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Treufeldt H, Burton C. Stigmatisation in medical encounters for persistent physical symptoms/functional disorders: Scoping review and thematic synthesis. PATIENT EDUCATION AND COUNSELING 2024; 123:108198. [PMID: 38367305 DOI: 10.1016/j.pec.2024.108198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To conduct a scoping review of stigma in medical encounters for persistent physical symptoms and functional disorders (PPS/FD). Stigma is a social attribute that links a person to an undesirable characteristic. It has been extensively studied in relation to mental illness but less so in relation to PPS/FD. METHODS We followed PRISMA-ScR reporting guidelines for scoping reviews. Searches for were designed using the SPIDER tool. We used descriptive and thematic analysis. RESULTS The searches identified 68 articles, of which 32 were eligible for inclusion. 31 out of the 32 studies used a qualitative methodology. 8 studies used an explicit definition of stigma, of which 6 used the Goffman (1963) definition. Only 2 studies directly examined clinical consultations, the remainder relied on recalled accounts by patients or professionals. Descriptive analysis identified the focus of the studies included: patient-physician interaction (n = 13); health care professionals' perceptions (n = 7); experiences of illness/stigma (n = 6); broader meaning of illness (n = 3); and patients' experiences of stigma in health care consultations (n = 3). CONCLUSION Patients experience stigmatisation in consultations for a wide range of PPS/FD. This suggests the presence of structural stigmatisation. PRACTICE IMPLICATIONS There is a need for effective stigma reduction strategies in consultations about persistent physical symptoms.
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Affiliation(s)
- Hõbe Treufeldt
- Division of Population Health, University of Sheffield, Samuel Fox House, Northern General Hospital, Sheffield S5 7AU, UK.
| | - Christopher Burton
- Division of Population Health, University of Sheffield, Samuel Fox House, Northern General Hospital, Sheffield S5 7AU, UK
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2
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Thursby S, Dismore L, Swainston K. Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis. BMC MEDICAL EDUCATION 2024; 24:328. [PMID: 38519955 PMCID: PMC10960475 DOI: 10.1186/s12909-024-05306-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and limited knowledge. Brief interventions that can be utilised in day-to-day practice are necessary to improve ways of managing PPS. This review aimed to establish (i) what training primary and secondary healthcare practitioners have undertaken to develop their clinical skills when working with PPS, (ii) what training techniques or theoretical models have been used within these interventions, and (iii) how effective was the training. METHOD A systematic literature search was undertaken on eight databases to identify professional development interventions for healthcare practitioners working with PPS, were of any study design, and at a minimum were single measure studies (i.e., training outcome alone). Studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and narratively synthesised. RESULTS Despite high methodological heterogeneity across the six included studies, they all aimed to improve healthcare practitioners' communication skills through educational (theory, awareness, attitudes, assessment, treatment, and management of PPS) and experiential (role play) learning. CONCLUSIONS The review findings demonstrate that developing healthcare practitioners' communicative behaviours led to increased confidence and self-efficacy when working with PPS, which facilitated improved consultations and improvements on some patient outcomes. Barriers to the uptake of training programmes and implementation into daily clinical practice are discussed, including the need for PPS to be formally implemented into undergraduate teaching and post-qualification continuous professional development. TRIAL REGISTRATION This review was registered at PROSPERO [CRD42022315631] prior to the review starting.
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Affiliation(s)
- Stacie Thursby
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, NE29 8NH, United Kingdom
| | - Lorelle Dismore
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, NE29 8NH, United Kingdom
| | - Katherine Swainston
- Faculty of Medical Sciences, School of Psychology, Newcastle University, 4 Floor Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE1 7RU, England.
