Abstract:Background: Discharge from a neonatal care unit is often experienced as a vulnerable time for parents. By communicating through digital technology, it may be possible to improve the support for parents and thereby make the transition from hospital to home less stressful. Aim: To develop an eHealth device supporting the transition from hospital to home for parents with a preterm-born child in Sweden using participatory design. Method: Employing a framework of complex interventions in health care using participa… Show more
“…gov identifier: NCT04150120). A specific mobile eHealth tablet was developed to allow digital communication between parents and health care providers during the family's transition from hospital to home [15,16]. The parents' usage and experiences of eHealth for self-management, with a focus on an evaluation of the eHealth tablet, has previously been described by Lindqvist et al [16].…”
Section: Designmentioning
confidence: 99%
“…In addition to conventional care, the parents were given an eHealth intervention delivered as an application on an Android-based tablet through which communication could be maintained with the professionals in the hospital [15]. The eHealth tablet operated by communicating wirelessly with a remote centralized server where all data were stored securely.…”
Section: Settingmentioning
confidence: 99%
“…The studies of parents that are available indicate an overall acceptance of eHealth within their child's health care [14]. Supporting parents with tele homecare and videocalls (eHealth) has reduced emergency visits and hospital visits, and enhanced accessibility, with many parents in the experimental groups preferring eHealth to physical visits, not the least during the Covid-19 pandemic [14,15].…”
Background
In recent years a variety of eHealth solutions has been introduced to enhance efficiency and to empower patients, leading to a more accessible and equitable health care system. Within pediatric care eHealth has been advocated to reduce emergency and hospital outpatient visits, with many parents preferring eHealth to physical visits following the transition from hospital to home. Still, not many studies have focused on access from the parental perspective. Therefore, the aim of the study was to analyze access to health care as perceived by parents when caring for their child at home, with conventional care supported by eHealth following pediatric surgery or preterm birth.
Methods
Twenty-five parents who went home with their child following hospitalization and received conventional care supported by eHealth (a tablet) were interviewed in this qualitative study. Directed content analysis was used, guided by a framework for dimensions of access previously described as: approachability, acceptability, affordability, appropriateness, and availability.
Results
All dimensions of access were present in the material with the dimensions of approachability, appropriateness and acceptability most frequently emphasized. The dimensions highlighted a strong acceptance of eHealth, which was perceived by the parents as beneficial, particularly access to communication with health care personnel familiar to them. The chat function of the tablet was often mentioned as positive. A new dimension was also identified: “aperture.” It is defined by the pathways by which communication is transmitted in cyberspace, and these pathways are not easily visualized for parents submitting information, therefore generating concerns.
Conclusions
Parents generally experienced good access to the eHealth-supported health care. Describing access through its dimensions complemented previous descriptions of eHealth in pediatric care and gave new insights. As such, the new dimension of “aperture”, the indeterminate opening of pathways of communication reflecting the uncertainty of not comprehending cyberspace, could be further evaluated. The dimensional framework of access is recommended when evaluating eHealth in the future.
Trial registration
ClinicalTrials.gov identifier: NCT04150120.
“…gov identifier: NCT04150120). A specific mobile eHealth tablet was developed to allow digital communication between parents and health care providers during the family's transition from hospital to home [15,16]. The parents' usage and experiences of eHealth for self-management, with a focus on an evaluation of the eHealth tablet, has previously been described by Lindqvist et al [16].…”
Section: Designmentioning
confidence: 99%
“…In addition to conventional care, the parents were given an eHealth intervention delivered as an application on an Android-based tablet through which communication could be maintained with the professionals in the hospital [15]. The eHealth tablet operated by communicating wirelessly with a remote centralized server where all data were stored securely.…”
Section: Settingmentioning
confidence: 99%
“…The studies of parents that are available indicate an overall acceptance of eHealth within their child's health care [14]. Supporting parents with tele homecare and videocalls (eHealth) has reduced emergency visits and hospital visits, and enhanced accessibility, with many parents in the experimental groups preferring eHealth to physical visits, not the least during the Covid-19 pandemic [14,15].…”
Background
In recent years a variety of eHealth solutions has been introduced to enhance efficiency and to empower patients, leading to a more accessible and equitable health care system. Within pediatric care eHealth has been advocated to reduce emergency and hospital outpatient visits, with many parents preferring eHealth to physical visits following the transition from hospital to home. Still, not many studies have focused on access from the parental perspective. Therefore, the aim of the study was to analyze access to health care as perceived by parents when caring for their child at home, with conventional care supported by eHealth following pediatric surgery or preterm birth.
