Need For Health Care Services Research Articles

Internet of Things-Enabled Technologies for Weight Management in Children and Adolescents: Protocol for a Systematic Review.

BackgroundChildhood obesity is a serious global issue, leading to increased medical spending on obesity-related diseases such as cardiovascular diseases and diabetes. There is a need for health care services that link health behavior to risk factors, such as diet and physical activity, and that provide better advice and feedback to users, which Internet of Things–enabled technologies could facilitate.ObjectiveThe objective of the systematic review will be to identify available Internet of Things–enabled technologies for weight management of children and adolescents (users younger than 18 years). It will also aim to understand the use, effectiveness, and feasibility of these technologies.MethodsWe will search the Medline, PubMed, Web of Science, Scopus, ProQuest Central, and IEEE Xplore Digital Library databases for studies published after 2010, using a combination of keywords and subject headings related to health activity tracking, youth, and Internet of Things. In addition, a Google search to identify grey literature will be conducted. Two authors will independently screen the titles and abstracts identified from the search and accept or reject the studies according to the study inclusion criteria. Any discrepancies will then be discussed and resolved. The quality of the included studies will be assessed using the Critical Appraisal Skills Programme (CASP) checklists. Data from included studies will be extracted into a predesigned form to identify the types of devices or apps, Internet of Things applications, and health outcomes related to weight management.ResultsA preliminary search on Medline returned 484 results. The publication of the final systematic review is expected in mid-2020.ConclusionsThe effectiveness and feasibility of physical activity trackers and consumer wearables for different patient groups have been well reviewed, but there are currently no published reviews that look into these technologies in the wider Internet of Things context. This review aims to address this gap by examining Internet of Things–enabled technologies that are designed for youth weight management and thus inform further research and clinical studies to reduce childhood obesity.International Registered Report Identifier (IRRID)PRR1-10.2196/16930

Barriers to Healthcare for People Who Inject Drugs: A Survey at a Syringe Exchange Program

Objective: Despite research demonstrating increased need for healthcare services among people who use drugs, few studies have investigated barriers to general healthcare in this population. We explored the most common barriers to general healthcare faced by clients utilizing syringe access services. Methods: Clients of Project Safe Point— a syringe access service serving Albany, NY and surrounding regions—were surveyed on their general health practices and specific health care barriers. Descriptive analyses were used to identify which barriers were most prevalent. Results: Of the clients surveyed (n = 59), the most common specific barriers were deprioritization of medical care (i.e., procrastination [80%], finding it easier to ignore the problem [63%]), cost (i.e., not having insurance [59%], not being able to afford the cost of care [58%]), transportation (53%), and judgement by clinicians (53%). When participants were asked to choose which was their biggest barrier to healthcare, judgement by clinicians was chosen more than twice as often as any other barrier. Conclusion: While people who inject drugs at a syringe access program often experience traditional barriers to healthcare (i.e., logistical barriers, procrastination), nearly a quarter of the clients reported feeling judged by clinicians as their most significant barrier. Future work in this field should explore interventions that motivate clients to seek care and that reduce stigma in healthcare interactions.

Impact of Prolonged Lockdown due to COVID-19 in Patients with Parkinson's Disease

The COVID-19 pandemic has compelled countries to impose lockdowns to curb the spread. As a result of the lockdown and need for health care services to cater to acute diseases on priority, patients with chronic illnesses such as Parkinson's disease (PD) may be facing several difficulties. This study aimed to explore the effects of prolongation of lockdown on patients with PD by evaluating possible problems faced during a lockdown and worsening of symptoms if any. One hundred patients with PD and their caregivers were contacted. We observed a significant increase in problems faced due to this pandemic, specifically, the inability to access health care, and difficulty procuring medication. Patients also reported worsening of motor symptoms. The present findings highlight the need for health care systems to consider a plan of action for chronic neurological diseases like PD, which are worsening in the absence of regular hospital visits.

