The Associations Between Mental Health Problems and Attitudes Toward Web-Based Health and Social Care Services : Evidence From a Finnish Population-Based Study

Background: The significance of web-based health and social care services has been highlighted in recent years. There is a risk that the digitalization of public services will reinforce the digital and social exclusion of vulnerable groups, such as individuals with mental health problems. Objective: This study aims to examine the associations between mental health problems and attitudes toward web-based health and social care services in the general population. The attitudes measured include lack of interest, perceived need for face-to-face encounters, and concern for safety. The study also evaluates whether sociodemographic characteristics (age, gender, education level, and poverty) modify these associations. Methods: Cross-sectional population-based data were collected from 4495 Finnish adults in 2017. Linear regression was used to examine the main effects and interactions of poor mental health and sociodemographic characteristics on attitudes toward web-based health and social care services. Results: The results show that mental health was associated with attitudes toward web-based health and social care services. Individuals with mental health problems were especially concerned about the safety of web-based services. Poor mental health was independently associated with negative attitudes toward web-based services over the effects of sociodemographic factors. Some of the associations between poor mental health and negative attitudes toward web-based services were stronger among older people and men. With regard to sociodemographic characteristics, particularly higher age, low education, and poverty were associated with negative attitudes toward web-based health and social care services. Conclusions: Poor mental health is associated with negative attitudes toward web-based health and social care services and thus indirectly with exclusion. It seems that being older and being male both reinforce the link between poor mental health and exclusion. In supporting the digital inclusion of people with mental health problems, attention should be paid to guidance and counseling, reliability, and the user-friendliness of web-based services as well as to the prevention of poverty. In addition, it is essential to see web-based services as complementary to, and not a substitute for, face-to-face services.Peer reviewe

Physicians' and nurses' experiences on EHR usability : Comparison between the professional groups by employment sector and system brand

Background: Usability associates with patient safety and quality of care. This article reports results from nationwide usability-focused survey studies for physicians and nurses in Finland. Earlier research has shown dissatisfaction and serious deficiencies, which hamper the efficient use of health information systems (HIS); however, evaluation studies covering the viewpoints of both user groups are practically lacking. Our study aimed at comparing end-users' experiences on the usability of electronic health record (EHR) systems by employment sector and EHR brand. Methods: To measure usability, we used the validated National Usability-focused HIS Scale (NuHISS). For this study, we selected 11 usability statements that relate to technical quality (n = 3), ease of use (n = 6), benefits (n = 1) and collaboration (n = 1), and were identical in both surveys. We report the responses from 3013 physicians and 2560 nurses working in public sector hospitals or primary care health centers in 2017. Results: Results in total and by healthcare sector showed notable differences between nurses' and physicians' experiences on usability of their EHR systems. Physicians were more satisfied than nurses on technical quality and learnability of the EHR-systems, while nurses experienced the ease of use better and were more satisfied with collaboration aspects than physicians. Two EHR brands used in hospitals appeared to have succeeded in supporting physician workflows, while two others used in health centers were more suitable for nurses' needs. Conclusions: Nurses' and physicians' experiences on EHR usability appear to vary more by EHR brand and employment sector rather than either professional group being generally more satisfied. Development of EHR systems should consider the perspectives of these two main user groups and their working contexts.Peer reviewe

Behavior change techniques to promote healthcare professionals' eHealth competency : A systematic review of interventions

Introduction: The use of eHealth is rapidly ->increasing; however, many healthcare professionals have insufficient eHealth competency. Consequently, interventions addressing eHealth competency might be useful in fostering the effective use of eHealth. Objective: Our systematic review aimed to identify and evaluate the behavior change techniques applied in interventions to promote healthcare professionals' eHealth competency. Methods: We conducted a systematic literature review following the Joanna Briggs Institute's Manual for Evidence Synthesis. Published quantitative studies were identified through screening PubMed, Embase, and CINAHL. Two reviewers independently performed full-text and quality assessment. Eligible interventions were targeted to any healthcare professional and aimed at promoting eHealth capability or motivation. We synthesized the interventions narratively using the Behavior Change Technique Taxonomy v1 and the COM-B model. Results: This review included 32 studies reporting 34 heterogeneous interventions that incorporated 29 different behavior change techniques. The interventions were most likely to improve the capability to use eHealth and less likely to enhance motivation toward using eHealth. The promising techniques to promote both capability and motivation were action planning and participatory approach. Information about colleagues' approval, emotional social support, monitoring emotions, restructuring or adding objects to the environment, and credible source are techniques worth further investigation. Conclusions: We found that interventions tended to focus on promoting capability, although motivation would be as crucial for competent eHealth performance. Our findings indicated that empathy, encouragement, and usercentered changes in the work environment could improve eHealth competency as a whole. Evidence-based techniques should be favored in the development of interventions, and further intervention research should focus on nurses and multifaceted competency required for using different eHealth systems and devices.Peer reviewe

Leaders' support for using online symptom checkers in Finnish primary care : Survey study