Methods
Twenty-five parents who went home with their child following hospitalization and received conventional care supported by eHealth (a tablet) were interviewed in this qualitative study. Directed content analysis was used, guided by a framework for dimensions of access previously described as: approachability, acceptability, affordability, appropriateness, and availability.
Results
All dimensions of access were present in the material with the dimensions of approachability, appropriateness and acceptability most frequently emphasized. The dimensions highlighted a strong acceptance of eHealth, which was perceived by the parents as beneficial, particularly access to communication with health care personnel familiar to them. The chat function of the tablet was often mentioned as positive. A new dimension was also identified: “aperture.” It is defined by the pathways by which communication is transmitted in cyberspace, and these pathways are not easily visualized for parents submitting information, therefore generating concerns.
Conclusions
Parents generally experienced good access to the eHealth-supported health care. Describing access through its dimensions complemented previous descriptions of eHealth in pediatric care and gave new insights. As such, the new dimension of “aperture”, the indeterminate opening of pathways of communication reflecting the uncertainty of not comprehending cyberspace, could be further evaluated. The dimensional framework of access is recommended when evaluating eHealth in the future.
Trial registration
ClinicalTrials.gov identifier: NCT04150120.
“…The eHealth device was developed in 2016 and refined in 2017-2018, in collaboration with representatives of patient organizations, professionals at the Departments of Neonatology and Pediatric Surgery, and researchers at Lund University [21]. Child-centered care [22] and participatory design (PD) [23] were practiced throughout the development in an iterative process based on continuous collection of feedback from the users involved in the care of the child [21]. Hence, the eHealth device was developed with the perspectives of both professionals and families of patients, and specifically designed for (1) neonatal care, and (2) postoperative follow-up after reconstructions for Hirschsprung disease and anorectal malformations.…”
The costly and complex needs for children with long-term illness are challenging. Safe eHealth communication is warranted to facilitate health improvement and care services. This mixed-methods study aimed to describe parents’ usage and experiences of communicating with professionals during hospital-to-home-transition after their child’s preterm birth or surgery for colorectal malformations, using an eHealth device, specifically designed for communication and support via nurses at the hospital. The eHealth devices included the possibility for daily reports, video calls, text messaging, and sending images. Interviews with 25 parents were analyzed with qualitative content analysis. Usage data from eHealth devices were compiled from database entries and analyzed statistically. Parents using the eHealth device expressed reduced worry and stress during the initial period at home through effective and safe communication. Benefits described included keeping track of their child’s progress and having easy access to support whenever needed. This was corroborated by usage data indicating that contact was made throughout the day, and more among families living far away from hospital. The eHealth device potentially replaced phone calls and prevented unnecessary visits. The eHealth technique can aid safe self-treatment within child- and family-centered care in neonatal and pediatric surgery treatment. Future research may consider organization perspectives and health economics.
“…Self-management intervention is an individuals’ ability to manage personal symptoms conditions, psychological health and lifestyles by utilizing resources [ 8 , 9 ]. eHealth self-management intervention is the use of information and communications technology (ICT) to support self-management [ 8 , 10 ].…”
Purpose
The objective of this paper is to design a protocol for a systematic review and meta-analysis on the effectiveness of self-management interventions in patients with chronic heart failure.
Methods
The protocol is developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol has been registered in PROSPERO (CRD42021246973). Base on the population, intervention, comparator, and outcome (PICO) framework, our research questions are: 1) What are the effects of eHealth self-management interventions on patients with chronic heart failure? 2) What factors of interventions might affect outcomes? The process includes: 1) search strategy and inclusion criteria; 2) data extraction; 3) risk of bias assessment and 4) data analysis. Searching process and data extraction will be guided by Cochrane Handbook for Systematic Reviews of Interventions. We will use Cochrane Risk of Bias tool to assess the risk of bias. The data analysis will be performed using Metafor package in R.
Conclusions
This systemic review will synthesize the current evidence and identify gaps. Findings in the meta-analysis will provide guidance for designing a more effective self-management intervention for patients with chronic heart failure in future.
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