https://www.mdu.se/

Background: The use of digital technology in higher education can enhance students’ motivation, knowledge and skills. In medical and nursing education, digital scenario-based simulation is an evidence-based way to improve skills and knowledge. In physiotherapy, a biopsychosocial and person-centred approach is recommended to support self-management and promote health-related behaviour changes in patients. Using Experiential Learning Theory (ELT) in developing simulation tools can support students’ learning and confidence. The aim of this study was to explore content and features desired by stakeholders for the development of a digital scenario-based simulation prototype to stimulate physiotherapy students’ learning of clinical skills.Summary of work: Four co-design workshops with 5-10 participants, including two physiotherapy students, one newly graduated physiotherapist, four educators, four clinical instructors and one representative from an educational company, were conducted. The participants discussed and presented ideas for the desired content and features of the digital scenario-based simulation. ELT and Kolb’s learning cycle were used to encourage discussion and idea presentation and in the analysis.Summary of results: The preliminary results highlight desired key content and features: interactive reality-based patient cases with video and audio recordings to create realistic experiences; individual and peer reflection through reflective questions and self-recording videos; varied examples of formulated analysis, hypotheses, SMART goals and interpretation of patient information with encouragement to formulate these independently; support for making choices, prioritizing and decision-making, with opportunities to follow up on decisions and evaluate outcomes. Participants emphasized the importance of contextual pedagogical elements providing constructive feedback, flexibility to individual needs, and user-friendly, engaging design with gamification features.Discussion and Conclusion:  Overall, the participants desired content and features that align with simulations in medical and nursing education. However, what uniquely distinguished the desired content and features for physiotherapy was the emphasis on supporting learning a holistic and person-centered approach, including setting individual goals and creating personalized treatment plans. The importance of long-term patient follow-up and outcome evaluation was also highlighted. Given that digital scenario-based simulation is relatively unexplored in physiotherapy, these findings are particularly significant. These insights may also be relevant for other health professions to adopt a holistic and person-centered approach.

Introduction

Musculoskeletal conditions are a significant global health problem. The demand for specialized and individualized care is increasing. This necessitates that physiotherapy (PT) education better equips students with clinical skills needed for clinical practice, during education and in future professional work.

Objective

To explore stakeholders’ perceptions of PT students’ clinical skills training needs within the musculoskeletal area in undergraduate PT education.

Methods

Semistructured focus groups and interviews were conducted with stakeholders from multiple undergraduate PT programs and clinical settings in Sweden, including PT students (n = 18), newly graduated physiotherapists (n = 3), educators (n = 5) and clinical instructors (n = 8). This study employed a qualitative design using inductive content analysis.

Results

One overarching main category, comprehensive clinical skills training in a supportive and reality-based education, and four categories emerged, each comprising 3–5 subcategories describing the stakeholders’ perceptions of PT students’ clinical skills training needs. The four categories are 1: Experiencing real or reality-based patient cases, 2: Applying knowledge and clinical skills, 3: Analyzing patient information and making clinical decisions, and 4: Having a supportive learning environment.

Conclusion

To better prepare PT students for clinical practice in the musculoskeletal area, stakeholders perceive students need comprehensive clinical skills training within a supportive and reality-based educational environment that facilitates reflective abilities. Engaging in diverse realistic patient encounters may enhance their ability to apply knowledge and skills in patient interactions, as well as strengthen their analytical and clinical decision-making abilities. Clinical reasoning and communication skills were emphasized over procedural skills.

