A cross-sectional study assessing determinants of the attitude to the introduction of eHealth services among patients suffering from chronic conditions

BACKGROUND: Provision of care to patients with chronic diseases remains a great challenge for modern health care systems. eHealth is indicated as one of the strategies which could improve care delivery to this group of patients. The main objective of this study was to assess determinants of the acceptance of the Internet use for provision of chosen health care services remaining in the scope of current nationwide eHealth initiative in Poland. METHODS: The survey was carried out among patients with diagnosed chronic conditions who were treated in three health care facilities in Krakow, Poland. Survey data was used to develop univariate and multivariate logistic regression models for six outcome variables originating from the items assessing the acceptance of specific types of eHealth applications. The variables used as predictors were related to the sociodemographic characteristics of respondents, burden related to chronic disease, and the use of the Internet and its perceived usefulness in making personal health-related decisions. RESULTS: Among 395 respondents, there were 60.3% of Internet users. Univariate logistic regression models developed for six types of eHealth solutions demonstrated their higher acceptance among younger respondents, living in urban areas, who have attained a higher level of education, used the Internet on their own, and were more confident about its usefulness in making health-related decisions. Furthermore, the duration of chronic disease and hospitalization due to chronic disease predicted the acceptance of some of eHealth applications. However, when combined in multivariate models, only the belief in the usefulness of the Internet (five of six models), level of education (four of six models), and previous hospitalization due to chronic disease (three of six models) maintained the effect on the independent variables. CONCLUSIONS: The perception of the usefulness of the Internet in making health-related decision is a key determinant of the acceptance of provision of health care services online among patients with chronic diseases. Among sociodemographic factors, only the level of education demonstrates a consistent impact on the level of acceptance. Interestingly, a greater burden of chronic disease related to previous hospitalizations leads to lower acceptance of eHealth solutions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12911-015-0157-3) contains supplementary material, which is available to authorized users

Relationship Between Electronic Health Literacy, Locus of Control, Trust in Physicians, Attitudes Towards Providers, and Medication Adherence

Health literacy is related to a variety of health outcomes, including diseases, quality of life, and even death. Few studies have investigated the relation of e-health literacy to outcomes or the mechanism by which they may be related. The purpose of this study was to evaluate the relation of e-health literacy to patients\u27 attitudes toward health care providers, trust in physicians, and medication adherence as well as theextent to which these relations were mediated by locus of control. Data were collected on participants 40 years and older having at least one chronic health condition from the Fostering Literacy for Good HealthToday and the Spanish-related project named Vive Desarollando Amplia Salud at Nova Southeastern University. Participants included 335 persons (mean age 57.5 years; 42 Whites and 293 Nonwhites; 161 men, 164 women, 9 transgender, 1 participant self-described as Other; and a sample mean education of 11.9 years). After controlling for age, education, gender, and race, the health literacy scale score was significantly related to Attitudes Towards Health Care Providers and trust in physicians, but not to medication adherence. The Electronic Health Literacy Scale score was significantly related to locus of control. Analysis of indirect effects showed that the relations between e-health literacy and Attitudes Towards Health Care Providers, trust in physicians, and medication adherence were mediated by internal locus of control. These findings have implications for research aimed at improving patient-provider communications through programs and policies that increase patients\u27 efficacy in using the internet to access health information

The Association between Future Anxiety, Health Literacy and the Perception of the COVID-19 Pandemic : a Cross-Sectional Study

Increased anxiety related to the Coronavirus Disease 2019 (COVID-19) pandemic in society and specific professional groups has been reported by many authors. Most have applied tools enabling assessing the general traits of anxiety. Tools specifically designed for an assessment of anxiety or fear related to COVID-19 have also been developed. However, no study has assessed the future anxiety in relation to the pandemic. This concept was defined by Zaleski in the end of the 20th century as the state of apprehension, fear, worry, and concern regarding unfavourable changes in the more remote personal future. The aim of this study was an analysis to establish the level and the determinants of future anxiety in Polish society related to the COVID-19 pandemic three months after the introduction of the state of epidemic. The analysis reported in the paper is based on the data obtained through a web-based survey carried out on a representative sample of 1002 Polish adults aged 18–74 years. The hierarchical linear regression model was developed for the analysis of the determinants of future anxiety from the responses to a questionnaire consisting of five items. The independent variables selected for inclusion in the model, apart from sociodemographic characteristics, encompassed health literacy (HL) and ehealth literacy (eHL), perceived health threat related to COVID-19 (PHTC19), and a COVID-19-related conspiracy belief score (CCBS) derived from three items asking about the most popular conspiracy theories. The regression model developed in the final step showed that the future anxiety scale score (FASS) was significantly associated with gender, vocational status, HL, PHTC19, and CCBS. The FASS was lower among men than women (regression coefficient (B) (standard error, SE) = −1.28 (0.39), p = 0.001), among entrepreneurs or farmers rather than among employees of the public or private sector (B(SE) = −1.55, p = 0.010), in persons with a higher HL (B(SE) = −0.43 (0.06), p < 0.001). A higher FASS was observed in respondents with higher rather than lower PHTC19 (B(SE) = 1.49 (0.17), p < 0.001) and in those with a higher CCBS (B(SE) = 0.33 (0.07), p < 0.001). The model accounted for 15.2% of the variance of the FASS. In conclusion, the COVID-19 pandemic is not only a cause of increased mental symptoms, but also of increased future anxiety. Health-related measures are significantly associated with the FASS

Exploring perspectives of people with type-1 diabetes on goalsetting strategies within self-management education and care

