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Ma Y, Law K, Hassan L, Nenadic G, van der Veer SN. Experiences and Views of Young People and Health Care Professionals of Using Social Media to Self-Manage Type 1 Diabetes Mellitus: Thematic Synthesis of Qualitative Studies. JMIR Pediatr Parent 2024; 7:e56919. [PMID: 38809591 PMCID: PMC11170052 DOI: 10.2196/56919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Social media have shown the potential to support type 1 diabetes self-management by providing informational, emotional, and peer-to-peer support. However, the perceptions of young people and health care professionals' (HCPs) toward the use of social media for type 1 diabetes self-management have not been systematically reviewed. OBJECTIVE The aim of this study is to explore and summarize the experiences and views of young people with type 1 diabetes and their HCPs on using social media for self-management across qualitative findings. METHODS We searched MEDLINE, Embase, PsycINFO, and CINAHL from 2012 to 2023 using Medical Subject Heading terms and text words related to type 1 diabetes and social media. We screened and selected the studies according to the inclusion and exclusion criteria. We quality appraised and characterized the included studies and conducted a thematic synthesis. RESULTS We included 11 studies in our synthesis. A total of 9 of them were qualitative and 2 were mixed methods studies. Ten focused on young people with type 1 diabetes and 1 on HCPs. All used content analysis and were of moderate to high quality. Thirteen descriptive themes were yielded by our thematic synthesis, contributing to five analytic themes: (1) differences in how young people interact with social media, (2) characteristics of social media platforms that influence their use and uptake for type 1 diabetes self-management, (3) social media as a source of information, (4) impact on young people's coping and emotional well-being, and (5) impact on support from and relationships with HCPs and services. CONCLUSIONS The synthesis suggests that we should consider leveraging social media's peer support capabilities to augment the traditional services for young people with type 1 diabetes. However, the patients may have privacy concerns about HCPs' involvement in their online activities. This warrants an update of existing guidelines to help young people use social media safely for self-managing their diabetes.
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Affiliation(s)
- Yanan Ma
- School of Computer Science, The University of Manchester, Manchester, United Kingdom
| | - Kate Law
- Division of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, United Kingdom
| | - Lamiece Hassan
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, United Kingdom
| | - Goran Nenadic
- School of Computer Science, The University of Manchester, Manchester, United Kingdom
| | - Sabine N van der Veer
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, United Kingdom
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2
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Knoppers T, Haley CE, Bouhouita-Guermech S, Hagan J, Bradbury-Jost J, Alarie S, Cosquer M, Zawati MH. From code to care: Clinician and researcher perspectives on an optimal therapeutic web portal for acute myeloid leukemia. PLoS One 2024; 19:e0302156. [PMID: 38635542 PMCID: PMC11025855 DOI: 10.1371/journal.pone.0302156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML), a rapidly progressing cancer of the blood and bone marrow, is the most common and fatal type of adult leukemia. Therapeutic web portals have great potential to facilitate AML research advances and improve health outcomes by increasing the availability of data, the speed and reach of new knowledge, and the communication between researchers and clinicians in the field. However, there is a need for stakeholder research regarding their optimal features, utility, and implementation. METHODS To better understand stakeholder perspectives regarding an ideal pan-Canadian web portal for AML research, semi-structured qualitative interviews were conducted with 17 clinicians, researchers, and clinician-researchers. Interview guides were inspired by De Laat's "fictive scripting", a method where experts are presented with scenarios about a future technology and asked questions about its implementation. Content analysis relied on an iterative process using themes extracted from both existing scientific literature and the data. RESULTS Participants described potential benefits of an AML therapeutic portal including facilitating data-sharing, communication, and collaboration, and enhancing clinical trial matchmaking for patients, potentially based on their specific genomic profiles. There was enthusiasm about researcher, clinician, and clinician-researcher access, but some disagreement about the nature of potential patient access to the portal. Interviewees also discussed two key elements they believed to be vital to the uptake and thus success of a therapeutic AML web portal: credibility and user friendliness. Finally, sustainability, security and privacy concerns were also documented. CONCLUSIONS This research adds to existing calls for digital platforms for researchers and clinicians to supplement extant modes of communication to streamline research and its dissemination, advance precision medicine, and ultimately improve patient prognosis and care. Findings are applicable to therapeutic web portals more generally, particularly in genomic and translational medicine, and will be of interest to portal end-users, developers, researchers, and policymakers.
