1
|
Lostelius PV, Mattebo M, Adolfsson ET, Söderlund A, Andersén M, Vadlin S, Revenäs Å. Development and usability evaluation of an electronic health report form to assess health in young people: a mixed-methods approach. BMC Med Inform Decis Mak 2023; 23:91. [PMID: 37165371 PMCID: PMC10170452 DOI: 10.1186/s12911-023-02191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/04/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Electronic Patient-Reported Outcomes (ePROs) have potential to improve health outcomes and healthcare. The development of health-technology applications, such as ePROs, should include the potential users and be theoretically grounded. Swedish Youth Health Clinics (YHCs) offer primarily sexual and psychological healthcare for young people aged 12 to 25 years old. Young people in healthcare settings are considered a vulnerable group. The development of a collection of Patient-Reported Outcomes (PROs) in an Electronic Health Report Form (eHRF) for identifying health and health-related problems in young people, was preceded by a qualitative interview study, exploring young people's views on using an eHRF at YHCs and which questions about health an eHRF should contain. The aim of the current study was to develop and evaluate the usability of an eHRF prototype for identifying health and health-related problems in young people visiting YHCs. METHODS This study used a participatory design. During the development, an expert panel consisting of eight researchers and one Information Technology worker, participated. A wide literature search was performed to find PROs to construct an eHRF prototype to cover health areas. A mixed methods usability evaluation included 14 participants (young people, healthcare professionals, and an expert panel). RESULTS The development resulted in an eHRF prototype, containing ten reliable and valid health questionnaires addressing mental-, physical-, and sexual health and social support, a self-efficacy question, and background questions, in total 74 items. The interviews in the usability evaluation resulted in three categories describing the usability of the eHRF: 'Captures the overall health of young people but needs clarification', 'Fun, easy, and optional and will keep young people's interest', and 'Potential contribution to improve the health consultation'. The quantitative results support the usability of the eHRF for YHCs. CONCLUSIONS The participatory approach contributed to development of the eHRF prototype to cover health areas adapted for the target population. The usability evaluation showed that the eHRF was usable and had the potential for self-reflection and contributions to cooperation between young people and healthcare professionals during the health consultation.
Collapse
Affiliation(s)
- Petra V Lostelius
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden.
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
- Centre for Innovation, Research and Education, Region Västmanland, Vastmanland Hospital, Vasteras, Sweden.
| | - Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Eva Thors Adolfsson
- Centre for Clinical Research, Region Västmanland - Uppsala University, Region Vastmanland, Vasteras, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Mikael Andersén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Sofia Vadlin
- Centre for Clinical Research, Region Västmanland - Uppsala University, Region Vastmanland, Vasteras, Sweden
| | - Åsa Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Centre for Clinical Research, Region Västmanland - Uppsala University, Region Vastmanland, Vasteras, Sweden
- Orthopedic Clinic, Västerås hospital Region Västmanland, Västerås, Sweden
| |
Collapse
|
2
|
Hammarström S, Bernhardsson S, Nilsen P, Elisson J, Frostholm E, Lindroth M. Ask me, listen to me, treat me well and I shall tell: a qualitative study of Swedish youths' experiences of systematic assessment of sexual health and risk-taking (SEXIT). Sex Reprod Health Matters 2022; 30:2146032. [PMID: 36476113 PMCID: PMC9733687 DOI: 10.1080/26410397.2022.2146032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sexual ill health among young people, in terms of sexually transmitted infections (STIs), unintended pregnancy, transactional sex and sexual violence, is a global public health concern. To that end, the SEXual health Identification Tool (SEXIT) was developed. The purpose of this study was to explore the visitors' experiences of a youth clinic visit when SEXIT was used. A purposively selected sample of 20 participants (16-24 years of age) was recruited from three Swedish youth clinics using SEXIT. Participants were interviewed individually in March and April 2016, and data were analysed using inductive qualitative content analysis. The analysis resulted in four main categories describing the participants' experiences of using SEXIT: "Issues of concern" includes descriptions of the items in SEXIT as important; "Enabling disclosure" describes how SEXIT serves as an invitation to talk and facilitates disclosure of negative experiences; "Road to change" captures experiences of the conversation with the healthcare professional; and "Managing power imbalance" describes experiences regarding the response and attitudes of the healthcare professional as well as the participants' fears of being judged. The categories are connected by the overarching theme "Ask me, listen to me, treat me well and I shall tell". This study contributes knowledge on young people's experiences of a tool-supported dialogue on sexual health and risk-taking initiated by the healthcare professional. Structured questions in a written format, as a basis for dialogue, are appreciated and experienced as a functioning way of addressing sexual ill health and risk-taking at Swedish youth clinics.
