The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study

Zhou, Ling-Ming; Wong, Eliza Lai-Yi; Wang, Dong

doi:10.2196/26721

Cited by 35 publications

(21 citation statements)

References 65 publications

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“…Pain should be controlled effectively in the early stages of KOA, with consideration of interventions such as physical therapy to avoid progression of acute pain to uncontrollable chronic pain. As soon as KOA is diagnosed, doctors and patients’ families should make decisions together and cooperate to standardize pain management 45 and encourage patients to exercise as appropriate to help preserve their joint function.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Quality of Life Before and After Total Knee Arthroplasty: A Multicenter Observational Study

Chang¹,

Fu²,

Cao³

et al. 2022

PPA

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Purpose To compare patients’ self-reported health-related quality of life (HRQoL) before and after total knee arthroplasty (TKA) and determine factors contributing to any heterogeneity in HRQoL. Patients and Methods This prospective multicenter observational study included 404 patients with knee osteoarthritis who underwent TKA between April 1, 2019 and December 30, 2019 and whose HRQoL was assessed preoperatively and 7 days and 1, 3, and 6 months postoperatively. Sociodemographic characteristics were assessed using a General Information Questionnaire, disability using the Knee Injury and Osteoarthritis Outcome Score (KOOS-PS), resting pain using the visual analogue scale (Pain-VAS), and HRQoL using the European Quality of Life Five Dimension Five Level (EQ-5D-5L) scale. The growth mixture model was used to identify group heterogeneity in the developmental trajectories of KOOS-PS, Pain-VAS, and EQ5D5L. Logistic regression was used to explore the factors influencing the developmental trajectories of factors affecting the developmental trajectory of HRQoL. Results The mean EQ-5D-5L score improved from 0.69 preoperatively to 0.90 at 6 months postoperatively. Longitudinal heterogeneity in HRQoL was observed in patients during recovery: 1) patients with a small and slow improvement in HRQoL and 2) patients who showed marked and rapid improvement in HRQoL. The main characteristics of the latter group were decreasing VAS pain scores, a monthly family income >2000 CNY (100 CNY equals approximately 14.9 USD), exercising for <30 min daily, and better knee function at baseline. Baseline knee function and change in knee function were significantly associated with the percentage change in HRQoL. Conclusion HRQoL improved considerably after TKA. However, there was heterogeneity in the changes in HRQoL depending on patients’ socioeconomic status, exercise, and baseline knee function. Dynamic tracking of the HRQoL of TKA patients and timely provision of rehabilitation guidance will promote continuous improvement of the HRQoL of TKA patients.

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Section: Discussionmentioning

confidence: 99%

Patient-Reported Quality of Life Before and After Total Knee Arthroplasty: A Multicenter Observational Study

Chang¹,

Fu²,

Cao³

et al. 2022

PPA

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“…However, the changing role of patients may have required physicians to more actively encourage their patients to engage in digital health [ 73 ]. Patients also need a variety of skills, such as digital health literacy, to play an independent role [ 74 ]. Simultaneously, physicians are increasingly expected to assess whether patients have properly understood health information in relation to their own situation [ 75 ].…”

Section: Discussionmentioning

confidence: 99%

The Interplay of Work, Digital Health Usage, and the Perceived Effects of Digitalization on Physicians’ Work: Network Analysis Approach