Background. Collaborative goal-setting strategies are widely recommended for diabetes self-management support within healthcare systems. Creating self-management plans that fit with peoples’ own goals and priorities has been linked with better diabetic control. Consequently, goal-setting has become a core component of many diabetes selfmanagement programmes such as the ‘Dose Adjustment for Normal Eating (DAFNE) programme’. Within DAFNE, people with Type-1 Diabetes (T1D) develop their own goals along with action-plans to stimulate goal-achievement. While widely implemented, limited research has explored how goal-setting strategies are experienced by people with diabetes.Therefore, this study aims to explore the perspectives of people with T1D on theimplementation and value of goal-setting strategies within DAFNE and follow-up diabetes care. Furthermore, views on barriers and facilitators to goal-attainment are explored.Methods. Semi-structured interviews were conducted with 20 people with T1D who attended a DAFNE-programme. Following a longitudinal qualitative research design, interviews took place 1 week, and 6-8 months after completion of DAFNE. A recurrent cross-sectional approach is applied in which themes will be identified at each time-point using thematic analyses.Expected results. Preliminary identified themes surround the difference in value that participants place on goal-setting strategies, and the lack of support for goal-achievement within diabetes care.Current stage. Data collection complete; data-analysis ongoing.Discussion. Goal-setting strategies are increasingly included in guidelines for diabetes support and have become essential parts of many primary care improvement schemes. Therefore, exploring the perspectives of people with T1D on the value and implementation of goal-setting strategies is vital for their optimal application

Healthy snacks consumption and the Theory of Planned Behaviour. The role of anticipated regret

Two empirical studies explored the role of anticipated regret (AR) within the Theory of Planned Behavior (TPB) framework (Ajzen, 1991), applied to the case of healthy snacks consumption. AR captures affective reactions and it can be defined as an unpleasant emotion experienced when people realize or imagine that the present situation would be better if they had made a different decision. In this research AR refers to the expected negative feelings for not having consumed healthy snacks (i.e., inaction regret). The aims were: a) to test whether AR improves the TPB predictive power; b) to analyze whether it acts as moderator within the TPB model relationships. Two longitudinal studies were conducted. Target behaviors were: consumption of fruit and vegetables as snacks (Study 1); consumption of fruit as snacks (Study 2). At time 1, the questionnaire included measures of intention and its antecedents, according to the TPB. Both the affective and evaluative components of attitude were assessed. At time 2, self-reported consumption behaviors were surveyed. Two convenience samples of Italian adults were recruited. In hierarchical regressions, the TPB variables were added at the first step; AR was added at the second step, and the interactions at the last step. Results showed that AR significantly improved the TPB ability to predict both intentions and behaviours, also after controlling for intention. In both studies AR moderated the effect of affective attitude on intention: affective attitude was significant only for people low in AR

Adoption of information technology based patient education in psychiatric nursing

The overall goal of the study was to describe adoption of information technology (IT)-based patient education (PE) developed for patients and nurses use in psychiatric nursing. The data were collected in three phases during the period 2000-2006 in a variety of psychiatric settings in Finland. Firstly, the development process of IT-based PE for patients with schizophrenia spectrum psychosis was described. Secondly, nurses’ adoption of IT-based PE and the variables explaining adoption were demonstrated. Moreover, use of daily IT-based PE in clinical practice and factors associated with use were identified and described. And thirdly, nurses’ experiences of the IT-based PE after one year clinical use were evaluated. IT-based PE program was developed in several stages based on users’ needs and it included information and multimedia applications. Altogether, almost 500 IT-based PE sessions were carried out by the nurses on the study wards and revealed nurses’ activity in educating patients using IT to vary and depend on the hospital in which they worked. Almost 80% of all the possible IT-based PE sessions involved 93 patients and 83 nurses. Less than 2% of the IT-based PE sessions were interrupted and less than 10% suffered disturbances due to the patients or external causes. Moreover, the patients whose education took more days had poorer mental status than those whose education was carried out over a shorter period. After a year’s experience, advantages and disadvantages were described by the nurses for both patients and nurses of the IT-based PE. IT-based PE can be used even on closed acute psychiatric wards with patients with serious mental health disorders. However, technology adoption requires time, and therefore, it must fit in with clinical practice. Collaboration between users and developers is needed when developing user-centered methods in the area of mental health services. Moreover, it is important to understand factors that affect IT adoption in healthcare settings. IT-based PE is one option in interactive and co-operative health care practice between patients and nurses. Therefore the staff should begin to refer patients to established, credible and well-maintained Internet sites that provide information on common psychological problems. Even if every nurse should be trained and engaged to carry out IT-based PE, by targeting the training especially for the most active nurses aids them to support the less active ones. Adoption should also be understood from a perspective that includes aspects related to the context where it is implemented and examine how and in what circumstances it works.Siirretty Doriast

Predictors of Intention to Use Health Literacy Strategies Among Physicians in Grenada

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important physicians use health literacy strategies. Grounded in the theory of planned behavior, the aim of this quantitative correlational study was to investigate the relationship between health literacy knowledge, health literacy experience, gender, the region of training, years of practice, and intentions to use health literacy strategies among physicians in Grenada. One hundred and eighteen physicians were sampled using a cross-sectional survey method. The results of the multiple linear regression analysis were significant, F(5, 112) = 7.38, p \u3c .001, R2 = .248. Health literacy knowledge (t = 3.901, p \u3c .001), health literacy experience (t = 3.056, p = .003), and years in practice (t = -.195, p = .027) significantly predicted intentions to use health literacy strategies. Gender and region of training did not provide any predictive value. The implications for positive social change include the potential for health literacy training and inclusion in medical school curricula. The provision of health literacy training at all levels of education and practice aid in ensuring physicians are knowledgeable about the health literacy process, able to use strategies that can improve patients’ health literacy, and able to improve patient health outcomes