The WebRA study: Opportunities and challenges in digital patient education from the perspective of patients with rheumatoid arthritis: A qualitative study

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Objective: To explore patients’ perceptions of digital patient education (PE), and how this contributes to self-management of rheumatoid arthritis (RA). Methods: Individual interviews based on ’interpretive description’ methodology. The patients were purposively selected from a randomized controlled trial that investigated the effects of digital PE. The analysis included a descriptive section, followed by the interpretation and extraction of the main messages. Results: Overall, participants had positive perceptions of the e-learning program. Advantages were flexibility, the possibility for repetition, entertainment, availability, and learning in familiar surroundings. Disadvantages were unmet relational support needs due to missing dialogue with health care providers (HCPs). For the majority, a need for insight into the condition led to an active approach to using e-learning. The e-learning program facilitated knowledge acquisition about RA, but relational support from HCPs and a positive attitude toward living with RA were also important for achieving self-management. Conclusion: Digital PE is useful for self-management support in RA, however different forms and combinations of PE must be offered in the future to accommodate various needs throughout the disease course. Practice implications: These results may inform future development and implementation of digital PE that adequately takes individual preferences for selfmanagement support into account.publishedVersio

The effectiveness of e-learning in patient education delivered to patients with rheumatoid arthritis: The WebRA study—protocol for a pragmatic randomised controlled trial

Background: Patient education is integral to the treatment and care of patients with rheumatoid arthritis. Change is taking place in the organisation of healthcare systems because of a demographic shift towards ageing populations, an increasing use of technology and advancements in digital technologies, allowing for new interventions. This study will aim to evaluate the effectiveness of a newly developed e-learning patient education programme based on self-management that targets patients with rheumatoid arthritis. Methods: A pragmatic multi-centre randomised controlled trial is planned. We intend to recruit approximately 200 patients with a new diagnosis (< 3months) of rheumatoid arthritis. Participants will be randomised 1:1 to web-based patient education delivered through an e-learning programme at home or standard face-to-face patient education provided at the hospital. The primary outcome is self-efficacy. Secondary outcomes are improved knowledge of rheumatoid arthritis, adherence to medication, health literacy level and quality of life. Outcomes will be measured at baseline and follow-up occurring 1, 3, 6 and 12months after enrolment. Furthermore, data on healthcare utilisation and utilisation of the e-learning programme will be assessed at the 12-month follow-up. Statistical analysis, including differences between groups, will be evaluated using the chi-square and Kruskal–Wallis tests. Statistical analysis will follow the intention-to-treat principle, and analysis of variance will be used to evaluate the within- and between-groups differences testing the hypothesis of the ‘superiority’ of web-based patient education over standard face-to-face education provided at the hospital. Per protocol analysis will be used to assess the impact of missing data. Enrolment started in February 2021 and will end in June 2022. Discussion: The study is expected to contribute to the evidence on the effectiveness of web-based patient education within rheumatic diseases. If the e-learning programme is effective, it will be incorporated into existing services to improve the self-management of patients with rheumatoid arthritis. Further, this mode of providing patient education may impact the organisation of health care for both rheumatic diseases and other chronic diseases by offering different modes of delivering patient education based on the needs and preferences of patients. Trial registration: ClinicalTrials.gov identifier NCT04669340. Registered on November 27, 2020. https://www.clinicaltrials.gov/ct2/show/NCT04669340?term=e-learning&cond=Rheumatoid+Arthritis&draw=2&rank=1. See Additional file 1 for detailed information on the dataset according to the World Health Organization Trial Registration Data Set

What Was (Also) at Stake When a Robot Bathtub Was Implemented in a Danish Elder Center: A Constructivist Secondary Qualitative Analysis

Assistive technologies are often considered to be passive tools implemented in targeted processes. Our previous study of the implementation of the robot bathtub in a Danish elder center suggested that purposeful rationality was not the only issue at stake. To further explore this, we conducted a constructivist secondary qualitative analysis. Data included interviews, participant observations, working documents, and media coverage. The analysis was carried out in two phases and revealed that the bathing of the older people was constructed as a problem that could be offensive to the users’ integrity, damaging to their well-being, and physically strenuous for the staff. The older users and the nursing staff were constructed as problem carriers. We conclude that technological solutions are not merely neutral and beneficial solutions to existing problems, but are rather part of strategic games contributing to the construction of the very problems they seek to solve

European Journal of Cardiovascular Nursing Patient Perception and Assessment of Admission to Acute Cardiac Care Unit On behalf of: European Society of Cardiology can be found at: European Journal of Cardiovascular Nursing Additional services and informati

Abstract Background: To provide equal care and treatment of cardiac patients it is common practice to base the work on clinical guidelines. These guidelines mainly cover the provider perspective rather than the patient perspective. Patient satisfaction, however, is an important parameter within quality development of professional services in hospitals. Patient satisfaction is, i.e. connected with the amount of information provided to the patient and how much patients are involved in their care and treatment. This is also assumed to apply within cardiac practice. However, in relation to acute admission there is no clear picture of the patients&apos; real preferences; likewise there is no documentation whether these preferences correspond with the nurses&apos; assumptions. Aim: The aim of this study was primarily to investigate what preoccupied patients admitted to cardiac care units with acute coronary syndrome in connection with the first hours of their admission, and secondly to discuss these perceptions in relation to the nurses&apos; perception from a previous pilot study. Method: A qualitative descriptive analysis of 30 semi-structured interviews was carried out to investigate the patient perception and assessment of care and treatment by acute admission. Results: The patients included 22 men and 8 women with an average age of 59 (SD = 11.5) years. In all, 5 themes: efficiency, professionalism, pain management, compassionate nursing and information were considered essential and all together they expressed what preoccupied the patients. Conclusion: It is possible to show what the patients think is important, also during acute admission. In general, the patients felt they were in good hands. Most important was the care providers&apos; competencies and that they &quot;knew their job&quot;. The patients&apos; experience of pain management might suggest insufficient care and treatment within this field

Attitudes to a robot bathtub in Danish elder care:A hermeneutic interview study

In Western countries, assistive technology is implemented on a large scale in elder care settings. Only a few studies have attempted to explore the different attitudes to assistive technology among various groups of users. In this study, we investigated and explained the different attitudes among the involved leaders, nursing staff, and older people to a newly‐implemented robot bathtub. Qualitative analyses of eight interviews with managers, nursing staff, and the older users revealed that the informants focused on different aspects (process, values, and functionality, respectively), used different implicit quality criteria, and ascribed different symbolic significance to the robot bathtub. Thus, the study demonstrated how attitudes toward the robot bathtub were connected to the informants’ institutional role. The findings challenge the current paradigm, where technology is expected to operate as a passive tool, simply facilitating desired human acts and interactions. Further studies drawing on the epistemological and ontological perceptions of science technology studies are needed in order to understand human rationalities in the assistive technology context and to offer new insights into how technology “works” in organizations