Health Care Experiences Research Articles

Standardized Patient Encounter to Enhance Care to LGBTQIA+ Patients

Context Athletic trainers provide care for a variety of patients with diverse backgrounds, including members of the lesbian, gay, bisexual, transgender, queer, intersex, other diverse sexualities, other gender identities, or other gender expressions (LGBTQIA+) community. Learners who gain experience with patients who identify as LBGTQIA+ should be better prepared clinicians. Objective The purpose of this paper is to describe a standardized patient (SP) experience for a patient who is gay and concerned about a sexually transmitted infection after a conversation with a previous partner. Background Patients who identify as LGBTQIA+ report substandard care and have poor health care experiences. Standardized patients are used in athletic training education as a method to teach and assess skills and can be used to improve the care that learners provide to patients who identify as gay. Educational Advantage Education drives clinical practice, and incorporating SP cases in which learners must provide care for a patient who is gay will help the learners provide better inclusive patient-centered care as a clinician. Conclusions Faculty may consider using a SP encounter to better prepare learners to provide care for a patient who is gay.

A small surprise with a big impact on patient engagement

A patient’s journey into endocrinology is shaped by a welcoming note on the examination table, symbolizing compassionate care and easing anxiety. The doctor’s collaborative demeanour, characterised by attentive engagement and openness to new ideas, fosters a partnership based on trust. This perspective encourages medical professionals to embrace humility, curiosity, and mutual respect, enhancing healthcare experiences and outcomes. Such practices require no significant investment but yield profound benefits in building equitable doctor-patient relationships and improving overall healthcare quality.

Healthcare Communication Experiences of Hispanic Caregivers of Childhood Cancer Survivors.

Interpersonal communication is a crucial component of the cancer experience that can contribute to managing cancer care and improving cancer survivors' and caregivers' quality of life. Cultural and contextual factors may impact Hispanic childhood cancer survivor (CCS) and parent caregiver relationships and communication. This study sought to describe the healthcare communication experiences of Hispanic parents with CCS, families, and medical providers. We conducted 15 semi-structured interviews with Hispanic caregivers from a safety-net hospital in Los Angeles County. Interviews were conducted in English and Spanish, audio-recorded and professionally transcribed, and analyzed using a thematic approach. Caregivers shared the importance and impact of medical communication when exploring the "first big talk" of the diagnosis, uncertainty about treatment, navigating multiple providers, therapeutic communication (i.e., providing emotional reassurance), and current and lingering effects of cancer. All caregivers shared "good communication" experiences, while others shared various barriers to communication, including a lack of understanding of the cancer diagnosis and caregiver experience, psychological challenges impacting communication, cultural and language differences, physical factors that limit communication, and young age of child impacting communication with caregivers. Our findings suggest that a strong interpersonal communication skill set for clinicians can contribute to managing cancer care and improving caregivers' psychological adjustment.

A qualitative study of home-visiting oral health care experience in vulnerable populations

A qualitative study of home-visiting oral health care experience in vulnerable populations

The challenges of living with Debilitating Symptom Complexes Attributed to Ticks (DSCATT) – A qualitative study

ObjectiveWe sought to explore the lived experience of people with Debilitating Symptom Complexes Attributed to Ticks (DSCATT) to inform the development of a potential treatment intervention. MethodsWe conducted one-to-one in-depth, semi-structured interviews with 13 people living in Australia affected by DSCATT. Interviews were transcribed and analysed using thematic analysis. ResultsAlthough participants attributed the origin of their illness to tick bites, not all were adamant they had Lyme disease. Negative experiences in conventional healthcare were marked and were reported to exacerbate the impact of the illness and affect mental health. Further, these negative experiences propelled participants to seek unapproved treatments (by Australian standards). The desire for the illness to be acknowledged and causative agents identified was pronounced among the participant group. ConclusionsIndividuals with DSCATT experience significant challenges amid a contentious healthcare landscape surrounding chronic symptoms attributed to ticks in Australia. Our findings suggest the need for empathetic, supportive and patient-centred treatments for this cohort. Implications for public healthDSCATT results in a considerable burden across multiple domains for those affected. Negative experiences with healthcare exacerbate the suffering of people with DSCATT in Australia. New approaches that acknowledge the illness experience of people with DSCATT, alongside evidence-based treatments that encompass biopsychosocial models of care, are needed to tackle this debilitating condition.