Morbidity Pattern among Elderly Population of Changu Narayan Municipality, Bhaktapur.

The Senior Citizens Acts 2063, Nepal defines the senior citizens (elderly population) as "people who are 60 years and above". Health is the most important determinant of the quality of life of people. Ill-health becomes a major obstacle for the well-being of the elderly population. This study was conducted to assess the morbidity pattern in elderly population. A community based cross-sectional study was carried out in field practice area of the Department of Community Medicine. 124 elderly population were selected by convenient sampling technique. A structured questionnaire was used to collect the data. Data was analyzed using SPSS version 20. Chi-square was used to test the association and p<0.05 was considered as significant. The mean age of elderly population was 69.85 years. Majority (47.6%) of them were in the age group of 60-69 years. Males (50.8%) were more than females (49.2%). Twelve respondents (9.7%) were not suffering from any form of morbidity. Most common morbidity was muscular skeleton problem (40.8%), followed by hypertension (36.3%), diabetes (29.8.8%), psychological (23.4%) and respiratory (18.6%). Other morbidities gastrointestinal, dental, ENT, eye and genitourinary system were found in around ten percentage of elderly population Conclusions: Majority of the elderly population were suffering from non-communicable diseases. There is a need for health care services at all level with special focus on disease prevention, early detection and treatment for elderly population. This study found high prevalence of musculoskeletal, hypertension, diabetes and psychological problem and low prevalence of respiratory, gastrointestinal, dental, ENT, genitourinary and eye problem.

Asylum seekers’ mental health in the Finnish Asylum Seekers Health and Wellbeing Survey (TERTTU)

Abstract Background Asylum seekers have major health and well-being burdens, including mental health. However, there is a lack of population-based survey data on the health status and service needs of asylum seekers in Europe. The TERTTU-project was launched to fill these information gaps and to develop the current health examination protocol for assessing the health, well-being and need for health care services, including mental health, of newly arrived asylum seekers. Methods As part of the TERTTU-project, systematic, nationally representative data was collected in 2018 by conducting a health examination and a face-to-face interview survey in reception centers in Finland (n = 1087). The sample was drawn from the Finnish Immigration Services electronic asylum database. Mental health was assessed with the HSCL and PROTECT questionnaires (SDQ among the children), along with questions of potentially traumatic experiences. Results 39% (95% CI 35,6-42,6) of the adults had current severe depressive and anxiety symptoms, 50% (95% CI 46,9-53,9) had an increased risk for PTSD, and 83% (95% CI 80,0-85,3) had experienced at least one potentially traumatic event before arriving to Finland. The most common psychosocial symptoms among 2-6 year-olds were behavioral symptoms (49%) and difficulties in peer relationships (37%). Difficulties in peer relationships were also common among 7-17 year-olds (49%), followed by challenges in the emotional domain (42%). Conclusions Potentially traumatic experiences and mental health problems are common among asylum seekers in Finland. Based on the survey-data, a national health examination protocol will be developed in 2019 to improve assessment and identification and to enable systematic health monitoring and evidence-based development of services for asylum seekers. A common health examination protocol will also unify practices across reception centers all over the country. Key messages Potentially traumatic experiences and mental health problems are common among asylum seekers in Finland. A national health examination protocol allows for the early identification of vulnerable groups and individuals.

Predicting the Cost of Health Care Services: A Comparison of Case-mix Systems and Comorbidity Indices That Use Administrative Data.

