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Primary Health Care Nurses’ Experiences of Consultations With Internet-Informed Patients: Qualitative Study
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.ORCID-id: 0000-0003-1543-6512
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
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2019 (Engelska)Ingår i: JMIR Nursing, ISSN 2562-7600, Vol. 2, nr 1, artikel-id e14194Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Most people in modern societies now use the Internet to obtain health-related information. By giving patients knowledge, digital health information is considered to increase patient involvement and patient-centered interactions in health care. However, concerns are raised about the varying quality of health-related websites and low health literacy in the population. There is a gap in the current knowledge of nurses’ experiences with Internet-informed patients.

Objective: The objective of this study was to explore primary health care nurses’ experiences of consultations with patients who present health-related information from the Internet.

Methods: This is a qualitative study based on interviews with 9 primary health care nurses. Data were analyzed using qualitative content analysis. Results are reported according to the consolidated criteria for reporting qualitative research guidelines.

Results: The phenomenon of Internet-informed patients was considered to change the usual rules in health care, affecting attributes and actions of patients, patterns of interactions in consultations, and roles of nurses and patients. Three categories were identified: (1) Facing the downsides of Googling, (2) Patients as main actors, and (3) Nurse role challenged. Although the benefits of health-related Internet information were described, its negative consequences were emphasized overall. The problems were mainly ascribed to inaccurate Internet information and patients’ inability to effectively manage the information.

Conclusions: Our study suggests ambivalent attitudes among nurses toward health-related Internet information. In order to promote equitable care in the digital era, increased awareness in health care about useful strategies for overcoming the difficulties and embracing the benefits of conferring with Internet-informed patients seems to be a legitimate goal.

Ort, förlag, år, upplaga, sidor
JMIR Publications , 2019. Vol. 2, nr 1, artikel-id e14194
Nyckelord [en]
eHealth, Internet, consumer health information, health literacy, patient-centered care, qualitative research, primary health care
Nationell ämneskategori
Omvårdnad
Identifikatorer
URN: urn:nbn:se:umu:diva-162733DOI: 10.2196/14194OAI: oai:DiVA.org:umu-162733DiVA, id: diva2:1346066
Tillgänglig från: 2019-08-27 Skapad: 2019-08-27 Senast uppdaterad: 2023-12-09Bibliografiskt granskad
Ingår i avhandling
1. eHealth literacy and internet use for health information: a study in Swedish primary healthcare
Öppna denna publikation i ny flik eller fönster >>eHealth literacy and internet use for health information: a study in Swedish primary healthcare
2023 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[sv]
eHälsolitteracitet och internetanvändning för hälsoinformation : en studie inom svensk primärvård
Abstract [en]

Background: Primary healthcare (PHC) is facing significant challenges in Sweden and around the world. One way to address such challenges is through health-related Internet information (HRII) and other eHealth services, which are resources for high-quality, accessible and cost-effective care. Such re­sources have been found to assist in improving individual health, especially for people with chronic conditions such as type 2 diabetes. More specifically, eHealth services may play an important role in increasing patients’ knowledge, engagement and autonomy in health management, as well as enhancing their self-care practices. However, patients must have adequate capabilities – collectively known as eHealth literacy (eHL) – in order to use eHealth services effectively. 

Aim: The overall aim of this thesis was to explore eHL and HRII use in the context of Swedish PHC. 

Methods: Data collection for paper I was conducted through individual interviews with PHNs, which were then analysed using qualitative content analysis. Paper II involved patients with type 2 diabetes who were interviewed individually or responded to open-ended survey questions; the data were analysed using thematic analysis. In paper III, which was a translation and validation study, the data consisted of cognitive interviews and questionnaires predominantly answered by PHC visitors, and employed psychometric analysis methods. The same data from PHC visitors were used in paper IV, in which descriptive and comparative statistics and logistic regression analyses were employed. 

Results: In paper I, the interviewed PHNs expressed mixed feelings regarding consultations with Internet-informed patients. While they recognised benefits such as increased patient engagement and the support of self-care, their responses focused on the challenges they encountered. These challenges included patient confusion and unwarranted anxiety stemming from HRII, as well as conflicted, time-consuming and unnecessary healthcare consultations. In paper II, patients with type 2 diabetes outlined their challenges associated with online COVID-19 information, which encompassed information overload, conflicting content and notable emotional impact. They described employing diverse coping strategies to address these challenges, including restricting their information consumption, relying on authoritative sources, actively evaluating source credibility, engaging in discussions with others and applying common sense. In paper III, the eHealth Literacy Questionnaire (eHLQ) was translated and culturally adapted to assess eHL in a Swedish context. The Swedish version of the eHLQ was found to demonstrate robust psychometric properties. In paper IV, it was determined that older age groups (>60) were assessed with lower eHL in several eHLQ domains, including those regarding motivation and ability to use HRII and digital technology. In addition, older age groups reported that eHealth services did not suit their individual needs. Variables that were found to be independently associated with lower eHL across several domains were advanced age and the perception that HRII was not useful or important. 

Conclusion: Both the patients and PHNs in this thesis encountered challenges related to patients’ acquisition of HRII and utilisation of eHealth services. A collective and important objective for healthcare professionals and authorities should be to facilitate patients’ HRII and eHealth service usage. Therefore, PHNs and other healthcare professionals should actively encourage open discussions with patients about the latter’s HRII findings, recommend credible websites, explore potential barriers to patients’ eHealth usage, motivate patients to use eHealth services and suggest ways for patients to enhance their eHL. Healthcare authorities and eHealth developers are suggested to increasingly involve end-users in the development of eHealth services and provide opportunities for customisation based on individual needs. 

Ort, förlag, år, upplaga, sidor
Umeå: Umeå University, 2023. s. 99
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 2277
Nyckelord
eHealth, eHealth literacy, health literacy, nursing, primary healthcare, person-centred card care
Nationell ämneskategori
Omvårdnad
Identifikatorer
urn:nbn:se:umu:diva-217574 (URN)9789180702195 (ISBN)9789180702201 (ISBN)
Disputation
2024-01-12, Aula Biologica, Biologihuset, Linnaeus väg 7, Umeå, 09:00 (Svenska)
Opponent
Handledare
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärdDiabetesfondenKempestiftelserna
Tillgänglig från: 2023-12-15 Skapad: 2023-12-09 Senast uppdaterad: 2023-12-11Bibliografiskt granskad

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Sjöström, Anna E.Hörnsten, ÅsaHajdarevic, SenadaIsaksson, Ulf

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