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- Glock, Hanna, et al.
(author)
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Attitudes, Barriers, and Concerns Regarding Telemedicine Among Swedish Primary Care Physicians : A Qualitative Study
- 2021
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In: International Journal of General Medicine. - 1178-7074. ; 14, s. 9237-9246
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Journal article (peer-reviewed)abstract
- PURPOSE: The primary care physician's traditional patient contacts are challenged by the rapidly accelerating digital transformation. In a quantitative survey analysis based on the theory of planned behavior, we found high behavioral intention to use telemedicine among Swedish primary care physicians, but low reported use. The aim of this study was to further examine the physicians' experiences regarding telemedicine, with a focus on possible explanations for the gap between intention and use, through analysis of the free-text comments supplied in the survey.MATERIAL AND METHODS: The material was collected through a web-based survey which was sent out to physicians at 160 primary health care centers in southern Sweden from May to August 2019. The survey covered four areas: general experiences of telemedicine, digital contacts, chronic disease monitoring with digital tools, and artificial intelligence. A total of 100 physicians submitted one or more free-text comments. These were analyzed using qualitative content analysis with an inductive approach.RESULTS: The primary care physicians expressed attitudes towards telemedicine that focused on clinical usefulness. Barriers to use were the loss of personal contact with patients and a deficient technological infrastructure. The major concerns were that these factors would result in patient harm and an increased workload. The connection between intention and use postulated by the theory of planned behavior was not applicable in this context, as external factors in the form of availability and clinical usefulness of the specific technology were major impediments to use despite a generally positive attitude.CONCLUSION: All telemedicine tools must be evaluated regarding clinical usefulness, patient safety, and effects on staff workload, and end users should be included in this process. Utmost consideration is needed regarding how to retain the benefits of personal contact between patient and provider when digital solutions are introduced.
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| 2. |
- Glock, Hanna, et al.
(author)
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‘In the end, I’m the one who has to do the job’ : Participant experience of a lifestyle intervention for patients with hypertension
- 2023
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In: Scandinavian Journal of Primary Health Care. - 0281-3432. ; 41:4, s. 457-468
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Journal article (peer-reviewed)abstract
- Objective: Cardiovascular disease can be prevented through lifestyle changes, but such changes are often hard to attain. Text message interventions with lifestyle advice have shown small but promising effects. Our objective was to explore participant experience of a text message lifestyle intervention for patients with hypertension, and implications for future lifestyle interventions. Design and subjects: Fourteen participants were purposefully selected for telephone interviews after completion of a text message lifestyle intervention. A semi-structured interview guide with open-ended questions was used. Interviews were recorded and transcribed verbatim. The material was analyzed through systematic text condensation as described by Malterud, a data-driven analysis style that includes deductive elements. Setting: Primary care in three regions in southern Sweden. Results: The analysis resulted in three themes. ‘Blood pressure and lifestyle, how seriously to take it?’ revealed a remaining need for knowledge regarding to what extent lifestyle affects risk for cardiovascular disease. ‘The text messages–a useful reminder in need of tailoring’ described that the design of the intervention was satisfactory, but suggested improvements through increased individualization. Finally, ‘Water off a duck’s back or a kick in the pants–when does behavior change?’ showed how some participants responded to the push to change while others did not, supplying material for further analysis in a framework of behavioral change theory. Conclusion: A key to adoption was advice that was applicable in daily life. Timing in relation to a diagnosis of hypertension or other motivational factors, and tailoring to prior knowledge, habits, and limitations could increase effectiveness.
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| 3. |
- Modée Borgström, Agnes, et al.
(author)
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Occurrence of mucosa-affecting diseases of the upper airways in middle ear cholesteatoma patients : a nationwide case-control study
- 2024
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In: European Archives of Oto-Rhino-Laryngology. - : Springer. - 0937-4477 .- 1434-4726.
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Journal article (peer-reviewed)abstract
- PURPOSE: Exploring a possible link between upper airway inflammation and the development of cholesteatoma by studying the association between mucosa-affecting diseases of the upper airways and cholesteatoma surgery.METHODS: This is a nationwide case-control study of 10,618 patients who underwent surgery for cholesteatoma in Sweden between 1987 and 2018. The cases were identified in the National Patient Register and 21,235 controls matched by age, sex and place of residency were included from national population registers. Odds ratios (OR) and corresponding 95% confidence intervals were used to assess the association between six types of mucosa-affecting diseases of the upper airways and cholesteatoma surgery.RESULTS: Chronic rhinitis, chronic sinusitis and nasal polyposis were more common in cholesteatoma patients than in controls (OR 1.5 to 2.5) as were both adenoid and tonsil surgery (OR > 4) where the strongest association was seen for adenoid surgery. No association was seen between allergic rhinitis and cholesteatoma.CONCLUSION: This study supports an association between mucosa-affecting diseases of the upper airways and cholesteatoma. Future studies should aim to investigate the mechanisms connecting mucosa-affecting diseases of the upper airways and cholesteatoma formation regarding genetic, anatomical, inflammatory and mucosa properties.
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