Case-mix systems and comorbidity indices aggregate clinical information about patients over time and are used to characterize need for health care services. These tools were validated for their original purpose, but those purposes are varied, and they have not been compared directly in the context of predicting costs of health care services. To compare predictions of next-year health care service costs across 4 tools, including: the Johns Hopkins Adjusted Clinical Groups (ACG), the Elixhauser Comorbidity Index, Charlson-Deyo Comorbidity Index, and the Canadian Institute for Health Information (CIHI) population grouper. British Columbia administrative data from fiscal years 2012-2013 were used to generate case-mix variables and the comorbidity indices. Outcome variables include next-year (2013-2014) total, physician, acute care, and pharmaceutical costs, Outcomes were modeled using 2-part models. Performance was compared using adjusted R, root mean squared error, and mean absolute error using the predicted and the actual next-year cost. Models including the CIHI grouper (239 conditions) and ACG system had similar performance in most cost categories and slightly better fit than Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). Adding a dummy variable for nonusers in the models for CCI and ECI increased R values slightly. All these systems have empirical support for use in predicting health care costs, despite in some cases being developed for other purposes. No system is particularly effective at predicting next-year acute care cost, likely because acute events are often by definition unexpected. The freely available ECI and CCI comorbidity indices implemented using the highest-performing methods developed here may be a good choice in many circumstances.

The use of mobile systems to access health care big data in the Namibian environment

AbstractAs the need for health care services increases, some health facilities in many developing countries such as Namibia are challenged with accessing its big data. Despite the success of mobile systems, its use to access health care big data is challenging, which have impact on manageability and improvement of service delivery. The main problem is that the factors that influence interaction between mobile systems and health care big data are not empirically known within the Namibian context. The Namibian Ministry of Health (MoH) was therefore used as a case in this study. Qualitative methods and an interpretivist approach were employed, and structuration theory was used to underpin the study, which means the theory guided the analysis of the data. From the analysis, five factors were found to influence interaction in the use of mobile systems to access health care big data. On the basis of these factors, a model is proposed, which is a contribution to improving health care service delivery in the country through its practical implications: guiding interactions among health care stakeholders and developing policy for accessing patients' big data.

Access to primary care for persons with spinal cord injuries in the greater Gaborone area, Botswana.

BackgroundPeople with spinal cord injury (SCI) often have great need for healthcare services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana.ObjectiveThis study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone area, Botswana.MethodsA quantitative, cross-sectional, observational study was conducted. Data were collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive and inferential analysis was performed.ResultsThe male to female ratio was 2.8:1. The mean age of participants was 40 years (standard deviation 9.59). Road traffic crashes caused 85% of the injuries. Most participants visited primary care facilities between 2 and 10 times in the 6 months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated satisfaction with services. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height-adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs.ConclusionPrimary care services were mostly affordable and adequate. Availability, acceptability and accessibility aspects created barriers.

Understanding rural caregivers’ experiences of cancer care when accessing metropolitan cancer services: a qualitative study

ObjectiveTo explore the experiences of cancer caregivers who live in rural Australia and travel to a metropolitan cancer health service to access cancer treatment.DesignA qualitative study using semistructured, audio-recorded interviews...

Asthma attack prediction based on weather factors

Asthma is a chronic disease which concern public health over all the world. Predicting overabundant need for healthcare services is helpful for healthcare suppliers, as it allows them to adequately plan and provide the resources that deliver services easier and suitably. Several researches have linked asthma triggers with weather and environmental changes. In this study, ‘linear regression model (LRM)‘ and ‘quantile regression model (QRM)’ are used to predict overabundant need for healthcare services for asthma monthly admissions in Polk, using backdated data from 2010 to 2017. Five weather variables were examined: maximum temperature, minimum temperature, precipitation level, humidity and thunderstorms. LRM and QRM models of asthma monthly admissions are fitted in two ways: the first way is the base model which using all the weather variables, and the second way is the reduced model which using a subset of these variables according to the pseudo R2. Models were cross-validated using the mean absolute percentage error and the level of accuracy. The base QRM predictive model with the 45th percentile of the distribution was the best fit and it detect utmost number of monthly asthma admissions at accuracy of 87.55 %, followed by base LRM with an accuracy of 87.13 %. The reduced LRM and QRM models give lower results with an accuracy of 86% and 85.9% respectively. The finding suggest that the weather variables are giving better results for the predictive model even if they have a low correlation relationship. The combination between weather variables and asthma, taking in temperature, precipitation level, humidity and thunderstorms can be utilized in predicting future asthma admission patients.