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Fränkl E, Hasenbank N, Dumröse K, Löwe B, Kohlmann S. Public and patient involvement in the development of an internet-based guide for persistent somatic symptoms (GUIDE.PSS): A qualitative study on the needs of those affected. Health Expect 2023; 27:e13931. [PMID: 38062910 PMCID: PMC10757203 DOI: 10.1111/hex.13931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/13/2023] [Accepted: 11/23/2023] [Indexed: 01/01/2024] Open
Abstract
BACKGROUND Persistent somatic symptoms (PSS) frequently remain under-treated in health care settings. Evidence-based services that lead affected individuals to early guideline-based care are currently missing. This study aimed to identify the needs of those affected concerning an internet-based guide. The second aim was to evaluate public and patient involvement (PPI). METHODS Participants experiencing PSS for at least 6 months were recruited via hospitals, psychotherapeutic practices and self-help organizations. Qualitative data were gathered via ideation discussions and prioritization tasks. Thematic analysis was conducted to gain insight on the needs of people with lived experiences. PPI was quantitatively evaluated with the Public and Patient Engagement Evaluation Tool. RESULTS A total of 12 individuals participated (eight females, ages 22-66 years, duration of symptoms 1-43 years). Participants wanted to feel more supported, validated, in control and engaged with managing their health. Content-related preferences included education, self-help, social support and contact addresses. The majority of participants (>90%) experienced their involvement as worthwhile. CONCLUSIONS To the best of our knowledge, this is one of the first studies describing PPI in intervention development for PSS. The involvement was perceived as a valuable contribution to the development process. PATIENT OR PUBLIC CONTRIBUTION Adults with lived experiences were involved at the level of collaboration through the establishment of a participatory research team (PRT) and at the level of consultation through a workshop series, including one of the coauthors. They were involved in developing and validating intervention material and checking data interpretation.
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Affiliation(s)
- Eirin Fränkl
- Department of Psychosomatic Medicine and PsychotherapyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Nele Hasenbank
- Department of Psychosomatic Medicine and PsychotherapyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | | | - Bernd Löwe
- Department of Psychosomatic Medicine and PsychotherapyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and PsychotherapyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
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Andersen JH, Risør MB, Frostholm L, Rask MT, Rosendal M, Rask CU. Managing persistent physical symptoms when being social and active is the norm: a qualitative study among young people in Denmark. BMC Public Health 2023; 23:1949. [PMID: 37805452 PMCID: PMC10560405 DOI: 10.1186/s12889-023-16910-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/05/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND An increasing number of young people in Western countries report persistent physical symptoms (PPS). PPS may disturb everyday activities and they may have negative consequences for later adult mental and physical health. Still little is known about how young people handle PPS in their everyday lives. This study examines how young people with PPS attempt to manage their symptoms while staying engaged in their daily activities and what is at stake in these attempts. METHODS This qualitative study involved semi-structured interviews with 11 young people with PPS. Photo-elicitation was used to capture the participants' experiences as they occurred in their everyday lives. The data material was analysed using a thematic analysis approach, as well as theory on subjectivity and social acceleration. RESULTS The participants employed alleviating measures and tried to find patterns between their activities and the severity of their symptoms in order to adjust their activity level. Decisions not to participate in social activities were accompanied by feelings of missing out. The participants' attempts at adjusting their activity level was challenged by norms of being social and active, and they experienced difficulty prioritizing their activities and explaining their symptoms to others. CONCLUSION PPS shaped the participants' sense of how to act towards their bodies and social relationships in interaction with societal norms. The participants' subject formation and symptom experiences should thus be seen as a biosocial process.
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Affiliation(s)
- Julie Høgsgaard Andersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus, Denmark.
- Research Clinic for Functional Disorders and Psychosomatics, Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark.
