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Using HIT to Support Informal Caregivers of Cancer Patients at Home: a Needs AssessmentAl Awar, Zeina January 2016 (has links)
Introduction: This research investigated the requirements of an HIT solution that is usable and useful to informal caregivers of cancer patients on home palliative care.
Methodology: A needs assessment method was used with an exploratory and a confirmatory stage. Eight semi-structured interviews and two focus groups were used for data collection. Qualitative content analysis was used to analyse caregiver experiences with both inductive and deductive coding.
Results/Discussion: Expressed and unexpressed caregiver needs were extracted into four categories, Implementation, Presentation, Information, and Practical Caregiving, and used to create the application requirements. Five user personas were created based on caregiving intensity and the functional level of the patients, a method of tailoring the application content to the different personas was created, and a low-fidelity prototype of the application was designed.
Conclusion: The findings of this research can improve the preparedness and coping of informal caregivers of cancer patients on home palliative care.
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Consumer Adoption of Personal Health RecordsMajedi, Armin January 2014 (has links)
Health information technology (HIT) aims to improve healthcare services by means of technological tools. Patient centered technologies such as personal health records are relatively new HIT tools that enable individuals to get involved in their health management activities. These tools enable the transformation of health consumer behavior from one of passive health information consumers to that of active managers of their health information. This new role is more interactive and engaged, and with such tools, patients can better navigate their lives, and exercise more control over their treatments, hence potentially also leading to improvement in the quality of health services. Despite the benefits of using personal health record systems for health consumers, the adoption rate of these systems remains low. Many free and paid services have not received the uptake that had been anticipated when these services were first introduced. This study investigates some factors that affect the adoption of these systems, and may shed light on some potential reasons for low adoption rates.
In developing the theoretical model of this study, social cognitive theory (SCT) and technology acceptance model (TAM) were utilized. The theoretical model was validated through a quantitative survey-based methodology, and the results were derived using structural equation modeling techniques.
The key findings of this study highlight the role of individual and environmental factors as determinants of end-user behavior in the adoption of personal health records. The results show that in addition to perceptions of usefulness and ease of use, factors such as social norms and technology awareness are also significantly associated with various factors that directly and indirectly affect intention to use PHRs
Based on the results obtained in this study, recommendations are offered for technology providers, and possible directions are proposed for academic researchers.
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Soutien social et réseau personnel au cœur de l’expérience du cancer / Social support and personal network of cancer patientsDefossez, Adrien 09 December 2014 (has links)
Cette thèse s’inscrit dans la continuité des travaux sociologiques de réseaux sociaux qui s’intéressent au concept de soutien social. Le travail de recherche porte sur les ressources insérées dans le réseau de relations des patients atteints de cancer ainsi que sur la configuration de ces réseaux personnels. Pour ce faire, la thèse se focalise sur le soutien informationnel qui constitue un des grands types de soutien que l’on rencontre dans la littérature sociologique. Les informations de santé accessibles à travers l’entourage relationnel sont considérées comme des ressources qui permettent aux malades de répondre aux difficultés qu’ils rencontrent dans le cadre de la pathologie cancéreuse. L’analyse est basée sur des entretiens réalisés auprès de patients pris en charge dans des services d’oncologie. Cette thèse se donne deux objectifs : le premier est de rendre compte du soutien social dans le cadre d’une pathologie chronique telle que le cancer. De ce point de vue-là, la thèse montre les difficultés que les malades rencontrent pour obtenir les ressources recherchées. Le second objectif est de contribuer à la réflexion théorique sur la mobilisation des liens sociaux. La recherche décrit les contraintes et opportunités du réseau des malades notamment à travers l’analyse des modes de régulations des relations personnelles. / The thesis we sustain is rooted in the social network analysis interested in the concept of social support. This study deals with the resources embedded in the social network of cancer patients and on the structure of these personal networks. The thesis focuses on informational support that is one of the main kinds of support we can find in the sociological literature. Health information patients access through their social ties are social resources upon which they may draw when facing difficulties. Based on semi-structured interviews with cancer patients, this study pursues two aims: the first one is to describe social support in the case of chronic diseases such as cancer. From this perspective, the thesis shows the patient difficulties to obtain appropriate resources. The second aim is to contribute to the theoretical thought on social ties’ mobilization. This research describes the constraints and opportunities of patients’ network through an analysis of the social ties rules.
