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  • 1.
    Aminoff, Hedvig
    et al.
    KTH, Skolan för kemi, bioteknologi och hälsa (CBH), Medicinteknik och hälsosystem.
    Meijer, Sebastiaan
    KTH, Skolan för kemi, bioteknologi och hälsa (CBH), Medicinteknik och hälsosystem, Hälsoinformatik och logistik.
    Groth, Kristina
    Arnelo, Urban
    User Experience in Remote Surgical Consultation: Survey Study of User Acceptance and Satisfaction in Real-Time Use of a Telemedicine Service2021Inngår i: JMIR Human Factors, E-ISSN 2292-9495, E-ISSN 2292-9495, Vol. 8, nr 4, s. e30867-e30867Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Teleguidance, a promising telemedicine service for intraoperative surgical consultation, was planned to scale upat a major academic hospital in partnership with 5 other hospitals. If the service was adopted and used over time, it was expectedto provide educational benefits and improve clinical outcomes during endoscopic retrograde cholangiopancreatography (ERCP),which is a technically advanced procedure for biliary and pancreatic disease. However, it is known that seemingly successfulinnovations can play out differently in new settings, which might cause variability in clinical outcomes. In addition, few telemedicineservices survive long enough to deliver system-level outcomes, the causes of which are not well understood.Objective: We were interested in factors related to usability and user experience of the telemedicine service, which might affectadoption. Therefore, we investigated perceptions and responses to the use and anticipated use of a system. Technology acceptance,a construct referring to how users perceive a technology’s usefulness, is commonly considered to indicate whether a new technologywill actually be used in a real-life setting. Satisfaction measures were used to investigate whether user expectations and needshave been met through the use of technology. In this study, we asked surgeons to rate the perceived usefulness of teleguidance,and their satisfaction with the telemedicine service in direct conjunction with real-time use during clinical procedures.Methods: We designed domain-specific measures for perceived usefulness and satisfaction, based on performance and outcomemeasures for the clinical procedure. Surgeons were asked to rate their user experience with the telemedicine service in directconjunction with real-time use during clinical procedures.Results: In total, 142 remote intraoperative consultations were conducted during ERCP procedures at 5 hospitals. The demandfor teleguidance was more pronounced in cases with higher complexity. Operating surgeons rated teleguidance to have contributedto performance and outcomes to a moderate or large extent in 111 of 140 (79.3%) cases. Specific examples were that teleguidancewas rated as having contributed to intervention success and avoiding a repeated ERCP in 23 cases, avoiding 3 PTC, and 11referrals, and in 11 cases, combinations of these outcomes. Preprocedure beliefs about the usefulness of teleguidance weregenerally lower than postprocedure satisfaction ratings. The usefulness of teleguidance was mainly experienced through practicaladvice from the consulting specialist (119/140, 85%) and support with assessment and decision-making (122/140, 87%).Conclusions: Users’ satisfaction with teleguidance surpassed their initial expectations, mainly through contribution to nontechnicalaspects of performance, and through help with general assessment. Teleguidance shows the potential to improve performance and outcomes during ERCP. However, it takes hands-on experience for practitioners to understand how the new telemedicineservice contributes to performance and outcomes.

    Fulltekst (pdf)
    fulltext
  • 2.
    Darwich, Adam S.
    et al.
    KTH, Skolan för kemi, bioteknologi och hälsa (CBH), Medicinteknik och hälsosystem, Hälsoinformatik och logistik.
    Bostroem, Anne-Marie
    Karolinska Inst, Div Nursing, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Theme Inflammat & Aging, Huddinge, Sweden.;Stockholms Sjukhem, Res & Dev Unit, Stockholm, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Hlth, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.;Karolinska Univ Hosp, Med Unit Occupat Therapy & Physiotherapy, Theme Womens Hlth & Allied Profess, Stockholm, Sweden..
    Raghothama, Jayanth
    KTH, Skolan för kemi, bioteknologi och hälsa (CBH), Medicinteknik och hälsosystem, Hälsoinformatik och logistik.
    Meijer, Sebastiaan
    KTH, Skolan för kemi, bioteknologi och hälsa (CBH), Medicinteknik och hälsosystem, Hälsoinformatik och logistik.
    Investigating the Connections Between Delivery of Care, Reablement, Workload, and Organizational Factors in Home Care Services: Mixed Methods Study2023Inngår i: JMIR Human Factors, E-ISSN 2292-9495, Vol. 10, artikkel-id e42283Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Home care is facing increasing demand due to an aging population. Several challenges have been identified in the provision of home care, such as the need for support and tailoring support to individual needs. Goal-oriented interventions, such as reablement, may provide a solution to some of these challenges. The reablement approach targets adaptation to disease and relearning of everyday life skills and has been found to improve health-related quality of life while reducing service use.Objective: The objective of this study is to characterize home care system variables (elements) and their relationships (connections) relevant to home care staff workload, home care user needs and satisfaction, and the reablement approach. This is to examine the effects of improvement and interventions, such as the person-centered reablement approach, on the delivery of home care services, workload, work-related stress, home care user experience, and other organizational factors. The main focus was on Swedish home care and tax-funded universal welfare systems.Methods: The study used a mixed methods approach where a causal loop diagram was developed grounded in participatory methods with academic health care science research experts in nursing, occupational therapy, aging, and the reablement approach. The approach was supplemented with theoretical models and the scientific literature. The developed model was verified by the same group of experts and empirical evidence. Finally, the model was analyzed qualitatively and through simulation methods.Results: The final causal loop diagram included elements and connections across the categories: stress, home care staff, home care user, organization, social support network of the home care user, and societal level. The model was able to qualitatively describe observed intervention outcomes from the literature. The analysis suggested elements to target for improvement and the potential impact of relevant studied interventions. For example, the elements "workload" and "distress" were important determinants of home care staff health, provision, and quality of care.Conclusions: The developed model may be of value for informing hypothesis formulation, study design, and discourse within the context of improvement in home care. Further work will include a broader group of stakeholders to reduce the risk of bias. Translation into a quantitative model will be explored.

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