| | - Mette Bech Risør
- Department of Public Health, The Research Unit for General Practice, University of Copenhagen, Copenhagen, Denmark
- General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsoe, Norway
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mette Trøllund Rask
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Marianne Rosendal
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- The Research Unit for General Practice, Aarhus, Denmark
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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5
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van der Ven J, van den Bemt BJF, van Dijk L, Opdam M, Haegens LL, Vriezekolk JE, Verhoef LM. Preferences of Patients With Musculoskeletal Disorders Regarding the Timing and Channel of eHealth and Factors Influencing Its Use: Mixed Methods Study. JMIR Hum Factors 2023; 10:e44885. [PMID: 37756049 PMCID: PMC10568401 DOI: 10.2196/44885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 06/22/2023] [Accepted: 07/22/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Implementation of eHealth is progressing slowly. In-depth insight into patients' preferences and needs regarding eHealth might improve its use. OBJECTIVE This study aimed to describe when patients want to use eHealth, how patients want to communicate and receive information digitally, and what factors influence the use of eHealth in clinical practice. METHODS A multimethod study was conducted. Two meetings of ~5.5 hours with plenary information sessions and focus groups were held with 22 patients from the rheumatology, orthopedics, and rehabilitation departments of a Dutch hospital specialized in musculoskeletal disorders. Assignments were performed during the focus groups in which qualitative (eg, semistructured interview questions) and quantitative (ie, voting and ranking factors) data were collected. RESULTS The way patients want to use eHealth varies between patients and moments of a patient's care pathway. Patients' digital channel preferences depended on the need for interaction with a health care provider (HCP). The interaction need is in turn influenced by the degree to which information or communication is specific to an individual patient and leads to consequences for the patient. The 5 most important factors influencing the use of eHealth were access to medical information (eg, electronic health records), perceived control over disease management, correctness and completeness of information, data security, and access to information or an HCP at any time. The 5 least important factors influencing eHealth use were help with using digital devices, having internet or equipment, digital skills, attitude or emotions toward eHealth, and societal benefits. CONCLUSIONS Patients identified opportunities for using eHealth during all moments of their care pathway. However, preferences for eHealth varied between patients and phases in the care pathway. As a consequence, eHealth should be tailored to fit individual patients' preferences but also the need for interaction regarding different topics by offering a variety of digital channels with a gradient of interaction possibilities. Furthermore, digital skills and access to the internet might become less important to focus on in the future. Improving eHealth use by patients may be achieved by providing patients access to correct and safe (medical) information and more control over their care.
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Affiliation(s)
- Jeffrey van der Ven
- Department of Research, Sint Maartenskliniek, Ubbergen, Netherlands
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - Bart J F van den Bemt
- Department of Research, Sint Maartenskliniek, Ubbergen, Netherlands
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - Liset van Dijk
- Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Merel Opdam
- Department of Research, Sint Maartenskliniek, Ubbergen, Netherlands
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - Lex L Haegens
- Department of Research, Sint Maartenskliniek, Ubbergen, Netherlands
- Radboud University Medical Centre, Nijmegen, Netherlands
| | | | - Lise M Verhoef
- Department of Research, Sint Maartenskliniek, Ubbergen, Netherlands
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Kushniruk A, Hedegaard L, Rask MT, Clemensen J, Frostholm L, Rosendal M. Designing and Developing an eHealth Program for Patients With Persistent Physical Symptoms: Usability Study. JMIR Hum Factors 2023; 10:e42572. [PMID: 36753312 PMCID: PMC9947758 DOI: 10.2196/42572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Patients with persistent physical symptoms presenting in primary care are often affected by multiple symptoms and reduced functioning. The medical and societal costs of these patients are high, and there is a need for new interventions tailored to both the patients and health care system. OBJECTIVE This study aimed to examine the usability of an unguided, self-help treatment program, "My Symptoms," developed to assist patients and general practitioners in symptom management. METHODS In all, 11 users (4 patients with persistent physical symptoms and 7 laypeople) participated in web-based thinking-aloud interviews involving the performance of predefined tasks in the program. Thematic analysis was used to categorize the severity of usability issues. General usability heuristics were cross-referenced with the usability issues. RESULTS The analysis identified important usability issues related to functionality, navigation, and content. The study shows how therapeutic knowledge in some cases was lost in the translation of face-to-face therapy to a digital format. The user testing helped uncover how the functionality of the digital elements and general navigation of the program played a huge part in locating and accessing the needed treatment. Examples of redesign to mediate the therapeutic value in the digital format involving health care professionals, web developers, and users are provided. The study also highlights the differences of involving patients and laypeople in the interviews. CONCLUSIONS Taking the experience of common symptoms as a point of departure, patients and laypeople contributed to finding usability issues on program functionality, navigation, and content to improve the program and make the treatment more accessible to users.
