Users evaluation of a Spanish eHealth pediatric website

A systematic review of consumers' and healthcare professionals' trust in digital healthcare

Despite the well-documented importance of trust in digital healthcare, its domains are not well-understood, preventing theoretically robust instruments for standardised measurements. We identified instruments measuring trust in digital healthcare, explored definitions, associated factors, and outcomes. We systematically reviewed the literature using tailored searches and 49 studies measuring trust in digital healthcare from either consumers', healthcare professionals', or both perspectives were included. Trust in digital healthcare is complex and, from a consumers' perspective, can influence digital healthcare use, adoption, acceptance, and usefulness. Consumers' trust can be affected by the degree of human interaction in automated interventions, perceived risks, privacy concerns, data accuracy, digital literacy, quality of the digital healthcare intervention, satisfaction, education, and income. Healthcare professionals' trust is enhanced by education and observing good digital health performance. While studies can benefit from rigorous trust measurements, future efforts should address the need for a theoretical framework for trust in digital healthcare.

Enhancing Telemedicine Communication for Improved Outpatient Pediatric Trauma Care

INTRODUCTION

Pediatric traumatology is a complex field that requires a comprehensive understanding of physeal development, remodeling potential, and the ossification process in order to ensure appropriate patient treatment. The objective of this study was to assess the willingness of practicing physicians to participate in a telemedicine collaboration aimed at enhancing the exchange between the outpatient and inpatient sectors and promoting the digitalization of the pediatric sector. This is in response to the growing significance of digitalization in the medical field.

METHODS

A survey consisting of 15 items was sent to 800 practicing trauma surgeons, pediatric surgeons, and pediatricians within a 100 km radius of Hamburg, Germany. The survey included questions about the respondents' professional experience and telemedicine experience, as well as inquiries about possible telemedicine collaborations.

RESULTS

The response rate was 19.3%. Less than half of the participants already used telemedicine in daily practice. In general, 75% of respondents expressed an interest in collaborating with the inpatient sector. The most common reasons for hospital referral were the need for surgery, inadequate treatment of children in practice and co-assessment. The majority were in favor of flexible communication, either via video telephony, imaging applications like or messaging applications.

CONCLUSIONS

The study revealed a high level of interest in telemedicine collaboration. Information exchange should be tailored to individual needs, with practitioners requiring a versatile and personalized approach that includes imaging. Strict enforcement of data protection regulations is essential. Further research is needed to evaluate the effectiveness of telemedicine collaboration in the treatment of pediatric trauma in both hospital and outpatient settings.

Using QR Codes as a Form of eHealth to Promote Health Among Women in a Pandemic: Cross-sectional Study

Background

QR codes have played an integral role during the pandemic in many sectors, but their use has been limited in the health care sector, especially by patients. Although some authors have stated that developing specific content for women on how to cope with health problems could be an effective way to prevent problems, especially during pandemics, there is little research regarding the use of QR codes to promote health during a pandemic, and even fewer studies are focused on women. Moreover, although the importance of assessing these interventions from the users’ perspective has been stated, research carried out from this point of view is still scarce.

Objective

This study aimed to assess the usefulness of using QR codes with information to promote women’s health in the context of a pandemic. We also sought to design and validate a questionnaire to assess this.

Methods

A cross-sectional study was conducted among women in the gynecology waiting rooms of a reference hospital. Exploratory factorial analysis with the split-half method and Cronbach α values was performed for questionnaire validation. Univariant and bivariant analyses were performed to analyze the data obtained.

Results

In total, 186 women took part in the study. Exploratory factor analysis identified 2 domains: usability and applicability in medical practice. The Cronbach α value was .81. Overall, 83.7% of the answers to the first domain and 56.4% of those to the second were favorable. Women with university education or those who had used QR codes before scored better in the usability domain, while no differences were observed in the applicability scores.

Conclusions

Using QR codes in the gynecology clinics’ waiting rooms can help promote women’s health during a pandemic, regardless of their education level or whether they have used QR codes before. The questionnaire developed herein is a helpful tool to assess this. These findings are important for clinical practice. This research can be performed in other ambits, specialties, or countries.