A Systemic Review on the Adoption of Service Design Practices to Improve the Quality of User Experience and Organization in the Healthcare Environment

Healthcare services and spaces are recognized as complex ecosystems where different user categories interact daily facing often urgent and difficult situations that challenge the established organizational and procedural models. The increasingly evolving needs and conditions influencing the processes affect the capacity to quickly adapt the available operational models as well as spaces to provide a timely and efficient response. This calls for new approaches and methods to enable the managing staff to overcome the conventional silos-based structure and integrate new methods and tools to facilitate interdisciplinary analysis and synergies. Some frontrunning healthcare structures started to adopt Service Design practices, which are largely grounded in the Design Thinking approach, to reshape the conventional models for improving the quality of user experience with remarkable expected impacts on social, economic, and environmental sustainability in the mid-long run. Following the rigorous investigation structure of Systemic Review, the paper explores the adoption of Service Design practices in frontrunner experiences focusing on organizational aspects to draft a reference framework, including successful factors, barriers, and viable pathways, which are currently missing. The main scope of the paper is accordingly to address the detected gaps in clarifying methods tools and goals of Service Design-oriented practices for improving healthcare processes and user experience quality. The main reported findings highlight the importance of introducing Co-Design and participative practices to integrate specialistic perspectives and organizational aspects as well as to engage all the key players at different levels.

Medical Complexity of Children with Special Healthcare Needs and Healthcare Experiences.

The rising prevalence of CSHCN has led to significant challenges for caregivers, particularly mothers, who face difficulties from caregiving demands and managing complex healthcare interactions. The objective of this study was to examine the association between the medical complexity of CSHCN and the healthcare experiences of their mothers while exploring the influence of sociodemographic factors on these associations. The study utilized data from the 2016-2020 National Survey of Children's Health (NSCH), involving 17,434 mothers of CSHCN. Mothers provided information on the medical complexity of CSHCN, healthcare experiences (care coordination, family-centered care, and shared decision-making), and sociodemographic information (race, community, insurance, child sex, age, and federal poverty level). Results from multiple regressions revealed that greater medical complexity was associated with more negative healthcare experiences. Minoritized mothers, those in rural areas, and families with lower income reported lower levels of family-centered care, indicating significant disparities. Additionally, the negative association between medical complexity and healthcare experiences was pronounced for White families and those with private insurance compared to minoritized families and those with public insurance. This study highlights the necessity for targeted interventions to improve care coordination, family-centered care, and shared decision-making, emphasizing the need for a comprehensive, family-centered approach to address healthcare disparities and promote health equity for CSHCN and their families.

Experiences of Black Women With Pelvic Floor Disorders-A Qualitative Analysis Study.

Disparities research in Black women with pelvic floor disorders (PFDs) has primarily focused on epidemiology or surgical outcomes, but little is known about the patient perspective on seeking PFD care. To provide quality and equitable care to Black women with PFDs, we conducted a qualitative study to hear their perspectives and lived health care experiences. Black women seeking care for PFDs at a tertiary care institution were invited to participate in qualitative interviews. Open-ended questions explored participants' knowledge, attitudes, and health care experiences. Interviews were transcribed verbatim and coded line-by-line. Inductive content analysis was performed to identify key themes, and consensus was achieved among the research team. Eight Black women aged 21-83 years consented to participate. Patients noted a stigma surrounding PFDs, both among health care professionals and their community. They noted several barriers to care: financial, logistical, and racial bias. They cited difficulties in patient-health care professional communication, including not feeling heard or treated as an individual. They preferred gender and racial concordance with their physicians. These women expressed both a desire for more knowledge and to share this knowledge and advocate for other women. Black women expressed distinct obstacles in their PFD health care. They reported not feeling heard or treated as a unique individual. The themes derived from this study identify complex patient-centered needs that can serve as the basis for future quality improvement work and/or hypothesis-driven research. By grounding health disparities research in patient perspectives, we can improve the health care experiences of Black women.

