also profoundly affected due to the health conditions of their relatives. We propose a User-centred Positive Design as a hybrid framework by merging the traditional User-cantered design and positive design frameworks to enhance the informal caregivers’ subjective well-being. Our ongoing project (Carer-eSupport) will be used as a case study, and its main objective is to co-create and evaluate a web-based support system for informal caregivers of people with cancer. The proposed framework can be used for the design and development of health information systems with a special focus on users’ wellbeing and positive emotions.
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| 27. |
- Ahmad, Awais, et al.
(author)
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Improving Remote Examination Formats : Addressing Challenges and Providing Recommendations for University Educators in the Age of ChatGPT
- 2024
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Conference paper (peer-reviewed)abstract
- The availability of Large Language Models (LLM), such as the widely accessible ChatGPT, has raised concerns regarding the reliability of assessment formats in university education. This presentation sheds light on the potential impact of ChatGPT on existing remote examination formats and offers recommendations to overcome associated challenges. Through interviews with three computer science educators and an analysis of insights from blog posts, social media platforms, and academic forums, we gathered diverse opinions and experiences related to ChatGPT's impact on university assessment formats. Our findings reveal challenges, particularly in cheating prevention, prompting the need for educators to adapt their teaching methods to this evolving landscape. While GPT performs well in answering open-ended questions, it struggles with calculations and problem-solving, with multiple-choice questions posing additional challenges. Incorporating interactive activities and oral examinations should be prioritized in this context. As ChatGPT gains traction, institutions must address concerns to maintain academic integrity.
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| 28. |
- Ahmad, Awais, et al.
(author)
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Positive Design Framework for Carer-eSupport : A Qualitative Study to Support Informal Caregivers of Patients with Head and Neck Cancer in Sweden
- 2023
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In: JMIR Cancer. - : JMIR Publications. - 2369-1999. ; 9
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Journal article (peer-reviewed)abstract
- Background: Informal caregivers of patients with head and neck cancer (HNC), such as the patient’s spouse, other close relatives, or friends, can play an important role in home-based treatment and health care. Research shows that informal caregivers are usually unprepared for this responsibility and need support with taking care of patients and other daily life activities. These circumstances place them in a vulnerable position, and their well-being may be compromised. This study is part of our ongoing project Carer eSupport, which aims to develop a web-based intervention to facilitate informal caregivers in the home environment. Objective: This study aimed to explore the situation and context of informal caregivers of patients with HNC and their needs for designing and developing a web-based intervention (Carer eSupport). In addition, we proposed a novel framework for the development of a web-based intervention aimed at promoting the well-being of informal caregivers. Methods: Focus groups were conducted with 15 informal caregivers and 13 healthcare professionals. Both informal caregivers and healthcare professionals were recruited from 3 university hospitals in Sweden. We adopted a thematic data analysis process to analyze the data.Results: We investigated informal caregivers’ needs, critical factors for adoption, and desired functionalities of Carer eSupport.A total of 4 major themes, including information, web-based forum, virtual meeting place, and chatbot, emerged and were discussed by informal caregivers and health care professionals for Carer eSupport. However, most study participants did not like the idea of a chatbot for asking questions and retrieving information and expressed their concerns such as a lack of trust in robotic technologies and missing human contact while communicating with chatbots. The results from the focus groups were discussed through the lens of positive design research approaches.Conclusions: This study provided an in-depth understanding of informal caregivers’ contexts and their preferred functions for a web-based intervention (Carer eSupport). Using the theoretical foundation of designing for well-being and positive design in the informal caregiving context, we proposed a positive design framework to support informal caregivers’ well-being. Our proposed framework might be helpful for human-computer interaction and user experience researchers to design meaningful health interventions with a clear focus on users’ well-being and positive emotions, especially for informal caregivers of patients with HNC.
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| 29. |
- Bärkås, Annika, et al.
