Mette Juel Rothmann

Participatory design methods in telemedicine research

Healthcare systems require a paradigm shift in the way healthcare services are delivered to counteract demographic changes in patient populations, expanding technological developments and the increasing complexity of healthcare. Participatory design (PD) is a methodology that promotes the participation of users in the design process of potential telehealth applications. A PD project can be divided into four phases including: the identification and analysis of participant needs; the generation of ideas and development of prototypes; testing and further development of prototypes; and evaluation. PD is an iterative process where each phase is planned by reflecting on the results from the previous phase with respect to the participants’ contribution. Key activities of a PD project include: fieldwork; literature reviewing; and development and testing. All activities must be applied with a participatory mindset that will ensure genuine participation throughout the project. Challenges associated with the use of PD include: the time required to properly engage with participants; language and culture barriers amongst participants; the selection of participants to ensure good representation of the user group; and empowerment. PD is an important process, which is complemented by other evaluation strategies that assess organisational requirements, clinical safety, and clinical and cost effectiveness. PD is a methodology which encourages genuine involvement, where participants have an opportunity to identify practical problems and to design and test technology. The process engages participants in storytelling, future planning and design. PD is a multifaceted assessment tool that helps explore more accurately clinical requirements and patient perspectives in telehealth.

Usage of an Exercise App in the Care for People With Osteoarthritis: User-Driven Exploratory Study

Background Exercise has proven to reduce pain and increase quality of life among people living with osteoarthritis (OA). However, one major challenge is adherence to exercise once supervision ends. Objective This study aimed to identify mental and physical barriers and motivational and social aspects of training at home, and to test or further develop an exercise app. Methods The study was inspired from participatory design, engaging users in the research process. Data were collected through focus groups and workshops, and analyzed by systematic text condensation. Results Three main themes were found: competition as motivation, training together, and barriers. The results revealed that the participants wanted to do their training and had knowledge on exercise and pain but found it hard to motivate themselves. They missed the observation, comments, and encouragement by the supervising physiotherapist as well as their peers. Ways to optimize the training app were identified during the workshops as participants shared their experience. Conclusions This study concludes that the long-term continuation of exercising for patients with OA could be improved with the use of a technology tailored to users’ needs, including motivational and other behavioral factors.

Experiences of being diagnosed with osteoporosis: a meta-synthesis

SummaryThis systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient’s point of view. Using individuals’ experiences and meanings can promote tailored and targeted information and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory.IntroductionTo be diagnosed with osteoporosis with or without fragility fractures affects individuals differently. The aim of this review was firstly to aggregate existing qualitative evidence regarding an individual’s experience of being diagnosed with osteoporosis at different stages, and secondly, to use a systematic approach to develop a conceptual understanding of central issues relevant for health professionals in order to provide support and guidance to patients/individuals.MethodsThis study used a systematic review methodology and methods for qualitative synthesis as recommended by Cochrane and integrated the findings of qualitative research from eight databases (Medline, PubMed, CINAHL, Embase, SweMed+, PsycINFO, ERIC, Web of Science) to July 2016. Selection and assessment were performed by three authors while four authors were involved in the analysis. Findings were cross-checked with the original article to ensure consistency with the individual’s accounts.ResultsOur findings have revealed that individuals diagnosed with osteoporosis do not perceive osteoporosis as a biomedical trajectory but as a self-perceived continuum of severity and health. To be diagnosed with osteoporosis affects individuals differently depending on, for example, personal experience, pre-conceived notions of or knowledge about the disease, fragility fractures or pain. Hence, individuals will create a meaning of the diagnosis based on self-perceived fracture risk, self-perceived severity of osteoporosis and at the same time, self-perceived health.ConclusionsThis meta-synthesis provides knowledge for health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient’s point of view. The experience, meaning and significance of osteoporosis must be taken into consideration and can be used to promote tailored and targeted information and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory.

Blogs - Læringsfællesskab med rum til refleksion

Anvendelse af blogs i laeringssituationer kan give studerende mulighed for at reflektere i faellesskab. Derfor blev blogs afprovet blandt universitetsstuderende med det formal at undersoge, hvordan studerende oplever anvendelsen af blogmediet, samt undersoge hvilke former for refleksion, som blogs kan understotte. Undersogelsen var baseret pa en sociokulturel forstaelse af laering, hvor laering ses som en proces, der konstrueres gennem interaktioner. Blogs blev afprovet som en del af et undervisningsforlob for 24 studerende. Blogindlaeggene blev analyseret mhp at identificere refleksionsniveauet, og der blev gennemfort et fokusgruppeinterview med fem studerende for at afdaekke de studerendes oplevelser med at blogge. Konklusionen er at blogmediet tilbyder et laeringsfaelleskab, som giver de studerende mulighed for refleksion. Desuden tyder det pa, at muligheden for refleksion forringes ved uklarhed over opgaven og usikkerhed pa hvordan blogmediet anvendes. Endelig kan anvendelsen af blogs i laeringssituationer udfordre de gaengse opfattelser af laering, hvilket kan skabe forvirring hos de studerende.

Evidence for Medical treatment for tertiary prophylaxis of osteoporosis

Fracture Prevention Programmes have been shown to increase both the number of patients offered bone scans and the uptake of pharmaceutical therapy, thus potentially reducing the number of further fractures. Cost-effectiveness analyses suggest that such programmes may be net cost-saving. We recommend that Fracture Prevention Programmes be developed and implemented to ensure that patients presenting with fractures are offered diagnosis and treatment for osteoporosis.