DNA Methylation Levels of the ACE2 Promoter Are Not Associated with Post-COVID-19 Symptoms in Individuals Who Had Been Hospitalized Due to COVID-19.

It is known that SARS-CoV-2 can translocate via membrane ACE2 exopeptidase into the host cells, and thus hypomethylation of ACE2 possibly upregulates its expression, enhancing the risk of SARS-CoV-2 infection. This study investigated if DNA methylation levels of the ACE2 promoter are associated with the development of post-COVID-19 symptomatology in a cohort of COVID-19 survivors who had been previously hospitalized. Non-stimulated saliva samples were obtained from 279 (51.5 male, mean age: 56.5 ± 13.0 years old) COVID-19 survivors who were hospitalized during the first wave of the pandemic. A face-to-face interview in which patients described the presence of post-COVID-19 symptoms (defined as a symptom that started no later than three months after SARS-CoV-2 infection) that they suffered from to an experienced healthcare trainer was conducted. Methylation of five CpG dinucleotides in the ACE2 promoter was quantified using bisulfite pyrosequencing. The percentage of methylation (%) was associated with the presence of the following reported post-COVID-19 symptoms: fatigue, dyspnea at rest, dyspnea at exertion, brain fog, memory loss, concentration loss, or gastrointestinal problems. Participants were assessed a mean of 17.8 (SD: 5.3) months after hospitalization. At that time, 88.1% of the patients experienced at least one post-COVID-19 symptom (mean number for each patient: 3.0; SD: 1.9 post-COVID-19 symptoms). Dyspnea at exertion (67.3%), fatigue (62.3%), and memory loss (31.2%) were the most frequent post-COVID-19 symptoms in the sample. Overall, the analysis did not reveal any difference in the methylation of the ACE2 promoter in any of the CpG locations according to the presence or absence of fatigue, dyspnea at rest, dyspnea at exertion, memory loss, brain fog, concentration loss, and gastrointestinal problems. This study did not find an association between methylation of ACE2 promoter and the presence of post-COVID-19 fatigue, dyspnea, cognitive or gastrointestinal problems in previously hospitalized COVID-19 survivors.

"They still phone even though they know I'm deaf": exploring experiences of deaf people in health services in Wales, UK.

Deaf and hard of hearing people persistently experience barriers accessing health services, largely due to ineffective communication systems, a lack of flexible booking arrangements, and a lack of Deaf awareness training for health professional staff. Face to face focus groups were conducted with 66 Deaf and hard of hearing people in Deaf clubs across Wales, UK. Thematic analysis was undertaken. Responses identified from focus groups are reported as barriers faced using health services, improvements that would make a difference, impact of accessibility of health services, and a potential Sign language badge for healthcare staff. Deaf people report that health professionals lack training on Deaf awareness and do not know how to communicate effectively with Deaf and hard of hearing people. Further research into Deaf awareness and training resources for health professionals are needed to establish what improves Deaf cultural competencies, and ultimately makes healthcare experiences more positive for people who are Deaf.

Establishing Best Practices in Telehealth Care for Adults with Developmental Disabilities in the United States: An e-Delphi Study.