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Affiliation(s)
- Terese Knoppers
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Cassandra E. Haley
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | | | - Julie Hagan
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | | | - Samuel Alarie
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Marie Cosquer
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
| | - Ma’n H. Zawati
- Centre of Genomics and Policy, McGill University, Montreal, Quebec, Canada
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Lee MK, Walsh E, Willgerodt M, O'Connor MR. School Nurses' Diabetes-Related Attitudes and Self-efficacy in Diabetes Education and Management. J Sch Nurs 2023; 39:487-495. [PMID: 34617813 DOI: 10.1177/10598405211043126] [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: 11/16/2022] Open
Abstract
This study explored relationships between school nurses' diabetes-related attitudes, self-efficacy in diabetes management and education, and care practices. One-hundred fourteen school nurses who have taken care of students with type 1 diabetes in public schools comprised this descriptive study sample. Participants completed online surveys. School nurses' diabetes-related attitudes were not related to their self-efficacy in diabetes education, but nurses' attitudes towards the psychosocial impact of diabetes were significantly related to their self-efficacy in diabetes management, and the number of students with diabetes was a significant contributor to this relationship. Nurses' full-time status and the type of school they worked in were significantly related to their self-efficacy in providing diabetes education. School nurses' positive attitudes about providing care for students with diabetes were related to having a higher level of self-efficacy in providing diabetes management. Based on the findings, recommendations are made for health consolidated schools and full-time school nurses.
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Affiliation(s)
- Mee Kyung Lee
- University of Washington School of Nursing, Seattle, Washington, USA
| | - Elaine Walsh
- University of Washington School of Nursing, Seattle, Washington, USA
| | - Mayumi Willgerodt
- University of Washington School of Nursing, Seattle, Washington, USA
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Lang M, Lemieux S, Hébert J, Sauvageau G, Zawati MH. Legal and Ethical Considerations for the Design and Use of Web Portals for Researchers, Clinicians, and Patients: Scoping Literature Review. J Med Internet Res 2021; 23:e26450. [PMID: 34762055 PMCID: PMC8663501 DOI: 10.2196/26450] [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: 12/11/2020] [Revised: 03/17/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background This study aims to identify a novel potential use for web portals in health care and health research: their adoption for the purposes of rapidly sharing health research findings with clinicians, scientists, and patients. In the era of precision medicine and learning health systems, the translation of research findings into targeted therapies depends on the availability of big data and emerging research results. Web portals may work to promote the availability of novel research, working in tandem with traditional scientific publications and conference proceedings. Objective This study aims to assess the potential use of web portals, which facilitate the sharing of health research findings among researchers, clinicians, patients, and the public. It also summarizes the potential legal, ethical, and policy implications associated with such tools for public use and in the management of patient care for complex diseases. Methods This study broadly adopts the methods for scoping literature reviews outlined by Arskey and O’Malley in 2005. Raised by the integration of web portals into patient care for complex diseases, we systematically searched 3 databases, PubMed, Scopus, and WestLaw Next, for sources describing web portals for sharing health research findings among clinicians, researchers, and patients and their associated legal, ethical, and policy challenges. Of the 719 candidate source citations, 22 were retained for the review. Results We found varied and inconsistent treatment of web portals for sharing health research findings among clinicians, researchers, and patients. Although the literature supports the view that portals of this kind are potentially highly promising, they remain novel and are not yet widely adopted. We also found a wide range of discussions on the legal, ethical, and policy issues related to the use of web portals to share research data. Conclusions We identified 5 important legal and ethical challenges: privacy and confidentiality, patient health literacy, equity, training, and decision-making. We contend that each of these has meaningful implications for the increased integration of web portals into clinical care.
