Digitally excluded in a highly digitalized country: An investigation of Swedish outpatients with psychotic disorders and functional impairments

Holmberg, Christopher; Gremyr, Andreas; Karlsson, Viktor; Asztély, Karin

doi:10.1016/j.ejpsy.2022.04.005

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…Compared to the general population, people with psychosis were twice less likely to have foundation or life skills in using digital technology [65]. The opportunity to access training in order to increase confidence and skills in using technology has been suggested as a way to increase accessibility and reduce the digital divide that continues to exist for people with psychosis [64][65][66]. Further, the use of blended approaches whereby therapists provide support to people whilst using digital interventions has also been found to increase engagement and confidence in using technology [12,17,67].…”

Section: Discussionmentioning

confidence: 99%

A systematic review of users experiences of using digital interventions within psychosis: a thematic synthesis of qualitative research

Dennard,

Patel,

Garety

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Purpose Although the development of digital mental health support for people with psychosis has been increasing, the development and opportunities to access this have been more limited compared to other mental health conditions. Qualitative research exploring the experiences of using digital interventions amongst people with psychosis is even less well developed; however, such research is crucial in capturing the experiences of using digital interventions to ensure they are meeting the needs of people with psychosis. This paper aimed to synthesise qualitative data related to the experiences of people with psychosis who have used digital interventions. Methods A systematic literature search was conducted of articles published between 1992 and October 2023 using PubMed, MBase, PsycINFO, & OVID Medline. Two reviewers independently reviewed and screened 268 papers. Papers that met inclusion criteria were quality assessed using The Critical Appraisal Skills Programme (CASP) qualitative studies checklist. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist was used to guide the structure of the report. Results A thematic synthesis of 19 studies revealed six overarching themes which related to different aspects and features of the digital interventions: participants’ relationship with technology; the accessibility of the interventions; how the interventions could impact on individuals’ awareness and management of mental health; enhanced communication and relationships; and opportunities for reflection. Conclusions Benefits of using digital interventions are discussed. Areas for development and improvements are highlighted. Finally, recommendations for stakeholders who develop and implement digital interventions for psychosis are made.

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Section: Discussionmentioning

confidence: 99%

A systematic review of users experiences of using digital interventions within psychosis: a thematic synthesis of qualitative research

Dennard,

Patel,

Garety

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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“…First, specific psychotic diagnoses were not coded. Although most patients in the registry have schizophrenia, other types of psychotic disorders are also represented [ 69 ] buy may differ in their clinical presentation. Specific information about pharmaceutical treatments, including antipsychotic compounds, doses, polypharmacy, and non-antipsychotic treatment, could also help to draw conclusions from the data.…”

Section: Discussionmentioning

confidence: 99%

Psychometric and clinical evaluation of schizophrenia remission criteria in outpatients with psychotic disorders

Sakinyte

Holmberg

2023

BMC Psychiatry

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Background Psychotic disorders such as schizophrenia have debilitating effects on health and functioning. Given symptomatic remission’s recent emergence as a viable treatment goal, the Remission in Schizophrenia Working Group’s criteria (RSWG-cr), based on eight items from the Positive and Negative Syndrome Scale (PANSS-8), are frequently used in clinical and research settings. Against that background, we sought to evaluate the PANSS-8’s psychometric properties and examine the RSWG-cr’s clinical validity among outpatients in Sweden. Methods Cross-sectional register data were collected from outpatient psychosis clinics in Gothenburg, Sweden. Following confirmatory and exploratory factor analyses of PANSS-8 data (n = 1,744) to assess the PANSS-8’s psychometric properties, internal reliability was evaluated using Cronbach’s alpha. Next, 649 of the patients were classified according to the RSWG-cr and their clinical and demographic characteristics compared. Binary logistic regression was used to estimate odds ratios (OR) and assess each variable’s impact on remission status. Results The PANSS-8 showed good reliability (α = .85), and the 3D model of psychoticism, disorganization, and negative symptoms presented the best model fit. According to the RSWG-cr, 55% of the 649 patients were in remission; they were also more likely to live independently, be employed, not smoke, not take antipsychotics, and have recently received a health interview and physical examination. Patients living independently (OR = 1.98), who were employed (OR = 1.89), who were obese (OR = 1.61), and who had recently received a physical examination (OR = 1.56) also had an increased likelihood of remission. Conclusions The PANSS-8 is internally reliable, and, according to the RSWG-cr, remission is associated with variables of interest for patients’ recovery, including living independently and being employed. Although our findings from a large, heterogeneous sample of outpatients reflect everyday clinical practice and reinforce past observations, the directions of those relationships need to be assessed in longitudinal studies.

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“…For example, Sweden and the Netherlands are ranked with a score above 0.8, but inquiries have shown that some people are digitally excluded, which makes exclusion an even bigger issue for some as a consequence of the broad digitalization of public services and healthcare. 54 , 55 Thus, being on the outskirts of digitalization in a digitalized society entails the risk of being excluded from contact with healthcare and social services. 56 – 58 Taking all of this into consideration, the critical voices found in the present results serve as an important counterpoint to only seeing the bright side of digitalization – which has been termed the oxymoron of digitalization.…”

Section: Discussionmentioning

confidence: 99%

Digital inclusion: A mixed-method study of user behavior and content on Twitter

Salzmann-Erikson

2023

DIGITAL HEALTH

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Objective This study is the first to explore user behavior and characterize the content shared about digital inclusion on Twitter. Methods This mixed-methods research consists of 14,000 tweets featuring the hashtag “#digitalinclusion,” posted on Twitter over 15 months. A machine learning technique, latent Dirichlet allocation, was utilized to discover abstract topics within the tweets statistically. The algorithm identified important keywords and text associated with each topic by modeling the underlying word co-occurrence patterns in the dataset. A manual qualitative content analysis was applied to the qualitative data (1000 tweets). Results Tweets containing #digitalinclusion are driven by four motives: 1) warning against the risks of digital exclusion; 2) tweets that promote actions to increase digital inclusion; 3) tweets that call for others to take action to improve digitalization; and 4) tweets that are neutral but fuel the debate by being active. Quantitative analysis revealed that users discussing digital inclusion come from various continents, including the USA, Europe, Africa, and Asia. There were 3931 unique user accounts, with individuals posting between one and 368 tweets. Approximately half of the tweets contained some embedded media. Conclusion The study concludes that digital inclusion is a subject that engages Twitter users worldwide. Tweets that were associated with community and local initiatives and sustainable development had the highest engagement in terms of the number of retweets and likes. The interpretation is that digital inclusion is crucial for achieving equity in living conditions and enhancing access to health information and services. While initiatives to increase digital inclusion are underway, Twitter users call for more efforts to prevent growing digital exclusion. Twitter, as a social media platform, is valuable for studying the motivations that drive digital inclusion and help counter digital exclusion.

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Digitally excluded in a highly digitalized country: An investigation of Swedish outpatients with psychotic disorders and functional impairments

Cited by 6 publications

References 14 publications

A systematic review of users experiences of using digital interventions within psychosis: a thematic synthesis of qualitative research

A systematic review of users experiences of using digital interventions within psychosis: a thematic synthesis of qualitative research

Psychometric and clinical evaluation of schizophrenia remission criteria in outpatients with psychotic disorders

Digital inclusion: A mixed-method study of user behavior and content on Twitter

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