eHealth Information Research Articles

Forced centralized allocation in the emergency department-what has the COVID-19 pandemic changed?

IVENA eHealth (IVENA, interdisziplinärer Versorgungsnachweis, mainis IT-Service GmbH, Offenbach am Main, Germany) supports the coordination of emergency admissions by providing real-time data on treatment options in hospitals. Overload or technical problems can lead to hospitals having to temporarily deregister parts or the entire emergency department, which can lead to acute admissions. The COVID-19 pandemic may have further exacerbated the situation, which was analyzed as part of this study. This descriptive analysis used the IVENA eHealth information technology (IT) system to examine the occupancy and acute occupancy figures in the Munich ambulance service area from 2016-2022. Particular attention was paid to inpatient (SCII) and shock room + admissions in the specialties of internal medicine, neurology, trauma surgery and urology, as well as the development of acute occupancies, especially after the COVID-19 pandemic. During the COVID-19 pandemic in 2020, the number of patients in the surveyed specialist areas fell by 23.7% (2021: -15% and 2022: -11% compared to 2019). The proportion of acute admissions fell in 2020 compared to 2019 (5.9% acute admissions vs.6.8%) and rose disproportionately in 2021 (7.7% vs.6.8%) and 2022 (24.9% vs.6.8%). There are many reasons for the increase in acute admissions, including the increase in inpatient admissions, the bottleneck in transferring patients (exit block) and the shortage of staff in the healthcare system. The COVID-19 pandemic has exacerbated some of these problems, which could explain the increase in acute admissions. Acombination of different solutions is now needed to ensure adequate emergency care.

System interoperability and data linkage in the era of health information management: A bibliometric analysis.

Background: Across the world, health data generation is growing exponentially. The continuous rise of new and diversified technology to obtain and handle health data places health information management and governance under pressure. Lack of data linkage and interoperability between systems undermines best efforts to optimise integrated health information technology solutions. Objective: This research aimed to provide a bibliometric overview of the role of interoperability and linkage in health data management and governance. Method: Data were acquired by entering selected search queries into Google Scholar, PubMed, and Web of Science databases and bibliometric data obtained were then imported to Endnote and checked for duplicates. The refined data were exported to Excel, where several levels of filtration were applied to obtain the final sample. These sample data were analysed using Microsoft Excel (Microsoft Corporation, Washington, USA), WORDSTAT (Provalis Research, Montreal, Canada) and VOSviewer software (Leiden University, Leiden, Netherlands). Results: The literature sample was retrieved from 3799 unique results and consisted of 63 articles, present in 45 different publications, both evaluated by two specific in-house global impact rankings. Through VOSviewer, three main clusters were identified: (i) e-health information stakeholder needs; (ii) e-health information quality assessment; and (iii) e-health information technological governance trends. A residual correlation between interoperability and linkage studies in the sample was also found. Conclusion: Assessing stakeholders' needs is crucial for establishing an efficient and effective health information system. Further and diversified research is needed to assess the integrated placement of interoperability and linkage in health information management and governance. Implications: This research has provided valuable managerial and theoretical contributions to optimise system interoperability and data linkage within health information research and information technology solutions.

Seeking professional help in health crises: The impact of cognitive factors, discrete emotions, and eHealth information seeking on mental health communication.

A common challenge facing public health practitioners and communication scholars is how to best change perceptions and increase favorable attitudes and awareness of health recommendations, such as help-seeking about depression. Given the need to identify persuasive ways to communicate depression, this study examined how discrete emotions, cognition, and engaging eHealth information-seeking behavior affected US adults' intentions regarding help-seeking about depression. The results from an online survey of 1422 US adults revealed (1) elated emotion and loving emotion; (2) depression consciousness; (3) attitude toward seeking help from mental health services; and (4) eHealth information-seeking significantly predicted intention to seek help from professionals. In addition, depression consciousness, attitude toward seeking help from mental health services, and eHealth information-seeking acted as sequential mediators for the relationship between elated emotion, loving emotion, and behavioral intention. Implications for health communication and depression communication research and practice are discussed.

Continuing Educational Program in Nursing Informatics for Greek Nurses.

