Wickström Hanna, Tuvesson Hanna, Öien Rut, Midlöv Patrik, Fagerström Cecilia
Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
Blekinge Wound Healing Centre, Karlshamn, Sweden.
JMIR Hum Factors. 2020 Dec 9;7(4):e23188. doi: 10.2196/23188.
eHealth solutions such as digital decision support systems (DDSSs) have the potential to assist collaboration between health care staff to improve matters for specific patient groups. Patients with hard-to-heal ulcers have long healing times because of a lack of guidelines for structured diagnosis, treatment, and follow-up. Multidisciplinary collaboration in wound management teams is essential. A DDSS could offer a way of aiding improvement within wound management. The introduction of eHealth solutions into health care is complicated, and the engagement of the staff seems crucial. Factors influencing and affecting engagement need to be understood and considered for the introduction of a DDSS to succeed.
This study aims to describe health care staff's experiences of engagement and barriers to and influencers of engagement when introducing a DDSS for wound management.
This study uses a qualitative approach. Interviews were conducted with 11 health care staff within primary (n=4), community (n=6), and specialist (n=1) care during the start-up of the introduction of a DDSS for wound management. The interviews focused on the staff's experiences of engagement. Content analysis by Burnard was used in the data analysis process.
A total of 4 categories emerged describing the participants' experiences of engagement: a personal liaison, a professional commitment, an extended togetherness, and an awareness and understanding of the circumstances.
This study identifies barriers to and influencers of engagement, reinforcing that staff experience engagement through feeling a personal liaison and a professional commitment to make things better for their patients. In addition, engagement is nourished by sharing with coworkers and by active support and understanding from leadership.
数字决策支持系统（DDSSs）等电子健康解决方案有潜力协助医护人员之间的协作，以改善特定患者群体的状况。由于缺乏结构化诊断、治疗和随访指南，难愈合溃疡患者的愈合时间较长。伤口管理团队中的多学科协作至关重要。DDSS可以提供一种促进伤口管理改善的方法。将电子健康解决方案引入医疗保健领域很复杂，员工的参与似乎至关重要。为使DDSS的引入取得成功，需要了解和考虑影响参与的因素。
本研究旨在描述医护人员在引入伤口管理DDSS时的参与体验、参与的障碍和影响因素。
本研究采用定性方法。在引入伤口管理DDSS的启动阶段，对11名初级（n = 4）、社区（n = 6）和专科（n = 1）护理领域的医护人员进行了访谈。访谈聚焦于员工的参与体验。数据分析过程中采用了伯纳尔德的内容分析法。
共出现了4个类别，描述了参与者的参与体验：个人联系、专业承诺、更广泛的团结以及对情况的认识和理解。
本研究确定了参与的障碍和影响因素，强化了员工通过感受到个人联系和为患者改善状况的专业承诺来体验参与。此外，与同事分享以及领导的积极支持和理解会促进参与。