Background: Telehealth care is now a key element of mainstream health care since the COVID-19 pandemic, with all types of health care providers joining the digital revolution. As a population experiencing health care disparities, adults with developmental disabilities and their supporters have described variable experiences with telehealth care that contribute to overall care quality and health outcomes. Methods: This e-Delphi study established consensus on best practices in telehealth care for adults with developmental disabilities in the United States. Online surveys and videoconferencing interviews were conducted with 44 expert panelists with experience with telehealth care and developmental disabilities, including adults with developmental disabilities, family members, direct support professionals, nurses, and health care providers. Results: Three rounds of surveys resulted in a set of 9 guidelines consisting of 42 items. The guidelines addressed 1) appropriate situations for telehealth care, 2) communication needs and preferences, 3) support person collaboration, 4) education and anticipatory guidance, 5) reminders, 6) coordination of care, 7) equitable and fair access, 8) privacy and safety, and 9) evidence-based practice. Conclusion: Health care providers can adopt these best practice guidelines to ensure telehealth care is provided equitably and safely to adults with developmental disabilities. Policy advocacy is needed for the uptake of these guidelines and for health care providers and adults with developmental disabilities to access the resources needed for safe and effective telehealth care use.

Optimizing primary healthcare experience: assessing client satisfaction in Kaduna State, Northwest Nigeria

BackgroundClient satisfaction is a multidimensional construct focusing on clients’ perceptions and evaluations of the treatment and care received. It is one of the factors affecting the outcomes of healthcare and the use of health services. Therefore, we aimed to assess clients’ satisfaction with PHC services in Kaduna State, Northwest Nigeria.MethodologyA cross–sectional descriptive study was conducted in Kaduna State, Northwest, Nigeria which evaluate the satisfaction of clients and caregivers accessing healthcare in PHC centres. A sample size of 217 was determined using Fisher’s formula, with a multi-stage sampling technique used to randomly select eligible respondents, who have accessed at least a PHC service in any of the PHCs in the State were included in the study, A semi-structured, interviewer-administered questionnaire was administered, and the data collected was analyzed using SPSS version 23.0. Appropriate statistical tests were used to examine the association between dependent and independent variables, while predictor variables that showed significant association with the outcome variables were further subjected to logistic regression analysis, to determine factors that affect clients’ satisfaction with PHC services. Statistical significance was determined at an alpha level set at 0.05 at a 95% confidence interval.ResultsThirty-one percent of the respondents were satisfied with PHC services in Kaduna State with a mean composite satisfaction score of 3.78 ± 0.67. Age, ethnicity, level of education, and occupational status were factors affecting clients’ satisfaction with PHC services among the respondents. On multivariate analysis, age, ethnicity, educational status, and occupational status were significant factors affecting clients' satisfaction with PHC services. Clients of Hausa/Fulani extraction are one and a half times less likely to be satisfied with PHC services when compared to clients from other tribes [aOR = 1.5, 95% CI (1.21–4.67); p = 0.003]. In terms of educational status, clients with formal education are one and a one-third times more likely to be satisfied [aOR = 1.3, 95% CI (0.17–0.94)] with PHC service when compared with their counterparts with informal education (p = 0.034).ConclusionClients’ satisfaction with PHC services in Kaduna State, Northwest Nigeria was sub-optimal. Healthcare providers were recommended to improve their attitude bearing in mind clients’ peculiarities.

Identifying the priorities for supervision by lived experience researchers: a Q sort study

