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      Patients’ and Health Care Professionals’ Perceptions of the Potential of Using the Digital Diabetes Questionnaire to Prepare for Diabetes Care Meetings: Qualitative Focus Group Interview Study

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          Abstract

          Background

          In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers.

          Objective

          The objective of the study was to conduct focus group interviews to capture patients’ and health care professionals’ perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study.

          Methods

          A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach.

          Results

          Two main categories were revealed by the qualitative analysis: perceptions of digital technology and the digital questionnaire in diabetes management and care and perceptions of participation in diabetes care. An overarching theme that emerged from the focus group interviews was patients’ and professionals’ involvement in diabetes care using digital tools.

          Conclusions

          The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.

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          Most cited references16

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          Healthcare professionals' competence in digitalisation: A systematic review.

          To identify key areas of competence for digitalisation in healthcare settings, describe healthcare professionals' competencies in these areas and identify factors related to their competence.
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            WHO guidance for digital health: What it means for researchers

            In healthcare, digital solutions have been adopted with zeal, but there is paucity of evidence for benefits and harms of these solutions. The impact, immediate or long term, of digital applications on healthcare has not been assessed. With the overwhelming numbers and types of digital solutions, it is becoming increasingly important to develop evidence-based insights for the integration of these solutions in routine medical care. Digitalization can certainly empower and enable patients and physicians to achieve health objectives. The World Health Organisation has released guidance for digital health after a critical review of available evidence for the benefits, harms, acceptability, feasibility, resource use and equity considerations of digital health interventions. This guidance can potentially inspire and impact future research endeavors for digital applications. In this paper, the guidance has been reviewed in context of the current research situation and insights are shared for researchers engaged in the design and assessment of digital interventions.
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              ‘Having to learn this so late in our lives…’ Swedish elderly patients’ beliefs, experiences, attitudes and expectations of e-health in primary health care

              Abstract Objective: The elderly are an increasing group and large consumers of care in Sweden. Development of mobile information technology shows promising results of interventions for prevention and treatment of chronic diseases. Exploring the elderly patients’ beliefs, attitudes, experiences and expectations of e-health services helps us understand the factors that influence adherence to such tools in primary care. Material and methods: We conducted focus group interviews with 15 patients from three primary health care centers (PHCCs) in Southern Sweden. Data were analysed with thematic content analysis with codes and categories emerged from data during analysis. Results: We found one comprehensive theme: ‘The elderly’s ambivalence towards e-health:  reluctant curiosity, a wish to join and need for information and learning support’. Eight categories emerged from the text during analysis: ‘E-health – a solution for a non-existing problem?’, ‘The elderly’s experiences of e-health’, ‘Lack of will, skills, self-trust or mistrust in the new technology’, ‘Organizational barriers’, ‘Wanting and needing to move forward’, ‘Concerns to be addressed for making e-health a good solution’, ‘Potential advantages with e-health versus ordinary health care’ and ‘Need for speed, access and correct comprehensive information’. Conclusions: Elderly patients in Sweden described feelings of ambivalence towards e-health, raising concerns as accessibility to health care, mistrust in poor IT systems or impaired abilities to cope with technology. They also expressed a wish and need to move forward albeit with reluctant curiosity. Successful implementation of e-health interventions should be tailored to target different attitudes and needs with a strong focus on information and support for the elderly. Key points Exploring the elderly patients’ beliefs, experiences, attitudes and expectations of the fast developing e-health services helps us understand the factors that influence adherence to such tools in primary care. Elderly patients in Sweden reported ambivalence and different experiences and attitudes towards e-health, raising concerns as accessibility to health care, costs and mistrust in poor IT systems or impaired abilities to cope with technology. They also expressed a wish and need to move forward albeit with reluctant curiosity. Successful implementation of e-health interventions should be tailored to target different attitudes and needs with a strong focus on information and support for the elderly.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                August 2020
                19 August 2020
                : 22
                : 8
                : e17504
                Affiliations
                [1 ] Sahlgrenska University Hospital Gothenburg Sweden
                [2 ] Institute of Medicine Department of Molecular and Clinical Medicine University of Gothenburg Gothenburg Sweden
                [3 ] Sophiahemmet University Stockholm Sweden
                [4 ] Department of Clinical Sciences and Education Karolinska Institutet Stockholm Sweden
                [5 ] Center of Registers Västra Götaland Nationella Diabetesregistret Gothenburg Sweden
                [6 ] School of Education, Health and Social Studies Dalarna University Falun Sweden
                [7 ] Department of Medical Sciences, Clinical Diabetology and Metabolism Uppsala University Uppsala Sweden
                Author notes
                Corresponding Author: Katarina Eeg-Olofsson katarina.eeg-olofsson@ 123456vgregion.se
                Author information
                https://orcid.org/0000-0002-3376-4707
                https://orcid.org/0000-0003-3309-136X
                https://orcid.org/0000-0002-0323-9610
                https://orcid.org/0000-0001-8682-2045
                Article
                v22i8e17504
                10.2196/17504
                7468633
                32812884
                5fd00546-cc72-45be-9775-ff64c8a2c41f
                ©Katarina Eeg-Olofsson, Unn-Britt Johansson, Ebba Linder, Janeth Leksell. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.08.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 17 December 2019
                : 10 March 2020
                : 15 April 2020
                : 13 May 2020
                Categories
                Original Paper
                Original Paper

                Medicine
                digital questionnaire,health care professionals,diabetes care,focus group interview,qualitative research,ehealth 

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