Nurses are required to adapt to a complex and rapidly evolving environment that incorporates new IT technologies. Continuing, lifelong learning, especially in the fast-growing fields of Nursing Informatics, eHealth and related Information and Communication Technologies, is vital to the professionalism of nurses. The study presents the curriculum development and implementation of the educational project entitled "Training of Nurses in Nursing Informatics and Information and Communication Technologies (ICT)" which has been designed and offered to Greek nurses as a continuing - lifelong online educational program by the Health Informatics Laboratory of the National and Kapodistrian University of Athens. The training material was created in three modules and 29 sub-modules, considering the new advancements and recommended competencies, necessary for the nurse, in the fields of Nursing Informatics and ICT. So far, eight training cycle courses have been offered to 1388 nurses, free of charge. Each course integrates synchronous and asynchronous distance learning methods and requires a workload of 70 hours over 10 weeks. The initial evaluation of the course by the participants, concerning its effectiveness, usefulness, and innovation are very encouraging.

Providing Provenance in eHealth.

eHealth data can be generated by different health professionals. Documenting and storing the provenance of medical data will help in providing patients and medical institutions with trustable and traceable information regarding medical procedures and their results. The use of a modular architecture like HIPAMS allows covering different eHealth information representation formats as well as providing protection mechanisms and access control.

Sociodigital Determinants of eHealth Literacy and Related Impact on Health Outcomes and eHealth Use in Korean Older Adults: Community-Based Cross-Sectional Survey.

eHealth literacy is an essential skill for pursuing electronic health information, particularly for older people whose health needs increase with age. South Korea is now at the intersection of a rapidly digitalizing society and an increasingly aged population. eHealth literacy enables older people to maximize the effective use of emerging digital technology for their health and quality of life. Understanding the eHealth literacy of Korean older adults is critical to eliminating the gray digital divide and inequity in health information access. This study aims to investigate factors influencing eHealth literacy in older Korean adults and its impact on health outcomes and eHealth use. This was a cross-sectional survey. Community-dwelling older adults 65 years and older in 2 urban cities in South Korea were included. eHealth literacy was measured by the eHealth Literacy Scale. Ordinal logistic regression was used to analyze factors associated with eHealth literacy and multivariate ANOVA for the impact of eHealth literacy on health outcomes and eHealth use. In total, 434 participants were analyzed. A total of 22.3% (97/434) of participants had high eHealth literacy skills. Increasing age, higher monthly income, and time spent on the internet were significantly associated with eHealth literacy (P<.001), and social media users were 3.97 times (adjusted odds ratio 3.97, 95% CI 1.02-15.43; P=.04) more likely to have higher skill. Higher eHealth literacy was associated with better self-perceived health and frequent use of digital technologies for accessing health and care services (P<.001). Disparity in socioeconomic status and engagement on the internet and social media can result in different levels of eHealth literacy skills, which can have consequential impacts on health outcomes and eHealth use. Tailored eHealth interventions, grounded on the social and digital determinants of eHealth literacy, could facilitate eHealth information access among older adults and foster a digitally inclusive healthy aging community.

E-health literacy in stroke patients: Latent profile analysis and influencing factors.

This study sought to explore latent categories of electronic health (e-health) literacy among stroke patients and analyse its influencing factors. A cross-sectional, descriptive exploratory design with the STROBE reporting checklist was applied. Between July and October 2020, 558 stroke participants from three tertiary care hospitals in Henan Province, China, were recruited using a convenience sampling method. A general information questionnaire and the Electronic Health Literacy Scale were used to collect their socio-demographic information and e-health literacy. Latent profile analysis was used to analyse latent categories of e-health literacy in stroke patients. Multiple logistic regression was used to analyse factors influencing latent categories of e-health literacy in stroke patients. Three latent categories of e-health literacy existed, including the low e-health literacy group, the low application-high decision-making group and the high literacy-low decision-making group. Multiple logistic regression showed that education level, presence of comorbidities, willingness to interact with people with mental illness, health information sources, frequency of Internet access, frequency of health information inquiry and willingness to receive remote care were predictors of the participants' latent categories of e-health literacy. Three latent categories of e-health literacy in stroke patients exist, and each latent category's characteristics should be considered while developing health education programmes. It is imperative that healthcare providers understand the requirement of creating tailored and efficient health education programmes for various categories of stroke patients to enhance their e-health literacy. It is imperative to improve Chinese stroke patients' overall e-health literacy. We categorized stroke patients' e-health literacy using advanced LPA. These findings hold implications for healthcare approaches, contributing to the enhancement of stroke patients' e-health literacy, enabling them to apply the acquired e-health information to manage and solve their own health issues. No patient or public contribution.

