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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 10 (2008)  >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/16667

Title: Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications
Authors: Nijland, Nicol
van Gemert-Pijnen, Julia
Boer, Henk
Steehouder, Michaël F
Seydel, Erwin R
Eysenbach, Gunther
Keywords: Original Paper
primary care
access to information
electronic patient-provider communication
Issue Date: 15-May-2008
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Nicol Nijland, Julia van Gemert-Pijnen, Henk Boer, Michaël F Steehouder, Erwin R Seydel. Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications. J Med Internet Res 2008;10(2):e13 <URL: http://www.jmir.org/2008/2/e13/>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2008/2/e13/ ] Background: Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care. Objective: The aim of this study was to determine user-centered criteria for successful application of Internet-based technology used in primary care for supporting self-care. Methods: We conducted scenario-based tests combined with in-depth interviews among 14 caregivers and 14 patients/consumers to describe the use of various self-care applications and the accompanying user problems. We focused on the user-friendliness of the applications, the quality of care provided by the applications, and the implementation of the applications in practice. Results: Problems with the user-friendliness of the self-care applications concerned inadequate navigation structures and search options and lack of feedback features. Patients want to retrieve health information with as little effort as possible; however, the navigation and search functionalities of the applications appeared incapable of handling patients’ health complaints efficiently. Among caregivers, the lack of feedback and documentation possibilities caused inconvenience. Caregivers wanted to know how patients acted on their advice, but the applications did not offer an adequate feedback feature. Quality of care problems were mainly related to insufficient tailoring of information to patients’ needs and to efficiency problems. Patients expected personalized advice to control their state of health, but the applications failed to deliver this. Language (semantics) also appeared as an obstacle to providing appropriate and useful self-care advice. Caregivers doubted the reliability of the computer-generated information and the efficiency and effectiveness of secure email consultation. Legal or ethical issues with respect to possible misuse of email consultation also caused concerns. Implementation problems were mainly experienced by caregivers due to unclear policy on email consultation and the lack of training for email consultations. Conclusions: Patients’ and caregivers’ expectations did not correspond with their experiences of the use of the Internet-based applications for self-care. Patients thought that the applications would support them in solving their health problems. Caregivers were more reserved about the applications because of medico-legal concerns about misuse. However, the applications failed to support self-care because eHealth is more than just a technological intervention. The design of the applications should include a way of thinking about how to deliver health care with the aid of technology. The most powerful application for self-care was secure email consultation, combined with a suitable triage mechanism to empower patients’ self-awareness. Future research should focus on the effectiveness of such Web-based triage mechanisms for medical complaints and on the development of interactive features to enhance patients’ self-care.
Description: Reviewer: Umefjord, Goran
Reviewer: Tjora, Aksel
URI: http://dx.doi.org/ 10.2196/jmir.957
ISSN: 1438-8871
Rights: © Nicol Nijland, Julia van Gemert-Pijnen, Henk Boer, Michaël F Steehouder, Erwin R Seydel. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.05.2008. Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided 1) the original work is properly cited, including full bibliographic details and the original article URL on www.jmir.org, and 2) this statement is included.
Appears in Collections:Volume 10 (2008)

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