Background: A growing body of evidence supports the efficacy of eHealth interventions in coping with a variety of illnesses and disorders, including short- and long-term pain conditions. The efficacy and continued use of eHealth treatment programs depend not only on content and technology but also on the patients’ motivation, acceptance and adherence. Despite interest from patients, existing chronic pain eHealth studies have experienced high attrition rates. New interventions are necessary, focusing specifically on patients’ needs, perspectives, expectations and context of use. Aim: The present study seeks to identify the unmet informational and support needs of patients with chronic pain, and to investigate how an eHealth intervention can be designed to address these needs. In doing this, caregivers experiences and needs are included. Users’ requirements for functionality and design are also explored. Method: Individual interviews were conducted with patients living with different chronic pain conditions (N=15; e.g., neuropathic pain, musculoskeletal pain and rheumatic pain). Treatment backgrounds varied, ranging from general practitioners’ visits and physical therapy in primary health care to more specialized treatments in secondary health care. Caregivers (spouses; N=5) were also interviewed to provide insight into caregivers’ experiences, needs and perspectives and to gain a deeper understanding of the patient group. Results: Interviews provided insight into needs and wishes of patients and their caregivers living with chronic pain related to everyday life and coping. The need for mastery, normalization and activity pacing were highlighted. Furthermore, the need for a positive distraction, especially in relation to high pain levels, stressful situations and struggles with sleep were expressed by both groups. Preferences as to design of an eHealth tool, type of platform and privacy issues were identified, showing accessibility to be a key factor for user adoption. Conclusions: The study provides important knowledge about the everyday needs of patients with chronic pain and their preferences in relation to a digital pain management intervention. Possible areas where an eHealth intervention might support existing treatments, such as learning and mastery courses, are also identified. Results give direction for further development and prototyping of an intervention that will ultimately be tested in a randomized controlled trial.
To increase the adherence to eHealth and mHealth tools gameful designs are becoming commonplace, and to be successful, these designs need to both be suitable for and meet the needs and expectations of its users. As a group, people living with chronic illnesses has challenges not experienced by the general population. This study presents early findings from an activity in a co-design workshop, done with three different groups of chronic patients, investigating what games the participants like or dislike and what they find engaging and motivating when playing these.
e-health programs carry promise to support self-management of chronic illness, including chronic pain. Whether such programs succeed depends not only on patients' acceptance and adherence, but also on health care providers’ attitudes and willingness to support the use of such programs. Health care providers working with chronic pain have a focal role in supporting patients’ coping with pain, and their input is therefore essential for the development and utility of any tool in management of chronic pain. Using service design methods, the present study seeks to; 1) explore health care providers’ experiences and challenges in chronic pain management, and 2) identify health care providers’ needs, requirements and potential challenges to usage of a chronic pain e-health program. Semi-structured individual interviews were conducted with healthcare providers (N=12; i.e., an anaesthesiologist, general practitioners, psychologists, a psychiatrist, physical therapists, a registered nurse and an occupational therapist) across health service levels, all working within chronic pain management. The interviews provide insight into health care providers’ challenges and unmet needs in management of chronic pain, as well as their prerequisites and necessities for making a chronic pain e-health program usable and efficient. The interviews reveal that health care providers often feel at a loss due to the complexity of the many challenges presented by chronic pain patients. Findings indicate a need for a common explanatory model for chronic pain across health care providers. Findings also underline lack of time to explain and provide a biopsychosocial understanding of pain for patients, and to guide the promotion and acquirement of appropriate pain coping strategies. The results emphasize the utility and potential benefit of an e-health program in a) structuring treatment and follow-up of chronic pain patients in health care practices, and b) identifying important aspects of self-management of chronic pain. Health care providers’ preferences for the intervention's content, context of use, and platform type are identified, as well as potential challenges and obstacles for implementation and use of such a technological program in health care practices. The analysis identifies health care providers' preferences for the intervention's content, context of use, and platform type; as well as potential challenges and obstacles for implementation and use of such a technological program in health care practices. In conclusion, findings present valuable guidance from health care providers to be considered in building, prototyping and testing a chronic pain e-health self-management program.
