Runz-Jørgensen Sidsel M, Schiøtz Michaela L, Christensen Ulla
Bispebjerg University Hospital, Research Unit for Chronic Conditions, Copenhagen, Denmark.
The Danish Heart Foundation, Copenhagen, Denmark.
J Comorb. 2017 Aug 24;7(1):96-111. doi: 10.15256/joc.2017.7.98. eCollection 2017.
The prevalence of multimorbidity is increasing, creating challenges for patients, healthcare professionals, and healthcare systems. Given that chronic disease management increasingly involves eHealth, it is useful to assess its perceived value among people with multimorbidity.
To explore challenges related to multimorbidity and patients' perspectives on eHealth.
Ten semi-structured interviews with adults, living with multimorbidity in Copenhagen, Denmark. Interviews focused on patient-experienced challenges, from challenges related to self-management to challenges experienced in the healthcare sector, as well as perceptions of eHealth. During interviews, participants were presented with pictures of different eHealth technologies. Data analysis followed the systematic text condensation approach.
Participants experienced challenges in their daily lives, e.g. when practicing self-management activities, when navigating the healthcare sector, and when interacting with healthcare professionals. Patient-perceived value of eHealth varied, depending on their burden of illness and treatment: those with a greater burden had more positive perceptions of eHealth, and expressed more intention to use it. Participants with less complex disease patterns and less burdensome treatment regimens were more likely to perceive eHealth as something worthless and undesirable. Participants stressed that eHealth should only be introduced as an optional supplement.
eHealth can potentially address some patient-experienced challenges related to multimorbidity by promoting self-management, patient-centeredness, and access. However, patients' needs and preferences vary and eHealth cannot substitute the personal interaction between patient and healthcare professionals. Our findings point to the importance of patient assessment and stratification to ensure appropriate use of eHealth.
多重疾病的患病率正在上升,给患者、医疗保健专业人员和医疗保健系统带来了挑战。鉴于慢性病管理越来越多地涉及电子健康,评估其在患有多重疾病的人群中的感知价值是有用的。
探讨与多重疾病相关的挑战以及患者对电子健康的看法。
对丹麦哥本哈根患有多重疾病的成年人进行了10次半结构化访谈。访谈聚焦于患者经历的挑战,从与自我管理相关的挑战到在医疗保健部门经历的挑战,以及对电子健康的看法。在访谈过程中,向参与者展示了不同电子健康技术的图片。数据分析采用系统文本浓缩法。
参与者在日常生活中遇到挑战,例如在进行自我管理活动时、在医疗保健部门就医时以及与医疗保健专业人员互动时。患者对电子健康的感知价值各不相同,这取决于他们的疾病负担和治疗情况:疾病负担较重的人对电子健康的看法更积极,并表示更愿意使用它。疾病模式较简单、治疗方案负担较轻的参与者更有可能认为电子健康毫无价值且不可取。参与者强调,电子健康只能作为一种可选的补充手段引入。
电子健康有可能通过促进自我管理、以患者为中心和提高可及性来解决一些与多重疾病相关的患者经历的挑战。然而,患者的需求和偏好各不相同,电子健康不能替代患者与医疗保健专业人员之间的人际互动。我们的研究结果指出了患者评估和分层以确保适当使用电子健康的重要性。