Background The workload in health care is increasing and hence, mental health issues are on the rise among health care professionals (HCPs). The digitization of patient care could be related to the increase in stress levels. It remains unclear whether the health information system or systems and digital health technologies (DHTs) being used in health care relieve the professionals or whether they represent a further burden. The mental construct that best describes this burden of technologies is mental workload (MWL). The measurement methods of MWL are particularly relevant in this sensitive setting. Objective This review aimed to address 2 different but related objectives: identifying the factors that contribute to the MWL of HCPs when using DHT and examining and exploring the applied assessments for the measurement of MWL with a special focus on eye tracking. Methods Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement, we conducted a systematic review and processed a literature search in the following databases: MEDLINE (PubMed), Web of Science, Academic Search Premier and CINAHL (EBSCO), and PsycINFO. Studies were eligible if they assessed the MWL of HCPs related to DHT. The review was conducted as per the following steps: literature search, article selection, data extraction, quality assessment (using the Standard Quality Assessment Criteria for Evaluation Primary Research Papers From a Variety of Fields [QualSyst]), data analysis, and data synthesis (narrative and tabular). The process was performed by 2 reviewers (in cases of disagreement, a third reviewer was involved). Results The literature search process resulted in 25 studies that fit the inclusion criteria and examined the MWL of health care workers resulting from the use of DHT in health care settings. Most studies had sample sizes of 10-50 participants, were conducted in the laboratory, and had quasi-experimental or cross-sectional designs. The main results can be grouped into two categories: assessment methods and factors related to DHT that contribute to MWL. Most studies applied subjective methods for the assessment of MWL. Eye tracking did not play a major role in the selected studies. The factors contributing to a higher MWL were clustered into organizational and systemic factors. Conclusions Our review of 25 papers shows a diverse assessment approach toward the MWL of HCPs related to DHT as well as 2 groups of relevant contributing factors to MWL. Our results are limited in terms of interpretability and causality due to methodological weaknesses of the included studies and may be limited by some shortcomings in the search process. Future research should concentrate on adequate assessments of the MWL of HCPs dependent on the setting, the evaluation of quality criteria, and further assessment of the contributing factors to MWL. Trial Registration PROSPERO (International Prospective Register of Systematic Reviews) CRD42021233271; https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42021233271

Background The workload in health care is high; physicians and nurses report high stress levels due to a demanding environment where they often have to perform multiple tasks simultaneously. As a result, mental health issues among health care professionals (HCPs) are on the rise and the prevalence of errors in their daily tasks could increase. Processes of demographic change are partly responsible for even higher stress levels among HCPs. The digitization of patient care is intended to counteract these processes. However, it remains unclear whether these health information systems (HIS) and digital health technologies (DHT) support the HCPs and relieve stress, or if they represent a further burden. The mental construct that describes this burden of technologies is mental workload (MWL). Work in the clinic can be viewed as working in safety-critical environments. Particularly in this sensitive setting, the measurement methods of MWL are relevant, mainly due to their strongly differing levels of intrusiveness and sensitivity. The method of eye tracking could be a useful way to measure MWL directly in the field. Objective The systematic review aims to address the following questions: (1) In which manner do DHT contribute to the overall MWL of HCPs? (2) Can we observe a direct or indirect effect of DHT on MWL? (3) Which aspects or factors of DHT contribute to an increase in MWL? (4) Which methods/assessments are applied to measure MWL related to HIS/DHT? (5) What role does eye tracking/pupillometry play in the context of measuring MWL? (6) Which outcomes are being assessed via eye tracking? Methods Following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement, we will conduct a systematic review. Based on the research questions, we define keywords that we then combine in search terms. The review follows the following steps: literature search, article selection, data extraction, risk of bias assessment, data analysis, and data synthesis. Results We expect results as well as a finalization of the review in the summer of 2021. Conclusions This review will evaluate the impact of DHT on the MWL of HCPs. In addition, assessment methods of MWL in the context of digital technologies will be systematically analyzed. Trial Registration PROSPERO (International Prospective Register of Systematic Reviews) CRD42021233271; https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42021233271 International Registered Report Identifier (IRRID) DERR1-10.2196/29126

Background: Digitisation affects our working environment. It demands new cognitive and digital skills of healthcare employees. Technostress and burnout are more likely to occur due to the additional workload. Aim: Objective is the identification of determinants affecting work related technostress. Methodology: We carried out a systematic review according to the PRISMA statement. For the identification of the digital factors, we applied an inductive content analysis based on Mayring’s theory. Results: Included studies showed the following factors to be relevant for coping with technostress: autonomy, competence, understanding of roles, time pressure, attitude, security and ergonomics. The emerging factors serve the regulation of stress in the healthcare system and contribute to better healthcare and higher occupational safety.

Zusammenfassung Ziel der Studie Angesichts aktueller gesundheitspolitischer Bestrebungen zur eHealth-Implementierung stellt sich die Frage, welche Bevölkerungsgruppen Online-Gesundheitsangebote in Anspruch nehmen, um diese gezielter auf Nutzerbedürfnisse abstimmen zu können. Die Studie untersucht, ob Unterschiede in der Nutzung von Gesundheitsinformationen und psychologischer Online-Beratung auf Basis soziodemografischer und gesundheitsbezogener Merkmale in der deutschen Bevölkerung bestehen. Methodik Die Grundlage für die Querschnittsuntersuchung mithilfe logistischer Regressionsanalysen bildet die Innovationsstichprobe des deutschen sozioökonomischen Panels, das von September 2016 bis Februar 2017 erhoben wurde, mit 4802 Personen im Alter von 17–95 Jahren. Ergebnisse 55% der Befragten gaben an, Gesundheitsinformationen im Netz zu suchen, während 1,1% angaben, Erfahrungen mit Online-Beratung aufzuweisen. Die Onlinesuche nach Gesundheitsinformationen wurde durch das Alter (Odds Ratio (OR)=0,96; 95-%-KI=0,96–0,97), Geschlecht (OR=1,20; 95-%-KI=1,05–1,36), die Bekanntheit von Internettherapien (OR=2,57; 95-%-KI=2,20–3,00), Erfahrung mit Psychotherapie (OR=1,40; 95-%-KI=1,16–1,69) sowie die Diagnosen Asthma (OR=1,14; 95-%-KI=1,01–1,29) oder Schlaganfall (OR=0,66; 95-%-KI=0,52–0,84) signifikant bestimmt. Bei der Nutzung von Online-Beratung erwiesen sich Bekanntheit von Internettherapie und die Erfahrung mit Psychotherapie als signifikante Determinanten. Schlussfolgerung Mit diesem erstmalig gewonnenen, verlässlichen Bild zur Bekanntheit von Internettherapien und zu Determinanten der Nutzung von Online-Gesundheitsangeboten in der deutschen Bevölkerung können zielgruppenspezifische Strategien zur Verbesserung der Versorgungssituation entwickelt werden.

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