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Towards Effortless Use of Information Technology in Home Healthcare with a Networked Digital Pen
Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

When care is moved from the hospital to the home the demands for high quality care still remain. For problems arising from the geographical separation of patients and professional caregivers, information and communication technology may offer important solutions. The overall aim of this thesis was to describe relevant requirements, to design and implement an IT-based system, and finally to evaluate the system’s influence on symptom control and support for both patients/next-of-kin and professional caregivers in advanced home healthcare. Of importance were needs in basic as well as advanced home healthcare, as were usability perspectives of both patients and professional caregivers. Requirement areas such as security, mobility, and responsibility, which should be considered when monitoring patients in the home, were identified. A prototype system for everyday assistance for diabetes patients was designed, and a system for frequent pain assessment for palliative home healthcare patients using a pain diary, digital pen and mobile Internet technology, was developed and evaluated through a qualitative content analysis approach. Twelve palliative cancer patients and six professional caregivers participated. The data collected included an ease-of-use questionnaire, and interviews with patients, spouses and professional caregivers. Patients expressed increased and improved contact with the caregivers, increased participation in their own care, a sense of increased security, and easiness in using the equipment in spite of severe illness and difficulties in comprehending the technology and system intervention. The professional caregivers showed a shifting outlook towards the pain assessment method; an initial cautious outlook due to low expectations of the patients’ abilities to use the pain assessment method and the caregivers’ own reluctance to use the system and change their way-of-working. Despite this, the professional caregivers experienced positive outcomes in terms of an increased awareness of pain, and positive patient influences including increased participation in their care, increased security and improved changes in pain treatment as a response to reported pain assessments. In conclusion, the networked digital pen system provided an effortless method for pain assessment and had positive influences on the care. The results imply that digital pen technology is suitable for the assessment of symptoms by palliative patients since these patients often have a limited capacity to handle technology due to their state of health.

Place, publisher, year, edition, pages
2006.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1039
Keyword [en]
Home care services, Hospital-based, Requirements, Pain Assessment, Visual Analogue Scale, Palliative care, Digital pens, Mobile phones, Internet
National Category
Biomedical Laboratory Science/Technology
Identifiers
URN: urn:nbn:se:liu:diva-7840ISBN: 91-85523-17-8 (print)OAI: oai:DiVA.org:liu-7840DiVA: diva2:22779
Public defence
2006-10-06, Linden, Hälsouniversitetet, Campus US, Linköpings Universitet, Linköping, 09:15 (English)
Opponent
Supervisors
Note
On the day of the public defence date of the doctoral thesis the status of article III and IV was Submitted.Available from: 2006-11-30 Created: 2006-11-30 Last updated: 2009-03-05
List of papers
1. Requirements and prototyping of a home health care application based on emerging JAVA technology.
Open this publication in new window or tab >>Requirements and prototyping of a home health care application based on emerging JAVA technology.
Show others...
2002 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, Vol. 68, no 1-3, 129-139 p.Article in journal (Refereed) Published
Abstract [en]

IT support for home health care is an expanding area within health care IT development. Home health care differs from other in- or outpatient care delivery forms in a number of ways, and thus, the introduction of home health care applications must be based on a rigorous analysis of necessary requirements to secure safe and reliable health care. This article reports early experiences from the development of a home health care application based on emerging technologies. A prototype application for the follow-up of diabetes patients is presented and discussed in relation to a list of general requirements on home health care applications.

Keyword
Home health care, Diabetes patients, Requirements, Monitoring, JAVA technology
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14167 (URN)10.1016/S1386-5056(02)00071-0 (DOI)
Available from: 2006-11-30 Created: 2006-11-30 Last updated: 2013-11-13
2. A system for symptom assessment in advanced palliative home healthcare using digital pens.
Open this publication in new window or tab >>A system for symptom assessment in advanced palliative home healthcare using digital pens.
2004 (English)In: Medical informatics and the Internet in medicine, ISSN 1463-9238, Vol. 29, no 3-4, 199-210 p.Article in journal (Refereed) Published
Abstract [en]

