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迈向血友病护理的个性化护理和患者赋权及个人健康记录的视角:定性访谈研究。

Toward Personalized Care and Patient Empowerment and Perspectives on a Personal Health Record in Hemophilia Care: Qualitative Interview Study.

机构信息

Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands.

Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands.

出版信息

JMIR Hum Factors. 2024 Sep 3;11:e48359. doi: 10.2196/48359.

Abstract

BACKGROUND

To enable personalized treatment and shared decision-making in chronic care, relevant health information is collected. However, health information is often fragmented across hospital information systems, digital health apps, and questionnaire portals. This also pertains to hemophilia care, in which scattered information hampers integrated care. We intend to co-design a nationwide digital personal health record (PHR) for patients to help manage their health information. For this, user perspectives are crucial.

OBJECTIVE

This study aims to assess patients' and health care providers' perspectives regarding the use of a PHR in hemophilia care in the Netherlands, required functionalities, and expectations and concerns.

METHODS

In this semistructured interview study, 19 pediatric and adult persons with hemophilia, parents, and women with other inherited bleeding disorders, as well as 18 health care providers working within and outside of hemophilia treatment centers, participated. Perspectives of patients and providers were explored separately. To explore requirements, participants were asked to prioritize functionalities.

RESULTS

Participants expected a PHR would increase the transparency of health information, improve patients' understanding of their illness, and help the coordination of care between health care providers and institutions. Prioritized functionalities included the integration of relevant health information and patient-entered data. Formulated expectations and concerns focused on 4 themes: usability, safety, inclusiveness, and implementation. While patients expressed worries over medicalization (ie, more confrontational reminders of their illness), providers were concerned about an increased workload.

CONCLUSIONS

People with hemophilia, their parents, and health care providers welcomed the development of a PHR, as they expected it would result in better coordinated care. Formulated expectations and concerns will contribute to the successful development of a PHR for persons with hemophilia, and ultimately, for all persons with a chronic condition.

摘要

背景

为了实现慢性病管理的个性化治疗和共同决策,需要收集相关的健康信息。然而,健康信息常常分散在医院信息系统、数字健康应用程序和问卷门户中。这同样适用于血友病的护理,分散的信息阻碍了综合护理的实施。我们旨在共同设计一个全国性的数字化个人健康记录(PHR),帮助患者管理其健康信息。为此,用户视角至关重要。

目的

本研究旨在评估荷兰血友病患者和医疗保健提供者对使用 PHR 的看法、所需功能以及期望和顾虑。

方法

在这项半结构化访谈研究中,19 名患有血友病的儿童和成人、父母以及患有其他遗传性出血性疾病的女性,以及 18 名在血友病治疗中心内外工作的医疗保健提供者参与其中。分别探讨了患者和提供者的观点。为了探索需求,要求参与者对功能进行优先级排序。

结果

参与者期望 PHR 能够提高健康信息的透明度,增进患者对自身疾病的理解,并有助于协调医疗保健提供者和机构之间的护理。被优先考虑的功能包括整合相关健康信息和患者输入的数据。形成的期望和顾虑主要集中在 4 个主题:可用性、安全性、包容性和实施。虽然患者对医疗化表示担忧(即,更多地面对他们疾病的提醒),但提供者则担心工作负荷增加。

结论

血友病患者、他们的父母和医疗保健提供者欢迎开发 PHR,因为他们期望这将带来更好的协调护理。形成的期望和顾虑将有助于为血友病患者成功开发 PHR,并最终为所有患有慢性疾病的人开发 PHR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dc5/11408883/846c45c48ea8/humanfactors_v11i1e48359_fig1.jpg

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