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Patients' experiences of using an e-Health tool for self-management support after prostate cancer surgery: a deductive interview study explained through the FITT framework
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. (eHälsoinstitutet;eHealth Institute)ORCID iD: 0000-0003-2074-3584
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.ORCID iD: 0000-0001-8398-9552
Kalmar County Hospital, Sweden.ORCID iD: 0000-0002-7158-2883
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Karolinska Institutet, Sweden. (eHälsoinstitutet;eHealth Institute;DISA-IDP;reaction)ORCID iD: 0000-0002-4108-391x
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2020 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 6, p. 1-8, article id e035024Article in journal (Refereed) Published
Abstract [en]

Objective To evaluate patients' experiences of using a web-based application, especially its usability as support for self-care activities after prostate cancer surgery. Design A deductive content analysis was used, stemming from the Fit between Individuals, Task and Technology (FITT) framework. Setting One surgical department in south of Sweden between October 2015 and April 2016 and between September 2017 and July 2018. Participants Fifteen men who had undergone radical prostatectomy for prostate cancer. Results By organising data in accordance with the FITT model, three main categories with ten subcategories were identified. Patients gave feedback on functions that suited them and their needs, as well as potential adjustments and improvements. Patients experienced that ePATH gave them easy access to reliable information regarding their rehabilitation. Directed information about ePATH at enrolment was seen as important. ePATH was perceived to have a logical structure that was easy to follow. However, when the structure was unclear, patients became less motivated to use a function. Conclusions Patients experienced ePATH as satisfactorily user-friendly and useful as a complementary self-management support after prostate cancer surgery, especially when the information and tasks were tailored to their preferences and the system design features supported individual autonomy.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2020. Vol. 10, no 6, p. 1-8, article id e035024
National Category
Nursing
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
URN: urn:nbn:se:lnu:diva-98763DOI: 10.1136/bmjopen-2019-035024ISI: 000576935700016PubMedID: 32601113Scopus ID: 2-s2.0-85087391154OAI: oai:DiVA.org:lnu-98763DiVA, id: diva2:1498846
Available from: 2020-11-05 Created: 2020-11-05 Last updated: 2024-05-07Bibliographically approved
In thesis
1. Support for patients and the role of eHealth in rehabilitation after radical prostatectomy
Open this publication in new window or tab >>Support for patients and the role of eHealth in rehabilitation after radical prostatectomy
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Patients undergoing radical prostatectomy for prostate cancer often experience urinary incontinence and sexual dysfunction posttreatment. Active self-care can reduce this burden. However, support maybe needed to maintain motivation during the long rehabilitation. eHealth has the potential to provide such support.

Aim: To investigate the effects of eHealth support and describe patients'experiences of support in self-care during the rehabilitation after radical prostatectomy.

Method: The Medical Research Council’s framework for complex interventions governed the overall design of this thesis. In Study I, patients’ experiences of the usability of a new eHealth support, the electronic Patient Activation in Treatment at Home (ePATH), was described using individual interviews and deductive content analysis. The effects of ePATH on symptoms and activation were evaluated through a multicenter longitudinal randomized controlled trial (II, III). Patients planned for radical prostatectomy at three sites were eligible for inclusion. The intervention group had access to ePATH during one year after surgery. Questionnaires at five timepoints were analyzed with linear mixed models and generalized estimation equations. Study IV described patients’ experiences of support for managing self-care through individual interviews and inductive content analysis.

Results: Study I covered the usability of ePATH as to managing the technology, turning input into output, and how the eHealth support assisted in task performance. The randomized controlled trial showed no significant differences between groups regarding urinary incontinence, sexual function, physical activity, pelvic floor exercises (II), or patient activation (III). In the intervention group, 64% used ePATH. Initial patient activation and depression significantly influenced patient activation over the course of the rehabilitation year. In Study IV, patients described a progression in self-care management, where their abilities grew through interconnected phases.

Conclusion: The needs for support differ during a patient's journey through prostate cancer rehabilitation. This places demands on the support and underscores the need for accessibility, individual adaptation, and continuity. Future research should focus on adjustable aids for patients in long-term rehabilitation, integrating multiple aspects, to enable tailoring of the support.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2024. p. 105
Series
Linnaeus University Dissertations ; 522
Keywords
eHealth, patient activation, prostate cancer, radical prostatectomy, randomized controlled trial, self-care, support, telemedicine, usability
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-129194 (URN)10.15626/LUD.522.2024 (DOI)9789180821513 (ISBN)9789180821520 (ISBN)
Public defence
2024-05-31, Fullriggaren, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2024-05-07 Created: 2024-05-07 Last updated: 2024-05-13Bibliographically approved

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Nilsson, LinaHellström, AmandaWennerberg, CamillaEkstedt, MirjamSchildmeijer, Kristina

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