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Affiliation(s)
| | - Leonora Hedegaard
- Department of Culture and Learning, Aalborg University, Aalborg, Denmark
| | - Mette Trøllund Rask
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark
| | - Jane Clemensen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Marianne Rosendal
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark.,Research Unit for General Practice, Aarhus University, Aarhus, Denmark
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Hybelius J, Gustavsson A, Af Winklerfelt Hammarberg S, Toth-Pal E, Johansson R, Ljótsson B, Axelsson E. A unified Internet-delivered exposure treatment for undifferentiated somatic symptom disorder: single-group prospective feasibility trial. Pilot Feasibility Stud 2022; 8:149. [PMID: 35854392 PMCID: PMC9294766 DOI: 10.1186/s40814-022-01105-0] [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: 11/24/2021] [Accepted: 06/24/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Exposure-based psychological treatment appears to have beneficial effects for several patient groups that commonly report distress related to persistent somatic symptoms. Yet exposure-based treatment is rarely offered in routine care. This may be because existing treatment protocols have been developed for specific symptom clusters or specific unwanted responses to somatic symptoms, and many clinics do not have the resources to offer all these specialised treatments in parallel. In preparation for a randomised controlled trial, we investigated the feasibility of a new and unified Internet-delivered exposure treatment (OSF.io: cnbwj) for somatic symptom disorder regardless of somatic symptom domain (e.g. cardiopulmonary, fatigue, gastrointestinal, pain), combination of unwanted emotions (e.g. anger, anxiety, fear, shame) and whether somatic symptoms are medically explained or not. We hypothesised that a wide spectrum of subgroups would show interest, that the treatment would be rated as credible, that adherence would be adequate, that the measurement strategy would be acceptable and that there would be no serious adverse events. METHODS Single-group prospective cohort study where 33 self-referred adults with undifferentiated DSM-5 somatic symptom disorder took part in 8 weeks of unified Internet-delivered exposure treatment delivered via a web platform hosted by a medical university. Self-report questionnaires were administered online before treatment, each week during treatment, post treatment and 3 months after treatment. RESULTS Participants reported a broad spectrum of symptoms. The Credibility/Expectancy mean score was 34.5 (SD = 7.0, range: 18-47). Participants completed 91% (150/165) of all modules and 97% of the participants (32/33) completed at least two exposure exercises. The average participant rated the adequacy of the rationale as 8.4 (SD = 1.5) on a scale from 0 to 10. The post-treatment assessment was completed by 97% (32/33), and 84% (27/32) rated the measurement strategy as acceptable. The Client Satisfaction Questionnaire mean score was 25.3 (SD = 4.7, range: 17-32) and no serious adverse events were reported. Reductions in subjective somatic symptom burden (the Patient Health Questionnaire 15; d = 0.90) and symptom preoccupation (the somatic symptom disorder 12; d = 1.17) were large and sustained. CONCLUSIONS Delivering a unified Internet-delivered exposure-based treatment protocol for individuals with undifferentiated somatic symptom disorder appears to be feasible. TRIAL REGISTRATION ClinicalTrials.gov, NCT04511286 . Registered on August 13, 2020.
