scholarly journals Holding It Together�Patients' Perspectives on Postoperative Recovery When Using an e-Assessed Follow-Up: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Karuna Dahlberg ◽  
Maria Jaensson ◽  
Ulrica Nilsson ◽  
Mats Eriksson ◽  
Sigrid Odencrants
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Recovery Period ◽  
Day Surgery ◽  
Postoperative Recovery ◽  
Mobile App ◽  
Care Organization ◽  
Next Of Kin ◽  
Qualitative Interview Study

BACKGROUND There is an emerging trend to perform surgeries as day surgery. After a day surgery, most of the recovery period takes place at home, and patients are responsible for their own recovery. It has been suggested that electronic health (eHealth) technologies can support patients in this process. A mobile app has recently been developed to assess and follow up on postoperative recovery after a day surgery. OBJECTIVE The aim of this study was to explore experiences associated with postoperative recovery after a day surgery in patients using a mobile app to assess the quality of their recovery. METHODS This is a qualitative interview study with an explorative and descriptive design. Participants were recruited from 4 different day surgery units in different parts of Sweden. The study included 18 participants aged >17 years who had undergone day surgery and used the Recovery Assessment by Phone Points, a mobile app for follow-up on postoperative recovery after day surgery. Participants were purposively selected to ensure maximum variation. Semistructured individual interviews were conducted. Data were analyzed using thematic analysis. RESULTS A total of two themes and six subthemes emerged from the data: (1) the theme Give it all you’ve got with the subthemes Believing in own capacity, Being prepared, and Taking action, where participants described their possibilities of participating and themselves contributing to improving their postoperative recovery; and (2) the theme The importance of feeling safe and sound with the subthemes Feeling safe and reassured, Not being acknowledged, and Not being left alone, which describe the importance of support from health care professionals and next of kin. CONCLUSIONS It is important that patients feel safe, reassured, and acknowledged during their postoperative recovery. They can achieve this themselves with sufficient support and information from the health care organization and their next of kin. Using a mobile app, both for assessment and to enable contact with the day surgery unit during the postoperative recovery period, can improve care and create a feeling of not being alone after surgery. We propose that postoperative recovery starts in the prerecovery phase when patients prepare for their recovery to get the best possible outcome from their surgery.

scholarly journals Waiting for Cardiac Surgery—Support Experienced by Next of Kin

2005 ◽  
Vol 4 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Bodil Ivarsson ◽  
Trygve Sjöberg ◽  
Sylvia Larsson
Keyword(s):  
Health Care ◽  
Cardiac Surgery ◽  
Health Care Professionals ◽  
Critical Incident ◽  
External Factors ◽  
Care Organization ◽  
Next Of Kin ◽  
Internal Factors ◽  
Heart Operation ◽  
Negative Factors

Background: Next of kin (NoK) play a crucial role for patients waiting for cardiac surgery. Aim: To describe experience of support, in the form of important events, by next of kin while their intimates were waiting for a heart operation. Methods: The design was qualitative and the “critical incident” technique was used. Incidents were collected via interviews with 23 next of kin to patients waiting for heart surgery and the informants were chosen by the patient themselves. Findings: In all, 224 important events, both positive and negative, were identified in the interviews and two main areas emerged in the analysis: internal factors and external factors. Positive internal factors were associated with finding strength, whereas negative factors were associated with uncomfortable feelings. Positive external factors were associated with participating in care and receiving attention, whereas negative factors were associated with dissatisfaction with the health-care organization and failing social network. Conclusion: This study shows that next of kin experienced positive support when they received attention and information and felt involvement in the care. An important implication for the health-care professionals and public authorities is the understanding of the experience of support expressed by next of kin, to provide them with optimal information and support.

scholarly journals Digital secondary prevention follow-up after percutaneous coronary intervention (PCI) at home: what are the users perspectives?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
HL Elstad ◽  
A Edvardsen ◽  
F Astin ◽  
A Steinsbekk ◽  
D Atar ◽  
...  
Keyword(s):  
Health Care ◽  
Percutaneous Coronary Intervention ◽  
Secondary Prevention ◽  
Health Information ◽  
Health Care Professionals ◽  
Coronary Intervention ◽  
Next Of Kin ◽  
Percutaneous Coronary ◽  
At Home

