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Jiang Y, Gao J, Sun P, Nan J, Zou X, Sun M, Song X. Factors Associated with the e-Health Literacy Among Older Adults with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study. Telemed J E Health 2024; 30:e1138-e1147. [PMID: 37851981 DOI: 10.1089/tmj.2023.0394] [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] [Indexed: 10/20/2023] Open
Abstract
Background: The telemanagement model in chronic diseases needs older patients to have a certain level of e-Health literacy. According to Electronic Health Literacy model, factors associated with the e-Health literacy among older patients could be comprehensively investigated from individual, situational, and environmental aspects. Objectives: To investigate the e-Health literacy levels among older patients with chronic obstructive pulmonary disease (COPD) and explore associated factors. Methods: A cross-sectional study was conducted among older patients with COPD. The e-Health Literacy Scale was used to measure individuals' e-Health literacy. The multiple linear regression was applied to identify factors associated with e-Health literacy. Results: A total of 230 responses were included in the final analysis. The average score of e-Health literacy for older COPD patients was 24.66 (6.86). After adjusting the model, the results of multiple linear regression demonstrated that aging attitudes (B = 0.067, p < 0.001), technophobia (B = -0.285, p < 0.001), and self-efficacy (B = 0.431, p < 0.001) accounted for 68.3% (p < 0.001) of the total variation in e-Health literacy. Conclusion: This study identifies significant correlations of technophobia, aging attitudes, and self-efficacy, respectively, with e-Health literacy, and self-efficacy and technophobia may be constant predictive factors of e-Health literacy. In the future, intervention research on e-Health literacy should be conducted from a social psychology perspective, with particular emphasis on addressing negative aging attitudes and technophobia. That will promote the tele-management model of chronic diseases. Trial Registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR1900028563; http://apps.who.int/trialsearch/default.aspx.
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Affiliation(s)
- Yuyu Jiang
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jing Gao
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Pingping Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiang Nan
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xueqiong Zou
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Manyao Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xianjing Song
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
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Byrne T, Murray N, McDonnell-Naughton M, Rowan NJ. Perceived factors informing the pre-acceptability of digital health innovation by aging respiratory patients: a case study from the Republic of Ireland. Front Public Health 2023; 11:1203937. [PMID: 37942252 PMCID: PMC10628059 DOI: 10.3389/fpubh.2023.1203937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/22/2023] [Indexed: 11/10/2023] Open
Abstract
It is appreciated that digital health is increasing in interest as an important area for efficiently standardizing and developing health services in Ireland, and worldwide. However, digital health is still considered to be in its infancy and there is a need to understand important factors that will support the development and uniform uptake of these technologies, which embrace their utility and ensure data trustworthiness. This constituted the first study to identify themes believed to be relevant by respiratory care and digital health experts in the Republic of Ireland to help inform future decision-making among respiratory patients that may potentially facilitate engagement with and appropriate use of digital health innovation (DHI). The study explored and identified expert participant perceptions, beliefs, barriers, and cues to action that would inform content and future deployment of living labs in respiratory care for remote patient monitoring of people with respiratory diseases using DHI. The objective of this case study was to generate and evaluate appropriate data sets to inform the selection and future deployment of an ICT-enabling technology that will empower patients to manage their respiratory systems in real-time in a safe effective manner through remote consultation with health service providers. The co-creation of effective DHI for respiratory care will be informed by multi-actor stakeholder participation, such as through a Quintuple Helix Hub framework combining university-industry-government-healthcare-society engagements. Studies, such as this, will help bridge the interface between top-down digital health policies and bottom-up end-user engagements to ensure safe and effective use of health technology. In addition, it will address the need to reach a consensus on appropriate key performance indicators (KPIs) for effective uptake, implementation, standardization, and regulation of DHI.