(author)
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Patients’ access to their psychiatric notes : Current policies and practices in Sweden
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:17
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Journal article (peer-reviewed)abstract
- Patients’ access to electronic health records (EHRs) is debated worldwide, and access to psychiatry records is even more criticized. There is a nationwide service in Sweden which offers all citizens the opportunity to read their EHR, including clinical notes. This study aims to explore Swedish national and local policy regulations regarding patients’ access to their psychiatric notes and describe to what extent patients currently are offered access to them. The rationale behind the study is that current policies and current practices may differ between the 21 self-governing regions, although there is a national regulation. We gathered web-based information from policy documents and regulations from each region’s website. We also conducted key stakeholder interviews with respondents from the regions and cross-regional private care providers, using a qualitative approach. The results show that 17 of 21 regions share psychiatric notes with patients, where forensic psychiatric care was the most excluded psychiatric care setting. All private care providers reported that they mainly follow the regions’ guidelines. Our findings show that regional differences concerning sharing psychiatric notes persist, despite Swedish regulations and a national policy that stipulates equal care for everyone. The differences, however, appear to have decreased over time, and we report evidence that the regions are moving toward increased transparency for psychiatry patients.
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| 30. |
- Bärkås, Annika, et al.
(author)
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Patients' Access to Their Psychiatric Records : A Comparison of Four Countries
- 2022
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In: Challenges of Trustable AI and Added-Value on Health. - Amsterdam; Berlin; Washington, DC : IOS Press. - 9781643682846 - 9781643682853 ; 294, s. 510-514
-
Conference paper (peer-reviewed)abstract
- Several Nordic and Baltic countries are forerunners in the digitalization of patient ehealth services and have since long implemented psychiatric records as parts of the ehealth services. There are country-specific differences in what clinical information is offered to patients concerning their online patient accessible psychiatric records. This study explores national differences in Sweden, Norway, Finland, and Estonia in patient access to their psychiatric records. Data was collected through a socio-technical data collection template developed during a workshop series and then analyzed in a cross-country comparison focusing on items related to psychiatry records online. The results show that psychiatric records online are offered to patients in all four countries, and provide the same functionality and similar psychiatry information. Overall, the conclusion is that experiences of various functionalities should be scrutinized to promote transparency of psychiatric records as part of the national eHealth services to increase equality of care and patient empowerment.
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| 31. |
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| 32. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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Experiences of Extensive User Involvement through Vision Seminars in a Large IT Project
- 2023
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In: Interacting with computers. - : Oxford University Press. - 0953-5438 .- 1873-7951. ; 35:4, s. 543-552
-
Journal article (peer-reviewed)abstract
- As the complexity of IT systems increases, the demand for methods taking the whole work situation into account grows. The Vision Seminar (VS) process addresses the future usage of technologies in complex digital work environments. This paper describes the experiences of conducting the VS process in the context of a large IT project to improve study-administrative work. The participants and stakeholders' experiences of participating in VS workshops were studied as the effect the participants and stakeholders believed the vision might have. Data were gathered through interviews and a survey. The participants were confident that the time spent on workshops was worthwhile and that achieving the future described in the resulting vision was feasible. The stakeholders perceived the VS process as rigorous. They were happily surprised by the positive spirit and engagement displayed by the participants. The utility of the resulting vision not being obvious was the most notable weakness mentioned.
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| 33. |
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| 34. |
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| 35. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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Professional decision making with digitalisation of patient contacts in a medical advice setting : a qualitative study of a pilot project with a chat programme in Sweden
- 2021
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:12
-
Journal article (peer-reviewed)abstract
- Objectives: Patient e-services are increasingly launched globally to make healthcare more efficient and digitalised. One area that is digitalised is medical advice, where patients asynchronously chat with nurses and physicians, with patients having filled in a form with predefined questions before the chat. This study aimed to explore how occupational professionalism and the possibility of professional judgement are affected when clinical patient contact is digitalised. The study’s overall question concerns whether and how the scope of the healthcare staff’s professional judgement and occupational professionalism are affected by digitalisation.Design and setting: A qualitative study of healthcare professionals working in a pilot project with a chat programme for patients in a medical advice setting in Sweden.Participants and analysis: Contextual inquiries and 17 interviews with nurses (n=9) and physicians (n=8). The interviews were thematically analysed. The analysis was inductive and based on theories of decision making.Results: Three themes emerged: (1) Predefined questions to patients not tailored for healthcare professionals’ work, (2) reduced trust in written communication and (3) reduced opportunity to obtain information through chat communication.Conclusions: The results indicate that asynchronous chat with patients might reduce the opportunity for nurses and physicians to obtain and use professional knowledge and discretionary decision making. Furthermore, the system’s design increases uncertainty in assessments and decision making, which reduces the range of occupational professionalism.