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Affiliation(s)
- Michael Lang
- Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Sébastien Lemieux
- Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Josée Hébert
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,The Leucegene Project at Institute for Research in Immunology and Cancer, Université de Montréal, Montreal, QC, Canada.,Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada
| | - Guy Sauvageau
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Division of Hematology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada
| | - Ma'n H Zawati
- Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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5
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Kong W, Song S, Zhao YC, Zhu Q, Sha L. TikTok as a Health Information Source: Assessment of the Quality of Information in Diabetes-Related Videos. J Med Internet Res 2021; 23:e30409. [PMID: 34468327 PMCID: PMC8444042 DOI: 10.2196/30409] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/21/2021] [Accepted: 08/07/2021] [Indexed: 01/19/2023] Open
Abstract
Background Diabetes has become one of the most prevalent chronic diseases, and many people living with diabetes use social media to seek health information. Recently, an emerging social media app, TikTok, has received much interest owing to its popularity among general health consumers. We notice that there are many videos about diabetes on TikTok. However, it remains unclear whether the information in these videos is of satisfactory quality. Objective This study aimed to assess the quality of the information in diabetes-related videos on TikTok. Methods We collected a sample of 199 diabetes-related videos in Chinese. The basic information presented in the videos was coded and analyzed. First, we identified the source of each video. Next, 2 independent raters assessed each video in terms of the completeness of six types of content (the definition of the disease, symptoms, risk factors, evaluation, management, and outcomes). Then, the 2 raters independently assessed the quality of information in the videos, using the DISCERN instrument. Results In regard to the sources of the videos, we found 6 distinct types of uploaders; these included 3 kinds of individual users (ie, health professionals, general users, and science communicators) and 3 types of organizational users (ie, news agencies, nonprofit organizations, and for-profit organizations). Regarding content, our results show that the videos were primarily about diabetes management and contained limited information on the definition of the disease, symptoms, risk factors, evaluation, and outcomes. The overall quality of the videos was acceptable, on average, although the quality of the information varied, depending on the sources. The videos created by nonprofit organizations had the highest information quality, while the videos contributed by for-profit organizations had the lowest information quality. Conclusions Although the overall quality of the information in the diabetes videos on TikTok is acceptable, TikTok might not fully meet the health information needs of patients with diabetes, and they should exercise caution when using TikTok as a source of diabetes-related information.
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Affiliation(s)
- Wenwen Kong
- Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China
| | - Shijie Song
- School of Information Management, Nanjing University, Nanjing, China
| | - Yuxiang Chris Zhao
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China
| | - Qinghua Zhu
- School of Information Management, Nanjing University, Nanjing, China
| | - Ling Sha
- Nanjing Jiangning Maternal and Child Health and Family Planning Service Center, Nanjing, China
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Larentis AV, Barbosa DNF, da Silva CR, Barbosa JLV. Applied Computing to Education on Noncommunicable Chronic Diseases: A Systematic Mapping Study. Telemed J E Health 2019; 26:147-163. [PMID: 30807261 DOI: 10.1089/tmj.2018.0282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The number of deaths from noncommunicable chronic diseases (NCDs) has increased worldwide. These deaths would be partly avoidable if prevention and follow-up measures were applied to reduce risk factors. Computing can help educate individuals, improving their knowledge about NCDs. This article presents a systematic mapping of studies that apply computing to education on NCDs. The results allow a general view of the literature and the identification of research opportunities. Materials and Methods: The methodology followed three steps: (1) definition of search databases from computer science and health sciences, (2) selection of keywords for search string composition, and (3) application of inclusion and exclusion criteria to filter the results. The survey occurred from January 2008 to April 2018. Results: The initial search resulted in 19,675 papers, of which 38 were selected after applying the filter criteria. The use of mobile computing stood out in 25 papers. The education modalities were self-management and educational content for diabetes (10 papers), asthma (1), cardiovascular disease (1) and chronic diseases (1), self-management of diabetes and games (1), educational content (15), games (6), personalized content (2), and virtual community (1). The percentage of papers on diabetes was 65%. Most solutions (55%) do not use data from individuals to provide information considering their health condition. In addition, 19 papers produced outcome measures by means of experiments. Conclusions: Mobile computing was the most used technology in the papers. In addition, self-management, educational content, and games were the most used mechanisms. A research opportunity consists of personalized assistance. In this sense, ubiquitous learning can provide a continuous and contextualized education.
