Ulrika Josefsson

Patients creating self-help on the internet -lessons for future design of internet based healthcare resources

This paper reports from an ongoing research work on patients¿ use of the Internet for medical information with special focus on how this can inform the design of future IT use in the healthcare ¿ patient relationship. The paper explores the process of initiating patient communities online as a way of coping and making sense of a difficult life situation when facing illness. The purpose of the paper is to analyze this process in order to increase our understanding of what triggers some individuals to put the technology to use in order to create online communities for patients. A better understanding of these processes is believed to be important both to increase our knowledge of the activities as an online phenomenon but also to inform the design of future information technology use. A descriptive qualitative design of the study was used and ten face-to-face, semi-structured interviews were conducted with purposefully selected patients who share the experience of initiating and managing online communities. In addition, online observations of 15 communities were performed mainly focusing their general structure and design. On a general level it is concluded that the initiation of patients¿ online community building is grounded in personal coping processes involving a complex mix of different coping strategies rather than as direct and purposeful action in order to fulfill group specific purposes. In addition it is suggested that the experiences and the knowledge developed by the patients during this process can be a valuable resource both in the design and in the maintenance of information technology support used in the healthcare ¿ patient relationship.

Elaborate Change Management: Improvisational Introduction of Groupware in Public Sector

This paper deals with the issue of how the use of a plan can improve change management when introducing groupware in the public sector, using an improvisational perspective. The research is based on an empirical study at a municipal administration investigating changes in the work situation after the implementation of groupware. When an improvisational model of change management was applied certain development possibilities of the model and its use appeared. Firstly, the model does not acknowledge anticipated changes that do not occur in practice. Secondly, we argue that a more active utilization of a plan enables guidance of the process. Finally, we emphasize the necessity of translating a plan into a local context.

Person-centred web-based support - development through a Swedish multi-case study

BackgroundDeparting from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons’ needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care.Methods/DesignThe research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described.DiscussionTo allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people’s experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In summary, the main intention of the project outlined here is to contribute with both a synthesis of results on meta-level from four cases and a substantial contribution to the field person-centred care.