Centre for Research Ethics & Bioethics, Uppsala University Department of Public Health and Caring Sciences, Uppsala, Sweden
Elsa Science, Stockholm, Sweden.
BMJ Open. 2023 Dec 20;13(12):e072274. doi: 10.1136/bmjopen-2023-072274.
Over the last few decades, there have been significant improvements in the treatment of rheumatoid arthritis (RA), with the development of new treatments and guidelines for teamwork and patient self-care and access to digital tools. This study aimed to explore the experiences of individuals with RA interacting with healthcare. It also looked at how a self-care application, an educational programme called the 'healthcare encounter', improved patient-doctor communication.
Semistructured interviews were conducted, and qualitative content analysis was performed.
The potential participants, individuals with established, or under investigation for, RA diagnosis at rheumatology clinics in Sweden, were asked to participate in the study via a digital self-care application called the Elsa Science Self-care app.
Ten interviews were performed with participants from nine clinics following a meeting with the rheumatologist or other healthcare personnel between September 2022 and October 2022. Phrases, sentences or paragraphs referring to experiences from healthcare meetings and opinions about the digital programme were identified and coded. Codes that reflected similar concepts were grouped; subcategories were formulated, and categories were connected to their experiences and opinions.
Among our participants, three main categories emerged: the availability of healthcare, individual efforts to have a healthier life and personal interaction with healthcare. Participants described that the 'healthcare encounter' educational programme can be a source of information, which confirms, supports and creates a sense of control.
The participants valued being seen and taking part in a dialogue when they had prepared themselves (observed symptoms over time and prepared questions). The implementation of digital self-care applications might need to be incorporated into the healthcare setting, so that both the patients and the healthcare personnel have a shared understanding. Collaboration is essential in this context.
在过去几十年中，类风湿关节炎（RA）的治疗取得了重大进展，新的治疗方法和团队合作、患者自我护理以及获得数字工具的指南不断涌现。本研究旨在探讨 RA 患者与医疗保健互动的经验，并研究自我护理应用程序（一种名为“医疗保健邂逅”的教育计划）如何改善医患沟通。
进行半结构式访谈，并进行定性内容分析。
潜在参与者是在瑞典风湿病诊所确诊或正在接受 RA 诊断的患者，通过名为 Elsa Science Self-care 的数字自我护理应用程序被邀请参与研究。
2022 年 9 月至 10 月期间，在与风湿病医生或其他医疗保健人员会面后，从九家诊所中进行了十次访谈。确定并编码了与医疗保健会议经历和对数字计划的意见有关的短语、句子或段落。反映类似概念的代码被分组；形成子类别，并将类别与他们的经历和意见联系起来。
在我们的参与者中，出现了三个主要类别：医疗保健的可及性、个人努力过上更健康的生活以及与医疗保健的个人互动。参与者描述说，“医疗保健邂逅”教育计划可以作为信息来源，这可以确认、支持和创造一种控制感。
参与者重视在有准备的情况下（随着时间观察症状并准备问题）被看到并参与对话。数字自我护理应用程序的实施可能需要纳入医疗保健环境中，以便患者和医疗保健人员有共同的理解。在这种情况下，协作是必不可少的。
