Determinants of ICT usage for healthcare among people with disabilities: The moderating role of technological and behavioural constraints

A self-care process model for patients with chronic noncommunicable diseases

Self-care of patients with chronic noncommunicable diseases is an essential component of contemporary healthcare. The purpose of this paper is to present a novel self-care process model and place it in the broader context of professional care. The extended Event-driven Process Chain approach to process modelling was used, focusing on a detailed overview of sequences of events, connections and activities and other elements/building blocks. A self-care process model was designed. The model is divided into two parts. The first part represents the self-care process when patients are able to manage their symptoms and be independent. The second part includes the process when patients are unable to perform self-care and/or need professional support. By identifying the essential elements of this process and incorporating them into the patients' care process, we can ensure that professional support for self-care creates a dynamic balance in the patients' ecosystems. Patients with chronic noncommunicable diseases need to make timely decisions about individual aspects of their health and seek professional help. In this way, an optimal level of health and well-being of patients can be achieved. Focusing on the patients' self-care process could also reduce treatment costs and improve the quality of life of patients. The novel designed model of the process of self-care, with all its essential elements, can be supported by digital technology, especially in the decision-making process and needs to become an important part of healthcare and long-term care systems.

Tensions between closure of the digital divide and acts of care in residential settings for persons with disabilities. A study of adopting customised information and communication technology

PURPOSE

In contemporary society, being unable to take advantage of information and communication technology (ICT) can create barriers to maintaining social relations and, thus, can increase the risk of social exclusion and loneliness. Prior studies have revealed that, among persons with disabilities, customised ICT can contribute to the maintenance and improvement of personal social networks. Nevertheless, there is still a need for knowledge regarding the adaption of ICT of those involved when customized ICT are set up in the residents for persons with disabilities.

METHODS

Through conducting interviews with four residents, as well as their relatives and members of staff this article explores how KOMP, a customised ICT product designed to enhance digital contact among people who are unable to use ICT independently, was applied in four different municipal residences in Norway. Collective qualitative analysis was utilised to perform this investigation.

RESULTS

The analysis show that KOMP can help strengthen relationships, interferes with interactional practices, and underscores the institutionalised lives in the residences. These findings emphasise that applying customised ICT/KOMP in such settings highlights the underlying tensions regarding residents' rights to self-determination and privacy.

CONCLUSIONS

This study provides insights into how formal and informal regulations developed by relatives and staff, with the purpose of both protecting residents and protecting oneself from digital exposure, impacts the residents' ability to take advantage of customised ICT and overcome the digital disability divide.

Applications to augment patient care for Internal Medicine specialists: a position paper from the EFIM working group on telemedicine, innovative technologies & digital health

Telemedicine applications present virtually limitless prospects for innovating and enhancing established and new models of patient care in the field of Internal Medicine. Although there is a wide range of innovative technological solutions in Europe, there are overarching elements associated with such technologies when applied to the practices of Internal Medicine specialists. The European Federation of Internal Medicine (EFIM) strongly advocates for active leadership and influence from the Internal Medicine societies and specialist physicians across Europe in the development and application of telemedicine and digital technologies in healthcare. This position paper's conclusions were drawn via Delphi method, which was developed collaboratively from July 2021 to December 2023. The panel, consisting of experts in clinical medicine, public health, health economics and statistics, assessed various aspects related to telemedicine. Participants assigned scores on a Likert scale reflecting perceived value and potential risks. The findings were consolidated in a comprehensive checklist aligning with relevant literature and a SWOT analysis. Specifically, key issues that need to be addressed include promoting the professional development of e-health competencies in the healthcare and medical workforce, using educational campaigns to promote digital literacy among patients and caregivers, designing and implementing telemedicine applications tailored to local conditions and needs and considering the ethical and legal contexts under which these applications are employed. Importantly, there is currently no consensus on care models or standardized protocols among European Internal Medicine specialists regarding the utilization of telemedicine. This position paper aims to outline the opportunities and challenges associated with the application of telemedicine in Internal Medical practice in Europe.

Inaccessible Possibilities: experiences of using ICT to engage with services among young persons with disabilities

PURPOSE

The use of Information and communications technologies (ICT) in the public sector is widespread and on the increase. There is a need to develop knowledge regarding the end users experiences of using ICT to engage with services. This study aims to provide knowledge regarding young persons with disabilities or chronic disease experience using ICT to engage with health- and social care services.

MATERIALS AND METHODS

Nine young persons between 16 and 25, living with chronic disease or physical disability, participated in this study. The data was collected using semi-structured interviews. The interviews were recorded, transcribed verbatim and analysed using Constructivist Grounded Theory.

RESULTS

Three categories were identified that reflected the young persons' experiences with using ICT to engage with health and social care services. (1) Navigating in an information overflow, (2) Experiencing disparate dialogues, (3) Utilising the potential of ICT. The young persons experienced that ICT used for engaging with health and social care services did not necessarily fit their need, yet, they saw how ICT had potential to increase engagement with services, especially with an increased focus on dialogue. The findings can be subsumed by the core category Inaccessible Possibilities, illustrating both the potentials and the challenges ICT presented.

CONCLUSION

The study shows that although young persons are perceived as digitally native, they experienced challenges using ICT to engage with health- and social services. The poor fit of ICT combined with navigation- and accessibility issues, hinder engagement. However, ICT inhabit a potential to increase engagement, especially communication.IMPLICATIONS FOR REHABILITATIONYoung persons' experiences show that ICT can be useful for enhancing engagement with health and social care servicesICT provided by health and social services does not necessarily meet young persons need for dialogueAn increased focus on accessibility and design is necessary to ensure people with disabilities access to ICT used by health- and social care services.

Examining the determinants of eHealth usage among elderly people with disability: The moderating role of behavioural aspects

BACKGROUND

Existing studies have demonstrated that behavioural barriers impede eHealth usage among senior citizens. However, thus far, no analysis of how such barriers affect elderly people with disabilities (PwD) has been conducted. Thus, the study investigates the predictors of eHealth usage among elderly PwD.

METHODS

Using data from a 2018 nationwide disability survey comprising 14,798 respondents in Australia, multivariate logistic regression models are used to predict the relationship between eHealth usage and the various characteristics of respondents, including access to information and communication technologies (ICTs), socioeconomic status, and level of education.

RESULTS

Although most participants (approximately 88%) have access to ICTs, few (only around 9%) have used eHealth services. The results show a number of factors are associated with an increased likelihood of using eHealth services, including higher educational attainment (odds ratio [OR] = 3.12, 95% confidence interval [CI]: 2.38, 4.24), employment (OR = 1.43, 95% CI: 1.06, 1.94), higher household income (OR = 1.39, 95% CI: 1.00, 1.96), and ICT access (OR = 15.92, 95% CI: 10.51, 27.01). The probability of eHealth use is lower for the oldest-old (OR = 0.35, 95% CI: 0.22, 0.45). In addition, the estimates from interaction effects suggest the effect of ICT penetration on use of eHealth falls by a negligible amount because of resistive attitudinal barriers (OR = 0.01, 95% CI: 0.01, 0.06).

CONCLUSION

Given the challenges of ageing populations and pandemics, such as COVID-19, eHealth services are a vital part of an effective, inclusive, and robust health care system. This study demonstrates the presence of a significant digital divide among elderly PwD and suggests that public and private efforts should be made to increase the availability of ICT infrastructure. Training could also increase inclusion in this regard.