Becoming more of an insider: A grounded theory study on patients’ experience of a person-centred e-health intervention

Abstract

Objective The aim was to explore the experiences of a person-centred e-health intervention, in patients diagnosed with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF). Design Grounded theory was applied to gather and analyse data. Setting The study is part of a research project evaluating the effects of person-centred care (PCC) using a digital platform and structured telephone support for people with COPD or CHF recruited from nine primary care units in Sweden. Participants Twelve patients from the intervention group were purposefully selected in accordance with the initial sampling criteria. Intervention The intervention was delivered through a digital platform and telephone support system for 6 months. The intervention relied on person-centred ethics operationalised through three core PCC components: patient narratives, partnership and shared documentation. Results A core category was formulated: Being welcomed through the side door when lacking the front door keys. The core category reflects how a PCC intervention delivered remotely provides access to mutual and informal meetings at times when professional contacts were desired to support patient self-management goals. According to patients’ wishes, family and friends were seldom invited as care partners in the e-health context. Conclusions A PCC intervention delivered remotely as a complement to standard care in a primary care setting for patients diagnosed with COPD or CHF is a viable approach to increase patients’ access and involvement in preventive care. The e-health intervention seemed to facilitate PCC, strengthen patients’ position in the health service system and support their self-management.

Remote Monitoring Programs for Cardiac Conditions

“…Of the 30 included publications, 1 each was described as using community-based action research, 141 multi-level qualitive study design, 195 interpretive phenomenological analysis, 130 descriptive qualitative with a phenomenographic approach, 133 phenomenological-hermeneutic approach, 90 and qualitative explorative approach. 196 Two publications each were reported as using a qualitative descriptive design and 197,198 grounded theory, 199,200 and 2 publications from the same study used qualitative process design. 201,202 The remaining 18 publications did not report the study design used.…”

“…83,85,101,106,112,123,[203][204][205][206][207][208][209][210][211][212][213][214] Semi-structured interviews were used as the primary method of data collection by 20 of the included publications. 83,85,90,101,106,112,123,133,197,198,[200][201][202][203][205][206][207]210,211,214 Five used both focus groups and interviews, 130,204,208,209,213 and 3 publications used focus groups alone to collect data. 141,199,212 One publication used audio-or video-recorded consultations between providers and patients 196 and another used observations, documents, and interviews.…”

“…123,205,209 Three publications each reported using grounded theory. 199,200,208 Two publications each reported using constant comparison, 101,214 a phenomenological approach, 90,133 a framework approach, 106,207 and deductive analysis. 112,203 One publication each reported using grounded theory and thematic analysis, 195 thematic analysis and constant comparison, 202 category analysis, 206 interpretive phenomenological analysis, 130 and interaction analysis.…”

“…Fourteen publications reported studies conducted in the UK. 83,85,101,106,130,198,201,202,204,[206][207][208]212,214 Six publications reported studies conducted in Sweden, 112,133,196,200,205,211 4 in Canada, 123,195,197,210 and 3 each in the US. 141,203,209 One publication each reported on a study conducted in Malaysia, 213 Finland, 199 and Denmark.…”

“…Ten of the publications reported on remote monitoring programs for heart failure, 101,106,112,123,133,141,203,205,206,209 and 6 publications reported on programs that included heart failure and other chronic conditions (e.g., chronic obstructive pulmonary disease, diabetes). 130,195,200,204,207,208 These programs tended to measure weight, blood pressure, and pulse, and administered daily symptom questionnaires and transmitted data to a health care provider such as a telehealth nurse for monitoring, with the objective of preventing exacerbations of participants' condition and hospitalizations.…”