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| 36. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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The effects of automation of a patient‑centric service in primary care on the work engagement and exhaustion of nurses
- 2020
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In: Quality and User Experience. - 2366-0139 .- 2366-0147. ; 5:9
-
Journal article (peer-reviewed)abstract
- Digitalising patient-centric services to address society’s challenges with an ageing population and healthcare provision is by many seen as important. Studying the effects of the digitalisation on the work engagement of the users of the new systems is vital in this context, especially since previous research has established that the work engagement at work in healthcare is problematic. Work engagement is defined as a positive, fulfilling, affective-motivational state of work related well being, as is closely connected to the experience of resources and demands in the work context. These resources can be for example digital support, experienced demands or empowerment whereas exhaustion is connected to work demand in a workplace. This study contributes to knowledge about the effects of digitalisation on work engagement and exhaustion in the context of patient-centred services and eHealth. Contextual interviews were conducted on site for 5 h with nurses using a new chat function and using telephone for medical advice to patients. Additionally, semi-structured interviews were conducted with all the nurses participating in this digitalisation project to gather more insights into their work engagement in the two work situations. Results were analysed in different themes of areas affected by the digitalisation in the two overarching themes: job demands and job resources. The results show that the change to a chat function when communicating with advice seekers had connection to work engagement in several ways. The nurses experienced less time pressure and emotional pressure, but also a loss of job control and feedback from colleagues working from home.
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| 37. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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UX professionals’ learning and usage of UX methods in agile
- 2022
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In: Information and Software Technology. - : Elsevier. - 0950-5849 .- 1873-6025. ; 151, s. 107005-107005
-
Journal article (peer-reviewed)abstract
- Context: The usage of User Experience (UX) methods has been studied through the years. However, little is known about UX professionals’ lifelong learning processes related to UX methods in Agile, choosing what UX methods to use, and the enablers and hindrances for using the UX methods.Objective: The study aims to broaden current knowledge about UX professionals’ lifelong learning practices to understand their work situations better. The paper describes how UX professionals learn about and choose UX methods, their frequency of use, and the enablers and barriers when using the UX methods in Agile.Method: An interview study was conducted with 13 UX professionals from various industries and two countries working with Agile and UX. We used a qualitative approach, and a thematic analysis was carried out to answer the research questions.Results: The results show that support from colleagues is an essential component for learning about the methods and how to use UX methods. Time pressure makes UX professionals choose methods they know will deliver their desired results. Prototyping, user testing, user journeys, and workshops are the most frequently used UX methods. Additionally, the results show that UX professionals think that the UX methods are often too complicated and take too long to learn. Additionally, they find it challenging to integrate UX methods into Agile.Conclusion: These findings indicate that UX methods might work better if designed to be less complicated and deliver results more efficiently. Moreover, collegial and peer learning is central to UX professionals. The HCI community could be more active in supporting this culture by sharing information and learning. Finally, the usability and UX of the tools affect which UX methods are used.
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| 38. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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Walking in the Jungle with a Machete : ICT Leaders' Perspectives on User-Centred Systems Design
- 2022
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In: Behavior and Information Technology. - : John Wiley & Sons. - 0144-929X .- 1362-3001. ; 41:6, s. 1230-1244
-
Journal article (peer-reviewed)abstract
- Previous research has established that leaders in information and communication technology (ICT) are crucial for establishing a user-centred systems design perspective in ICT for work-related tasks. This paper therefore describes the perspectives of 18 ICT leaders in three kinds of leadership roles (managers, project leaders and specialists) in order to understand their views of user-centred systems design concerning ICT. It uses the concept of technological frames of reference to analyse three domains: technology-in-use, technology strategy and nature of technology. The results show that many specialists see user involvement as a critical factor in successfully establishing new information and communication technologies, but that these systems are currently built around the needs of management rather than end users. Looking forward, all three relevant social groups are optimistic about how ICT will become more user-centred and more strategically aligned in the future. However, changes in ICT are described as extremely energy-consuming and difficult – akin to ‘walking in the jungle with a machete’. Finally, we discuss the relevance of technological frames and present some implications for the successful establishment of user-centred system design as a perspective in organisations.