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Affiliation(s)
- Andrêsa Vargas Larentis
- Applied Computing Graduate Program, University of Vale do Rio dos Sinos, São Leopoldo, Brazil
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7
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Ghandour EK, Gagnon MP, Fortin JP. [Factors influencing electronic personal health record (ePHR) adoption by Primary Health Care providers in Quebec: Professional and organizational perspective]. SANTE PUBLIQUE 2018; 29:837-850. [PMID: 29473398 DOI: 10.3917/spub.176.0837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION We aimed to describe and analyse the factors and conditions influencing ePHR adoption by primary healthcare professionals for the follow-up and management of chronic diseases, as perceived by healthcare professionals and health organization managers. METHODS A qualitative study was conducted in the context of an ePHR experimentation project in Quebec. In-depth semi-structured individual interviews were conducted with 11 professionals and three managers directly involved in ePHR implementation in a primary healthcare organization. RESULTS The results highlight the emergence of themes comprising facilitators or barriers to ePHR adoption. The main factors identified were the clinicians' leadership and previous involvement in organizational transformations, the context of practice, technology maturity providing a useful, additional and relevant content, integration with the available clinical information systems facilitating two-way communication and supporting the development of patient-professional partnerships and patients' use and adherence. The organizational precursors identified refer to the organizational receptivity to change, adjustment to participants' values, and the policies and practices set up to support ePHR adoption by professionals and their patients. Cost is a major issue determining ePHR implementation. CONCLUSION The factors and conditions identified will be useful strategically and operationally to design and implement new clinical and organizational practices and develop adapted technologies facilitating ePHR adoption by professionals.
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De Angelis G, Wells GA, Davies B, King J, Shallwani SM, McEwan J, Cavallo S, Brosseau L. The use of social media among health professionals to facilitate chronic disease self-management with their patients: A systematic review. Digit Health 2018; 4:2055207618771416. [PMID: 29942633 PMCID: PMC6016564 DOI: 10.1177/2055207618771416] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 03/21/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The objective of this systematic review was to summarize the evidence pertaining to the use of social media by health professionals to facilitate chronic disease self-management with their patients. METHODS A systematic approach was used to retrieve and extract relevant data. A total of 5163 citations were identified, of which seven unique studies met criteria for inclusion; one was a randomized controlled trial, two were prospective cohort studies, and four were qualitative studies. The following social media platforms were evaluated: discussion forums (6 studies) and collaborative project (1 study). RESULTS The available evidence suggests that health professionals perceived discussion forums and collaborative projects to be useful social media platforms to facilitate chronic disease self-management with patients. No relevant evidence was found regarding the use of other social media platforms. Most studies indicated positive findings regarding health professionals' intention to use discussion forums, while the one study that used a collaborative project also indicated positive findings with its perceived ease of use as health professionals felt that it was useful to facilitate chronic disease self-management with patients. Mixed findings were seen in regards to health professionals' perceived ease of use of discussion forums. The most common barrier to using social media platforms was the lack of time in health professionals' schedules. CONCLUSIONS Discussion forums and collaborative projects appear to be promising resources for health professionals to assist their patients in self-managing their chronic conditions; however, further research comparing various social media platforms is needed.