Associations Between Sociodemographic Characteristics, eHealth Literacy, and Health-Promoting Lifestyle Among University Students in Taipei: Cross-Sectional Validation Study of the Chinese Version of the eHealth Literacy Scale.

The popularization of the internet and rapid development of mobile devices have led to an increased inclination and opportunities to obtain health-related information online. The eHealth Literacy Scale (eHEALS), widely used for measuring eHealth literacy, assesses an individual's ability to search, understand, appraise, and use eHealth information. However, the Chinese version of the eHEALS multiple-factor model remains to be validated, and the correlation between eHEALS and the health-promoting lifestyle profile (HPLP) among university students is rarely explored in Taiwan. This study aimed to examine the fit, validity, and reliability of the Chinese eHEALS multiple-factor model and to clarify the predictive effects of eHEALS on the HPLP among university students. University students in Taipei, the capital of Taiwan, were recruited, and 406 valid questionnaires including sociodemographic characteristics, eHEALS, and HPLP responses were collected. Confirmatory factor analysis was performed to validate the Chinese eHEALS. Independent sample t test, 1-way ANOVA, and multiple linear regression analyses were conducted to examine the relationship between sociodemographic variables and the HPLP. Pearson product-moment correlation and binary logistic regression analyses were performed to ascertain the predictive effects of eHEALS on the HPLP. The Chinese eHEALS exhibited an optimal fit when delineated into the search, usage, and evaluation 3-factor model (comparative fit index=0.991, Tucker-Lewis index=0.984, root mean square error of approximation=0.062), and its validity and reliability were confirmed. The mean eHEALS score of university students was 3.17/4.00 (SD 0.48) points, and the score for the evaluation subscale was the lowest (mean 3.08, SD 0.56 points). Furthermore, there were significant sex, institution orientation, daily reading time, daily screen time, primary information channel, and perceived health status differences in the HPLP: male participants (t404=2.346, P=.02), participants attending general university (t404=2.564, P=.01), those reading ≥1 hour daily (F2,403=17.618, P<.001), those spending <3 hours on mobile devices or computers daily (F2,403=7.148, P<.001), those acquiring information from others (t404=3.892, P<.001), and those with a good perceived health status (F2,403=24.366, P<.001) had a significantly higher score. After adjusting for sociodemographic variables, the eHEALS score remained an independent predictor of the HPLP. Compared to students with relatively high eHEALS scores, those with relatively low eHEALS scores had a 3.37 times risk of a negative HPLP (adjusted odds ratio [OR]=3.37, 95% CI 1.49-7.61), which could explain 14.7%-24.4% of the variance (Cox-Snell R2=0.147, Nagelkerke R2=0.244, P=.004). There is room for improvement in eHealth literacy among university students in Taipei. eHEALS may be used to screen students who require HPLP improvement, thereby providing appropriate eHealth literacy training programs, particularly those targeting evaluation literacy. Additionally, the 3-factor model of the Chinese eHEALS used in this study results in more definite scale content, thus increasing the practicality and applicability of this scale in health-promoting studies.

Measuring electronic health literacy in the context of diabetes care: psychometric evaluation of a Persian version of the condition-specific eHealth literacy scale for diabetes

