Norwegian Research Centre for Electronic Health Records (EHR), Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway ; Faculty of Health Science, Nord-Trøndelag University College, Levanger, Norway.
Faculty of Health Science, Molde University College, Molde, Norway.
J Multidiscip Healthc. 2014 Dec 8;7:561-72. doi: 10.2147/JMDH.S70470. eCollection 2014.
The Individual Care Plan (ICP) was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP]) was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles.
Data were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model.
Users and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users' own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred.
Use of the e-ICP challenged the user-professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care documentation and planning tools.
个体护理计划（ICP）在挪威推出，以满足新的法定要求，即让用户参与医疗保健规划，纳入多学科和跨部门协作。使用基于网络的解决方案（电子 ICP [e-ICP]）来支持规划和文件编制。本研究旨在调查基于网络的协作如何挑战用户和专业人员的角色。
数据来自 15 名用户和 8 名护理专业人员的半结构化访谈，以及总共 8 名护理专业人员的 2 次焦点小组访谈。使用逐步分析模型的系统文本浓缩法对数据进行分析。
用户和护理专业人员在电子 ICP 协作中采取主动或被动的角色。用户和护理专业人员都积极主动的情况下，配对有助于确保规划顺利进行；积极主动的护理专业人员和被动的用户之间的配对也是如此。由于信息的可用性以及用户自己进行规划的能力或意愿，积极主动的用户与被动的护理专业人员配对也能使护理计划顺利进行。双方都被动的情况下，则不会进行任何规划活动。
电子 ICP 的使用挑战了医患关系。在某些情况下，护理过程中会发生权力转移，从而赋予患者权力。这一知识可以用来建立一种新的理解，即当用户和护理专业人员平等访问医疗保健文件和规划工具时，角色功能如何受到挑战。
