Healthcare professionals’ perceived problems in fast-track hip and knee arthroplasty:results of a qualitative interview study

Abstract Background: Fast-track and outpatient arthroplasty methodologies combine evidence-based clinical features with organizational optimization resulting in a streamlined pathway from admission to discharge and beyond. This qualitative study explored perceived problems of healthcare professionals during fast-track hip and knee arthroplasty. Methods: Semi-structured interviews were conducted with four surgeons, two anesthesiologists, ten nurses, and four physiotherapists. An inductive content analysis was used to analyze the data. NVivo qualitative data analysis software was used. Results: Analysis of the data revealed eight main categories of problems: patient selection, referrals, meeting the Health Care Guarantee, patient flow, homecare, patient counseling, transparency of the journey, and receiving feedback. In addition, problems related to information flows and communication, responsibilities between different stakeholders, and existing information systems were identified. Conclusions: The study revealed that healthcare professionals perceived several problems during the fast-track journey that reduce its effectiveness and make it more difficult to meet the Health Care Guarantee. Problems could be alleviated by changing internal and external organizational practices, as well as by developing new information and communication technologies that would provide up-to-date communication channels for healthcare professionals and patients. In addition, new collaboration mechanisms should be developed in order to solve the problems that occur across different organizations

Patients’ satisfaction and experiences during elective primary fast‐track total hip and knee arthroplasty journey:a qualitative study

Abstract Aims and objectives: To explore how satisfied patients are with the process of treatment and care, and to identify the experiences that patients perceive during elective primary fast‐track total hip and knee arthroplasty journey. Background: Greater satisfaction with care has predicted better quality of recovery, and patient experience has been positively associated with patient safety and clinical effectiveness. However, little is still known about how patients experience their treatment and care. Design: A qualitative interview study. Methods: The study was conducted among 20 patients in a single joint replacement centre during 2018. Patient satisfaction was measured using a numerical rating scale. Patients’ experiences were identified through qualitative semi‐structured interviews which were analysed using an inductive content analysis method. The COREQ checklist was used (Supplementary File 1). Results: The mean numerical rating scale score for overall satisfaction was 9.0 (SD 1.1) on a scale from 0 to 10. The patients’ experiences were grouped under eight main categories that were derived from the qualitative data in the analysis: 1) patient selection, 2) meeting the Health Care Guarantee, 3) patient flow, 4) post‐discharge care, 5) patient counselling, 6) transparency of the journey, 7) communication and 8) feedback. Conclusions: The findings suggest that patients are highly satisfied after an elective primary fast‐track total hip and knee arthroplasty. However, closer analysis of the patients’ experiences reveals challenges and suggestions on how they could be solved, often involving digital technologies. Relevance to clinical practice: As the number of total joint arthroplasties grows, patients and their families need to take ever greater responsibility, for their own care from advance preparation to rehabilitation. The findings of the study can be used to organise work, improving patient‐clinical communication, fostering engagement, and improving patient centredness. In addition, the results pinpoint the issues on how the patient experience could be improved

BLB : a persuasive and interactive installation designed to improve well-being

Well-being is a broad subject, which is described in this paper as: a personal balance of mental, social and physical being, influenced by life circumstances and life factors. These factors include emotions, engagement, life satisfaction, intentional activities and social network. The project described in this paper aims at improving well-being through the design of a persuasive and interactive installation for the home environment. After the investigation of well-being by means of a literature study, cultural probes and questionnaires, a concept was developed. This paper describes the design, implementation and evaluation of this concept. ‘BLB’, as it is called, encourages its users to seize the moment in order to increase their well-being

Persuasive practices: learning from home security advisory services

Research on persuasive technologies (PT) focuses, primarily, on the design and development of IT for inducing change of individual’s behavior and attitude through computer-human and computer-mediated influence. The issue of practices in co-located human-human persuasive encounters remained unattended in the PT community. This study uses the notion of persuasive practices to understand the course of events in face-to-face home security advisory sessions – it specifies and illustrates such practices and discusses their impact on the persuasiveness of the encounter. Furthermore, it presents potential of IT to support such persuasive practices thus opening new research possibilities of PT research

Short-term effects of a digital patient journey solution on patient-reported outcomes and health care utilization in arthroplasty:a pragmatic randomized controlled trial

Abstract Mobile health solutions for patient support have been proposed as promising and safe alternatives to usual care in adults undergoing primary total hip and knee arthroplasty. Studies of such applications, however, have produced conflicting results and only moderate- to low-quality evidence. This study aims to evaluate the short-term effects of a digital patient journey solution on patient-reported outcomes and health care utilization in patients undergoing total hip and knee arthroplasty using a pragmatic randomized controlled trial design. Randomly allocated patients in the control arm (n = 35, 64 ± 9 years) received usual care, while patients in the intervention arm (n = 34, 62 ± 11 years) received the digital patient journey solution in addition to usual care. The primary outcome was health-related quality of life as measured by the EuroQol EQ-5D-5L scale. Secondary outcomes included functional recovery, pain, self-efficacy, patient experience, adherence to fast-track protocol, and health care utilization. Participants were followed from a preoperative surgical visit until a postoperative follow-up visit at 6–12 weeks. The health-related quality of life, functional recovery, pain, patient experience, adherence to the fast-track protocol, and health care utilization did not differ between the arms. During the study, however, the self-efficacy to use digital health services (p=0.027) increased in the intervention arm. The use of the digital patient journey solution was not superior to usual care in terms of patient-reported outcomes and health care utilization. However, the solution improved the self-efficacy of patients to use digital health services, which may lead to greater demand for similar digital offerings as patient become more familiar with mobile health solutions

ProSPer: a MOST model extension applied to persuasive interactive system

International audienceDeveloping persuasive interactive system faces the challenge of describing multiple-domain goals to be achieved, along with an context-aware driving of persuasion. We developed ProSPer, a model capable of dealing with this challenges and we implemented two experiments using an Android application and a selfmonitoring bracelet. The preliminary results shows that participants understood and applied effectively the model, giving further design prospectives of research and development

Advancing Typology of Computer-Supported Influence: Moderation Effects in Socially Influencing Systems

Persuasive technologies are commonly engineered to change behavior and attitudes of users through persuasion and social influence without using coercion and deception. While earlier research has been extensively focused on exploring the concept of persuasion, the present theory-refining study aims to explain the role of social influence and its distinctive characteristics in the field of persuasive technology. Based on a list of notable differences, this study outlines how both persuasion and social influence can be best supported through computing systems and introduces a notion of computer-moderated influence, thus extending the influence typology. The novel type of influence tends to be more salient for socially influencing systems, which informs designers to be mindful when engineering such technologies. The study provides sharper conceptual representation of key terms in persuasive engineering, drafts a structured approach for better understanding of the influence typology, and presents how computers can be moderators of social influence