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Affiliation(s)
- Jonna Hybelius
- Department of Psychology, Stockholm University, Stockholm, Sweden.,Liljeholmen Primary Health Care Center, Region Stockholm, Liljeholmstorget 7, Stockholm, 117 63, Sweden.,Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden.,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Anton Gustavsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Sandra Af Winklerfelt Hammarberg
- Liljeholmen Primary Health Care Center, Region Stockholm, Liljeholmstorget 7, Stockholm, 117 63, Sweden.,Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden.,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Eva Toth-Pal
- Liljeholmen Primary Health Care Center, Region Stockholm, Liljeholmstorget 7, Stockholm, 117 63, Sweden.,Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden.,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Robert Johansson
- Department of Psychology, Stockholm University, Stockholm, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erland Axelsson
- Liljeholmen Primary Health Care Center, Region Stockholm, Liljeholmstorget 7, Stockholm, 117 63, Sweden. .,Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden. .,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. .,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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8
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Klastrup LK, Rosendal M, Rask MT, Christensen KS, Rask CU. Functional somatic symptoms in youths in general practice: A cross-sectional study on prevalence, clinical management and perceived burden. J Psychosom Res 2022; 156:110765. [PMID: 35276589 DOI: 10.1016/j.jpsychores.2022.110765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Functional somatic symptoms (FSS) may progress into a functional disorder if poorly managed, which may have serious implications. This cross-sectional study describes the management of youths compared to adults in general practice and estimates the prevalence of FSS in youths in this setting by comparing consultation-related aspects between youths with FSS and 1) youths with a specific diagnosis and 2) adults with FSS. METHODS We used data from a Danish survey (2008-2009), including 3295 face-to-face consultations between GPs and patients aged 15-64 years. Patients were divided into youths (15-24 years) and adults (25-64 years) and then into subgroups according to the GPs' classifications: 1) specific diagnosis, 2) resolving symptom and 3) FSS. Logistic regression analysis was used for all comparisons, and estimates were adjusted for gender, concomitant chronic disorder and GP cluster. RESULTS The GPs more frequently ensured continuity of care in adults (AOR:0.75, 95%CI:0.61-0.92, p < 0.01) and perceived youths as less time consuming (AOR:0.58, 95%CI: 0.43-0.77, p < 0.01) and less burdensome (AOR:0.60; 95%CI: 0.45-0.81, p < 0.01) compared to adults. FSS prevalence was 4.4% in youths and 9.0% in adults. However, GPs perceived youths with FSS as more burdensome (AOR:7.77, 95%CI:2.93-20.04, p < 0.01) and more time consuming (AOR:3.98, 95%CI:1.42-11.12, p < 0.01) than youths with a specific diagnosis. No significant differences were found between youths and adults with FSS, respectively, in regards to perceived burden and consultation time. CONCLUSION The results indicate age-related variations in the prevalence and clinical management of FSS in general practice. The GPs perceived both youths and adults with FSS time consuming, which underlines a need for supportive management strategies.
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Affiliation(s)
- L K Klastrup
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Denmark.
| | - M Rosendal
- Research Clinic for Functional Disorders, Aarhus University Hospital, Denmark; Research Unit for General Practice, Aarhus, Denmark.
| | - M T Rask
- Research Clinic for Functional Disorders, Aarhus University Hospital, Denmark.
| | - K S Christensen
- Research Unit for General Practice, Aarhus, Denmark; Department of Public Health, Aarhus University, Denmark.
| | - C U Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
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Chen SH, Yu KH, Lee YH, Shao JH. Expectations of an Online-Self-Management Program for Rheumatoid Arthritis. Clin Nurs Res 2021; 31:1023-1032. [PMID: 34423684 DOI: 10.1177/10547738211041692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative descriptive study aimed to explore expectations of patients and healthcare experts for an online self-management program for rheumatoid arthritis. Participants were recruited from rheumatology clinics, medical centers, and universities in Taiwan. Individual face-to-face, semi-structured interviews were conducted with patients (n = 16) and healthcare experts (n = 7). Content analysis of the interview data resulted in five subthemes for expectations of an online self-management program: information about how the disease trajectory would impact future health status, availability of opportunities for self-monitoring, opportunities to interact with fellow patients and healthcare providers, simplicity and ease-of-use of the program, and methods to facilitate patient-motivation. These subthemes formulated two overarching themes: content and format. An online self-management program for patients with rheumatoid arthritis should provide evidence-based information about disease variables and behaviors aligned with the specific needs of the individual and adopt strategies that encourage and increase motivation and confidence.
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Affiliation(s)
- Su-Hui Chen
- Chang Gung University of Science and Technology, Taoyuan City.,Chang Gung Memorial Hospital, Taoyuan City
| | | | | | - Jung-Hua Shao
- Chang Gung Memorial Hospital, Taoyuan City.,Chang Gung University, Taoyuan City
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