Finnish Journal of eHealth and eWelfare

Health self-management of older employees: identifying critical peak experiences of a patient portal

2023-02-14T20:11:41+02:00

Digitalization could provide efficient and cost-effective health and well-being services to the rapidly aging population. However, digital services do not always meet their needs. We investigated the experiences and service needs of older employees by collecting quantitative and qualitative data through a survey (n = 497). The results suggested a negative association between user satisfaction and age during retirement transition. Peak experiences were meaningful, explaining a 26% variation in the overall evaluation of the portal. The negative peak experiences concerned poorly functioning features, and the positive ones the ability to take care of one’s health smoothly and easily. The respondents had high expectations for functionality, efficiency, and ease of use. They wanted more support for self-managing health: controlling weight, sleeping, recovery, and exercising.

Development and validation of instrument for assessment of situational awareness in operational management of nursing leaders in hospital settings

2023-03-14T07:19:38+02:00

Nursing leaders in charge of operational management in acute care environments need continuous real-time information regarding workflow, human resources, and patient situations to support their immediate decision making. However, nursing leaders report that the current information systems do not provide sufficient support to help their decision making. The aim of this study was to develop an instrument for the evaluation of situational awareness of nursing leaders in operational management into the hospital setting. First, an established situational awareness scale was combined with literature to develop a draft for the instrument. Second, an expert panel assessed the content validity of the instrument, and finally, the psychometric properties of the instrument were evaluated by a cross-sectional online survey. The final version of the instrument consisted of three dimensions: Demands of patient care (5 items), Human resources (5 items) and Materials (6 items). The scale content validity index for all 16 items was 0.88. The instrument was tested with nursing professionals in charge of operational management (n=349). The overall situational awareness was 4.18, the highest dimension was the human resources (mean 4.63), while lowest score was seen for the dimension patient care (mean 3.84). The construct validity and internal consistency of the instrument was deemed good. The instrument may support systematic assessments of situational awareness, pinpointing areas of information management that need improvement. It may support evaluation of development projects, interventions, or implemented information systems. As situational awareness is an integral element of operational management in all health care, future research should explore it in other clinical environments and with other professions.

Ward level analysis of standardized nursing data – example of the FinCC use

2023-02-20T20:16:55+02:00

The use of the standardized nursing terminology makes patient care transparent. It enables the description nursing care processes and generating knowledge for decision-making and management. The structure of the Finnish Care Classification (FinCC) structures the documentation of nationally agreed core nursing data: nursing diagnoses, interventions, and outcomes.

The purpose is to analyze the use of FinCC to record nursing diagnoses, interventions and outcomes in electronic health records in three hospitals. In this descriptive study, appropriate sampling from data repositories in the Internal Medicine wards of three hospitals was applied. The research data consisted of anonymous ward-level data collected over a six-month period. The data was analyzed according to the distributions of the use of FinCC's component, main and subcategory levels.

According to the results, the process phases of nursing diagnoses, interventions and outcomes are used in all hospitals. All three levels of FinCC (component, main and subcategories) were used to document nursing care. Mainly, the documentation of diagnoses and interventions were carried out at the main and subcategories levels, with the exception of one hospital, where part of the diagnoses were documented using the component level. In addition, in two hospitals, the diagnoses were documented directly at the diagnoses phase of the process, without using the component, main or subcategory level. All hospitals used all components of FinCC to describe diagnoses and interventions, with the exception of one hospital where the component Life Cycle was not used to document interventions.

Standardized nursing data from data repositories can be used for secondary purposes to analyse care processes and care modes. This information can be further used in the management e.g., to estimate nursing care competencies and educational needs at the hospitals.

Improving children’s patient experience with a mobile hospital clowning application – Initial user experiences from the clowns’ perspective

2023-03-16T16:29:04+02:00

eHealth solutions are increasingly being developed to support patient care and improve patients’ experiences (PXs). Recently, the coronavirus disease 2019 (COVID-19) pandemic and the shortage of nurses in several countries, including Finland, have further underscored the need for new digital services. In the context of children’s hospitals, care-supporting services include hospital clowns who work to provide emotional support for children and improve their PXs. Hospital clowns are known to have a positive impact on children’s PX.

The Finnish hospital clown organization Sairaalaklovnit ry has published its first mobile application Sairaalaklovnit to provide a digital contact platform to reach patients remotely via messages. The application is mainly targeted at child patients and includes both entertainment and messaging facets for communication between child patients and hospital clowns. The two main user groups for this application can be considered to be child patients and hospital clowns.

This article presents the data and results found during a study related to the user experience (UX) of the Sairaalaklovnit application. With the research questions, “Which aspects influence the UX of the hospital clown application?” and more specifically, out of the two user groups, “How do Finnish hospital clowns experience the new hospital clown mobile application?”, this study aims to gain an understanding of how Finnish hospital clowns experience the newly developed application for expanding physical contact with patients into a digital form. The qualitative data used in this article were collected in the summer of 2022 through an online questionnaire (n = 5) and semi-structured interviews (n = 3) with hospital clowns.

