Informed citizen and empowered citizen in health: results from an European survey

Background: The knowledge about the relationship between health-related activities on the Internet (i.e. informed citizens) and individuals? control over their own experiences of health or illness (i.e. empowered citizens) is valuable but scarce. In this paper, we investigate the correlation between four ways of using the Internet for information on health or illness and citizens attitudes and behaviours toward health professionals and health systems and establish the profile of empowered eHealth citizens in Europe. Methods: Data was collected during April and May 2007 (N = 7022), through computer-assisted telephone interviews (CATI). Respondents from Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal participated in the survey. The profiles were generated using logistic regressions and are based on: a) socio-demographic and health information, b) the level of use of health-related online services, c) the level of use of the Internet to get health information to decide whether to consult a health professional, prepare for a medical appointment and assess its outcome, and d) the impact of online health information on citizens? attitudes and behavior towards health professionals and health systems. Results: Citizens using the Internet to decide whether to consult a health professional or to get a second opinion are likely to be frequent visitors of health sites, active participants of online health forums and recurrent buyers of medicines and other health related products online, while only infrequent epatients, visiting doctors they have never met face-to-face. Participation in online health communities seems to be related with more inquisitive and autonomous patients. Conclusions: The profiles of empowered eHealth citizens in Europe are situational and country dependent. The number of Europeans using the Internet to get health information to help them deal with a consultation is raising and having access to online health information seems to be associated with growing number of inquisitive and self-reliant patients. Doctors are increasingly likely to experience consultations with knowledgeable and empowered patients, who will challenge them in various ways

FOCUS : frailty management optimisation through EIPAHA commitments and utilisation of stakeholders’ input – an innovative European project in elderly care

The goal of FOCUS, which stands for Frailty Management Optimization through EIPAHA Commitments and Utilization of Stakeholders’ Input, is to reduce the burden of frailty in Europe. The partners are working on advancing knowledge of frailty detection, assessment, and management, including biological, clinical, cognitive and psychosocial markers, in order to change the paradigm of frailty care from acute intervention to prevention. FOCUS partners are working on ways to integrate the best available evidence from frailty-related screening tools, epidemiological and interventional studies into the care of frail people and their quality of life. Frail citizens in Italy, Poland and the UK and their caregivers are being called to express their views and their experiences with treatments and interventions aimed at improving quality of life. The FOCUS Consortium is developing pathways to leverage the knowledge available and to put it in the service of frail citizens. In order to reach out to the broadest audience possible, the FOCUS Platform for Knowledge Exchange and the platform for Scaling Up are being developed with the collaboration of stakeholders. The FOCUS project is a development of the work being done by the European Innovation Partnership on Active and Healthy Ageing (EIPAHA), which aims to increase the average healthy lifespan in Europe by 2020 while fostering sustainability of health/social care systems and innovation in Europe. The knowledge and tools developed by the FOCUS project, with input from stakeholders, will be deployed to all EIPAHA participants dealing with frail older citizens to support activities and optimize performance

Comprehensive Geriatric Assessment VS medical care for an erlrly person

Prognozy demograficzne wskazują, że najszybciej rosnącą grupą wiekową pacjentów na świecie są osoby powyżej 65. roku życia. Szacuje się, że ich odsetek w 2050 r. osiągnie ok. 31,3% populacji Polski. Oznacza to, że ludzie w wieku podeszłym będą dominować wśród pacjentów zgłaszających się do lekarzy wszystkich specjalności. Opieka medyczna w okresie starości powinna być ukierunkowana na indywidualne potrzeby pacjenta. Prawidłowe zdiagnozowanie objawów, określenie potrzeb zdrowotnych seniora we wszystkich wymiarach determinuje dalsze postępowanie medyczne. Narzędziem ułatwiającym to zadanie jest całościowa ocena geriatryczna (COG). To wielodyscyplinarne narzędzie, a zarazem złożony proces diagnostyczny, składający się z szeregu skal, którego celem jest określenie zakresu zaburzeń zdrowia seniora, jego zdolności do samodzielnego funkcjonowania, potrzeb i problemów na płaszczyźnie fizycznej, psychicznej, socjoekonomicznej oraz środowiskowej. Główne skale znajdujące zastosowanie w COG to: ADL, IADL, Barthel i inne służące do oceny stanu funkcjonalnego seniora. W ramach COG ocenia się także stan psychiczny chorego, stosując skalę MMSE , skrócony test sprawności umysłowej Hodgkinsona, test rysowania zegara, skalę Yesavage’a i inne. Z kolei ocena socjalno-środowiskowa ma na celu zdefiniowanie potrzeb osoby w wieku podeszłym w zakresie opieki doraźnej oraz długoterminowej.Demographic projections show that the fastest growing age group of patients in the world are people over 65 years of age. For instance, it is estimated that in 2050 their share will reach approximately 31.3% of the Polish population. This means that the elderly will certainly dominate among patients visiting doctors of all specializations. Health care at old age should be focused on individual needs of the patient. A right diagnosis of symptoms, identifying the health needs of seniors in all dimensions, determines application of further medical procedures. A tool that facilitates this task is Comprehensive Geriatric Assessment (CGAGA). CGAGA is a multidisciplinary tool and also a complex diagnostic process, consisting of a series of scales, the aim of which is to determine the scope of seniors’ health disorders, their ability to operate independently, their needs and problems encountered in the physical, psychological, socio-economic and environmental spheres. The main scales which apply in the CGAGA are: ADL, IADL, Barthel and others which serve to assess the functional capacity of the senior. As part of the CGAGA one can also evaluate the psychological state, using MMSE , Hodgkinson test, CDT, scale of Yesavage and others. In turn, the social-environmental assessment is meant to define the needs of elderly patients, which are connected with emergency interventions and long-term care

