Abstract
Chronic skin ulcers are a significant challenge for patients and health service resources, and ulcer treatment often requires the competence of a specialist. Although e-health interventions are increasingly valued for ulcer care by giving access to specialists at a distance, there is limited research on patients’ use of e-health services for home-based ulcer treatment. This article reports an exploratory qualitative study of the first Norwegian web-based counselling service for home-based ulcer treatment, established in 2011 by the University Hospital of North Norway (UNN). Community nurses, general practitioners (GPs) and patients are offered access to a web-based record system to optimize ulcer care. The web-based ulcer record enables the exchange and storage of digital photos and clinical information, by the use of which, an ulcer team at UNN, consisting of specialized nurses and dermatologists, is accessible within 24 h. This article explores patients’ experiences of using the web-based record for their home-based ulcer treatment without assistance from community nurses. Semi-structured interviews were conducted with a total of four patients who had used the record. The main outcomes identified were: autonomy and flexibility; safety and trust; involvement and control; and motivation and hope. These aspects improved the patients’ everyday life during long-term ulcer care and can be understood as stimulating patient empowerment.
Highlights
Chronic and complex ulcers are a widespread problem that represents a significant challenge for patients and health services [1,2]
Through the introduction of a web-based ulcer record for home-based ulcer treatment, patients gained improved access to expert advice from a hospital dermatology ward as part of a collaborative follow-up for ulcer treatment. This e-health tool placed new responsibilities on patients, they used it in ways that can be interpreted as stimulating patient empowerment
The web-based record can be understood as facilitating efforts for a reconstruction of normality in patients’
Summary
Chronic and complex ulcers are a widespread problem that represents a significant challenge for patients and health services [1,2]. In collaboration with general practitioners (GPs), have the primary responsibility for providing care to patients with ulcers, but patients’ self-care can play an important role. Insufficient knowledge of ulcer treatment is common in primary healthcare services, as well as in local hospitals [1,2,5]. Treatment of long-lasting ulcers often requires the competence of a specialist, access to which is limited in rural areas. Repeated visits to specialist hospitals are often necessary, representing an important cost factor for healthcare systems and placing a significant burden on the patients, because such visits are time-consuming and often include long travel distances [6,7]
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