The hospital clowns were mostly satisfied with the published application, but some deficiencies were mentioned. Most of the complaints were related to technical issues. However, the application was seen as a useful tool that can bridge physical and digital contact with children. The developer has been made aware of the technical issues and fixes expected in the future. For future research, it can be beneficial to rerun the UX study for the hospital clowns and possibly with a larger sample to see whether there have been any changes after the technical issues have been solved. Moreover, studying how child patients, which constitute the other user group, experience the new application, can prove to be beneficial for possible future development.

Practical nurses’ experiences of client and patient information systems support for performance - cross-sectional study

2023-02-28T21:22:42+02:00

The support provided by client and patient information systems for the performance of social and health care work tasks has previously been studied among doctors, nurses, and highly qualified social professionals. The research targeted at practical nurses is a continuation of these studies. The research focused on how client and patient information systems support the work, cooperation and flow of information of practical nurses and how useful they assess these information systems in their work.The online survey was forwarded to practical nurses of working age in the register of members of the Finnish Federation of Local and Basic Caregivers (SuPer ry) and the Union of Public and Welfare Sectors (JHL) in spring 2022. Averages and percentages of the material were calculated.

The amount of 3866 practical nurses responded to the electronic survey from all wellbeing services counties and Åland. The average age of respondents was 49 years and the majority of respondents spoke Finnish as their mother tongue (92.9%). Most of the practical nurses worked in social welfare. About one third (27.9%) had more than 20 years of work experience. Practical nurses estimated themselves to be an experienced user of information systems. Half (50-64 %) of practical nurses in different settings reported that information systems help to ensure continuity of care when it comes to identifying the benefits associated with information systems. A key problem was that the use of IT systems takes too much working time from clients.

Practical nurses felt that the information systems mainly supported their work. However, they reported deficiencies in the ability of the information system to produce a summary of the patients’ health status. While information systems supported the exchange of information within their own organisation, there were challenges in the exchange of information between social and healthcare organisations. The support of information systems for the exchange of information between clients or their relatives was poor. In addition to information systems, telephone and papers were used on a weekly basis. Neither the regional information systems nor Kanta services were the usual means of exchanging information in the work of practical nurses.

The assessments of the information systems by practical nurses were rather positive. Support for information-search in the exchange of information between organisations and experience that summaries should be more supportive for work confirmed earlier results from surveys. Information systems’ support for the work is highlighted in the current context were staff shortages and growing service needs pose challenges to new welfare areas.

Tietojärjestelmät lähihoitajien työn tukena eri toimintaympäristöissä: kokemuksia tuotemerkeittäin 2022

2023-02-14T19:30:06+02:00

Information systems are supposed to support client work and nursing. The study examines the extent to which different client information systems and electronic health records support the work of practical nurses in different work environments. Moreover, the study produced brand-specific information about user experiences related to the some of the strategic goals of Finnish eHealth and eSocial Strategy and to support the development of information systems.

The data collection for the practical nurses was conducted for the first time in spring 2022 as a part of the project ‘Monitoring and assessment of social welfare and health care information system services (STePS 3.0)’ that provide information on the achievement of the national strategy for information management. An electronic survey was directed at the working-age members of trade unions [the Finnish Federation of Local and Basic Caregivers (SuPer); the Trade Union for the Public and Welfare Sectors (JHL)]. The survey was answered by 3,866 practical nurses, and most of them worked in social services.

The average ratings of the system brands ranged from moderate (6) to good (8) on the scale from fail (4) to excellent (10). The practical nurses most often considered the benefit of the information systems to be found in the support they provided in regard to the continuity of care and quality of care. Regardless of the system brand, the shared experience was that the information systems take up too much working time. Summary views were only at a fairly good or weak level for many of the system brands. It was common that the same issue had to be documented in several places: in social care the range was 51−61%, in public hospitals 61−72%, in community health centre 60−73% and in private sector 47−73%.

The study produced brand-specific information on user experiences to support systems development work in future. In development work, it is important to consider the different working environments. The experience of practical nurses that information systems take up too much time from client work should be taken into consideration. All possibilities to streamline practices related to documentation and work processes within the organization and counties should take to account.

Health technology readiness: The translation of READHY-FIN questionnaire

2023-03-01T01:54:47+02:00

The digital healthcare services have become everyday activities for more and more citizens. The capabilities of citizens, such as knowledge, skills, attitudes, including trust and motivation, will determine their ability to exploit health technologies such as various digital health services. However, a large number of citizens have experienced difficulties in using digital health services. It is important to understand how citizens can make use of digital health services and how to improve the accessibility of digital services by creating services that meet their needs. This requirement is met by The Multidimensional Readiness and Enablement Index for Health Technology (READHY), which includes 13 domains with a total of 65 items. The questionnaire is internationally validated and used. The purpose of this study is to describe the READHY-FIN translation process and the structure of the Finnish questionnaire.