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Affiliation(s)
- Gino De Angelis
- School of Rehabilitation Sciences, University of Ottawa, Canada
| | - George A Wells
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Canada
| | | | - Judy King
- School of Rehabilitation Sciences, University of Ottawa, Canada
| | | | | | | | - Lucie Brosseau
- School of Rehabilitation Sciences, University of Ottawa, Canada
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Canada
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Town R, Midgley N, Ellis L, Tempest R, Wolpert M. A qualitative investigation of staff's practical, personal and philosophical barriers to the implementation of a web-based platform in a child mental health setting. COUNSELLING & PSYCHOTHERAPY RESEARCH 2017. [DOI: 10.1002/capr.12129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Rosa Town
- The Anna Freud National Centre for Children and Families; London UK
- The Evidence Based Practice Unit; London UK
| | - Nick Midgley
- The Anna Freud National Centre for Children and Families; London UK
- The Research Department of Clinical, Educational and Health Psychology at University College London; London UK
- The Child Attachment to Psychological Therapies Research Unit (ChAPTRE); London UK
| | - Louise Ellis
- The Anna Freud National Centre for Children and Families; London UK
- The Evidence Based Practice Unit; London UK
| | | | - Miranda Wolpert
- The Anna Freud National Centre for Children and Families; London UK
- The Evidence Based Practice Unit; London UK
- The Research Department of Clinical, Educational and Health Psychology at University College London; London UK
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10
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Kopanitsa G. A Qualitative Study of the Barriers and Opportunities for Adoption of Web-Portals for Doctors and Patients in Russia. J Med Syst 2017; 41:62. [PMID: 28271462 DOI: 10.1007/s10916-017-0713-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/22/2017] [Indexed: 11/25/2022]
Abstract
The use of Web portals has several benefits. They have been proven to enhance communication between patients and health care professionals, allow patients to play a more active role in their own treatment and self-management, increase self-efficiency. Doctors can access patients' medical data and give recommendations to the patients. Some evidence of positive outcomes has been reported including improved clinical indicators and reduced health service use, as well as enhanced feelings of security and increased satisfaction with health and social care services. However, a number of studies have demonstrated that these types of solutions often fail to be successfully implemented and adopted within routine healthcare. The goal of the study was to analyze attitude of tuberculosis patients and doctors and identify perceived opportunities and barriers to operate a Web portal. The perceptions of 30 tuberculosis patients and 18 doctors (10 general practitioners and 8 phthisiatricians) from Tomsk, Russia were collected through semi-structured interviews. The responses were analyzed using grounded theory and thematic analysis, in order to understand the participants' opinions and attitudes towards accepting tuberculosis web-portal in the treatment and rehabilitation process. We have recognized core topics that represented the participants' responses. These core topics indicated that most respondents mentioned "the potential of tuberculosis web-portal to establish a better communication between doctors and patients" and "the increased health status of the patients" as the most valuable outcomes of adopting the tool. Both doctors and patients also expressed their opinions on the usability of the solutions, with no significant concerns reported about its usability. The main barrier we identified was different expectations of doctors and patients: doctors expected that the portal would decrease the amount of paper work and will help them to quickly react in acute cases, however, the patients were disappointed that the portal did not allow them to be able to reach doctors on the 24/7 basis and have a consultation whenever they felt they needed it. Finally, our findings disclosed that participants appreciated the perceived clinical utility of the portal, which could further have an influence on their intention to use it. The findings from our reported study in the area of tuberculosis treatment and rehabilitation suggested that the participants generally accepted the introduction of web-portal for the purpose of reporting health status and getting recommendation from the doctors as an alternative to the traditional doctor visits.
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Affiliation(s)
- Georgy Kopanitsa
- Institute Cybernetic Center, Tomsk Polytechnic University, Lenina 30, 634050, Tomsk, Russia. .,Tomsk state university of architecture and building, Solyanaya 2, Tomsk, Russia.
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Das A, Faxvaag A, Svanæs D. The Impact of an eHealth Portal on Health Care Professionals' Interaction with Patients: Qualitative Study. J Med Internet Res 2015; 17:e267. [PMID: 26601678 PMCID: PMC4704899 DOI: 10.2196/jmir.4950] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/21/2015] [Accepted: 10/21/2015] [Indexed: 12/11/2022] Open
Abstract
Background People who undergo weight loss surgery require a comprehensive treatment program to achieve successful outcomes. eHealth solutions, such as secure online portals, create new opportunities for improved health care delivery and care, but depend on the organizational delivery systems and on the health care professionals providing it. So far, these have received limited attention and the overall adoption of eHealth solutions remains low. In this study, a secure eHealth portal was implemented in a bariatric surgery clinic and offered to their patients. During the study period of 6 months, 60 patients and 5 health care professionals had access. The portal included patient information, self-management tools, and communication features for online dialog with peers and health care providers at the bariatric surgery clinic. Objective The aim of this study was to characterize and assess the impact of an eHealth portal on health care professionals’ interaction with patients in bariatric surgery. Methods This qualitative case study involved a field study consisting of contextual interviews at the clinic involving observing and speaking with personnel in their actual work environment. Semi-structured in-depth interviews were conducted with health care professionals who interacted with patients through the portal. Analysis of the collected material was done inductively using thematic analysis. Results The analysis revealed two main dimensions of using an eHealth portal in bariatric surgery: the transparency it represents and the responsibility that follows by providing it. The professionals reported the eHealth portal as (1) a source of information, (2) a gateway to approach and facilitate the patients, (3) a medium for irrevocable postings, (4) a channel that exposes responsibility and competence, and (5) a tool in the clinic. Conclusions By providing an eHealth portal to patients in a bariatric surgery program, health care professionals can observe patients’ writings and revelations thereby capturing patient challenges and acting and implementing measures. Interacting with patients through the portal can prevent dropouts and deterioration of patients’ health. However, professionals report on organizational challenges and personal constraints related to communicating with patients in writing online. Further development of guidelines and education of health care professionals about how to handle, prioritize, communicate, and facilitate patients online is required in addition to increased attention to the organizational infrastructures and incentives for enabling such solutions in health care.