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| 39. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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What brings women into ehealth? : Women's career trajectories in digital transformations in health care
- 2020
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In: Proceedings of the 12th International Conference on e-Health.
-
Conference paper (peer-reviewed)abstract
- Digital transformation of health care services is addressed world-wide in order to more efficiently meet the patients’ information and health care needs. However, little is known about the people working with this transformation, where two traditionally gendered fields meet; health care and IT. While work with digitalization generally is dominated by men, digitalization of health care services involves a large number of women. This case study explores the career trajectories of women working with the digital transformation of eHealth services. Who are the women in this eHealth project, and how did they come to working with this digital transformation? The analysis shows different types of trajectories that brought the women into eHealth transformations: The first illustrating women who were pushed into working with eHealth by their job descriptions, the second showing women using eHealth as an escape route from something else, and the last trajectory showing how women stumbled across eHealth and decided to stay on. This has implications for the educational system, and points to the need for being able to study computer science later in life. It also calls for a better understanding of what drives women in transformation processes.
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| 40. |
- Daniels, Mats, 1956-, et al.
(author)
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Why Don't You Tell Me What I Need to Know? : Self-Flipped Classroom and Students' Personal Epistemology
- 2021
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In: 2021 IEEE Frontiers in Education Conference (FIE). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781665438513
-
Conference paper (peer-reviewed)abstract
- This is a full research paper addressing the crucial element of understanding students when creating learning environments. It is for instance important to be aware of how students appreciate our way of teaching and to consider consequences of students not understanding or plainly disliking a setup. This paper addresses the negative experiences of students in a peer-learning environment named the self-flipped classroom. Through the lens of a theory of personal epistemology we investigate course evaluation reports and observations from anonymous students. Results indicate that the personal epistemology framework indeed gives some answers to students disliking the self-flipped aspect of the course, and that some students would rather be told what to learn in detail as in the quote: “why don't you tell me what I need to know?”. Finally the paper presents some ideas on ways forward.
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| 41. |
- Dolezel, Michal, et al.
(author)
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Towards Mapping of Information Technology : Induced Alterations in Online Physicians’ Professional Identities
- 2022
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In: Linköping Electronic Conference Proceedings 187. - 9789179293444 ; , s. 69-76
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Conference paper (peer-reviewed)abstract
- Digital Patient Contact Technologies (DPCT), including telemedicine solutions and digital tools for text-based communication between patients and physicians, play a major role in today’s healthcare. Professional identity defines norms, principles, and logic that guide one’s professional actions. Presently, little research evidence is available regarding professional identity changes in the context of DPCT implementations. This work theoretically and empirically illustrates the nature of the possible DPCT’ impact on physicians’ professional identities. To this end, a conceptual framework was constructed and the interviews with eight physicians operating an asynchronous healthcare-advice chat service (1177 Vårdguiden) in Uppsala, Sweden were examined.
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| 42. |
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Generic Requirements for Inclusive Healthcare Software: Supporting Older Adults and People with Intellectual and Developmental Disability
- 2023
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Editorial proceedings (peer-reviewed)abstract
- As healthcare technology advances, it is important to ensure that everyone benefits from healthcare software, regardless of age or ability. That is why our research team has been working to identify and encapsulate the unique needs of two groups when developing software systems: older adults and people with mild intellectual and developmental disabilities. Through our research, we have developed design patterns that software engineers can use to create more usable healthcare software to support these groups. These patterns identify the generic requirements for usability including accessibility, crucial for creating software that meets the needs of marginalised populations. In this paper, we describe the steps we undertook to identify and develop these requirements. We discover many overlapping needs of these two cohorts. Our research aims to benefit older adults and people with mild intellectual and developmental disabilities and improve the lives of many others facing similar challenges. As we expand our research to other cohorts, we will be able to identify additional generic requirements that make healthcare software development more inclusive and effective.
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| 43. |
- Golay, Diane, 1992-, et al.