Background/Purpose: A cancer diagnosis and subsequent treatment can be traumatic and presents with a multitude of challenges and stressors. Psychosocial interventions have the potential to facilitate psychological adaptation and improved coping under such circumstances. However, for a variety of reasons such interventions are not always available or attainable. To address this issue, this project combines well-established stress-management interventions for patients with cancer with cutting edge computerized technology, creating an innovative and accessible app-based cognitive behavioral stress management intervention (i.e., StressProffen) available for cancer patients. Phase I (design, development and pilot testing) in this project will be presented. Methods: The study employs participatory and service design and the intervention app is developed in close collaboration between health care personnel, cancer patients (i.e., users), behavioral scientists, eHealth specialists and IT designers/developers. All intervention content is anchored in evidence based stress management psychosocial oncology interventions. Design and development is complete and pilot testing will be complete December 2016. Pilot testing involves adult Norwegians (N=20) representing the most common cancer diagnoses in Norway (i.e., breast-, prostate-, lung-, colon-, bladder-, ovarian-, or skin cancer). Results: Qualitative results will be reported on design, development and pilot testing. Quantitative results will be reported on the pilot test. Conclusion and Implications: Psychosocial interventions for cancer patients are not always available. This study has designed, developed and is pilot testing (Phase I) an intervention app; StressProffen, for stress management in cancer. Phase II will test the app with repeated measures in a randomized controlled trial, examining impact on stress, distress, quality of life, self-regulation and health behaviors. If effective, the intervention app has the potential to improve or maintain well-being, self-management and sense of self-control for patients living with cancer. The intervention can provide extensive outreach, improved flexibility and high accessibility for a diverse group of cancer patients.
Background: eHealth interventions have the potential to support patients in self-managing their illness, improve quality of life and enhance self-efficacy. Despite interest from patients and their health care providers, eHealth interventions are seldom used as intended and have high attrition rates. To avoid this, it is important to ensure that the interventions are designed in line with the users’ requirements and contexts. Therefore, at Center for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, we use Service Design methods to involve end-users and other stakeholders in the whole process of design and development of eHealth interventions. This presentation will show how we integrate the Service Design methods into our work, by showing some examples. Materials and Methods: Service Design (Stickdorn & Schneider 2011) is used as an approach to support the entire design and development process, aiming to elicit user wants and needs, and identifying how to best fit the eHealth intervention into the daily routines of patients and health care providers. Together with researchers and software developers, patients and health care providers are involved at each stages of intervention development. In the initial phase we use methods such as interviews and focus groups with stakeholders to identify their needs and requirements and observations to identify contextual conditions. The results are summarized into for example intervention Journey maps (“road maps”) or Personas (fictive patient characters). Based on gained insights, the next phases include series of workshops, where we together define opportunities, get inspiration, co-create ideas and develop intervention prototypes. Prototypes are then iteratively tested, validated and adapted through series of formative evaluations, using methods such as usability testing, think-aloud protocol, before the interventions are ready for final efficacy trials. Results: We will present some examples of how Service Design methods can be used to involve different stakeholders into design and development of eHealth intervention. The close collaboration between researchers, software developers, patients and health care providers creates a genuine platform to develop solutions which are inspired by genuine behaviors, contexts and needs. Conclusions: Even if the involvement of patients and health care providers is time-consuming and there is need for careful facilitation, the Service Design approach is useful for creating eHealth and other healthcare interventions that are in line with the users’ needs and requirements. In this way, we are able to create interventions that people want to use, and thus contributes in creating better health for people.
In literature there are different projects showing how new information and communications technology (ICT) systems can be used for enhancing communication between and among patients and clinicians over Internet. Besides advantages these systems offer to both patients and clinicians there is also great concern that utilizing new technologies can limit and negatively influence patient-clinician face-to-face communication. This paper underlines these concerns and describes two projects in our research center that promote more effective offline patient-clinician communication.