Health Professionals’ Attitudes Towards Using a Web 2.0 Portal for Child and Adolescent Diabetes Care: Qualitative Study

Abstract

Background The Internet, created and maintained in part by third-party apomediation, has become a dynamic resource for living with a chronic disease. Modern management of type 1 diabetes requires continuous support and problem-based learning, but few pediatric clinics offer Web 2.0 resources to patients as part of routine diabetes care.Objectives To explore pediatric practitioners’ attitudes towards the introduction of a local Web portal for providing young type 1 diabetes patients with interactive pedagogic devices, social networking tools, and locally produced self-care and treatment information. Opportunities and barriers related to the introduction of such systems into clinical practice were sought.Methods Twenty clinicians (seven doctors, nine nurses, two dieticians, and two social welfare officers) from two pediatric diabetes teams participated in the user-centered design of a local Web 2.0 portal. After completion of the design, individual semi-structured interviews were performed and data were analyzed using phenomenological methods.Results The practitioners reported a range of positive attitudes towards the introduction of a local Web 2.0 portal to their clinical practice. Most interviewees were satisfied with how the portal turned out, and a sense of community emerged during the design process and development of the portal’s contents. A complementary role was suggested for the portal within the context of health practice culture, where patients and their parents would be able to learn about the disease before, between, and after scheduled contacts with their health care team. Although some professionals expected that email communication with patients and online patient information would save time during routine care, others emphasized the importance of also maintaining face-to-face communication. Online peer-to-peer communication was regarded as a valuable function; however, most clinicians did not expect that the portal would be used extensively for social networking amongst their patients. There were no major differences in attitudes between different professions or clinics, but some differences appeared in relation to work tasks.Conclusions Experienced clinical practitioners working in diabetes teams exhibited positive attitudes towards a Web 2.0 portal tailored for young patients with type 1 diabetes and their parents. The portal included provision of third-party information, as well as practical and social means of support. The practitioners’ early and active participation provides a possible explanation for these positive attitudes. The findings encourage close collaboration with all user groups when implementing Web 2.0 systems for the care of young patients with chronic diseases, particularly type 1 diabetes. The study also highlights the need for efforts to educate clinical practitioners in the use of Web publishing, social networking, and other Web 2.0 resources. Investigations of attitudes towards implementing similar systems in the care of adults with chronic diseases are warranted.

Informações on-line como suporte às famílias de crianças e adolescentes com doença crônica

“…The topics covered in the selected studies were as follows: two studies address the use of a tool to assess websites (23)(24) ; six address the development, use, evaluation, and/or application of software for computers and smartphones (14, 16-17, 19, 21-22) ; two deal with the attitude and behaviour of health professionals and parents of children and adolescents when accessing online portals (18,20) ; one paper compares the effectiveness of direct access to an online platform with regard to the consultation of health workers (15) ; and another demonstrates how the characteristics of parents influence searches of health information online (13) . The analysis of the selected studies revealed positive and negative aspects of the use of online information for the families of children and adolescents with chronic illness, which resulted in two categories: Potentialities of the use of online information for the families of children and adolescents with chronic illness, and Weaknesses of the use of online information for the families of children and adolescents with chronic illness.…”

“…Chart 1 -Characterisation of the papers included in the review (continue) In the first category, the potentialities of the use of online information to support children and youths with chronic disease were: search for online information, both sexes, in families with chronically ill children, which serves as relief for the parents since they verified that the symptoms and behaviours of their children are appropriate for the age and provide knowledge for the family members to discuss treatment with the physician (13) ; source of complementary knowledge (17) ; supports caregivers due to the dynamism, flow, and possibility of exchanging information (18,20) ; helps parents cope with chronic diseases (14,16,(19)(20)(21)(22) ; attracts teenage audiences (16) ; contributes in self-care (17)(18) ; has positive results in online therapeutic follow-up, as in the consultations at the doctors' offices (15) ; and although the internet is widely accessed, health professionals continue to be the main source of information (20) . In the second category, the weaknesses of the use of online information to support the parents of children and adolescents with chronic diseases were: difficulties in understanding the information (14,19) ; the "digital divide" (limited knowledge of different languages, use of high-cost electronic devices, and access for the low-income population) (16,(19)(20)(21) ; restriction of online therapeutic models to populations in specific chronic conditions (15) ; low quality (23)(24) and reliability (24) of the available content; low availability of data for adolescents (23) ; deficit of skills of health professionals to identify and conduct the use of online support tools (20)(21)(22)(23)(24) , and ignorance of legal regulations on online communication …”

“…In the second category, the weaknesses of the use of online information to support the parents of children and adolescents with chronic diseases were: difficulties in understanding the information (14,19) ; the "digital divide" (limited knowledge of different languages, use of high-cost electronic devices, and access for the low-income population) (16,(19)(20)(21) ; restriction of online therapeutic models to populations in specific chronic conditions (15) ; low quality (23)(24) and reliability (24) of the available content; low availability of data for adolescents (23) ; deficit of skills of health professionals to identify and conduct the use of online support tools (20)(21)(22)(23)(24) , and ignorance of legal regulations on online communication (20) .…”

“…The dynamism of the internet provides a flow of simultaneous communication and becomes an instrument of support to caregivers in decision making and reduces family stress, which only benefits the child and/or adolescent (18,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) . In addition to the content available on the internet and online services, in order to cope with the chronic condition, parents, children, and adolescents use applications that focus on the specific pathology (14,16,(19)(20)(21)(22) .…”

Accessing and managing open medical resources in Africa over the Internet

“…Its success has given rise to the medical "Web 2.0", with initiatives like a medical collaborative encyclopedia [1], various focused medical conferences such as Medicine 2.0 [2], special issues of scientific journals [3], focused medical informatics, and medically-related social groups [4].…”