BackgroundLived experience researchers draw on their lived and living experiences to either lead on or inform research. Their personal experiences are relevant to the research topic and so they must manage the interplay of their health and healthcare experiences with the research, population, and data they work with, as well as the more general challenges of being a researcher. Lived experience researchers must navigate these dilemmas in addition to queries over their competency, due to issues relating to intersectionality and epistemic injustice. This justifies a motivation to better understand the experiences of lived experience researchers and develop appropriate and personalised supervision based on their preferences and needs. MethodsQ methodology was used to identify a collection of identity-related issues that impact lived experience researchers during PhD research in the context of the UK. These issues were presented in the form of 54 statements to 18 lived experience researchers to prioritise as topics to explore in supervision.ResultIt was found that lived experiences researchers could be grouped into three distinct factors following an inverted factor analysis: Factor 1: Strengthening my identity, skills, growth, and empowerment; Factor 2: Exploring the emotional and relational link I have with the research and Factor 3: Navigating my lived and professional experiences practically and emotionally. The findings suggest that there may be three types of lived experience researchers, each with different needs from supervision, suggesting the population is heterogeneous.ConclusionThe research identified a deeper understanding of the needs of lived experience researchers and highlights the importance of personalised supervision according to the individual needs of the researcher and their preferences for supervision. The findings reinforce the importance of integrating a clinical dimension into supervision to support the needs of all lived experience researchers.

Healthcare Students' Experiences of Learner-Educator Cocreation of Virtual Simulations: A Phenomenographic Study.

Cocreating virtual simulations with learners during a course is an innovative approach to improving student preparation for real-world practice while helping simulationists meet learner needs, support authentic assessment, and maximize the impact of simulation-based learning. This study explores differences in healthcare students' experiences of learner-educator cocreation of virtual simulations (LECoVSs) using phenomenographic methods. Identifying differences in perceptions of LECoVSs enables educators to make evidence-informed decisions about engaging in simulation cocreation as a tool to maximize learning. Phenomenography focuses on identifying different ways that participants can experience the same phenomenon, in this case, LECoVSs. The setting was a collaborative interprofessional simulation assignment between navigation and nursing students. Participants completed a demographic survey then submitted reflective journals completed during the course and/or an open-ended survey. Data analysis occurred in iterative stages, from familiarization with the data to grouping and interpreting themes. Nineteen open-ended surveys and 13 reflective journals from navigation and nursing students who completed the simulation assignment between 2021 and 2023 were analyzed. Students experienced LECoVSs in 4 increasingly complex ways: (1) supporting consistent student progress, (2) amending course expectations, (3) sharing decision-making, and (4) fostering mutual growth. Simulationists may leverage cocreation to improve student learning, access, empowerment, and professional growth. However, for students to achieve higher learning outcomes, educators need to clearly communicate the full potential of cocreation, how it can occur, and why it can support learning. This study's findings may be used as a framework for explaining simulation cocreation to students to maximize their learning.

Refugee and migrant women’s pathways into and through prisons: A systematic review of qualitative studies

Refugee and migrant women in prison are likely to have experiences of trauma and gender-based violence, which shape their pathways to prison and impact their experiences in prison. This systematic review analyses the findings of qualitative studies to gain a deeper understanding of the experiences of migrant and refugee women before and during imprisonment. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). A systematic search of four academic databases, ProQuest Central, Taylor and Francis Journals, SAGE Journals and APA PsycInfo and web and citation search was carried out between April and October 2022. The search dates for identifying literature were from September 2001 to September 2021. The review’s search strategy identified 3208 articles from 4 databases and 9 studies from web and citation search, of which 11 met the inclusion criteria for the review. Quality appraisal was conducted using the Critical Appraisal Skills Programme (CASP). Four analytic themes were identified that detail refugee and migrant women’s experiences before and during imprisonment: women’s pathways to imprisonment; health care experiences; intersectional identities and women’s agency in the context of prison experiences. The findings suggest that the current systems of incarceration fail to reflect the complexity of women prisoners’ racial and ethnic backgrounds. Thus, there is a need for a greater understanding of refugee and migrant women’s experiences to promote better institutional and community support for women before and during prison to eliminate their pathways to the prison. There have been a few studies with a focus on refugee and migrant women in prison. This is an area which lacks focus in terms of both research and intervention, and this review will make an important contribution in this regard.

Perceptions of Individuals with Autism Spectrum Disorder on How Health Care Providers Address Sexual Health.