BackgroundDespite evidence that structured, multidisciplinary care for people with advanced heart failure (AHF) significantly enhances patients' quality of life, critical questions remain regarding how such care should be optimally designed. To improve the quality of life for people with AHF, healthcare professionals must deepen their understanding of what these patients genuinely need and how best to meet them in their illness trajectory.AimTo describe patients' experience of living with advanced heart failure in Sweden.MethodsFifteen patients with AHF from a medium-sized hospital in Sweden were recruited for a qualitative interview study. Content analyses were conducted.ResultsLiving with AHF was viewed as life changing. The overarching theme, To live in the present, describes the participants' overall experience of their life situation. Four categories and ten subcategories were identified. The four categories were: Symptoms affecting life, Making the most out of life given, Coping with emotions, and To be a part of health care.ConclusionThis study provides valuable insights in how patients with AHF experience their life and need care. The results highlight the need for health care to provide support to help patients cope with emotional, social, spiritual and practical everyday life situations to ease self-care.

Older adults are a heterogeneous population for which many e-health innovations are inaccessible. Involving older adults in user-centered design (UCD) with a specific focus on inclusive design is important to make e-health more accessible to this user group. This case study aimed to explore the feasibility of a new UCD approach aiming to minimize bias in the design phase of a digital support for older adults’ physical activity (PA). The study used mixed methods and applied UCD principles in a four-iteration design phase followed by an evaluation phase where 11 and 15 older adults participated, respectively. The users’ gender, PA level and technology experience (TE) were considered in recruitment, data analysis and prioritization of improvement efforts. In the design phase, users with different gender, PA level and TE participated and contributed with feedback, which was prioritized in the development. The adaptation included improving readability, simplifying layout and features, clarifying structure, and making the digital content more inclusive and relevant. The evaluation showed that the users had a positive experience of the prototype and could use it with some help. The study demonstrated that adopting e-health to assure digital inclusion among older adults must address several aspects. The UCD approach was feasible for amending user bias and for confirming that users of both genders and with varied PA- and TE level shaped the design. However, evaluation of the method with larger samples is needed. Moreover, further research on methods to involve digitally excluded populations in UCD is needed.

Background: Because poor health in youth risk affecting their entry in adulthood, improved methods for their early identification are needed. Health and welfare technology is widely accepted by youth populations, presenting a potential method for identifying their health problems. However, healthcare technology must be evidence-based. Specifically, feasibility studies contribute valuable information prior to more complex effects-based research. The current study assessed the process, resource, management, and scientific feasibility of the Youth Health Report System prototype, developed within a youth health clinic context in advance of an intervention study. Methods: This mixed-methods feasibility study was conducted in a clinical setting. The process, resource, management, and scientific feasibility of the Youth Health Report System were investigated, as recommended in the literature. Participants were youth aged 16–23 years old, attending a youth health clinic, and healthcare professionals from three clinics. The youth participants used their smart phones to respond to Youth Health Report System health questions and healthcare professionals used their computer to access the results and for registration system entries. Qualitative data were collected from interviews with healthcare professionals, which were described with thematic analysis. Youth participants’ quantitative Youth Health Report System data were analyzed for descriptive statistics. Results: Feasibility analysis of qualitative data from interviews with 11 healthcare professionals resulted in three themes: We expected it could be hard; Information and routines helped but time was an issue; and The electronic case report form was valuable in the health assessment. Qualitative data were collected from the Youth Health Report System. A total of 54 youth participants completed the evaluation questionnaire, and healthcare professionals retrieved information from, and made post-appointment system entries. Quantitative results revealed few missing items and acceptable data variability. An assessment template of merged qualitative and quantitative data guided a consensus discussion among the researchers, resulting in acceptable feasibility. Conclusions: The process-, resource-, management-, and scientific feasibility aspects were acceptable, with some modifications, strengthening the potential for a successful Youth Health Report System intervention study.