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Affiliation(s)
- Anita Das
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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12
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Callen J, Giardina TD, Singh H, Li L, Paoloni R, Georgiou A, Runciman WB, Westbrook JI. Emergency physicians' views of direct notification of laboratory and radiology results to patients using the Internet: a multisite survey. J Med Internet Res 2015; 17:e60. [PMID: 25739322 PMCID: PMC4376154 DOI: 10.2196/jmir.3721] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 12/15/2014] [Accepted: 01/21/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients are increasingly using the Internet to communicate with health care providers and access general and personal health information. Missed test results have been identified as a critical safety issue with studies showing up to 75% of tests for emergency department (ED) patients not being followed-up. One strategy that could reduce the likelihood of important results being missed is for ED patients to have direct access to their test results. This could be achieved electronically using a patient portal tied to the hospital's electronic medical record or accessed from the relevant laboratory information system. Patients have expressed interest in accessing test results directly, but there have been no reported studies on emergency physicians' opinions. OBJECTIVE The aim was to explore emergency physicians' current practices of test result notification and attitudes to direct patient notification of clinically significant abnormal and normal test results. METHODS A cross-sectional survey was self-administered by senior emergency physicians (site A: n=50; site B: n=39) at 2 large public metropolitan teaching hospitals in Australia. Outcome measures included current practices for notification of results (timing, methods, and responsibilities) and concerns with direct notification. RESULTS The response rate was 69% (61/89). More than half of the emergency physicians (54%, 33/61) were uncomfortable with patients receiving direct notification of abnormal test results. A similar proportion (57%, 35/61) was comfortable with direct notification of normal test results. Physicians were more likely to agree with direct notification of normal test results if they believed it would reduce their workload (OR 5.72, 95% CI 1.14-39.76). Main concerns were that patients could be anxious (85%, 52/61), confused (92%, 56/61), and lacking in the necessary expertise to interpret their results (90%, 55/61). CONCLUSIONS Although patients' direct access to test results could serve as a safety net reducing the likelihood of abnormal results being missed, emergency physicians' concerns need further exploration: which results are suitable and the timing and method of direct release to patients. Methods of access, including secure Web-based patient portals with drill-down facilities providing test descriptions and result interpretations, or laboratories sending results directly to patients, need evaluation to ensure patient safety is not compromised and the processes fit with ED clinician and laboratory work practices and patient needs.
