A case series of an off-the-shelf online health resource with integrated nurse coaching to support self-management in COPD

Background: COPD has significant psychosocial impact. Self-management support improves quality of life, but programs are not universally available. IT-based self-management interventions can provide home-based support, but have mixed results. We conducted a case series of an off-the-shelf Internet-based health-promotion program, The Preventive Plan (TPP), coupled with nurse-coach support, which aimed to increase patient activation and provide self-management benefits. Materials and methods: A total of 19 COPD patients were recruited, and 14 completed 3-month follow-up in two groups: groups 1 and 2 with more and less advanced COPD, respectively. Change in patient activation was determined with paired t-tests and Wilcoxon signed-rank tests. Benefits and user experience were explored in semistructured interviews, analyzed thematically. Results: Only group 1 improved significantly in activation, from a lower baseline than group 2; group 1 also improved significantly in mastery and anxiety. Both groups felt significantly more informed about COPD and reported physical functioning improvements. Group 1 reported improvements in mood and confidence. Overall, group 2 reported fewer benefits than group 1. Both groups valued nurse-coach support; for group 1, it was more important than TPP in building confidence to self-manage. The design of TPP and lack of motivation to use IT were barriers to use, but disease severity and poor IT skills were not. Discussion: Our findings demonstrate the feasibility of combining nurse-coach support aligned to an Internet-based health resource, TPP, in COPD and provide learning about the challenges of such an approach and the importance of the nurse-coach role

10 år med velfærdsteknologi: Strategi og praksis

Velfærdsteknologidagsordenen indtager en væsentlig rolle i diskussion om det danske velfærdssamfund, navnlig på sundheds- og ældreområdet. Artiklen redegør for tendensen og ridser baggrunden op for den aktuelle interesse for velfærdsteknologi som teknologisk satsningsområde. Vi byder ind med en definition af paraplybegrebet velfærdsteknologi og viser, hvordan forhåbningerne til velfærdsteknologi afspejler fire sameksisterende perspektiver; et effektivitets-, empowerment-, medarbejder- og vækstperspektiv. Baseret på resultater fra telemedicinprojektet TeleCare Nord illustrerer vi, hvordan de fire velfærdsteknologiperspektiver udfolder sig i praksis, og vi diskuterer udfordringer forbundet med at realisere forhåbningerne til velfærdsteknologi

An Iterative, Mixed Usability Approach Applied to the Telekit System from the Danish TeleCare North Trial

Objective. The aim of the present study is to evaluate the usability of the telehealth system, coined Telekit, by using an iterative, mixed usability approach. Materials and Methods. Ten double experts participated in two heuristic evaluations (HE1, HE2), and 11 COPD patients attended two think-aloud tests. The double experts identified usability violations and classified them into Jakob Nielsen’s heuristics. These violations were then translated into measurable values on a scale of 0 to 4 indicating degree of severity. In the think-aloud tests, COPD participants were invited to verbalise their thoughts. Results. The double experts identified 86 usability violations in HE1 and 101 usability violations in HE2. The majority of the violations were rated in the 0–2 range. The findings from the think-aloud tests resulted in 12 themes and associated examples regarding the usability of the Telekit system. The use of the iterative, mixed usability approach produced both quantitative and qualitative results. Conclusion. The iterative, mixed usability approach yields a strong result owing to the high number of problems identified in the tests because the double experts and the COPD participants focus on different aspects of Telekit’s usability. This trial is registered with Clinicaltrials.gov, NCT01984840, November 14, 2013