Introduction Poor mental health in young people has become a growing problem globally over the past decades. However, young people have also been shown to underutilize available healthcare resources. The World Health Organisation (WHO) has formulated guidelines for youth-friendly health services (YFHSs) to increase youth participation in healthcare. Still, little is known about how young people using these services perceive mental health, indicating a knowledge gap concerning the subjective evaluation of their mental health.Aim To investigate how young people visiting youth health clinics (YHC) perceive the concept of mental health and factors they view as central to maintaining mental health.Methods In total 21 interviews were carried out, 16 in 2018, and 5 in 2023 to assure no changes in findings after the COVID-19 pandemic. Subjects were recruited during visits to youth health clinics (YHCs) in mid-Sweden and were aged 15-23 years. Recruitment strived to achieve heterogeneity in the sample concerning gender, sexual orientation, gender identity and age. Interviews were transcribed and analysed using qualitative content analysis.Findings Findings of the analysis revealed two themes, "Mental health is helped and hindered by the surroundings" and "Mental health is difficult to understand and difficult to achieve". The participants described their health as highly dependent on their social surroundings, and that these are important to maintaining health but may also affect health negatively. They described mixed experiences of the health care services and mentioned prerequisites for seeking care for mental health problems such as accessibility and respect for their integrity, including the right to turn down offered treatment. The informants also viewed mental health as an ongoing undertaking that one must work for, and that it is sometimes difficult to know what constitutes mental health. They also expressed a need from healthcare services to enquire about their health, and to show an active interest in how they are doing.Conclusions Findings underline the need of young people's individual needs to be met in the healthcare system and their vulnerability to their social surroundings. Health status assessments in young people should consider social and individual factors to fully capture mental health.

Background: Electronic Patient-Reported Outcomes (ePROs) have potential to improve health outcomes and healthcare. The development of health-technology applications, such as ePROs, should include the potential users and be theoretically grounded. Swedish Youth Health Clinics (YHCs) offer primarily sexual and psychological healthcare for young people aged 12 to 25 years old. Young people in healthcare settings are considered a vulnerable group. The development of a collection of Patient-Reported Outcomes (PROs) in an Electronic Health Report Form (eHRF) for identifying health and health-related problems in young people, was preceded by a qualitative interview study, exploring young people’s views on using an eHRF at YHCs and which questions about health an eHRF should contain. The aim of the current study was to develop and evaluate the usability of an eHRF prototype for identifying health and health-related problems in young people visiting YHCs. Methods: This study used a participatory design. During the development, an expert panel consisting of eight researchers and one Information Technology worker, participated. A wide literature search was performed to find PROs to construct an eHRF prototype to cover health areas. A mixed methods usability evaluation included 14 participants (young people, healthcare professionals, and an expert panel). Results: The development resulted in an eHRF prototype, containing ten reliable and valid health questionnaires addressing mental-, physical-, and sexual health and social support, a self-efficacy question, and background questions, in total 74 items. The interviews in the usability evaluation resulted in three categories describing the usability of the eHRF: ‘Captures the overall health of young people but needs clarification’, ‘Fun, easy, and optional and will keep young people’s interest’, and ‘Potential contribution to improve the health consultation’. The quantitative results support the usability of the eHRF for YHCs. Conclusions: The participatory approach contributed to development of the eHRF prototype to cover health areas adapted for the target population. The usability evaluation showed that the eHRF was usable and had the potential for self-reflection and contributions to cooperation between young people and healthcare professionals during the health consultation.

Background

Many seniors need to increase their physical activity (PA) and participation in fall prevention exercise. Therefore, digital systems have been developed to support fall-preventive PA. Most of them lack video coaching and PA monitoring, two functionalities that may be relevant for increasing PA.

Objective

To develop a prototype of a system to support seniors' fall-preventive PA, which includes also video coaching and PA monitoring, and to evaluate its feasibility and user experience.

Methods

A system prototype was conceived by integrating applications for step-monitoring, behavioural change support, personal calendar, video-coaching and a cloud service for data management and co-ordination. Its feasibility and user experience were evaluated in three consecutive test periods combined with technical development. In total, 11 seniors tested the system at home for four weeks with video coaching from health care professionals.