Abstract Funding Acknowledgements Type of funding sources: Private hospital(s). Main funding source(s): LHL Hospital Gardermoen Bergesen Foundation Digital Secondary Prevention Follow-up After Percutaneous Coronary Intervention (PCI) at Home: What are the Users Perspectives? Background Secondary prevention for patients with established CHD is the mainstay of cardiovascular rehabilitation, but is not accessible to all eligible patients. Digital delivery offers a way to widen participation in secondary prevention to PCI patients, but little is known about users’ preferences. Purpose The purpose of this qualitative study was to explore service users, carers and health professionals views about potential challenges experienced in secondary prevention after PCI and preferences for support to inform the development of a digital home program. Methods A series of three focus group interviews were conducted in a broad user panel with former PCI patients (4), next-of-kin (1) and interdisciplinary health care professionals (4) between March 2017 and September 2019. Data was audiotaped, transcribed verbatim and analysed using content analysis. Results Three main themes and sub-themes on challenges and preferences for digital follow-up were identified: (1) Technology: feasibility including  safety, integration with known platforms, functionality, and user-friendly navigation were major assets, as well as the capability of monitoring medication adherence, smoking cessation and physical activity. (2) Communication: interactive, direct, clear, supportive, encouraging, visualizing, humorous, using virtual meeting rooms, as well as including direct responses on patients’ self-motivation and achieved goals and (3) Health information: basic step-by-step facts and questions-and-answers (FAQ), being practical, visual, and including side effects of medications and health services navigation. Conclusion User perspectives from former patients, next-of-kin and health care professionals reveal a preference for digital secondary prevention which offers functionality, communication, and health information during follow-up at home after a PCI.

Digital Diabetes Care System Observations from a market acceptance evaluation study in Vietnam (Preprint)

2019 ◽  
Author(s):  
Tran Quang Khanh ◽  
Pham Nhu Hao ◽  
Eytan Roitman ◽  
Baruch Marganitt ◽  
Avivit Cahn
Keyword(s):  
Health Care ◽  
Blood Glucose ◽  
Health Care Professional ◽  
Diabetes Care ◽  
Health Care Professionals ◽  
Mobile App ◽  
Physician Satisfaction ◽  
Diabetes Clinic ◽  
Blood Glucose Monitor ◽  
Hba1c Levels

BACKGROUND Digital technologies are gaining an important role in the management of patients with diabetes. The GlucoMe solution integrates multiple aspects of diabetes care: 1) Wireless blood glucose monitor - communicates glucose data automatically to any smartphone; 2) Mobile-app - securely transmits real-time blood glucose monitor data for cloud based analyses, and enables 2-way communication between patients and health care professionals; 3) Digital diabetes clinic – analyzes and presents data to the health care professional; and 4) Control tower software provides population management reports and sends individualized alerts. OBJECTIVE Assess clinical outcomes and user satisfaction of incorporating the GlucoMe digital solution in diabetes clinics of a developing country. METHODS Five hospital endocrinology clinics in Vietnam participated in a market acceptance evaluation pilot of the GlucoMe system. The clinics sequentially recruited all patients willing to join, so long as they had a smartphone and access to internet connectivity. Patients were provided with the GlucoMe app and blood glucose monitor and instructed in their use in individual or groups sessions. The digital diabetes clinic and control tower software were installed in the clinic computers. Face-to-face visits were conducted at baseline and at 12 weeks, with monthly digital visits scheduled in the interim and additional digital visits performed as needed. HbA1c levels were measured at baseline and at 12 weeks (±20 days). Treatment modification was at the discretion of the treating physician. Outcome measures included adherence to glucose monitoring, change in glycemic parameters and patient and physician satisfaction as assessed by questionnaires. Only patients completing the pilot were included in data analyses. RESULTS The study recruited 300 patients of whom 279 patients completed the evaluation. Dropout was due to change in internet access availability (18) or death (3). Adherence to glucose measurements gradually declined, yet, at study end 81% of the patients were measuring glucose at least once a week. Digital contact from the health care professional to the patient or vice-versa (excluding automated alerts) occurred in average every 6.2 days. Average glucose levels declined from 170.4±64.6 mg/dl in the first two weeks to 150.8±53.2 mg/dl in the last two weeks (P<0.001) (n=221). HbA1c levels at baseline and 12 weeks were available for only 126 of the patients and declined from 8.3±1.9% to 7.6±1.3 (P<0.001). Over 95% of the physicians and patients stated they would strongly support the broad usage of the GlucoMe platform in diabetes clinics across the country. CONCLUSIONS The GlucoMe digital solution was broadly accepted by both patients and health care professionals and improved glycemic outcomes. The digital platform yielded increased number of patient-health care professional interactions, yet of short duration, enabling judicious allocation of limited time resources. The durability, scalability and cost-effectiveness of this approach merit further study.

scholarly journals Comparing Attitudes to Containment Measures of Patients, Health Care Professionals and Next of Kin

2018 ◽  
Vol 9 ◽  
Author(s):  
Thomas Reisch ◽  
Simone Beeri ◽  
Georges Klein ◽  
Philipp Meier ◽  
Philippe Pfeifer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Next Of Kin ◽  
Containment Measures

scholarly journals Advance care planning in Norwegian nursing homes – limited awareness of the residents’ preferences and values? A qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lisbeth Thoresen ◽  
Reidar Pedersen ◽  
Lillian Lillemoen ◽  
Elisabeth Gjerberg ◽  
Reidun Førde
Keyword(s):  
Health Care ◽  
Nursing Homes ◽  
Advance Care Planning ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Care Planning ◽  
Next Of Kin ◽  
Medical Issues ◽  
Interdisciplinary Approaches ◽  
Advance Care