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Affiliation(s)
- Tara Byrne
- Saolta University Healthcare Group, HSE, Galway, Ireland
- Department of Nursing and Healthcare, Technological University of the Shannon (TUS), Athlone, Ireland
- Faculty of Engineering and Informatics, Technological University of the Shannon, (TUS), Athlone, Ireland
| | - Niall Murray
- Faculty of Engineering and Informatics, Technological University of the Shannon, (TUS), Athlone, Ireland
| | - Mary McDonnell-Naughton
- Department of Nursing and Healthcare, Technological University of the Shannon (TUS), Athlone, Ireland
| | - Neil J. Rowan
- Department of Nursing and Healthcare, Technological University of the Shannon (TUS), Athlone, Ireland
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Nyberg A, Sondell A, Lundell S, Marklund S, Tistad M, Wadell K. Experiences of Using an Electronic Health Tool Among Health Care Professionals Involved in Chronic Obstructive Pulmonary Disease Management: Qualitative Analysis. JMIR Hum Factors 2023; 10:e43269. [PMID: 36995743 PMCID: PMC10131608 DOI: 10.2196/43269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/13/2022] [Accepted: 02/26/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is one of the most common and deadliest chronic diseases of the 21st century. eHealth tools are seen as a promising way of supporting health care professionals in providing evidence-based COPD care, for example, by reinforcing information and interventions provided to the patients and providing easier access and support to the health care professional themselves. Still, knowledge is scarce on the experience of using eHealth tools from the perspective of the health care professional involved in COPD management. OBJECTIVE The study explored the experiences of using an eHealth tool among health care professionals that worked with patients with COPD in their daily clinical practice. METHODS This exploratory qualitative study is part of a process evaluation in a parallel group, controlled, pragmatic pilot trial. Semistructured interviews were performed with 10 health care professionals 3 and 12 months after getting access to an eHealth tool, the COPD Web. The COPD Web, developed using cocreation, is an interactive web-based platform that aims to help health care professionals provide health-promoting strategies. Data from the interviews were analyzed using qualitative content analysis with an inductive approach. RESULTS The main results reflected health care professionals' experiences in 3 categories: receiving competence support and adjusting practice, improving quality of care, and efforts required for implementation. These categories highlighted that using an eHealth tool such as the COPD Web was experienced to provide knowledge support for health care professionals that led to adaptation and facilitation of working procedures and person-centered care. Taken together, these changes were perceived to improve the quality of care through enhanced patient contact and encouragement of interprofessional collaboration. In addition, health care professionals expressed that patients using the COPD Web were better equipped to tackle their disease and adhered better to provided treatment, increasing their self-management ability. However, structural and external barriers bar the successful implementation of an eHealth tool in daily praxis. CONCLUSIONS This study is among the first to explore experiences of using an eHealth tool among health care professionals involved in COPD management. Our novel findings highlight that using an eHealth tool such as the COPD Web may improve the quality of care for patients with COPD (eg, by providing knowledge support for health care professionals and adapting and facilitating working procedures). Our results also indicate that an eHealth tool fosters collaborative interactions between patients and health care professionals, which explains why eHealth is a valuable means of encouraging well-informed and autonomous patients. However, structural and external barriers requiring time, support, and education must be addressed to ensure that an eHealth tool can be successfully implemented in daily praxis. TRIAL REGISTRATION ClinicalTrials.gov NCT02696187; https://clinicaltrials.gov/ct2/show/NCT02696187.
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Affiliation(s)
- André Nyberg
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Anna Sondell
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Sara Lundell
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Sarah Marklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Malin Tistad
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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Sönnerfors P, Skavberg Roaldsen K, Lundell S, Toots A, Wadell K, Halvarsson A. Preferences for an eHealth tool to support physical activity and exercise training in COPD: a qualitative study from the viewpoint of prospective users. BMC Pulm Med 2023; 23:65. [PMID: 36782155 PMCID: PMC9925217 DOI: 10.1186/s12890-023-02353-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Despite well-known positive effects of pulmonary rehabilitation, access is limited. New strategies to improve access are advocated, including the use of eHealth tools. OBJECTIVES The aim of this study was to explore prospective users' preferences for an eHealth tool to support the self-management of physical activity and exercise training in COPD. METHODS A qualitative research design was applied. Data was collected in six, audio recorded, digital co-creation workshops, which were guided by a participatory and appreciative action and reflection approach. A total of 17 prospective users took part in the process, including people with COPD (n = 10), relatives (n = 2), health care givers (n = 4) and a patient organization representative (n = 1). During the workshops, pre-selected relevant topics to exploring end-users' preferences for eHealth support in self-management in COPD were discussed. The workshops were recorded and transcribed. Data was analysed using inductive qualitative content analysis. RESULTS The overarching theme "fusing with, rather than replacing existing support structures" was uncovered when the two-sided relationship between positive expectations towards digital solutions and the fear of losing access to established rehabilitation systems, emerged in the discussions. Three categories were identified, focused on wishes for an evidence-based support platform of information about COPD, a well-designed eHealth tool including functionalities to motivate in the self-management of physical activity and exercise training, and requirements of various forms of support. Co-creators believed that there were clear benefits in combining the best of digital and existing support systems. CONCLUSIONS Co-creators viewed an eHealth tool including support for physical activity and exercise training as a valuable digital complement to the now existing rehabilitation services. A future eHealth tool needs to focus on user-friendliness and prospective users's requests.