Collapse
Affiliation(s)
- Sofia Hammarström
- Academic Researcher, Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden; Development Manager, Region Västra Götaland, Knowledge Centre for Sexual Health, Gothenburg, Sweden; Faculty of Health and Society, Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden. Correspondence:
| | - Susanne Bernhardsson
- Associate Professor, Region Västra Götaland, Research and Development Primary Health Care, Gothenburg, Sweden; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Per Nilsen
- Professor, Department of Health, Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden
| | - Jennie Elisson
- Registered Midwife, Region Västra Götaland, Mölnlycke Youth Clinic, Mölnlycke, Sweden
| | - Ellinor Frostholm
- Registered Midwife, Region Västra Götaland, Youth Clinics Central Administration, Gothenburg, Sweden
| | - Malin Lindroth
- Associate Professor, Faculty of Health and Society, Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| |
Collapse
|
3
|
Kilander H, Alehagen S, Hammarström S, Golsäter M. Identifying sexual risk-taking and ill health in the meeting with young people-experiences of using an assessment tool. Scand J Caring Sci 2022; 36:1189-1196. [PMID: 35445754 PMCID: PMC9790609 DOI: 10.1111/scs.13081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/27/2022] [Accepted: 04/03/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Identifying young people exposed to sexual risk-taking or violence is fundamental, when seeking to strengthen their health. However, young people seldom share sexual health concerns or experiences of violence with healthcare professionals (HCPs). Studies evaluating how use of a risk assessment tool influences the dialogue about sexual health and violence are sparse. AIMS The aim of this study was to explore HCPs' experiences of using the SEXual health Identification Tool (SEXIT) in encounters with young people at Swedish youth clinics. METHOD Three focus group interviews were conducted with 21 HCPs from nine youth clinics, where SEXIT had been introduced. Data were analysed using thematic content analysis. RESULTS Three themes were identified. The theme, Facilitates dialogue about sexuality and vulnerability, describes how the questionnaire pertaining to SEXIT helped to normalise and help both HCPs and young people to take part in the dialogue about sensitive issues. Need for a trustful encounter presents HCPs' ethical concerns regarding how the questionnaire affects the integrity of young people and trust-making. Sensitive topics entail challenges describes HCPs' challenges when dealing with sensitive issues. Additionally, it describes needs for knowledge and collaboration when targeting vulnerable young people. CONCLUSIONS The HCPs stated that using SEXIT developed their ability to address sensitive issues and helped both them and young people to take part in the dialogue about sexuality and exposure to violence. SEXIT involves experiences of ethical concerns regarding integrity and trust-making. It also entails challenges in having dialogues about sensitive issues, how to deal with risk assessment outcomes and in improvements regarding inter-professional collaborations.
Collapse
Affiliation(s)
- Helena Kilander
- Jönköping Academy for Improvement of Health and Welfare, School of Health and WelfareJönköping UniversityJönköpingSweden,Department of Women’s and Children’s HealthKarolinska InstitutetStockholmSweden,Department of Obstetrics and GynaecologyEksjö HospitalJönköpingSweden,Linköping UniversityLinköpingSweden,Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Siw Alehagen
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Sofia Hammarström
- Region Västra GötalandKnowledge Centre for Sexual HealthGothenburgSweden,Division of Society and Health, Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Marie Golsäter
- CHILD ‐ Research Group, School of Health and WelfareJönköping UniversityJönköpingSweden,Child Health ServicesJönköpingSweden,Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| |
Collapse
|
4
|
Lostelius PV, Mattebo M, Söderlund A, Revenäs Å, Thors Adolfsson E. An electronic patient-reported outcome created based on my needs is worth using: an explorative qualitative study investigating young people's opinions for a health assessment tool. J Patient Rep Outcomes 2022; 6:29. [PMID: 35347495 PMCID: PMC8960482 DOI: 10.1186/s41687-022-00436-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young people in different healthcare settings are positive about using electronic patient-reported outcomes (ePROs), which are meant to increase the effectiveness and safety of interventions from the patient's perspective. Sweden offers free healthcare to young people aged 12-25 years at 275 youth health clinics (YHCs), whose goals are to strengthen young people and promote sexual, physical, and mental health. YHCs need effective ways to identify the overall picture of young people's health and health-related problems. To our knowledge, there is no ePRO for YHCs that provides an overview of young people's health from several health perspectives. The aim of this study was to explore young people's view on content and design of an ePRO to provide an overview of their health and health related problems when visiting a YHC, and their opinion on what healthcare needs to consider when using the ePRO. This was an explorative qualitative study. The participants were included from five YHCs, in different socioeconomic areas in central Sweden. Fifteen participants were included: 10 girls, three boys, and two non-binary participants with an age range of 16-22 years. Data were collected using a semi-structured interview guide and individual interviews, and inductive content analysis was performed. RESULTS One main theme, "ePRO created based on my needs is worth using" and two sub-themes, "Appealing content and design" and "Trusting healthcare", emerged. The participants wanted that an ePRO should include overall questions about mental-, physical-, and sexual health and social support. Participants also believed the ePRO must disclose the risks of self-harm or suicide. The participants noted the importance of emotional and digital security when using the ePRO and having a confidential conversation with a healthcare provider. To share health information means to trust to gain health. CONCLUSIONS The study participants' views on content and design can form the basis for designing an ePRO for young people. Their thoughts on safety and treatment in healthcare can be considered in the development process. This study is the starting point for developing an ePRO for young people at YHCs.
Collapse
Affiliation(s)
- Petra V Lostelius
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden. .,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden. .,Centre for Clinical Research Region, Hospital of Västmanland Västerås, Region Västmanland - Uppsala University, 721 89, Västerås, Sweden.
| | - Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Åsa Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Centre for Clinical Research Region, Hospital of Västmanland Västerås, Region Västmanland - Uppsala University, 721 89, Västerås, Sweden.,Orthopedic Clinic, Region Västmanland, Västerås, Sweden
| | - Eva Thors Adolfsson
- Centre for Clinical Research Region, Hospital of Västmanland Västerås, Region Västmanland - Uppsala University, 721 89, Västerås, Sweden
| |
Collapse
|