Abstract Background 52% of all deaths in Norway occur in nursing homes. Still advance care planning (ACP) is scarce and heterogeneous. To improve the implementation and practice of ACP in nursing homes, knowledge about health care professionals’ views on ACP is vital. The objective of this study is to explore nurses and physicians’ aims and experiences with carrying out ACP in nursing homes. Methods Semi-structured group interviews were conducted with 20 health care professionals, recruited from nursing homes where ACP was performed regularly. Qualitative content analysis was used to analyse the data. Results The primary aim of the nursing home professionals when doing ACP in nursing homes were to build alliances with next of kin to avoid misunderstandings and future conflicts. Two main experiences with ACP were described: i) due to the sensitivity of ACP issues, it was important to balance directness with being sensitive, and ii) when the physicians raised questions concerning future medical treatment, the answers from residents as well as next of kin were often hesitant and unclear. Conclusion Our study add insights into how ACP is practiced in nursing homes and the professionals’ agenda. A focus on medical issues and achieving consensus with next of kin may result in lack of involvement of the residents and limited awareness of the residents’ needs. Interdisciplinary approaches, ACP-training and tailored guidelines may improve the implementation and practice of ACP.

scholarly journals The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands (Preprint)

2020 ◽  
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Elderly Care ◽  
Care Plan ◽  
Self Management ◽  
Medical Specialists

BACKGROUND Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. OBJECTIVE This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. METHODS Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. RESULTS Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). CONCLUSIONS The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

Optimising Hand Surgery during COVID-19 Pandemic

2021 ◽  
Vol 26 (01) ◽  
pp. 84-91
Author(s):  
Shivangi Saha ◽  
Suvashis Dash ◽  
Mohammed Tahir Ansari ◽  
Ashish Dhanraj Bichupuriya ◽  
Amit Kumar Gupta ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Hand Surgery ◽  
Patient Characteristics ◽  
Operative Management ◽  
Hand Injuries ◽  
Care Needs ◽  
Use Of Resources ◽  
Flap Cover

Background: With the emergence of the COVID-19 pandemic, most health-care personnel and resources are redirected to prioritize care for seriously-ill COVID patients. This situation may poorly impact our capacity to care for critically injured patients. We need to devise a strategy to provide rational and essential care to hand trauma victims whilst the access to theatres and anaesthetic support is limited. Our center is a level 1 trauma center, where the pandemic preparedness required reorganization of the trauma services. We aim to summarise the clinical profile and management of these patients and highlight, how we modified our practice to optimize their care. Methods: This is a single-centre retrospective observational study of all patients with hand injuries visiting the Department of Plastic Surgery from 22nd March to 31st May 2020. Patient characteristics, management details, and outcomes were analysed. Results: A total of 102 hand injuries were encountered. Five patients were COVID-19 positive. The mean age was 28.9 ± 14.8 years and eighty-two (80.4%) were males. Thirty-one injuries involved fractures/dislocations, of which 23 (74.2%) were managed non-operatively. Seventy-five (73.5%) patients underwent wound wash or procedure under local anaesthetic and were discharged as soon as they were comfortable. Seventeen cases performed under brachial-plexus block, were discharged within 24 hours except four cases of finger replantation/ revascularisation and one flap cover which were discharged after monitoring for four days. At mean follow-up of 54.4 ± 21.8 days, the rates of early complication and loss to follow-up were 6.9% and 12.7% respectively. Conclusions: Essential trauma care needs to continue keeping in mind, rational use of resources while ensuring safety of the patients and health-care professionals. We need to be flexible and dynamic in our approach, by utilising teleconsultation, non-operative management, and regional anaesthesia wherever feasible.

scholarly journals Development and Implementation of Survivorship Tools to Enable Medical Follow-Up After Childhood Cancer Treatment in Southern Sweden

2019 ◽  
pp. 1-6
Author(s):  
Magnus Petersson-Ahrholt ◽  
Thomas Wiebe ◽  
Lars Hjorth ◽  
Thomas Relander ◽  
Helena M. Linge
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Health Care Professionals ◽  
Risk Group ◽  
Southern Sweden ◽  
Quality Registry ◽  
Treatment Summary ◽  
Group Stratification

PURPOSE Survival rates after childhood cancer have increased from 20% to 80% since the 1970s. The increased number of survivors emphasizes the importance of late effects and their monitoring. Late effects may have a strong impact on quality of life in survivors. The purpose of this study was to make key data in a quality registry available for direct clinical use, enabling health care professionals to perform efficient and appropriate long-term medical follow-up after childhood cancer treatment. METHODS The population-based quality registry upon which this study is centered contains data on all individuals diagnosed with childhood cancer (diagnosed at 18 years of age or younger) in southern Sweden since January 1, 1970, and treatment data on 5-year survivors. Web tools, which were developed and implemented in a health care setting, generate a personalized treatment summary for each patient and enable risk group stratification of survivors. RESULTS Generation of a personalized treatment summary and risk group stratification of survivors led to identification of women at risk for developing breast cancer as a consequence of childhood cancer treatment. Three novel cases of previously undiagnosed breast cancer were identified. CONCLUSION The registry, together with the developed tools, enabled health care professionals to perform medical follow-up in this at-risk patient population.

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