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Affiliation(s)
- Pernilla Sönnerfors
- Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden. .,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
| | - Kirsti Skavberg Roaldsen
- grid.4714.60000 0004 1937 0626Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,grid.416731.60000 0004 0612 1014Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway ,grid.10919.300000000122595234Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sara Lundell
- grid.12650.300000 0001 1034 3451Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Annika Toots
- grid.12650.300000 0001 1034 3451Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden
| | - Karin Wadell
- grid.12650.300000 0001 1034 3451Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Alexandra Halvarsson
- grid.4714.60000 0004 1937 0626Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,grid.24381.3c0000 0000 9241 5705Women’s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
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Stark AL, Krayter S, Dockweiler C. Competencies required by patients and health professionals regarding telerehabilitation: A scoping review. Digit Health 2023; 9:20552076231218841. [PMID: 38107985 PMCID: PMC10722929 DOI: 10.1177/20552076231218841] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Background Telerehabilitation offers patients alternative access to therapy and has become more prominent during the COVID-19 pandemic. Despite the increasing attractiveness of such programs, there are research gaps regarding the required competencies in the demand-oriented technology use in rehabilitative care. Objective The study aims at collecting evidence on competencies required by patients and health professionals for using telerehabilitation. We analyse tasks and requirements associated with telerehabilitation and derive and systematise relevant competencies. Methods We conducted a scoping review and analysed MEDLINE, Psyndex, EMBASE, Cochrane Library, and Web of Science for empirical studies and grey literature from 2017 to May 2022. Articles had to be in English/German and refer to medical rehabilitation accompanied by health professionals taking place in the patient's home. Results One hundred ten articles were included, covering video conferencing systems, applications with video, audio, or visual therapy content, or wearables. Depending on the program, tasks before, during, and after therapy sessions differ, as do whether these are performed by health professionals, patients, or the technology. Users need digital, health-related, social, personal, and health professionals also professional competencies. This comprises telerehabilitation, technical, health-related, and clinical knowledge, a range of physical, cognitive, social-interactive, technical, and clinical skills, a positive attitude towards telerehabilitation and experience. Whether sociodemographic factors promote successful use is unclear. Conclusions Telerehabilitation requires a variety of different competencies from patients and health professionals - going beyond the sphere of technical skills. This highlights the need for an evaluation of existing programs for promoting competencies in the use of telerehabilitation and refinement of the programs in line with demands.
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Affiliation(s)
- Anna Lea Stark
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
| | - Stephan Krayter
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
| | - Christoph Dockweiler
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
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Lundell S, Toots A, Sönnerfors P, Halvarsson A, Wadell K. Participatory methods in a digital setting: experiences from the co-creation of an eHealth tool for people with chronic obstructive pulmonary disease. BMC Med Inform Decis Mak 2022; 22:68. [PMID: 35303895 PMCID: PMC8932463 DOI: 10.1186/s12911-022-01806-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/11/2022] [Indexed: 12/22/2022] Open
Abstract
Background Using participatory methods to engage end-users in the development and design of eHealth is important to understand and incorporate their needs and context. Within participatory research, recent social distancing practice has forced a transition to digital communication platforms, a setting that warrants deeper understanding. The aim of this study was to describe the experiences of, and evaluate a digital co-creation process for developing an eHealth tool for people with chronic obstructive pulmonary disease (COPD). Methods The co-creation was guided by Participatory appreciative action and reflection, where a convenience sample (n = 17), including persons with COPD, health care professionals, relatives and a patient organization representative participated in six digital workshops. User instructions, technical equipment, and skilled support were provided if necessary. Workshops centred around different topics, with pre-recorded films, digital lectures and home assignments to up-skill participants. Process validity, experiences and ownership in the co-creation process were evaluated by repeated respondent validation, member checking, questionnaires and by assessing attendance. Data was analysed quantitatively or qualitatively as appropriate. Results The co-creators were in general satisfied with the digital format of the workshops. Mean attendance and perceived engagement in workshops was high and the experience described as enjoyable. Engagement was facilitated by up-skilling activities and discussions in small groups. Few had used digital communication previously, and feelings ranging from excitement to concern were expressed initially. Technical issues, mainly audio related, were resolved with support. At completion, skills using equipment and digital platform surpassed expectations. Few disadvantages with the digital format were identified, and advantages included reduced travel, time efficiency and reduced infection risk. Conclusions Experiences of digital co-creation were overwhelmingly positive, despite initial barriers related to computer naivety and use of digital equipment and platforms. The high level of satisfaction, engagement, attendance rates, and agreement between individual and group views suggests that a digital co-creation process is a feasible method. Several important success factors were identified, such as the provision of information and education on discussion topics in advance of workshops, as well as the smaller group discussions during workshops. The knowledge gained herein will be useful for future digital co-creation processes.
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Affiliation(s)
- Sara Lundell
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden.
| | - Annika Toots
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden
| | - Pernilla Sönnerfors
- Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Alexandra Halvarsson
- Division of Physiotherapy, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Wadell
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden
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