(author)
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An Emotion-driven Approach to Hospital Physicians' Work-Related User Experience
- 2022
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In: Proceedings 10th Nordic Conference on Human-Computer Interaction - NordiCHI '22. - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450396998
-
Conference paper (peer-reviewed)abstract
- Recent studies have found a correlation between information technologyuse and physician burnout, though little is known aboutphysicians’ workplace user experience. Thus, this paper examinesphysicians’ work with electronic medication orders through a userexperience and well-being lens. We interviewed ten physiciansworking clinically at a large Swedish hospital and analyzed theirexperiences qualitatively from an emotion-driven perspective. Participants’stories were associated with joy, relaxation, confusion,anxiety, and frustration. On this basis, we formulated four UX goals:I feel joy as I complete my IT-supported tasks quickly and effortlessly,the steps I carry out feel meaningful as I understand their purpose,I feel confident on how to proceed to produce the outcome I want,and I experience relaxation as I feel supported in minimizing risk ofpatient harm. By (re)designing health IT systems and practices tofoster these positive experiences, health IT designers may improvephysician work well-being.
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| 44. |
- Golay, Diane, 1992-
(author)
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An Emotion-Focused Approach Towards Improving Clinicians' Work-Related User Experience
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Recent studies have associated clinician burnout with health information technology use. Researchers have attributed this negative impact of health information technology use on clinician well-being to poor system usability and insufficient clinician involvement in system design and implementation.Against this backdrop, this thesis first examined the discrete negative and positive emotions that clinicians experience at work in connection with health information technology use, and defined desirable user experience goals for health information technology design and implementation. Second, it identified different breakdowns in the communication between hospital nursing staff and information technology staff members.Data were collected through focus groups and interviews with registered nurses, nursing assistants, physicians, and information technology staff members working at or affiliated with a large Swedish hospital. The data were analyzed qualitatively through thematic analysis.Hospital nursing staff and physicians were found to experience frustration, perplexity, anxiety, alienation, psychological and moral distress, joy, relief, relaxation, and confidence in connection with their work-related use of health information technology. On this basis, joy, relaxation, confidence, gratitude and pride were identified as desirable user experience goals for clinicians' work-related information technology use. Finally, breakdowns in the communication between hospital nursing staff and information technology staff members were found to include lack of user studies, low-level filtering of nursing staff's electronic error reports, unintelligible electronic error reports, and nursing staff not attending in-person training sessions and not checking information technology-related communications on the intranet.These findings contribute to the field of human─computer interaction by shedding light on information technology staff members' work and on clinicians' work-related user experience, and by defining user experience goals for clinicians' work-related information technology use. Health information technology designers and implementers can draw from these findings to foster clinician well-being through the design of health information technology systems and routines.
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| 45. |
- Golay, Diane
(author)
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An invisible burden : An experience-based approach to nurses' daily work life with healthcare information technology
- 2019
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Licentiate thesis (other academic/artistic)abstract
- Information and Communication Technology (ICT) has been an increasingly pervasive component of most workplaces throughout the past half century. In healthcare, the turn to the digital has resulted into the broad implementation of Healthcare Information Technology (HIT). The impacts of ICT on work life have been investigated predominantly through surveys, although some researchers have advocated for the use of a qualitative, experience-based approach. Meanwhile, the existing body of research on the impacts of HIT on clinicians has painted a mixed picture of digitalization. Despite some clear benefits, HIT has indeed been found to have unexpected, unintended adverse consequences for hospital staff. Typical issues include loss in efficiency, extra effort to carry out routine tasks, and the creation of new, HIT-induced work activities. Simultaneously, research outside of the healthcare domain has shown that ICT could require extra effort from some users in order for the sociotechnical system to function properly – extra work often invisible to developers.Based on observation, interview and focus group data collected at a large Swedish hospital, this thesis set out to investigate the impact of HIT on hospital nurses from an experience-based perspective, resulting in four main contributions. First, a method supporting experience-based data analysis, the HolisticUX method, is introduced. Second, 13 forms of HIT-induced additional tasks in nurses' workload are identified, five of which are not acknowledged in previous research. Third, task avoidance is identified as a consequence of nurses' increased workload, negatively affecting patient safety, care quality and nurses' professional satisfaction. Finally, four factors are argued to contribute to a suggested invisibility of the HIT-induced time burden in nurses' work life to management and developers: 1) lack of a holistic perspective, 2) the hidden cost of a single click, 3) the invisibility of nursing work, and 4) visible data, invisible work.