Re-thinking unmet need for health care: introducing a dynamic perspective.

There is an increasing interest in assessing unmet need for health care services particularly in European countries. Despite this there has been relatively little analysis of unmet need in the European or wider international setting. It remains a challenge to pin down what types of unmet need can and should be addressed by health care policymakers, and how to go about identifying and quantifying those unmet needs. The objective of this paper is to propose a new way of thinking about unmet need for health care which can in turn guide analysis of unmet need in terms of potential data sources and analytic approaches. Unmet need is shown to be a complex multi-faceted concept that cannot be captured by a single indicator or measurement. To advance the literature in this field, this paper considers what happens to unmet need over time. By introducing a dynamic perspective, three alternative trajectories for health care needs are outlined: non-use of health care, delayed use of health care and sub-optimal use of health care. These trajectories are discussed with a view to improving the focus, and policy applicability, of empirical research in this field.

Abstract 245: Association Between Levels of Caregiver Engagement and Rates of Self-reported Healthcare Utilization After Stroke: A Mixed Methods Study

Background: Caregivers (CGs) are critical in helping stroke survivors retain function and receive adequate healthcare. We aimed to identify the activities that CGs are engaged in over the course of stroke care and explore the association between levels of CG engagement and rates of post-stroke formal healthcare utilization for care recipients (CRs). Methods: We qualitatively analyzed 9-month post-stroke interviews with CRs (n=118; 57.6) and CGs (n=87; 42.4%) about their experience before, during and following the stroke from the Caring for Adults Recovering from the Effects of Stroke (CARES)study. A codebook with data-driven codes was developed using an inductive iterative process and codes were assigned by two coders with 94.9% agreement. We classified CRs as having either engaged or non-engaged CGs based on whether they indicated CG involvement in any part of their stroke care in the interviews. Using Fisher’s exact test, we compared differences between groups in rates of self-reported visits to medical doctors, physical therapists, hearing or speech language pathologists (SLP), home health nurses/aids/personal attendants and mental health professionals, as well as differences in the number of emergency room (ER) visits and hospitalizations. Results: Interviewees most often described CG involvement as driving the CR to the hospital or calling 911 (n=48; 23.4%), requesting additional inpatient care (n=20; 9.8%), coordinating medical appointments (n=43; 21.0%) and monitoring recovery (n=23; 11.2%). CRs with engaged CGs had worse functioning (Stroke Impact Scale [median]=630.0 vs. 689.2; P=0.045), higher rates of audiology or SLP visits (33.3% vs. 22.6%; P=0.033) and more ER visits (mean 2 visits vs.1 visit; P=0.0032) compared to those with non-engaged CGs (Table 1). Conclusions: CRs with engaged CGs had higher rates of healthcare utilization compared to those with non-engaged CGs, suggesting that access to services may be facilitated by the CG. Higher rates of utilization may also be driven by more severe strokes and greater need for healthcare services in this group. Future research should focus on stroke severity as a potential modifier in the relationship between CG engagement and healthcare utilization.

Socially Accountable Academic Health Centers: Pursuing a Quadripartite Mission.