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Formative Research on an Instructional Design Theory for Virtual Patients in Clinical Education: A Pressure Ulcer Prevention Clinical Reasoning CaseSchladen, Manon Maitland 31 March 2015 (has links)
Despite advances in health care over the past decades, medical errors and omissions remain significant threats to patient safety and health. A large number of these mistakes are made by trainees, persons who are just beginning to build the case-based experiences that will transform them from novices to expert practitioners. Clinicians use both intuitive and deductive problem-solving skills in caring for patients and they acquire expertise in applying these skills through interaction with many and varied cases.
The contemporary heath care environment, with decreased lengths of stay for patients and reduced duty hours for trainees, makes getting optimal patient exposure difficult. Virtual patients (VPs), online, interactive patient cases, may help close the case exposure gap. Evidence has shown that VPs improve clinical reasoning skills, but no formal instructional design theory of VPs has been advanced. The goal was to conduct formative research to develop an instructional design theory of VPs to help novice clinicians cultivate clinical reasoning and diagnostic skills. The instructional design theory, goal-based scenarios (GBS), grounded in the learning theory, Case-based Reasoning, provided methods that promised to be appropriate to the goal.
An existing, two-module, multimedia VP, Matt Lane, A Pressure Ulcer Prevention Virtual Patient, was tested with 10 medical trainees to determine which methods of GBS it incorporated and which of its methods were not part of GBS. Leaners' experience of what worked and didn't work to promote learning in the VP was analyzed. The VP was found to incorporate all GBS methods and one significant method, the Life Model, that was not part of GBS. The Life Model Method involved replicating, with a high degree of fidelity, the experiences of a real patient in creating the VP scenario.
Recommendations for customization of GBS for VPs included more explicit advertisement of learning goals and leverage of Internet search engines to provide just-in-time resources to support problem-solving. Incorporation of the Life Model was also recommended along with the Simplifying Conditions Method from Elaboration Theory to manage the complexity inherent in the Life Model. The resultant, enhanced GBS theory may be particularly relevant in teaching patient-centered care.
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O impacto do nascimento pré-termo na mortalidade neonatal no município de Porto AlegreTietzmann, Marcos Roberto January 2017 (has links)
Objetivo: Avaliar o impacto do nascimento pré-termo sobre a mortalidade neonatal numa série temporal de 2000 a 2014 no município de Porto Alegre. Métodos: Estudo de coorte retrospectivo de base populacional com a utilização dos registros oficiais de nascimento e de morte ligados de 2000 a 2014 de recém-nascidos com menos de 32 semanas de idade gestacional de Porto Alegre. Foram utilizadas como variáveis independentes idade e escolaridade maternas, número de consultas pré-natal, tipo de hospital, via de parto, idade gestacional (IG), sexo e peso do recém-nascido e ano de nascimento. O desfecho primário foi morte neonatal (morte ocorrida de 0 a 27 dias de vida). Foram excluídos recém-nascidos duplicados, com menos de 500 gramas ou com peso inconsistente, com IG menor de 22 semanas, com anomalias congênitas, gemelares e de partos extra hospitalares. Foi calculado razão de risco (hazard ratio-HR) ajustado para o risco de morte neonatal para todas as variáveis independentes através de análise de sobrevivência pela regressão de Cox para riscos proporcionais com nível de significância p<0,05. Posteriormente, foi realizado análise por quintil de peso de nascimento. Resultados: Foram analisados os registros de 3282 recém-nascidos com IG menor que 32 semanas de 2000 a 2014 dos quais, 643 foram ao óbito neonatal e 2639 