Competence and Attitude of Family Physicians towards Sexuality Regarding Their Sexual Orientation, Age, or Having a Partner-Survey Study and Validation

BACKGROUND

The main objective of this study was to assess different aspects of family physicians (sex, age, sexual orientation, or having a partner) regarding their competencies, attitudes, and procedures towards their patients' sexuality. We also sought to develop a valid questionnaire to perform this task.

METHODS

A cross-sectional study was performed among family and community medicine physicians in southeast Spain.

RESULTS

A total of 259 family physicians participated. Overall, 69.9% were women, 80.7% were heterosexual, 80.7% had a partner, and 50.6% had not received specific sexology training. Homosexual physicians showed a slightly more positive attitude toward sexuality. Training in sexuality established differences in competencies and procedures, but no differences were found in the attitude regarding whether the physicians had a partner or their training. While younger ages were correlated with a more positive attitude, the global score was positively correlated with the age of the professionals.

CONCLUSIONS

Competences, attitudes, and knowledge of procedures do not depend on whether the professional has a partner, but there may be slight differences regarding attitude when considering the sexual orientation of the physicians. The attitude toward sexuality may not depend on previous training. Albeit younger family physicians have a more positive attitude, all providers become more involved with sexuality as they gain professional experience.

Implementation of a Personalized Digital Application for Pediatric Pre-Anesthesia Evaluation and Education: An Ongoing Usability Analysis and Dynamic Improvement Scheme

BACKGROUND

Pre-anesthesia evaluation session is a basic practice preceding any surgical procedure, aimed at tailoring individualized anesthetic plan per patient, improving safety, and providing patients with educational knowledge and tools in preparation for the surgery day. In the last two decades, electronic health (eHealth) and mobile health (mHealth) settings gradually replaced part of the face-to-face encounters as the platform for pre-anesthesia communication between doctor and patient, yielding a range of benefits as demonstrated in recent publications. Yet, there is a lack of studies examining the effectiveness of surgical mHealth applications focusing on the pediatric preanesthetic setting and addressing their usability among families.

OBJECTIVE

This study describes a dynamic approach for the development process of GistMD's pre-anesthesia mHealth system, a mobile-based educational and management system designed for the pediatric setting.

METHODS

The study was conducted in four departments in a 1500-beds quaternary, academic medical center in Tel Aviv, Israel. During the study period, pre-anesthesia system was sent via text message to families whose children were about to undergo surgery. The system included pre-anesthesia questionnaires, educational videos, downloadable instructions, and consent forms. Ongoing collection and examination of usability data were conducted during the implementation term including responsiveness, effectiveness, and satisfaction indicators. The information collected in each stage was used to draw conclusions regarding potential usability gaps of the system and to plan product adjustments for the following period.

RESULTS

In a period of 141 days of implementation, GistMD pre-anesthesia management system was sent to 769 families. Three product fit actions were applied during this term: (1) Change of text message scheduling, aimed at addressing learnability and accessibility, resulted in a significant increase of 27% (χ2 [1] = 12.65, P<.001) in view rates and 27.4% (χ2 [1] = 30.01, P<.001) in satisfaction rates; (2) Reduce the number of screens, aimed at increasing efficiency and operability, resulted in a significant decrease of 8.6% of cases in which users did not perform any activity on the system after logging in (χ2 [1] = 6.18, P=.02); (3) Patient-focused campaign in two departments aimed at addressing memorability, resulted in significant increases in eight of twelve usability indicators.

CONCLUSIONS

Our results indicate that mHealth product-fit decisions derived from theory-based approach and ongoing usability data analysis allow tailoring of most appropriate responses for usability gaps, as reflected in increasing use rates and satisfaction. In the case of the pre-anesthesia management system in the pediatric setting, increased usability conveyed important benefits for patients and families. This work suggests a framework and study methods that may also be applicable in other mHealth settings and domains.

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