Patients Everyday Life Experience of Person-Centred MHealth after Hospital Discharge
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Abstract
Background
Clinical efficiency of eHealth in randomized clinical trials in patients with chronic disease such as Chronic Heart Disease (CHD) has been quite unsatisfactory. Chronic disease management should focus on the empowering of the patient’s capacity to manage everyday life with his/her symptoms, nevertheless traditional management is still very disease-centric and objectifying. Few eHealth solutions facilitate the patient’s own capacity in order to support shared decision making. Person-centred ehealth (ePCC) wants to counteract this development by implementing a paradigm shift that focuses on dialog and partnership between the patient and healthcare provider during the entire care continuum. One way of initiating this paradigm shift is the development of ePCC tools that aligns care and rehabilitation to three basic PCC principles:
• initiating the partnership
• safeguarding the partnership
• documentation of the partnership
While the usage of mobile eHealth is rapidly increasing, we lack knowledge about how the patient perceives ePCC in everyday life.
Objective
To investigate the feasibility and effect of a ePCC application aimed for self-monitoring of signs and symptoms in patients with CHD.
Method
This study is a part of an on-going randomized controlled trial in Sweden for patients with CHD. Patients included in the intervention (n=115) are provided the option to use this eHealth support tool for at least 2 months after hospital discharge, either by downloading the smartphone application directly to their own phone or borrowing a smartphone with the application. Patients are trained at the hospital to use the smartphone application and the web-site for the following functions 1) writing a health diary 2) rating their current state of fatigue, motivation & concentration 3) obtaining daily trend graphs of physical activity via a built-in accelerometer 4) establish chat-contact with other patients in the study 5) establish contact with staff at e.g. their study clinic. Interviews are performed a few months after discharge with patient´s that have used the application at least once after discharge. Patients are asked to share their experience about everyday life with the ePCC application, facilitators and barriers using the app as well as suggestions for future improvement of the ePCC. Data analysis will be performed using content analysis.
Tentative results
Little instruction in using the smartphone was needed in the hospital. Approximately 50% of the patients accepted to use the smartphone as a self-care tool after discharge. Patients reported few technical/usability issues. Interpretation of the interviews point toward increased self-support and self-esteem, as the patients expressed a perceived support in following their health status in terms of being to able to control the their illness and its symptoms.
Conclusion
To our knowledge, this is the first study that will evaluate a combined smartphone and web-based person-centred diary for patient with CHD. Tentative findings indicate a feasibility of a smartphone application for patients. Further findings will be presented at the conference.
Clinical efficiency of eHealth in randomized clinical trials in patients with chronic disease such as Chronic Heart Disease (CHD) has been quite unsatisfactory. Chronic disease management should focus on the empowering of the patient’s capacity to manage everyday life with his/her symptoms, nevertheless traditional management is still very disease-centric and objectifying. Few eHealth solutions facilitate the patient’s own capacity in order to support shared decision making. Person-centred ehealth (ePCC) wants to counteract this development by implementing a paradigm shift that focuses on dialog and partnership between the patient and healthcare provider during the entire care continuum. One way of initiating this paradigm shift is the development of ePCC tools that aligns care and rehabilitation to three basic PCC principles:
• initiating the partnership
• safeguarding the partnership
• documentation of the partnership
While the usage of mobile eHealth is rapidly increasing, we lack knowledge about how the patient perceives ePCC in everyday life.
Objective
To investigate the feasibility and effect of a ePCC application aimed for self-monitoring of signs and symptoms in patients with CHD.
Method
This study is a part of an on-going randomized controlled trial in Sweden for patients with CHD. Patients included in the intervention (n=115) are provided the option to use this eHealth support tool for at least 2 months after hospital discharge, either by downloading the smartphone application directly to their own phone or borrowing a smartphone with the application. Patients are trained at the hospital to use the smartphone application and the web-site for the following functions 1) writing a health diary 2) rating their current state of fatigue, motivation & concentration 3) obtaining daily trend graphs of physical activity via a built-in accelerometer 4) establish chat-contact with other patients in the study 5) establish contact with staff at e.g. their study clinic. Interviews are performed a few months after discharge with patient´s that have used the application at least once after discharge. Patients are asked to share their experience about everyday life with the ePCC application, facilitators and barriers using the app as well as suggestions for future improvement of the ePCC. Data analysis will be performed using content analysis.
Tentative results
Little instruction in using the smartphone was needed in the hospital. Approximately 50% of the patients accepted to use the smartphone as a self-care tool after discharge. Patients reported few technical/usability issues. Interpretation of the interviews point toward increased self-support and self-esteem, as the patients expressed a perceived support in following their health status in terms of being to able to control the their illness and its symptoms.
Conclusion
To our knowledge, this is the first study that will evaluate a combined smartphone and web-based person-centred diary for patient with CHD. Tentative findings indicate a feasibility of a smartphone application for patients. Further findings will be presented at the conference.
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