Academic health centers (AHCs) in the United States have had a leading role in educating the medical workforce, generating new biomedical knowledge, and providing tertiary and quaternary clinical care. Yet the health status of the U.S. population lags behind almost every other developed world economy. One reason is that the health care system is not organized optimally to address the major driver of health status, the social determinants of health (SDOH). The United States' overall poor health status is a reflection of dramatic disparities in health that exist between communities and population groups, and these are associated with variations in the underlying SDOH. Improving health status in the United States thus requires a fundamental reengineering of the health delivery system to address SDOH more explicitly and systematically. AHCs' tripartite mission, which has served so well in the past, is no longer sufficient to position AHCs to lead and resolve the intractable drivers of poor health status, such as unfair and unjust health disparities, health inequities, or differences in a population's SDOH.AHCs enjoy broad public support and have an opportunity-and an obligation-to lead in improving the nation's health. This Perspective proposes a new framework for AHCs to expand on their traditional tripartite mission of education, research, and clinical care to include explicitly a fourth mission of social accountability. Through this fourth mission, comprehensive community engagement can be undertaken, addressing SDOH and measuring the health impact of interventions by using a deliberate structure and process, yielding defined outcomes.

Poverty predictors in the Czech Republic: do health predictors also matter?

Poverty has been investigated from various perspectives. Less attention has been paid to the health dimension however. The aim of the paper is to determine the impact of health predictors on poverty in the Czech Republic. Data from the Statistics on Income and Living Conditions and the method of logistic regression is used. We found that poverty is associated with health issues. Unmet need for healthcare services is a significant predictor of all observed types of poverty. The presence of health problems limiting individual's activities is associated with a risk of material deprivation and consistent poverty.

Self-reported health and quality of life outcomes of heart failure patients in the aftermath of a national economic crisis: a cross-sectional study.

AimsThere are indications that economic crises can affect public health. The aim of this study was to describe characteristics, health status, and socio‐economic status of outpatient heart failure (HF) patients several years after a national economic crisis and to assess whether socio‐economic factors were associated with patient‐reported outcome measures (PROMs).Methods and resultsIn this cross‐sectional survey, PROMs were measured with seven validated instruments, as follows: self‐care (the 12‐item European Heart Failure Self‐Care Behaviour scale), HF‐related knowledge (Dutch Heart Failure Knowledge Scale), symptoms (Edmonton Symptom Assessment System), sense of security (Sense of Security in Care—‘Patients' evaluation’), health status (EQ‐5D visual analogue scale), health‐related quality of life (HRQoL) (Kansas City Cardiomyopathy Questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale). Additional data were collected on access and use of health care, household income, demographics, and clinical status.The patients' (n = 124, mean age 73 ± 14.9, 69% male) self‐care was low for exercising (53%) and weight monitoring (50%) but optimal for taking medication (100%). HF‐specific knowledge was high (correct answers 12 out of 15), but only 38% knew what to do when symptoms worsened suddenly. Patients' sense of security was high (>70% had a mean score of 5 or 6, scale 1–6). The most common symptom was tiredness (82%); 12% reported symptoms of anxiety, and 18% had symptoms of depression. Patients rated their overall health (EQ‐5D) on average at 65.5 (scale 0–100), and 33% had poor or very bad HRQoL. The monthly income per household was <€3900 for 84% of the patients. A total of 22% had difficulties making appointments with a general practitioner (GP), and 5% had no GP. On average, patients paid for six health care‐related items, and >90% paid for medications, primary care, and visits to hospital and private clinics out of their own pocket. The cost of health care had changed for 71% of the patients since the 2008 economic crisis, and increased out‐of‐pocket costs were most often explained by a greater need for health care services and medication expenses. There was no significant difference in PROMs related to changes in out‐of‐pocket expenses after the crisis, income, or whether patients lived alone or with others.ConclusionsThis Icelandic patient population reported similar health‐related outcomes as have been previously reported in international studies. This study indicates that even after a financial crisis, most of the patients have managed to prioritize and protect their health even though a large proportion of patients have a low income, use many health care resources, and have insufficient access to care. It is imperative that access and affordable health care services are secured for this vulnerable patient population.