Saukkonen¹,

Elovainio²,

Virtanen³

et al. 2022

J Med Internet Res

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Background In health care, the benefits of digitalization need to outweigh the risks, but there is limited knowledge about the factors affecting this balance in the work environment of physicians. To achieve the benefits of digitalization, a more comprehensive understanding of this complex phenomenon related to the digitalization of physicians’ work is needed. Objective The aim of this study was to examine physicians’ perceptions of the effects of health care digitalization on their work and to analyze how these perceptions are associated with multiple factors related to work and digital health usage. Methods A representative sample of 4630 (response rate 24.46%) Finnish physicians (2960/4617, 64.11% women) was used. Statements measuring the perceived effects of digitalization on work included the patients’ active role, preventive work, interprofessional cooperation, decision support, access to patient information, and faster consultations. Network analysis of the perceived effects of digitalization and factors related to work and digital health usage was conducted using mixed graphical modeling. Adjusted and standardized regression coefficients are denoted by b. Centrality statistics were examined to evaluate the relative influence of each variable in terms of node strength. Results Nearly half of physicians considered that digitalization has promoted an active role for patients in their own care (2104/4537, 46.37%) and easier access to patient information (1986/4551, 43.64%), but only 1 in 10 (445/4529, 9.82%) felt that the impact has been positive on consultation times with patients. Almost half of the respondents estimated that digitalization has neither increased nor decreased the possibilities for preventive work (2036/4506, 45.18%) and supportiveness of clinical decision support systems (1941/4458, 43.54%). When all variables were integrated into the network, the most influential variables were purpose of using health information systems, employment sector, and specialization status. However, the grade given to the electronic health record (EHR) system that was primarily used had the strongest direct links to faster consultations (b=0.32) and facilitated access to patient information (b=0.28). At least 6 months of use of the main EHR was associated with facilitated access to patient information (b=0.18). Conclusions The results highlight the complex interdependence of multiple factors associated with the perceived effects of digitalization on physicians’ work. It seems that a high-quality EHR system is critical for promoting smooth clinical practice. In addition, work-related factors may influence other factors that affect digital health success. These factors should be considered when developing and implementing new digital health technologies or services for physicians’ work. The adoption of digital health is not just a technological project but a project that changes existing work practices.

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“…A further limitation is that the authors did not assess health literacy levels and this factor may have impacted on the perspectives of participants in this study. Higher health literacy has been associated with better experiences during SDM and improved capability wellbeing, 33 which is the ability to do and be the things that matter to the individual. 34 …”

Section: Discussionmentioning

confidence: 99%

Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study

et al. 2021

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BackgroundThe important role of primary care in promoting healthy lifestyle behaviours needs informed support.AimTo elicit views on a 39-item shared decision-making (SDM) aid (SHARE-D) for lifestyle change and refine it to improve implementation.Design & settingMixed methods study.MethodHealth professionals, patients, and support workers, with experience of managing, or a history of, cardio- or cerebrovascular disease, were purposively recruited based on age, gender, and urban/rural location (n = 34). Participants completed a survey, rating the importance of including each item in a decision-aid, designed for use by patients with health professionals, and suggesting modifications. Semi-structured interviews (n = 30/34) were conducted and analysed thematically.ResultsSubstantial agreement was observed on rating item inclusion. Based on survey and interview data, 9/39 items were removed; 13 were amended. Qualitative themes were: (i) core content of the decision-aid, (ii) barriers to use, (iii) motivation for lifestyle change, and (iv) primary care implementation. ‘Self-reflective’ questions and goal setting were viewed as essential components. The paper-based format, length, clarity, and time required were barriers to its use. Optional support considered within the aid was seen as important to motivate change. A digital version, integrated into patient record systems was regarded as critical to implementation. A revised 30-item aid was considered suitable for facilitating brief conversations and promoting patient autonomy.ConclusionThe SHARE-D decision aid for healthy lifestyle change appears to have good content validity and acceptability. Survey and interview data provided in-depth information to support implementation of a refined version. Further studies should examine its effectiveness.

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The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study

Cited by 35 publications

References 65 publications

Patient-Reported Quality of Life Before and After Total Knee Arthroplasty: A Multicenter Observational Study

Patient-Reported Quality of Life Before and After Total Knee Arthroplasty: A Multicenter Observational Study

The Interplay of Work, Digital Health Usage, and the Perceived Effects of Digitalization on Physicians’ Work: Network Analysis Approach

Refining a primary care shared decision-making aid for lifestyle change: a mixed-methods study

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