sobreviveram. O risco de morte neonatal absoluto diminuiu de 25% no triênio 2000 a 2002 para 17% no período de 2012 a 2014. O mesmo risco ajustado foi significativamente menor para os recém-nascidos de menor peso (média de 673 ± 86 gramas) de parto cesáreo [HR 0,57 (IC95% 0,45-0,73)] enquanto que, para os de maior peso (média 1.834 ± 212 gramas) este risco inverteu-se e foi significativamente maior para esta via de parto [HR 8,44 (IC95% 1,86-38,22)]. Conclusão: Houve diminuição do risco absoluto de morte neonatal entre os recém-nascidos com IG menor de 32 semanas nos últimos anos em Porto Alegre e o aprimoramento do uso racional do parto cesáreo nos hospitais do município pode contribuir para uma redução ainda maior desse indicador. / Objective: Assess impact of prematurity on neonatal mortality from 2000 to 2014 in Porto Alegre through official information systems. Methods: Populational base retrospective cohort study with record linkage of birth and death database certificates. There were included records of birth and death from 2000 to 2014 of infants with less than 32 weeks of gestational age of Porto Alegre. There were used mother age and schooling, number of antenatal visits, delivery type, hospital type, gestational age, sex and birth weight and birth year of infant as independent variables. The primary outcome examined was neonatal death (death at 0-27 days of age). There were excluded infant records duplicate, with less than 500g or inconsistent birthweight, with gestational age less than 22 weeks, with congenital anomalies, twins and out-of-hospital births. Adjusted Hazard Ratio (HR) were calculated for the risk of neonatal death for all independent variables through Cox regression for survival analysis with p-value<0,05 for statistical significance. The analysis also was performed at quintiles of birthweight. Results: There were 3282 infant records of infants with less than 32 weeks of gestational age from 2000 to 2014 who progress to 643 neonatal deaths or 2639 survival. The neonatal death absolut risk decline from 25% at 2000-2002 period to 17% at 2012-2014 period. The adjusted neonatal death risk was significantly reduced for lightest preterm (mean birthweight 673g ± 86) born by C-section [HR 0.57 (CI95% 0.45-0.73)], while, for the heaviest ones (mean birthweight 1.834g ± 212) the risk was significantly increased for that delivery route [HR 8.44 (CI95% 1.86-38.22)]. Conclusion: The absolut risk of neonatal death in infants with less than 32 weeks of gestational age has been declining over the years and more rational use of C-section can contribute to further improving the neonatal survival.
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Successful Strategies for Implementing Health Information Technology in Primary Care PracticeOtoo, Samuel O 01 January 2019 (has links)
Health information technology (HIT) owner-practitioners who adopt effective strategies for HIT implementation can improve primary facility care delivery and profitability. However, some HIT owner-practitioners have ineffective implementation strategies, so they have not realized the total revenue increases of more than 8%. Grounded in general systems theory, the purpose of this multiple case study was to explore successful strategies primary care practitioners (PCPs) use to implement HIT to improve primary facility care delivery and profitability. The participants included 6 owner-practitioners located in Queens County, NY, who successfully implemented HIT to improve facility care delivery and profitability. Data were collected through face-to-face interviews and a review of relevant practice documents. Data were analyzed using thematic analysis, yielding 3 themes: HIT education and training, costs of transitioning to HIT, and focusing on expected benefits of successful HIT implementation. By providing information on effective HIT strategies, the findings from this study could impact social change because PCPs may rely on faster and more accurate health information data to offer better diagnoses and enhance treatments for patients.