Medical providers report barriers that prevent them from discussing sexual health with patients with autism spectrum disorder (ASD). No investigations have examined the perspectives of adults with ASD about their sexual health care experiences. Twenty-five verbal young adults diagnosed with ASD and 40 young adults without ASD participated. An 8-item self-report survey assessed frequency of health care visits, age when sexual health was first discussed, and frequency/content of discussions with providers. The likelihood of discussing sexual health topics did not differ by group, χ 2 s < 3.25; p s > 0.07, except sexual victimization, which the ASD group reported having discussed less than the non-ASD group (32% vs 9%), χ 2 (1, N = 57) = 4.36, p = 0.04. Groups did not differ in their reported comfort level discussing sex/sexual health, having a primary care provider, or frequency of visits. The non-ASD group was significantly more likely to have received sexual health counseling (81%) than ASD group (52%), χ 2 (1, N = 58) = 5.33, p = 0.02. Participants in both groups reported having received sexual health information from similar sources except the ASD group was more likely to receive information from parents than the non-ASD group (68% vs 30%), χ 2 (1, N = 65) = 8.99, p = 0.003. Participants in the ASD and non-ASD groups reported similar comfort levels with sexual health discussions and access to health providers. Yet, the ASD group received less counseling related to sexual health-particularly sexual victimization screening-suggesting that critical information may be missing. Future studies should determine how to help providers overcome barriers to providing young adults with ASD sexual health aligned with their needs.

Ethnicity, disadvantage and pregnancy outcomes in the UK

Inequalities in maternal and perinatal outcomes related to ethnicity and socioeconomic deprivation are widening. Being of Black and Asian ethnicity independently increases the risk of maternal mortality and severe morbidity, as does living in the most deprived areas. Since a higher proportion of women of Asian and Black ethnicity live in the most deprived areas, this effect is compounded. Individual risks, such as obesity, are influenced by health and cultural beliefs and behaviour, social networks and norms, the environments in which we live, and access to and experience of healthcare, which are all intertwined with ethnicity and socioeconomic status. Clinicians can listen to women's and communities needs around ethnicity, race, and social determinants of health. Clinicians can also identify and use networks of community support and promote awareness within their practice and teams. Institutions can employ and retain diverse teams, measure health equity of services and develop an anti-discriminatory institutional culture.

Expert Evaluation of the Organizational Technology for Prolonging Doctors’ Professional Activity

Background. Healthcare professionals fall into the professions that significantly strengthen national economy. In order to avoid national economic losses, we should protect older healthcare professionals as a source of national workforce by developing and implementing a health-saving technology that prolongs their professional effective activity. Based on the previously conducted sociological survey of doctors providing medical care in the polyclinics of Moscow and Moscow Oblast, an assessment of the doctors’ professional competencies was carried out [1] and an organizational technology was formed [2] and then submitted to an expert evaluation. Objective. To expertly evaluate the importance of the activities that are included in the organizational technology prolonging the professional effective activity of older doctors. Materials and methods. The methods of sociological, statistical and expert evaluation were used for studying the experts’ opinions on the importance of each activity of organizational technology for prolonging the professional effective activity of healthcare professionals. Experts (n = 50) were asked to rank the activities according to the importance for achieving the result – support for the professional effective activity of doctors - in the case of the implementation of this organizational technology. The experts were specialists in the field of healthcare and public health: chief physicians, heads of departments of polyclinics in Moscow and Moscow Oblast, accredited in the specialty of the Higher Attestation Commission 03.02.03 "Public health, organization and sociology of healthcare, medical and social expertise" with leadership experience in healthcare from 1 to 29 years. The objectivity of experts’ judgment is based on their knowledge and expertise in healthcare and public health. Findings. The experts progressively evaluated the organizational technology, firstly by each stage and then as a whole. Thus, it was made a conclusion on the effectiveness of organizational technology preserving medical competencies and prolonging the professional effective activity of older doctors.