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Affiliation(s)
- Joanne Callen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
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Hanberger L, Ludvigsson J, Nordfeldt S. Use of a web 2.0 portal to improve education and communication in young patients with families: randomized controlled trial. J Med Internet Res 2013; 15:e175. [PMID: 23973555 PMCID: PMC3758041 DOI: 10.2196/jmir.2425] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 04/19/2013] [Accepted: 06/12/2013] [Indexed: 11/13/2022] Open
Abstract
Background Diabetes requires extensive self-care and comprehensive knowledge, making patient education central to diabetes
self-management. Web 2.0 systems have great potential to enhance health information and open new ways for patients and
practitioners to communicate. Objective To develop a Web portal designed to facilitate self-management, including diabetes-related information and social networking functions, and to study its use and effects in pediatric patients with diabetes. Methods A Web 2.0 portal was developed in collaboration with patients, parents, and practitioners. It offered communication with local practitioners, interaction with peers, and access to relevant information and services. Children and adolescents with diabetes in a geographic population of two pediatric clinics in Sweden were randomized to a group receiving passwords for access to the portal or a control group with no access (n=230) for 1 year. All subjects had access during a second study year. Users’ activity was logged by site and page visits. Health-related quality of life (HRQOL), empowerment (DES), and quality of information (QPP) questionnaires were given at baseline and after 1 and 2 study years. Clinical data came from the Swedish pediatric diabetes quality registry SWEDIABKIDS. Results There was a continuous flow of site visits, decreasing in summer and Christmas periods. In 119/233 families (51%), someone visited the portal the first study year and 169/484 (35%) the second study year. The outcome variables did not differ between intervention and control group. No adverse treatment or self-care effects were identified. A higher proportion of mothers compared to fathers visited once or more the first year (P<.001) and the second year (P<.001). The patients who had someone in the family visiting the portal 5 times or more, had shorter diabetes duration (P=.006), were younger (P=.008), had lower HbA1c after 1 year of access (P=.010), and were more often girls (P<.001). Peer interaction seems to be a valued aspect. Conclusions The Web 2.0 portal may be useful as a complement to traditional care for this target group. Widespread use of a portal would need integration in routine care and promotion by diabetes team members. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN):92107365; http://www.controlled-trials.com/ISRCTN92107365/ (Archived by WebCite at http://webcitation.org/6IkiIvtSb).
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Affiliation(s)
- Lena Hanberger
- Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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Amrita, Biswas D. Health care social media: expectations of users in a developing country. MEDICINE 2.0 2013; 2:e4. [PMID: 25075239 PMCID: PMC4085124 DOI: 10.2196/med20.2720] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/10/2013] [Accepted: 07/18/2013] [Indexed: 11/25/2022]
Abstract
Background Affordability, acceptability, accommodation, availability, and accessibility are the five most important dimensions of access to health services. Seventy two percent of the Indian population lives in semi-urban and rural areas. The strong mismatched ratio of hospitals to patients, rising costs of health care, rapidly changing demographics, increasing population, and heightened demands in pricing for technological health care usage in emerging economies necessitate a unique health delivery solution model using social media. A greater disease burden lies in the health care delivery in developing country like India. This is due to the lack of health care infrastructure in the majority of semi-urban and rural regions. New techniques need to be introduced in these regions to overcome these issues. In the present scenario, people use social media from business, automobiles, arts, book marking, cooking, entertainment, and general networking. Developed and advanced countries like the United States have developed their communication system for many years now. They have already established social media in a number of domains including health care. Similar practice incidences can be used to provide a new dimension to health care in the semi-urban regions of India. Objective This paper describes an extended study of a previous empirical study on the expectations of social media users for health care. The paper discusses what the users of social media expect from a health care social media site. Methods Multiple regression analysis was used to determine the significance of the affect of four factors (privacy, immediacy, usability, and communication) on the usage of health care social media. Privacy, immediacy, usability, and communication were the independent variables and health care social media was the dependant variable. Results There were 103 respondents who used the online questionnaire tool to generate their responses. The results from the multiple regression analysis using SPSS 20 showed that the model is acceptable, with P=.011, which is statistically significant on a P<.05 level. The observed F value (2.082) in ANOVA was less than the given value in the F table (2.61), which allowed us to accept the hypothesis that the independent variables influence the dependant variable. The users of social media in India expect that they can best utilize social media through emergency service information. They want to be able to learn the operations of the social media site quickly and expect to know about health camps and insurance collaborations. However, people like to become friends with people with similar interests based on their interests identified. Conclusions Health care social media requires intelligent implementation in developing economies. It needs to cater to the expectations of the users. The people in India, especially those in urban and semi-urban regions, are very interested in accepting the system.
