Background Chronic pain conditions are complicated and challenging to live with. Electronic health (eHealth) interventions show promise in helping people cope with chronic illness, including pain. The success of these interventions depends not only on the technology and intervention content but also on the users’ acceptance and adherence. Involving all stakeholders (eg, patients, spouses, health care providers, designers, software developers, and researchers) and exploring their input and preferences in the design and development process is an important step toward developing meaningful interventions and possibly strengthening treatment outcomes. Objective The aim of this study was to design and develop a user-centered, evidence-based eHealth self-management intervention for people with chronic pain. Methods The study employed a multidisciplinary and user-centered design approach. Overall, 20 stakeholders from the project team (ie, 7 researchers, 5 editors, 7 software developers, and 1 user representative), together with 33 external stakeholders (ie, 12 health care providers, 1 health care manger, 1 eHealth research psychologist, and 17 patients with chronic pain and 2 of their spouses) participated in a user-centered development process that included workshops, intervention content development, and usability testing. Intervention content was developed and finalized based on existing evidence, stakeholder input, and user testing. Stakeholder input was examined through qualitative analyses with rapid and in-depth analysis approaches. Results Analyses from stakeholder input identified themes including a need for reliable, trustworthy, and evidence-based content, personalization, options for feedback, behavioral tracking, and self-assessment/registration as factors to include in the intervention. Evidence-based intervention content development resulted in one face-to-face introduction session and 9 app-based educational and exercise-based modules. Usability testing provided further insight into how to optimize the design of the intervention to the user group, identifying accessibility and a simple design to be essential. Conclusions The design and development process of eHealth interventions should strive to combine well-known evidence-based concepts with stakeholder input. This study, designing and developing the pain management intervention EPIO, illustrates how a stakeholder-centered design approach can provide essential input in the development of an eHealth self-management intervention for people with chronic pain. Trial Registration ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104
Persons with morbid obesity had increased self-efficacy and selfesteem after patient education Background: Patient education providing positive results with regard to persons' coping with chronic illness is important to decrease the demand on health care services. Methods aimed at strengthening the person's self-perception may be an important supplement to medical treatment.Objective: To explore changes in self-efficacy and self-esteem one year after completing patient education.Method: Participants in patient courses for morbid obese persons at three different sites answered 12 questionnaires five times in 2009. This article presents results from questionnaires on self-efficacy and self-esteem completed on the first day of the course and 12 months after course completion. Results:From 185 course participants, 142 returned questionnaires the first day of the course and 67 completed it after one year. Mean age was 43.3, 75% female; 64% had less than 12 years of education; no statistically significant differences were found between women and men. The participants had increased scores on self-efficacy and selfesteem after one year. The results were both statistically and clinically significant. Conclusion:Courses providing basic knowledge about the illness and methods to strengthen perception of self may contribute to improved self-efficacy and self-esteem. The results are in accordance with international research on coping with illness.
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