Online symptom checkers (SCs) are eHealth solutions that offer healthcare organizations the possibility to empower their patients to independently assess their symptoms. The successful implementation of eHealth solutions, such as SCs, requires a supportive organizational culture and leadership. However, there is limited knowledge about the factors associated with leaders' support for the use of SCs. The aim of the study was to identify the factors associated to primary care leaders' support for SCs in triage and their experiences of the benefits and challenges related to the use of SCs. An online survey was used to collect data from 84 Finnish primary care leaders. The data were analyzed using statistical analysis methods and content analysis. Vision clarity, perceiving efficiency improvements, and considering the service to be beneficial for patients were associated with leaders' support for the service (beta ranging from 0.41 to 0.44, p < 0.001). Leaders' support for the service was also associated with how well the leaders provided information about the service to their subordinates (beta =0.22, p < 0.048). SCs present slightly more challenges than benefits regarding health professionals' work. The developers of SCs should focus more on features that decrease health professionals' workload as well as how the solution can benefit patients.Peer reviewe

The association between stress attributed to information systems and the experience of workplace aggression : a cross-sectional survey study among Finnish physicians

Publisher Copyright: © 2022, The Author(s).Background: Physicians commonly suffer from workplace aggression and its negative consequences. Previous studies have shown that stressors such as job demands increase the risk of inappropriate treatment at workplace. Poorly functioning, and constantly changing information systems form a major work stressor for physicians. The current study examined the association between physicians’ stress attributed to information systems (SAIS) and their experiences of workplace aggression. Workplace aggression covered physical and non-physical aggression, perpetrated by coworkers, patients, patient’s relatives, or supervisors. Methods: A cross-sectional survey study was conducted. The participants included 2786 physicians (67.4% women) who were sampled randomly from the registry of Finnish Medical Association, which covers almost all of the Finnish physician population. First, bivariate associations were studied among participant characteristics, SAIS and workplace aggression. Logistic regression analysis was then used to further determine how SAIS was associated with the likelihood of experiencing different types of aggression. Results: Higher levels of SAIS were associated with higher likelihood of aggression with regard to all types of aggression, except non-physical aggression perpetrated by patients or relatives. The demographic factors (work-sector, gender, age) did not have a noticeable influence on the association between SAIS and aggression. Conclusions: The present results build on previous evidence on the prevalence of SAIS and its negative effects on healthcare workers. Since SAIS may increase the risk of experiencing aggression, it is possible that SAIS also endangers the wellbeing of physicians and thereby the quality of patient care. Resourcing time and training during introduction of a new IS could alleviate time pressure and thus stress attributed to managing new information systems. The role of organizational climate and general workload in arousing SAIS and aggression should be examined in future studies.Peer reviewe

Keskeytykset terveyskeskuslääkärin työssä

Työn jatkuvaan keskeytymiseen on liitetty kielteisiä vaikutuksia, kuten päätöksenteon vaikeutumista sekä stressin, turhautumisen ja mahdollisesti virheiden lisääntymistä. Tässä tutkimuksessa tarkastellaan, kuinka usein terveyskeskuslääkärin työtehtävät keskeytyvät, miksi ne keskeytyvät ja miten lääkäri reagoi tehtävien keskeytymiseen. Tutkimuksessa havainnoitiin viittä terveyskeskuslääkäriä yhteensä 117 tuntia. Aineistoksi poimittiin kaikki ne tilanteet, joissa lääkärin työtehtävä keskeytyi. Keskeytyksiä löytyi yhteensä 102. Aineisto koodattiin Atlas.ti ohjelmalla ja analyysissä käytettiin sekä laadullisia että määrällisiä menetelmiä. Tulokset osoittavat, että terveyskeskuslääkärin työ keskeytyy noin kerran tunnissa vaihdellen 0.4 keskeytyksestä 1.9 keskeytykseen tunnissa. Kolme neljästä keskeytyksestä johtuu työn organisointitavasta kuten lääkäri-hoitaja työparimallista tai lääkärin tuutorointivastuusta. Loput ovat ennakoimattomia keskeytyksiä kuten tietokoneongelmia. Keskeytykset kumuloituvat niin, että niitä tulee useita peräkkäin tai myös keskeytyksen jälkeen aloitettu uusi tehtävä keskeytyy. Lähes kaikissa tapauksissa lääkäri keskeyttää sen hetkisen tehtävänsä ja siirtyy uuteen työtehtävään. Terveyskeskustyössä keskeytysten ennakoitavuus auttaa sopeutumaan niihin. Kuitenkin lääkärin työssä on myös tehtäviä, kuten vaativien lausuntojen laatiminen, jotka edellyttävät keskeytymätöntä työaikaa. Työhyvinvoinnin näkökulmasta kestävä tapa olisi järjestää lääkärille hiljaista työaikaa tai muuttaa esimerkiksi lausuntoja sellaisiksi, että niihin on mahdollisen keskeytyksenkin jälkeen helppo palata