BackgroundThe rise of the internet and social media has led to increased interest among diabetes patients in using technology for information gathering and disease management. However, adequate eHealth literacy is crucial for protecting patients from unreliable diabetes-related information online.ObjectiveTo examine the psychometric characteristics and explore the preliminary validity of the Persian version of the Condition-specific eHealth Literacy Scale for Diabetes (Persian CeHLS-D) to assess eHealth literacy in the context of diabetes care.MethodsAfter adapting, translating, examining content validity, and pilot testing the questionnaire, it was administered to 300 patients with type 2 diabetes mellitus (T2DM). Construct validity was assessed through confirmatory factor analysis, convergent and known-groups validity. The internal consistency (Cronbach’s alpha), composite reliability and maximum reliability, and test-retest correlation were assessed.ResultsFactor analysis supported the hypothesized two-factor model with 10 items, and the standardized factor loadings ranged from 0.44 to 0.86 (P-values < 0.001). Cronbach’s alpha and test-retest correlation were good for each factor. Convergent validity was confirmed by significant correlations of Persian CeHLS-D with diabetes health literacy, perceived usefulness and importance of using the internet for health information, internet anxiety, and perceived physical and mental health. Know-groups validity determined using groups with different internet-use frequencies, and different attitudes towards providing online healthcare services, were satisfied.ConclusionThis study demonstrated the Persian CeHLS-D as a reliable and valid measure of eHealth literacy among patients with T2DM in Iran. Its satisfactory psychometric properties support its use in research and clinical settings to assess eHealth literacy and inform interventions.

E-model for Early Detection of Breast Cancer and Patient Monitoring

Breast cancer is becoming one of the most common diseases among women and is a growing global concern. A significant number of women have died worldwide from breast cancer. Studies suggest that early detection gives one better chance at treatment and management. However, the major challenges in early detection of breast cancer are awareness issues and patients’ insensitivity about the disease. This implies that regular breast examination leads to early detection of signs and symptoms of breast cancer. This exercise has been challenged with awareness, improper ways of conducting it and reporting of signs and symptom to appropriate quarters. This work is aimed at designing and development of a computer assisted system that runs on both desktop and mobile device(s) to assist women in conducting self- breast examination. To achieve this, object oriented analysis and design methodology (OOADM) was adopted for investigation and implementation. This work was designed and implemented in Microsoft Visual Studio while MySQL was used as the database management (DBMS). The rule- based approach was used for classification of breast abnormality. The result is an eHealth information system for early detection of breast cancer and patient monitoring. This will assist women to properly conduct self-breast examination, upload signs and symptoms discovered and enable medical professionals monitor patients.

Electronic Health Literacy Scale-Web3.0 for Older Adults with Noncommunicable Diseases: Validation Study.

In the current digital era, eHealth literacy plays an indispensable role in health care and self-management among older adults with noncommunicable diseases (NCDs). Measuring eHealth literacy appropriately and accurately ensures the successful implementation and evaluation of pertinent research and interventions. However, existing eHealth literacy measures focus mainly on individuals' abilities of accessing and comprehending eHealth information (Web1.0), whereas the capabilities for web-based interaction (Web2.0) and using eHealth information (Web3.0) have not been adequately evaluated. This study aimed to examine the reliability, validity, and measurement invariance of the eHealth Literacy Scale-Web3.0 (eHLS-Web3.0) among older adults with NCDs. A total of 642 Chinese older adults with NCDs (mean age 65.78, SD 3.91 years; 55.8% female) were recruited in the baseline assessment, of whom 134 (mean age 65.63, SD 3.99 years; 58.2% female) completed the 1-month follow-up assessment. Baseline measures included the Chinese version of the 24-item 3D eHLS-Web3.0, the Chinese version of the 8-item unidimensional eHealth Literacy Scale (eHEALS), and demographic information. Follow-up measures included the 24-item eHLS-Web3.0 and accelerometer-measured physical activity and sedentary behavior. A series of statistical analyses, for example, Cronbach α, composite reliability coefficient (CR), confirmatory factor analysis (CFA), and multigroup CFA, were performed to examine the internal consistency and test-retest reliabilities, as well as the construct, concurrent, convergent, discriminant, and predictive validities, and the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence. Cronbach α and CR were within acceptable ranges of 0.89-0.94 and 0.90-0.97, respectively, indicating adequate internal consistency of the eHLS-Web3.0 and its subscales. The eHLS-Web3.0 also demonstrated cross-time stability, with baseline and follow-up measures showing a significant intraclass correlation of 0.81-0.91. The construct validity of the 3D structure model of the eHLS-Web3.0 was supported by confirmatory factor analyses. The eHLS-Web3.0 exhibited convergent validity with an average variance extracted value of 0.58 and a CR value of 0.97. Discriminant validity was supported by CFA results for a proposed 4-factor model integrating the 3 eHLS-Web3.0 subscales and eHEALS. The predictive validity of the eHLS-Web3.0 for health behaviors was supported by significant associations of the eHLS-Web3.0 with light physical activity (β=.36, P=.004), moderate to vigorous physical activity (β=.49, P<.001), and sedentary behavior (β=-.26, P=.002). Finally, the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence was supported by the establishment of configural, metric, strong, and strict invariances. The present study provides timely empirical evidence on the reliability, validity, and measurement invariance of the eHLS-Web3.0, suggesting that the 24-item 3D eHLS-Web3.0 is an appropriate and valid tool for measuring eHealth literacy among older adults with NCDs within the Web3.0 sphere.