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| 46. |
- Golay, Diane, 1992-, et al.
(author)
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Communication Breakdowns between Nurses and IT Department : Why Hospitals Fail at Improving the Usability of Health Information Technology
- 2020
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In: Proceedings of the 18th International Symposium on Health Information Management Research. - 9789189081093
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Conference paper (peer-reviewed)abstract
- Often, Health Information Technology (HIT) in hospitals consists of off the shelf systems that are configured and implemented by IT department workers. This means that these employees have a significant impact of the usability of HIT systems. Nonetheless, we currently do not know how IT department workers work. This prevents us from formulating educated recommendations aimed at improving HIT usability, known to be poor, especially from nurses’ perspective. In this paper, we hence present the results from an interview study, shedding light on 1) the communication channels that exist between nurses and IT department at a large public hospital in Sweden, and 2) the problems that undermine system-related communication between these two groups. Our findings stress the need for successful two-way communication between nurses and IT department in order to improve the usability of HIT in use.
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| 47. |
- Golay, Diane, 1992-, et al.
(author)
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Effortlessness and Security : Nurses' Positive Experiences With Work-Related Information Technology Use
- 2022
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In: Computers, Informatics, Nursing. - : Wolters Kluwer. - 1538-2931 .- 1538-9774. ; 40:9, s. 589-597
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Journal article (peer-reviewed)abstract
- Nurses' well-being at work has been an increasing concern the past few years, in particular in connection with work-related information technology use. Researchers have thus been called to explore ways of fostering nurses' well-being at work. However, little is known about the factors related to information technology that contribute to nurses' positive experience of and well-being at work. In this study, we sought to understand the appraisals and emotions at the core of nurses' positive experiences with information technology use at work. We conducted focus groups and semistructured interviews with 15 ward nurses working at a large Swedish hospital. The data were analyzed qualitatively using process and causation coding. We found appraisals of easy goal accomplishment, doing less of a particular task, knowing what the situation is and what has to be done, mastering the system, reduced risk of mistakes and omissions, and assured access to patient information. Using design theory, we connected these appraisals with four positive emotions: joy, relief, confidence, and relaxation. These findings suggest that effortlessness and security are central to nurses' positive experience of information technology. Implementing information technology–related features and practices associated with them in healthcare organizations may foster nurses' well-being at work.
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| 48. |
- Golay, Diane, 1992-, et al.
(author)
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Information Technology Use and Tasks Left Undone by Nursing Staff : A Qualitative Analysis
- 2023
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In: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 29:4, s. 1-10
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Journal article (peer-reviewed)abstract
- Nursing staff perceive information technology (IT) as time-consuming and impinging on direct patient care time. Despite this, researchers have directed little attention toward the interplay between IT use and tasks left undone by nursing staff. In this paper, we analyze interview and focus group data on hospital nursing staff’s experience working with IT to identify ways IT use interacts with tasks left undone. We found that tasks left undone by nursing staff can have IT-related antecedents and that IT-related tasks are also sometimes left undone. This analysis adds to the body of knowledge by showing that tasks related to the work environment and IT can be left undone and that nursing staff avoid certain IT-supported tasks because they do not know how to do them or why they ought to be done. These findings form the basis for our call for further research on the topic.
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| 49. |
- Golay, Diane, 1992-, et al.
(author)
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Negative emotions induced by work-related information technology use in hospital nursing
- 2022
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In: Computers, Informatics, Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 1538-2931 .- 1538-9774. ; 40:2, s. 113-120
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Journal article (peer-reviewed)abstract
- There is a lack of research into the implications of information technology-related issues for nurses' experiences and well-being at work. However, negative work experiences can generate negative emotions, which, in turn, can negatively affect well-being. Despite this, research has not systematically addressed negative emotions generated by work-related information technology use in hospital nursing. Drawing on data collected through focus groups and interviews with a total of 15 ward nurses, this paper identifies the discrete negative emotions that emerge from work-related information technology use in hospital nursing and maps the identified emotions onto the perceptions associated with and triggering them. The analysis was qualitative and included process, emotion, and causation coding alongside extensive memo writing. We identified six primary negative emotions: frustration, moral distress, alienation, psychological distress, anxiety, and perplexity. All of the identified emotions can be associated with four types of experiences of feeling hindered: mental effort, inability to carry out a task, doing extra or unnecessary work, and failing to complete a task successfully. The framework we present may support healthcare organizations in identifying potentially harmful information technology-related configurations in their infrastructure and implementing appropriate measures to foster nurses' well-being at work.
