Clinicians and patients perspectives on follow-up care and eHealth support after allogeneic hematopoietic stem cell transplantation: A mixed-methods contextual analysis as part of the SMILe study
Autor: | Sabina De Geest, Fabienne Dobbels, SMILe study team, Maria Kunze, Jasper Vanhoof, Lynn Leppla, Oliver Mauthner, Robert Zeiser, Monika Engelhardt, Sabine Valenta, Juliane Mielke, Lut Berben, Alexandra Teynor |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Contextual analysis Health Personnel Aftercare 03 medical and health sciences Young Adult 0302 clinical medicine Nursing Acute care Germany eHealth medicine Humans User-centered design Aged 030504 nursing Oncology (nursing) business.industry Self-Management Hematopoietic Stem Cell Transplantation Chronic care model Integrated care General Medicine Middle Aged Focus group Telemedicine Allogeneic stem cell transplantation Transplantation Context analysis Patient Satisfaction 030220 oncology & carcinogenesis Chronic Disease Implementation science Observational study Female 0305 other medical science business |
Zdroj: | European journal of oncology nursing : the official journal of European Oncology Nursing Society. 45 |
ISSN: | 1532-2122 |
Popis: | PURPOSE: We report on our contextual analysis's methodology, as a first step of an implementation science project aiming to develop, implement, and test the effectiveness of an integrated model of care in SteM-cell transplantatIon faciLitated by eHealth (SMILe). METHODS: We applied an explanatory sequential mixed-methods design including clinicians and patients of the University Hospital Freiburg, Germany. Data were collected from 3/2017 to 1/2018 via surveys in 5 clinicians and 60 adult allogeneic stem-cell transplantation patients. Subsequently, we conducted 3 clinician focus groups and 10 patient interviews. Data analysis followed a 3-step process: (1) creating narrative descriptions, tables, and maps; (2) mapping key observational findings per dimension of the eHealth-enhanced Chronic-Care Model; (3) reflecting on how findings affect our choice of implementation strategies. RESULTS: Current clinical practice is mostly acute care driven, with no interdisciplinarity and weak chronic illness management. Gaps were apparent in the dimensions of self-management support and delivery-system design. Health behaviors that would profit from support include medication adherence, physical activity and infection prevention. The theme "being alone and becoming an expert" underpinned patients need to increase support in hospital-to-home transitions. Patients reported insecurity about recognizing, judging and acting upon symptoms. The theme "eHealth as connection not replacement" underscores the importance of eHealth augmenting, not supplanting human contact. Synthesis of our key observational findings informed eight implementation strategies. CONCLUSION: Stakeholders are willing towards a chronic care-focused approach and open for eHealth support. The contextual information provides a basis for the SMILe model's development and implementation. ispartof: EUROPEAN JOURNAL OF ONCOLOGY NURSING vol:45 ispartof: location:Scotland status: published |
Databáze: | OpenAIRE |
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