Exploring Current Challenges on Security and Privacy in an Operational eHealth Information System

Exploring Current Challenges on Security and Privacy in an Operational eHealth Information System

Quality of Patient-Centered eHealth Information on Erosive Tooth Wear: Systematic Search and Evaluation of Websites and YouTube Videos.

Due to the declining prevalence of dental caries, noncarious tooth defects such as erosive tooth wear have gained increased attention over the past decades. While patients more frequently search the internet for health-related information, the quality of patient-centered, web-based health information on erosive tooth wear is currently unknown. This study aimed to assess the quality of patient-centered, web-based health information (websites and YouTube videos) on erosive tooth wear. German-language websites were systematically identified through 3 electronic search engines (google.de, bing.de or yahoo.de, and duckduckgo.com) in September 2021. Eligible websites were independently assessed for (1) technical and functional aspects via the LIDA instrument, (2) readability via the Flesch reading-ease score, (3) comprehensiveness of information via a structured checklist, and (4) generic quality and risk of bias via the DISCERN instrument by 2 different reviewers. An overall quality score (ie, higher scores being favored) generated from all 4 domains was used as the primary outcome. Quality scores from each domain were separately analyzed as secondary outcomes and compared by the Friedman test. The effect of practice-specific variables on quality scores of websites from private dental offices was assessed using generalized linear modeling. Eligible YouTube videos were judged based on (1) the comprehensiveness of information, (2) viewers' interaction, and (3) viewing rate. The comprehensiveness of information was compared between websites and YouTube videos using the Wilcoxon rank-sum test. Overall, 231 eligible websites and 7 YouTube videos were identified and assessed. The median overall quality of the websites was 33.6% (IQR 29.8%-39.2%). Secondary outcome scores amounted to 64.3% (IQR 59.8%-69.0%) for technical and functional aspects, 40.0% (IQR 34.0%-49.0%) for readability, 11.5% (IQR 3.9%-26.9%) for comprehensiveness of information, and 16.7% (IQR 8.3%-23.3%) for generic quality. While the comprehensiveness of information and generic quality received low scores, technical and functional aspects as well as readability resulted in higher scores (both Padjusted<.001). Regarding practice-specific variables, websites from private dental offices outside Germany (P=.04; B=-6.64, 95% CI -12.85 to -0.42) or from dentists who are a dental society member (P=.049; B=-3.55, 95% CI -7.09 to -0.01) resulted in lower readability scores (ie, were more difficult to read), while a shorter time since dentists' examination resulted in higher readability scores (P=.01; B=0.24 per year, 95% CI 0.05-0.43). The comprehensiveness of information from YouTube videos was 34.6% (IQR 13.5%-38.5%). However, the comprehensiveness of information did not vary between websites and YouTube videos (P=.09). Additionally, viewers' interaction (1.7%, IQR 0.7%-3.4%) and viewing rates (101%, IQR 54.6%-112.6%) were low. The quality of German-language, patient-centered, web-based information on erosive tooth wear was limited. Especially, the comprehensiveness and trustworthiness of the available information were insufficient. Web-based information on erosive tooth wear requires improvement to inform patients comprehensively and reliably.

Community of Interoperability Labs: Pragmatic Approach to Achieving Interoperability.