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| 50. |
- Gulliksen, Jan, et al.
(author)
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Digital spetskompetens – den nya renässansmänniskan : Genomlysning, definition, prognosverktyg och rekommendationer för framtida utveckling
- 2020
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Reports (pop. science, debate, etc.)abstract
- Att Sverige ska vara “bäst i världen på att utnyttja digitaliseringens möjligheter” är sedan 2011 regeringens övergripande digitaliseringsmål. Regeringens digitaliseringsstrategi från 2016 bryter ner målet i fem delmål, där digital kompetens är det som lyfts först och innehåller största andelen förslag. För att möta näringslivets och offentlig sektors behov måste matchningen av kompetens och behovet av en ökad digitalt kompetent arbetskraft tillgodoses enligt digitaliseringsstrategin. I “Smart industri”, regeringens nyindustrialiseringsstrategi, lyftes digitalisering av industri och ökade kompetensbehov, i regeringens nationella strategi för informations‐ och cybersäkerhet måste Sverige stärka behovet av kompetensförsörjning inom området. Det betonas även i regeringens nationella inriktning för artificiell intelligens från 2018 att om Sverige ska vara ledande i att tillvarata AI:s möjligheter för ökad välfärd och stärkt konkurrenskraft, behöver vi öka andelen personer som har de kunskaper som behövs för att använda och utveckla AI. I OECD:s analys “Going Digital in Sweden” från 2018 av vad Sverige behöver göra för att vara bäst i världen på att utnyttja digitaliseringens möjligheter, konstateras att bristen på digitala specialister och digital spetskompetens är en flaskhals för innovation och tillväxt i Sverige och behovet kommer att öka när digitaliseringen utvecklas och nya teknologier som AI får genomslag. Även Digitaliseringsrådet efterfrågar ett gemensamt agerande från arbetsmarknad, näringsliv och utbildningssektorn för ökad matchning mellan utbud och efterfrågan på digital kompetens samt för ökad jämställdhet i IT‐ branschen. Begreppet digital spetskompetens har flitigt använts i media och rapporter, utan att ha haft en gemensamt överenskommen definition eller betydelse. Denna rapport har analyserat och penetrerat digital spetskompetens för att förstå hur begreppet uppfattas av näringsliv och offentlig sektor, av de som anställer och de som utbildar, av de som själva besitter digital spetskompetens och de som har behov av att anlita sådan. Vi har diskuterat vad utbildning spelar för roll, huruvida det krävs en bred digital förståelse eller djup unik spetskompetens inom ett specifikt område, vad färdigheter har för betydelse, huruvida attityder och värderingar spelar någon roll och huruvida det krävs en konstant vidareutveckling av kunskapen för att kunna sägas besitta digital spetskompetens. Rapportens titel “Digital spetskompetens – den nya renässansmänniskan” är vald för att belysa de många krav och förväntningar som läggs på den digitalt spetskompetente i att vara såväl högutbildad och allmänbildad, vara ansvarstagande, föränderlig och stadigt i vidareutveckling, etc. Vi ser en förväntansbild som visar på komplexiteten att faktiskt kunna definiera begreppet på ett heltäckande sätt. Begreppet renässansmänniska avses inte tolkas maktstrukturellt. Arbetet har genomförts under perioden januari‐april 2020 av undertecknande forskare vid KTH och Uppsala universitet. Förutom huvudförfattarna har även Jeffrey Buckley, postdoktor i teknikvetenskapens lärande, bidragit med sammanställning och analys av litteraturen och rapid reviewprocessen. Vi vill härmed tacka alla som bidragit genom intervjuer, workshops, analyser och diskussioner och framför allt våra uppdragsgivare från UKÄ och Tillväxtverket för stöd och diskussioner under projektets gång. Tack också till Helena Bernald som korrekturläst och bistått med transkribering. För rapporten svarar dock huvudförfattarna.
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