Patient perspectives and preferences on cerclage and preterm birth: a focus group study

AimThis qualitative focus group study aims to asses cerclage-related symptoms, the impact of a cerclage on daily functioning and patient perspectives of their healthcare experience. This study extends beyond the current focus on surgical and obstetric outcomes of a cerclage, thereby contributing to a more comprehensive understanding of the challenges faced by individuals in the context of extreme preterm birth and fetal loss and the impact of a cerclage on multiple facets in life.MethodsParticipants were recruited from the Amsterdam University Medical Center, Amsterdam, the Netherlands or via the website of a Dutch patient organization for (extreme) preterm birth. Eligible participants were ≥ 18 years old with a previous vaginal and/or abdominal cerclage with a subsequent delivery at ≥ 34 weeks of gestation with neonatal survival. Two focus group discussions (FGD) were performed. A predefined format was used, which was identical for both the vaginal and abdominal cerclage group. The International Classification of Functioning, Disability and Health (ICF-DH) was used to provide structure. Outcomes were a broad range of participants reported perspectives on physical, emotional, and social-related quality of life.ResultsIn the Vaginal Cerclage Group (VCG) and Abdominal Cerclage Group (ACG), respectively, 11 and 8 participants were included. Fear for a subsequent pregnancy loss was the most limiting factor to perform daily activities during pregnancy in all participants with a cerclage. Fear to conceive again because of prior second-trimester fetal loss was experienced by 27% in the VCG and 13% in the ACG. The majority of participants experienced a reduction in anxiety after placement of their cerclage (VCG = 64%, ACG = 75%). Decreased mobility/bedrest (VCG = 100%, ACG = 75%) and blood loss (VCG = 55%, ACG = 13%) were frequently mentioned complaints during pregnancy with cerclage. Other aspects mentioned in both groups were social isolation, the lack of societal participation, and the perceived need to quit work and sports. All participants in the abdominal cerclage group reported a lack of comprehensible and unambiguous information about obstetric management and expectations during pregnancy in secondary care hospitals. Clear communication between secondary and tertiary care hospitals about obstetric management following an abdominal cerclage, for example, about the need for cervical length measurements by ultrasound, the need for bedrest or advice concerning sexual activity was missing (63%). Psychologic support was desired in half of all participants, but was not offered to them.ConclusionsThe fear of a subsequent pregnancy loss was reported as the most limiting factor in daily life by all participants. Cerclage placement resulted in the reduction of anxiety. Participants mentioned a significant impact of bedrest and activity restriction during pregnancy with cerclage on social participation and daily activities. Unfortunately, no high level evidence is available on this matter. Patients might even benefit from appropriate levels of physical activity throughout their pregnancy to promote their overall well-being. More evidence is needed to determine the optimal level of physical activity. There is a need for clear and unambiguous patient information about obstetric management.

Development in the adoption of a national digital healthcare system and experience at taking new technology in use – changes from 2019 to 2022

Introduction. The adoption of a national digital system for healthcare services in Iceland, and how people perceive their possibilities to adopt new technology is examined. Method. Surveys using random samples of people aged 18 years and older were conducted. The samples consisted of 1.800 people in 2019 and 1.200 in 2022. People 18-59 years old were reached by emails and 60 or older by phone. Response rates were 39% in 2019 and 45% in 2022. Analysis. The analysis is descriptive. Survey results from 2019 and 2022 are compared and differences by sex and age examined. Results. Considerable change was detected in use of the system for communication with health professionals tailored to participants health, while no increase was in obtaining information regarding issues not directly connected to people’s health history. The possibilities of adopting health technology were considered substantially better in 2022 than in 2019. Conclusion. People are likely to use digital healthcare systems when the situation requires, and they receive necessary support. It is important to consider the needs of those who are getting older for people to have equal opportunity to benefit from digital health information. Furthermore, reliable information offered by health professionals need to be promoted.