To achieve interoperability of health data, stakeholders must overcome various socio-technical challenges. The "Mind the GAPS, Fill the GAPS" framework was created by the Asia eHealth Information Network (AeHIN) in 2017 to help countries with their challenges with interoperability. A year later, AeHIN formed the Community of Interoperability Labs (COIL), a group of labs from six countries to share knowledge and resources. Since interoperability requires data exchange between disparate entities, it is imperative to establish a trustworthy space where stakeholders can come together and solve their common problems. The networked learning approach of the COIL makes possible the potential for interoperability within and between countries contributing to national and international understanding.

Associations of online health information seeking with health behaviors of cancer survivors.

To examine the effects of online health information seeking (OHIS) behavior on five health behaviors (regular physical activity, less sedentary, calorie checking, no alcohol consumption, and no smoking) among adult cancer survivors in the United States. A cross-sectional analysis was conducted with adult cancer survivors (≥18 years old) from Cycles 2, 3, and 4 of the Health Information National Trends Survey (HINTS). The respondents self-reported OHIS, and the data on the five health behaviors were pooled to perform descriptive and multivariable logistic regression analyses using Stata 17.0. Of the 1245 adult cancer survivors, approximately 74% reported OHIS behavior for themselves within the previous year of the survey. We found that OHIS was significantly and positively associated with the level of physical activity (odds ratio [OR] = 1.53, p = .002) and calorie checking (OR = 1.64, p = .001), but not with sedentary behavior, smoking, and alcohol consumption after adjusting for age, sex, race/ethnicity, education, income, body mass index (BMI), marital status, depression, and general health. Findings from this study suggest that most cancer survivors used various forms of digital tools and platforms to seek health information. The study also demonstrated an independent impact of OHIS behavior on physical activity and calorie checking. Healthcare professionals may need to encourage and guide cancer survivors to seek credible eHealth information and further utilize digital health tools as a platform for care delivery, promoting health behaviors and preventing adverse health outcomes among cancer survivors.

The association between electronic health information usage and patient-centered communication: a cross sectional analysis from the Health Information National Trends Survey (HINTS)

BackgroundPatient-provider communication can be assessed by the patient-centered communication (PCC) score. With rapid development of electronic health (eHealth) information usage, we are uncertain of their role in PCC. Our study aims to determine the association between PCC and eHealth usage with the analysis of national representative survey data.MethodsThis is a cross sectional analysis using the Health Information National Trends Survey 5 (HINTS 5) cycle 1 to cycle 4 data (2017–2020). Seven specific questions were used for PCC assessment, and eHealth usage was divided into two types (private-eHealth and public-eHealth usage). A multivariate logistic regression was performed to determine the association between PCC and eHealth usage after the adjustment of other social, demographic, and clinical variables.ResultsOur study analyzed a total of 13,055 unweighted participants representing a weighted population of 791,877,728. Approximately 43% of individuals used private eHealth and 19% used public eHealth. The adjusted odds ratio (AOR) of private-eHealth usage associated with positive PCC was 1.17 (95% CI 1.02–1.35, p = 0.027). The AOR of public-eHealth usage associated with positive PCC was 0.84 (95% CI 0.71–0.99, p = 0.043).ConclusionOur study found that eHealth usage association with PCC varies. Private-eHealth usage was positively associated with PCC, whereas public-eHealth usage was negatively associated with PCC.

E-Health technological barriers faced by Iraqi healthcare institutions

The health records management issues have detrimentally affected the Iraqi healthcare sector resultant from the inferior information technology integrity and the complicatedness of data. In order to resolve this problem, other methods of storage, management, and retrieval of health-related data can be offered by e-Health services. These aspects are important in tracking patients’ health conditions using multiple platforms at the service provider’s own convenience. However, there are numerous issues that hinder the extensive adoption of e-Health services by the health establishments in Iraq, such as issues on security and privacy, legalities connected to policies, and its implementation. The significance of the current study is its identification of the crucial aspects that will lead to the success of impacting the technical staff towards their positive acceptance and behavior with regard to the employment of e-Health information system in Iraqi hospitals. A self-administered survey was carried out on 104 technical staff from various healthcare organizations in Iraq using a simple random sampling technique. A nonparametric second-generation multivariate analysis was conducted on the compiled ordinal data by the utilization of the PLS-SEM approach. The outcomes indicated the favorable impact of several factors on the doctor’s employment of e-Health in Iraqi hospitals, comprising Availability and Affordability of the hardware and software, ICT Support Service, Network Reliability, Privacy, and Security. The results are important in assisting the comprehension of e-Health systems in the management of health data, in addition to the provision of the pertinent recommendations for policymakers to provide guidance, issue advice, directives to the healthcare professionals toward the continuous consideration of using advance information and communications technology at work.