Results

Initially, the system's feasibility was non-satisfactory due to insufficient stability and usability. However, most problems could be addressed and amended. In the third (last) test period, both seniors and coaches experienced the system prototype to be fun, flexible and awareness-raising. Interestingly, the video coaching which made the system unique compared to similar systems was highly appreciated. Nonetheless, even the users in the last test period highlighted issues due to insufficient usability, stability and flexibility. Further improvements in these areas are needed.

Conclusions

Video coaching in fall-preventive PA can be valuable for both seniors and health care professionals. High reliability, usability and flexibility of systems supporting seniors are essential.

Background: Young people in different healthcare settings are positive about using electronic patient-reported outcomes (ePROs), which are meant to increase the effectiveness and safety of interventions from the patient's perspective. Sweden offers free healthcare to young people aged 12-25 years at 275 youth health clinics (YHCs), whose goals are to strengthen young people and promote sexual, physical, and mental health. YHCs need effective ways to identify the overall picture of young people's health and health-related problems. To our knowledge, there is no ePRO for YHCs that provides an overview of young people's health from several health perspectives. The aim of this study was to explore young people's view on content and design of an ePRO to provide an overview of their health and health related problems when visiting a YHC, and their opinion on what healthcare needs to consider when using the ePRO. This was an explorative qualitative study. The participants were included from five YHCs, in different socioeconomic areas in central Sweden. Fifteen participants were included: 10 girls, three boys, and two non-binary participants with an age range of 16-22 years. Data were collected using a semi-structured interview guide and individual interviews, and inductive content analysis was performed.

Results: One main theme, "ePRO created based on my needs is worth using" and two sub-themes, "Appealing content and design" and "Trusting healthcare", emerged. The participants wanted that an ePRO should include overall questions about mental-, physical-, and sexual health and social support. Participants also believed the ePRO must disclose the risks of self-harm or suicide. The participants noted the importance of emotional and digital security when using the ePRO and having a confidential conversation with a healthcare provider. To share health information means to trust to gain health.

Conclusions: The study participants' views on content and design can form the basis for designing an ePRO for young people. Their thoughts on safety and treatment in healthcare can be considered in the development process. This study is the starting point for developing an ePRO for young people at YHCs.

Background: An increasing number of patients expect and want to play a greater role in their treatment and care decisions. This emphasizes the need to adopt collaborative health care practices, which implies collaboration among interprofessional health care teams and patients, their families, caregivers, and communities. In recent years, digital health technologies that support self-care and collaboration between the community and health care providers (ie, participatory health technologies) have received increasing attention. However, knowledge regarding the features of such technologies that support effective patient-professional partnerships is still limited. Objective: This study aimed to map and assess published studies on participatory health technologies intended to support partnerships among patients, caregivers, and health care professionals in chronic care, focusing specifically on identifying the main features of these technologies. Methods: A scoping review covering scientific publications in English between January 2008 and December 2020 was performed. We searched PubMed and Web of Science databases. Peer-reviewed qualitative, quantitative, and mixed methods studies that evaluated digital health technologies for patient-professional partnerships in chronic care settings were included. The data were charted and analyzed thematically. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist was used. Results: This review included 32 studies, reported in 34 papers. The topic of participatory health technologies experienced a slightly increasing trend across publication years, with most papers originating from the United States and Norway. Diabetes and cardiovascular diseases were the most common conditions addressed. Of the 32 studies, 12 (38%) evaluated the influence of participatory health technologies on partnerships, mostly with positive outcomes, although we also identified how partnership relationships and the nature of collaborative work could be challenged when the roles and expectations between users were unclear. Six common features of participatory health technologies were identified: patient-professional communication, self-monitoring, tailored self-care support, self-care education, care planning, and community forums for peer-to-peer interactions. Conclusions: Our findings emphasize the importance of clarifying mutual expectations and carefully considering the implications that the introduction of participatory health technologies may have on the work of patients and health care professionals, both individually and in collaboration. A knowledge gap remains regarding the use of participatory health technologies to effectively support patient-professional partnerships in chronic care management.