Symptom control is one of the most important components of delivering effective palliative care, and adequate symptom assessment is a prerequisite for good symptom control. Patients receiving treatment in palliative home healthcare is geographically separated from the caregivers making symptom control a challenge, a challenge that could be met by the use of information and communication technology. Technologies of today offer different ways for patients to assess their symptoms at home and send the assessments to the healthcare provider. Examples are the use of a PC, a touch-tone telephone, and a digital pen, which require different kinds of infrastructure in the patient's home, and which differ in strengths and weaknesses. As part of an ongoing quality assurance work within the hospital-based home care clinic at Linköping University Hospital, the project has designed, developed and implemented an IT-support system for pain assessments for patients at home using digital pen and mobile Internet technology. A questionnaire study indicated that pain assessment using digital pens was accepted by patients and that problems mainly arose from the use of the visual-analogue scale.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14168 (URN)10.1080/14639230400005966 (DOI)
Available from: 2006-11-30 Created: 2006-11-30 Last updated: 2009-05-25
3. Patients’ use of digital pens for pain assessment in advanced palliative home healthcare.
Open this publication in new window or tab >>Patients’ use of digital pens for pain assessment in advanced palliative home healthcare.
2008 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 77, no 2, 129-136 p.Article in journal (Refereed) Published
Abstract [en]

Background: Appropriate pain assessment is a necessary prerequisite for adequate pain control. A way to follow-up on the pain is to let patients use paper-based or electronic pain diaries.

Purpose: The aim was to explore and describe palliative home care patients’ experiences of assessing their pain by using a pain diary together with digital pen and mobile Internet technology.

Methods: A system for the follow-up of pain treatment was developed and evaluated by means of a qualitative cross-case content analysis. From December 2002 until September 2003 12 palliative patients, who initially assessed VAS pain ≥ 35 mm (VAS 0–100 mm), used the system. Patients reported their momentary pain intensity and the number of consumed extra doses of analgesics three times per day. Analysis data were collected from interviews with patients and spouses, questionnaires, medical records, and the system log.

Results: In spite of severe illness and difficulties in comprehending the technology and system intervention, patients found the pain diary and digital pen easy to use for pain assessment. Patients took a greater part in their own care and experienced an improved contact with their caregivers, which led to a sense of increased security. The medical records showed a quick response to variations in the patients’ health status by means of changes in medical treatment.

Conclusions: The pain assessment system for palliative patients using pain diaries together with digital pen and wireless Internet technology constitutes an effortless method and has positive influences on the care.

Keyword
Pain assessment; Visual analogue scale; Palliative care; Home care services, Hospital-based; Digital pens; Mobile phones; Internet
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14169 (URN)10.1016/j.ijmedinf.2007.01.013 (DOI)
Available from: 2006-11-30 Created: 2006-11-30 Last updated: 2017-12-13
4. Digital pens and pain diaries in palliative home healthcare: Professional caregivers’ experiences.
Open this publication in new window or tab >>Digital pens and pain diaries in palliative home healthcare: Professional caregivers’ experiences.
2007 (English)In: Medical Informatics and the Internet in Medicine, ISSN 1753-8157, Vol. 32, no 4, 287-296 p.Article in journal (Refereed) Published
Abstract [en]

Frequent pain assessment by the use of pain diaries for the follow-up of pain treatment can facilitate the caregivers' work with pain control in home health care. The aim was to explore and describe professional caregivers' experiences of palliative home health-care patients' use of pain diaries and digital pen technology for frequent pain assessment. A system for the follow-up of pain treatment was implemented in routine care and evaluated by means of a qualitative content analysis. Three nurses, two physicians and one secretary were interviewed. Additional analysis data were collected from patients' medical records, and the system log. The caregivers showed a shifting outlook towards the pain-assessment method, an initial cautious outlook due to low expectations of the patients' abilities to use the pain assessment method. Despite this, the caregivers experienced positive outcomes in terms of an increased awareness of pain, and positive patient influences including increased participation in their care, increased security, and improved changes in pain treatment as a response to reported pain assessments. Pain assessment by the use of pain diaries and digital pen technology has positive influences on palliative home-care patients and supports the caregivers' focus on the pain.

Keyword
Pain assessment; home care services, hospital-based; digital pens; mobile phones; Internet
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14170 (URN)10.1080/14639230701785381 (DOI)
Available from: 2006-11-30 Created: 2006-11-30

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