Involving Older Users in Design of Patient Accessible Electronic Health Records: Exploring the Potential of Open‐Ended Questions

ABSTRACTDespite older adults being one of the most important groups of users of eHealth services, including patient accessible electronic health records, these are claimed to not be designed to suit older users, and to not necessarily fulfill their information needs. User‐centered design methods often utilized when developing eHealth services have also been claimed to not work well for older adults. This paper suggests an alternative way of collecting ideas and feedback on eHealth from older adults, by including open‐ended questions in the data collection of larger studies on eHealth information behavior. When data are collected by methods like focus group interviews and surveys, older adults can be requested to envision an eHealth service that suits their needs. Results from studies in Finland are presented, and show that current eHealth services do not fulfill all information needs of older adults, as answers to the question in both focus group interviews and surveys contain practical suggestions for additional and more comprehensible information, easier ways of searching for needed information, and alternative channels for communication. Open‐ended questions can be a cost‐effective and timesaving way to help in the design and development of patient accessible electronic health records and other types of eHealth services.

"We are in the forgotten corner!" a qualitative study of experiences and challenges among Chinese older women at the onset of acute myocardial infarction.

Acute myocardial infarction (AMI) is a common and serious cardiovascular disease (CVD) that is one of the leading causes of death among women globally and in China. However, there are sex-associated differences and inequalities in the detection and management of AMI, especially in older people. There is little research demonstrating how challenges and barriers affect older women's help-seeking behavior and health-related procedures in China. The objective of this study was to explore the experiences of older women with AMI, focusing on their perception, challenges, and coping strategies at the onset of AMI in Wuhan, China. This study utilized a qualitative research design approach and conducted semi-structured, in-depth, and audio-recorded interviews with 18 women aged 65-84 years, purposively selected from two tertiary hospitals in Wuhan City from November 2021 to April 2022. Interpretative Phenomenological Analysis (IPA) was used in this study to analyze the data on 18 participants and three major themes were generated: disease perception disorder, negative coping strategies, and barriers due to social-environmental contexts. To reduce older women's delay in seeking help, healthcare professionals should provide public health education that emphasizes sex-related disparities, and age-specific knowledge-attitude aspects to high-risk groups. Policy-based and health administration recommendations, including e-health information support, access to care, and social-environmental factors, should be highlighted to promote women's health behavior.

Usability of Chronic Kidney Diseases Electronic-Health Information: A Systematic Review

Background: Information on chronic kidney disease is easily accessible in a variety of digital formats and is posted in health information resources, electronic health, or eHealth. In that it can enable people with chronic kidney disease to manage their condition, the field of eHealth is promising. Aims: The purpose of this study is to evaluate the usability of eHealth in the treatment of chronic kidney disease by critically analyzing the published papers in this area. Methods: The following databases were searched systematically: The following databases were thoroughly searched: EBSCO, CINAHL, ProQuest, MEDLINE, PubMed, Cochrane, and Google Scholar. Eight studies looked into the specific impact of eHealth on chronic kidney disease. These studies addressed a variety of subjects, including the user, healthcare professionals, and system bonding, mobile eHealth, content, and eHealth evaluation on chronic kidney disease. Results: There is a knowledge gap in the field of eHealth for chronic kidney disease. The findings reveal a significant disparity in the terminology and conceptualizations used in eHealth information on chronic kidney disease. The availability of eHealth information on chronic kidney disease that prioritizes patient education, behavior modification, and prevention has led to inconsistent usage. Lack of sufficient data may hinder the development of eHealth interventions for people with chronic kidney disease. Conclusion: This study emphasizes the urgent need for content acceptance and access as well as evaluation that is evidence-based for the conceptualization of eHealth for chronic kidney disease.