The translation and cultural adaptation process of the READHY followed the instructions of the University of Swinburne, which administers the survey rights. It consisted of three phases: 1) linguistic and cultural translation work, 2) cognitive interviews and 3) psychometric testing. The READHY-FIN questionnaire consists of five dimensions: 1) The intersection between users and technologies, 2) Users’ experience of systems, 3) Users’ attributes, 4) Social context and 5) The individuals’ capabilities to handle their condition and emotional response. Each dimension is divided into 2-4 domains and the domain contain 4-6 statements with a Likert-type response scale from 1 to 4. The structure of the READHY-FIN appears to correspond to the domains of the original measurement tool and the domains appear to be generally reliable. As a conclusion, READHY-FIN is a meaningful questionnaire to measure and enable the readiness to use health technology in different patient groups regardless of the type of technology.

Tiedon laatu johtajan, sote-asiakastyön tekijän ja asiakkaan näkökulmista

2023-04-13T22:42:01+03:00

Sote-alalla tuotetaan, tallennetaan ja hyödynnetään lisääntyvissä määrin tietoa eri toimijoiden yhteistyönä ja tarpeesta. Tietoa tuottavat niin kansalaiset kuin alan ammattilaiset erilaisiin organisaatiotasoisiin, kansallisiin ja kansainvälisiin järjestelmiin ja rekistereihin. Tiedon laadun merkitys on saanut enenevästi huomiota sote-palveluissa, koska tiedon laatu vaikuttaa yksilöön, organisaatioon ja yhteisöön liittyvään päätöksentekoon. Laadukkaan tiedon muodostumisen edellytyksenä on tiedon tuottajien ymmärrys tiedon merkityksestä ja osaaminen. Sosiaali- ja terveydenhuollon tietojenkäsittely-yhdistys on järjestänyt tutkimuspäiviä vuodesta 1998 lähtien. Näitä "Sosiaali- ja terveydenhuollon tietotekniikan ja tiedonhallinnan (SoTeTiTe)" -tutkimuspäiviä pidetään vuosittain ja niissä käsitellään Suomessa toteutettavaa alan monitieteisestä tutkimusta ja kehittämistyötä. Toimivat tietotekniikan ja tiedonhallinnan ratkaisut rakentuvat sote-alalla monialaiselle yhteistyölle, joka edellyttää, että ymmärretään oman asiantuntijuusalueen lisäksi myös muiden asiantuntijuutta. Yhteinen keskustelufoorumi luo mahdollisuuden oppia, jakaa innovaatioita ja keskustella alan vaatimuksista yksilötasosta kansalliseen näkökulmaan asti sekä verkostoitua yhteisön sisällä. Vuoden 2023 tutkimuspäivillä käsitellään tiedon laatua ja sen merkitystä sote-palveluiden kokonaisuudessa. Tässä FinJeHeW-lehden numerossa julkaistaan vuoden 2023 SoTeTiTe-tutkimuspäivillä esitetyt tieteelliset tutkimukset ja hankkeet

Conferences

2023-04-18T22:10:42+03:00

Artificial intelligence research in the COVend COVID-19 clinical trial project

2023-03-09T16:49:37+02:00

The COVend project aims at delivering a new effective therapy, FX06, against the SARS-CoV-2 virus infection for the management of the COVID-19 disease in hospitals. Nine of the 17 partners of the project consortium are hospitals responsible for collecting study subjects and administering the FX06 therapy to the patients. Although the clinical trial (IXION) has the main role in the project, the project has also a work package which develops and applies artificial intelligence (AI) methods to the data collected during the 28-day study period from the patients receiving the therapy. The AI work package applies exploratory data analysis methods to find patterns and profiles of the patients. Combined with the data about treatment methods and patient outcomes, the aim is to provide decision support for the therapy intervention in the later stage of the project.

PROSHADE – Tietoon pohjautuva jaettu päätöksenteko terveydenhuollossa

2023-03-18T23:15:26+02:00

The PROSHADE project is funded by the Strategic Research Council of the Academy of Finland for 2021–2026. The project is part of LITERACY program, where interdisciplinary solutions are researched and searched on critical information usage of individuals and organizations. In PROSHADE the focus of research is on decision-making and utilization of information in healthcare.

PROSHADE consists of four work packages (WP). This presentation focuses on work package 3 (WP3), which researches health information literacy and the participation of patients in shared decision-making in healthcare. Increasing patient's participation according to earlier studies leads for example to better treatment success, patient satisfaction and stronger commitment to treatment. Patient’s health literacy (the ability to identify, search, evaluate, and generate health-related data) plays a central role in shared decision-making. Patient generated data enables patient’s values and preferences to be taken into account better as part of shared decision-making. However, research is required to further strengthen shared decision making in interactions in healthcare.