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An Integrative Model of eHealth Communication: a Study of 18-30 Year Old College StudentsPrybutok, Gayle 08 1900 (has links)
eHealth is commonly defined as health services and information provided through the Internet and related technologies. Health educators have taken advantage of Internet and social media venues to disseminate health information essential to health risk management, disease prevention, and disease management and did not have a validated theoretical model to explain their experiences. The goal of this study was to create and test an integrated model of eHealth communication specific to 18-30 year old college students based on five research questions that identified and confirmed the factors most highly correlated with the presentation of health information on Internet or social media venues that improve eHealth literacy and provoke eHealth behavioral intention among college students. A sample of over 1400 18-30 year old college students was surveyed about their general and health information related use of the Internet and social media. As a result of exploratory factor analysis and subsequent structural equation modeling, the proposed theoretical model was revised and tested for statistical power. Two revised integrative models of eHealth communication, one for Internet and one for social media, were developed and validated. The model for social media shows statistically significant paths throughout the model; however, the model for the Internet reveals that the path between two constructs and Online Health Behavior are not statistically significant and is worthy of further examination. This study has important practical implications for eHealth educators, organizations dedicated to informing the public about specific diseases or health promotion techniques, health practitioners seeking improved strategies for effective eHealth message design, and to health information professionals.
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Designing, developing and evaluating a management information system for vitamin a supplementation programme managers in the Eastern Cape through action researchWagner-Meyer, Rolene M. January 2003 (has links)
Magister Public Health - MPH / Periodic high doses of vitamin A supplementation has been demonstrated to have a dramatic impact on vitamin A status and general health of children, significantly improving child survival. The Eastern Cape Department of Health has therefore adopted a provincial policy on vitamin A supplementation to improve the high child mortality and vitamin A deficiency rates experienced in the province. This study outlines a participatory approach to designing, developing and evaluating the implementation of a management information system (MIS) that will support district level Maternal, Women and Child Health programme managers in problem identification, planning and decision-making when implementing the Eastern Cape policy on vitamin A supplementation. It is an iterative process that: • Begins with a situational analysis
• Uses this situational analysis for the conceptualisation of the MIS
• Develops this MIS as a part of the vitamin A supplementation programme,
embedding the MIS in the management structure and operational systems and
• Evaluates the implementation of this MIS
The study introduces the concept of trace tables, an integral part of the MIS. It is a unique
tool that the researcher has developed to assist programme managers to monitor the
implementation of the various elements of a primary health care programme like vitamin
A supplementation.
The researcher discusses the key findings of the study, the participatory nature of this action research, and elements unique to this study in terms of the vitamin A supplementation programme, the development of a MIS, an action research approach and the context within which the development of the MIS occurred. The study is concluded with key lessons to be learnt from this research and the postulation of a model on a participatory approach to the development of a MIS for Primary Health Care programmes.
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Distriktssköterskors erfarenheter av att möta pålästa patienter som hämtat information från internet inför ett primärvårdsbesök / Primary health care nurses' experiences of meeting the knowledgeable patient who retrieved information on the internet prior to a primary care visitBodén, Anna, Sandberg, Amanda January 2021 (has links)
Bakgrund: Traditionellt har vården varit källan till information för människans sjukdomsdiagnos, behandling och prognos. I dagens digitala samhälle, finns samma evidensbaserade sidor som sjuksköterskan hämtar kunskap från tillgängliga för gemene man. Kunskap om sitt egna upplevda hälsotillstånd är idag ett av de mest sökta ämnet på internet och möjligheten att besitta specialistkunskap om sitt tillstånd är därför stor. Sjuksköterskor beskriver i mötet med den pålästa patienten, en känsla av förlägenhet i sin profession då de betraktar det som osannolikt att vara uppdaterad i nivå med den senaste kunskapen som patienten hämtat. Motiv: Det är angeläget att genomföra denna studie för att belysa de utmaningar en distriktssköterska som arbetar på en hälsocentral ställs inför, i ett samhälle där digitaliseringen gjort kunskap lättillgängligt. Syfte: Syftet med studien