European citizens' use of E-health services : a study of seven countries

Background: European citizens are increasingly being offered Internet health services. This study investigated patterns of health-related Internet use, its consequences, and citizens' expectations about their doctors' provision of e-health services. Methods: Representative samples were obtained from the general populations in Norway, Denmark, Germany, Greece, Poland, Portugal and Latvia. The total sample consisted of 7934 respondents. Interviews were conducted by telephone. Results: 44 % of the total sample, 71 % of the Internet users, had used the Internet for health purposes. Factors that positively affected the use of Internet for health purposes were youth, higher education, white-collar or no paid job, visits to the GP during the past year, long-term illness or disabilities, and a subjective assessment of one's own health as good. Women were the most active health users among those who were online. One in four of the respondents used the Internet to prepare for or follow up doctors' appointments. Feeling reassured after using the Internet for health purposes was twice as common as experiencing anxieties. When choosing a new doctor, more than a third of the sample rated the provision of e-health services as important. Conclusion: The users of Internet health services differ from the general population when it comes to health and demographic variables. The most common way to use the Internet in health matters is to read information, second comes using the net to decide whether to see a doctor and to prepare for and follow up on doctors' appointments. Hence, health-related use of the Internet does affect patients' use of other health services, but it would appear to supplement rather than to replace other health services

European citizens' use of E-health services: A study of seven countries

Abstract Background European citizens are increasingly being offered Internet health services. This study investigated patterns of health-related Internet use, its consequences, and citizens' expectations about their doctors' provision of e-health services. Methods Representative samples were obtained from the general populations in Norway, Denmark, Germany, Greece, Poland, Portugal and Latvia. The total sample consisted of 7934 respondents. Interviews were conducted by telephone. Results 44 % of the total sample, 71 % of the Internet users, had used the Internet for health purposes. Factors that positively affected the use of Internet for health purposes were youth, higher education, white-collar or no paid job, visits to the GP during the past year, long-term illness or disabilities, and a subjective assessment of one's own health as good. Women were the most active health users among those who were online. One in four of the respondents used the Internet to prepare for or follow up doctors' appointments. Feeling reassured after using the Internet for health purposes was twice as common as experiencing anxieties. When choosing a new doctor, more than a third of the sample rated the provision of e-health services as important. Conclusion The users of Internet health services differ from the general population when it comes to health and demographic variables. The most common way to use the Internet in health matters is to read information, second comes using the net to decide whether to see a doctor and to prepare for and follow up on doctors' appointments. Hence, health-related use of the Internet does affect patients' use of other health services, but it would appear to supplement rather than to replace other health services.</p

General principles to consider when designing a clinical communication assessment program

Objectives: Assessment of clinical communication helps teachers in healthcare education determine whether their learners have acquired sufficient skills to meet the demands of clinical practice. The aim of this paper is to give input to educators when planning how to incorporate assessment into clinical communication teaching by building on the authors’ experience and current literature. Methods: A summary of the relevant literature within healthcare education is discussed, focusing on what and where to assess, how to implement assessment and how to choose appropriate methodology. Results: Establishing a coherent approach to teaching, training, and assessment, including assessing communication in the clinical context, is discussed. Key features of how to implement assessment arepresented including: establishing a system with both formative and summative approaches, providing feedback that enhances learning and establishing a multi-source and longitudinal assessment program. Conclusions: The implementation of a reliable, valid, credible, feasible assessment method with specific educational relevance is essential for clinical communication teaching. Practice implications: All assessment methods have strengths and limitations. Since assessment drives learning, assessment should be aligned with the purpose of the teaching program. Combining the use of different assessment formats, multiple observations, and independent measurements in different settings is advised.status: publishe