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Affiliation(s)
- Amrita
- Indian Institute of Technology (IIT) Rajendra Mishra School of Engineering Entrepreneurship (RMSOEE) Kharagpur India
| | - Dhrubes Biswas
- Indian Institute of Technology (IIT) Rajendra Mishra School of Engineering Entrepreneurship (RMSOEE) Kharagpur India
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Nordfeldt S, Ängarne-Lindberg T, Nordwall M, Ekberg J, Berterö C. As Facts and Chats Go Online, What Is Important for Adolescents with Type 1 Diabetes? PLoS One 2013; 8:e67659. [PMID: 23805322 PMCID: PMC3689681 DOI: 10.1371/journal.pone.0067659] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 05/21/2013] [Indexed: 12/11/2022] Open
Abstract
Background Continued refinement of resources for patient information, education and support is needed. Considering the rapid development of new communication practices, the perspectives of young people themselves warrant more attention using a wide research focus. The purpose of this study was to understand information-seeking behaviours, Internet use and social networking online in adolescents with type 1 diabetes (T1DM). This applied to their everyday life, including the context of diabetes and their experiences and need of contact with T1DM peers. Methodology/Principal Findings Twenty-four adolescents aged 10–17 years with T1DM were recruited from a county hospital in the south-east of Sweden. Qualitative data were obtained using eight focus groups, wherein each participant engaged in a 60–90 minute video/audio-recorded session. The focus group data were transcribed and analysed using qualitative content analysis. Some demographic and medical information was also collected. The three main categories that were identified; Aspects of Security, Updating, and Plainness and their sub-categories gave significant information about how to enhance information retrieval and peer contacts related to T1DM. Regarding the persons' information-seeking behaviour, Internet use, and use of social media some differences could be identified depending on gender and age. Conclusions/Significance Sensitivity and adaptation to users' needs and expectations seem crucial in the development of future online resources for adolescents with T1DM. To start with, this could mean applying a wider range of already existing information and communication technologies. Health practitioners need to focus on the areas of security of information and communication, frequency of updating, and simplicity of design-less is more.
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Affiliation(s)
- Sam Nordfeldt
- Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Center for Medical Technology Assessment, Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- * E-mail:
| | - Teresia Ängarne-Lindberg
- Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Maria Nordwall
- Division of Paediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Paediatric Clinic, Vrinnevi Hospital, Norrköping, Sweden
| | - Joakim Ekberg
- Public Health Unit, School of Life Sciences, University of Skövde, Skövde, Sweden
| | - Carina Berterö
- Division of Nursing Sciences, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Nordfeldt S, Ängarne-Lindberg T, Nordwall M, Krevers B. Parents of adolescents with type 1 diabetes--their views on information and communication needs and internet use. A qualitative study. PLoS One 2013; 8:e62096. [PMID: 23626772 PMCID: PMC3633913 DOI: 10.1371/journal.pone.0062096] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/17/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known about parents' views on the use of online resources for information, education and support regarding childhood type 1 diabetes (T1DM). Considering the rapidly evolving new communication practices, parents' perspectives need to be explored. The main purpose of this paper was to explore parents' perceptions of their information-seeking, Internet use, and social networking online. This applied to their everyday life, including the contexts of T1DM and contact with peers. A second aim was to identify implications for future development of Internet use in this respect. METHODOLOGY/PRINCIPAL FINDINGS Twenty-seven parents of 24 young persons aged 10-17 with T1DM participated in eight focus group interviews during their regular visits to a county hospital. Focus group discussions were video/audio-taped, transcribed and analysed using inductive qualitative content analysis. Self-reported demographic and medical information was also collected. A main theme was Finding things out, including two sub-themes, Trust and Suitability. The latter were key factors affecting parents' perceptions of online resources. Parents' choice of information source was related to the situation, previous experiences and knowledge about sources and, most importantly, the level of trust in the source. A constantly present background theme was Life situation, including two sub-themes, Roles and functions and Emotions and needs. Parents' information-seeking regarding T1DM varied greatly, and was closely associated with their life situation, the adolescents development phases and the disease trajectory. CONCLUSIONS/SIGNIFICANCE Health practitioners and system developers need to focus on creating trust and suitability for users' needs. They should understand the children's diverse needs, which depend on their life situation, on the children's development, and on the disease trajectory. To enhance trust in online health information and support services, the participation of local practitioners is crucial.
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Affiliation(s)
- Sam Nordfeldt
- Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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