är att belysa distriktssköterskors erfarenheter av att möta pålästapatienter som hämtat information från internet inför ett primärvårdsbesök. Metod: Data för denna studie har inhämtats från åtta distriktssköterskor från fem hälsocentraler i Västerbotten. För att öka förståelsen av sjuksköterskans erfarenheter av den pålästa patienten har åtta semistrukturerade intervjuer utförts. Intervjuerna har analyserats utifrån en kvalitativ innehållsanalys. Resultat: Studien synliggör varierande erfarenheter av den pålästa patienten. Det framkom att distriktssköterskorna var eniga om att pålästa patienter som hämtat information från internet inför ett primärvårdsbesök kan vara både ansträngande och tidskrävande. Samtliga distriktssköterskor hävdar samtidigt att en påläst patient inte behöver vara något negativt. Konklusion: Slutsatsen pekar försiktigt mot att dagens digitaliserade samhälle medför att patienten ställer högre krav på distriktssköterskans kompetens. Studien belyser utmaningar och känslor som sjuksköterskor kan möta i sitt arbete med en påläst patient och synliggör potentiella behov av åtgärder som kan underlätta arbetet med den pålästa patienten som hämtat information från internet inför ett primärvårdsbesök. / Background: Traditionally, healthcare has been the source of information for diagnosis, treatment and prognosis. In today's digital society, the same evidence-based pages that the nurses' draws knowledge from is available to the public. Knowledge of one's own experienced health condition is today one of the most sought-after topics and the opportunity to possess specialist knowledge of one's condition is high. Nurses describe feelings of embarrassment in their profession as they consider it unlikely to be up to date with the latest knowledge. Motive: It is important to perform this study to describe the challenges a primary health care nurse faces in daily work where digitalisation has made knowledge easily accessible. Aim: Primary health care nurses’ experiences of meeting knowledgeable patients who retrieved information on the internet prior to a primary care visit. Methods: Data has been obtained from eight primary health nurses’ from five health centers in Västerbotten. To increase the understanding of the primary health nurses' experience of the knowledgeable patient, eight semi-structured interviews were held. The interviews were analyzed according to a qualitative content analysis. Result: The study highlights varying experiences. It emerged that primary health care nurse’s agreed that knowledgeable patients who obtained information from the internet prior to a primary care visit can be both exhausting and time-consuming. Although, all primary health care nurses’ claim that a knowledgeable patient does not have to be something negative. Conclusion: The conclusion cautiously points to the fact that today's digitalized society sets higher demands on the primary health care nurse's competence. The study highlights the challenges and emotions that the primary health care nurse may encounter. The study highlights potential needs for measures that can facilitate the work.
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An Evaluation of Computational Methods to Support the Clinical Management of Chronic Disease PopulationsFeller, Daniel January 2020 (has links)
Innovative primary care models that deliver comprehensive primary care to address medical and social needs are an established means of improving health outcomes and reducing healthcare costs among persons living with chronic disease. Care management is one such approach that requires providers to monitor their respective patient panels and intervene on patients requiring care. Health information technology (IT) has been established as a critical component of care management and similar care models. While there exist a plethora of health IT systems for facilitating primary care, there is limited research on their ability to support care management and its emphasis on monitoring panels of patients with complex needs. In this dissertation, I advance the understanding of how computational methods can better support clinicians delivering care management, and use the management of human immunodeficiency virus (HIV) as an example scenario of use.
The research described herein is segmented into 3 aims; the first was to understand the processes and barriers associated with care management and assess whether existing IT can support clinicians in this domain. The second and third aim focused on informing potential solutions to the technological shortcomings identified in the first aim. In the studies of the first aim, I conducted interviews and observations in two HIV primary care programs and analyzed the data generated to create a conceptual framework of population monitoring and identify challenges faced by clinicians in delivering care management. In the studies of the second aim, I used computational methods to advance the science of extracting from the patient record social and behavioral determinants of health (SBDH), which are not easily accessible to clinicians and represent an important barrier to care management. In the third aim, I conducted a controlled experimental evaluation to assess whether data visualization can improve clinician’s ability to maintain awareness of their patient panels.
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