The cost incurred by victims of bullying from a societal perspective: estimates based on a German online survey of adolescents

Being a victim of bullying is linked to various social, emotional and behavioral problems potentially leading to a reduced quality of life. Furthermore, victims of bullying may cause extensive costs for society, for example by an above-average need for healthcare services. The present study was designed to quantify the costs and the loss of quality of life attributable to bullying by comparing victims with a control group of non-bullied students. A cross-sectional sample of 1293 adolescents (mean age 14.07, SD = 1.36) and their parents reported on bullying victimization, quality of life (adolescents' self-report), and annual direct (medical and non-medical) as well as indirect costs (parents' self-report) from a societal perspective (all expressed in €, year 2014 and 2015). For frequent (20.6% of our sample; costs: €8461.80 p.a.) but not occasional (13.3%; costs: €2850.06) bullying, victimization was associated with significantly higher costs compared to non-bullied adolescents (costs: €3138.00; annual difference between frequently bullied students and controls: €5323.01 p.a.; p = 0.008). Cost drivers included increased direct medical costs, but mostly indirect costs caused by productivity losses of the parents. Self-reported quality of life of frequent victims was considerably reduced (T = - 10.96; p < 0.001); also occasional bullying showed significantly reduced values in global quality of life (T = - 5.73; p < 0.001). The present findings demonstrate that frequent bullying is associated with substantial cost to society and reduced quality of life of victims. This observation underscores the need for effective school-based bullying prevention and suggests a high potential of effective programs to be cost effective as well.

30-day all-cause readmission rates among a cohort of individuals with rare conditions

BackgroundThere is a need to examine health care utilization of individuals with the rare conditions muscular dystrophies, spina bifida, and fragile X syndrome. These individuals have a greater need for health care services, particularly inpatient admissions. Prior studies have not yet assessed 30-day all-cause readmission rates. ObjectiveTo estimate 30-day hospital readmission rates among individuals with three rare conditions. HypothesisRare conditions patients will have a higher 30-day all-cause readmission rate than those without. MethodsData from three sources (2007–2014) were combined for this case-control analysis. A cohort of individuals with one of the three conditions was matched (by age in 5 year age groups, gender, and race) to a comparison group without a rare condition. Inpatient utilization and 30-day all-cause readmission rates were compared between the two groups. Logistic regression analyses compared the odds of a 30-day all-cause readmission across the two groups, controlling for key covariates. ResultsA larger proportion in the rare condition group had at least one inpatient visit (46.1%) vs. the comparison group (23.6%), and a higher 30-day all-cause readmission rate (Spina Bifida-46.7%, Muscular Dystrophy-39.7%, and Fragile X Syndrome-35.8%) than the comparison group (13.4%). Logistic regression results indicated that condition status contributed significantly to differences in readmission rates. ConclusionsHigher rates of inpatient utilization and 30-day all-cause readmission among individuals with rare conditions vs. those without are not surprising, given the medical complexity of these individuals, and indicates an area where unfavorable outcomes may be improved with proper care coordination and post discharge care.

Factors associated with health-related quality of life 6years after ICU discharge in a Finnish paediatric population: a cohort study.

Long-term data are urgently needed in children after intensive care. The aim of this study was to measure health-related quality of life 6years after intensive care in a paediatric intensive care population. This national, multicentre study enrolled all children and young people admitted to intensive care units (ICUs) in Finland in 2009 and 2010. The data concerning ICU stay were collected retrospectively from the ICU data registries and combined with prospective data from Paediatric Quality of Life Inventory (PedsQL 4.0) questionnaires, the generic 15D, 16D or 17D instrument, and data regarding children's chronic diagnoses and need for healthcare support. The questionnaires were answered by 1109 of 3682 living children and adolescents admitted to an ICU, response rate was 30.1%. Among the responders, 90 children (8.4%) had poor (under - 2 SD) PedsQL scores. Children with low scores had a higher rate of chronic diagnoses (94.4% vs. 47.6%), medication on a daily basis (78.7% vs. 29.4%) and a greater need for healthcare services (97.7% vs. 82.2%) than those with normal scores. Diagnoses associated with poor quality of life were asthma, epilepsy, cerebral palsy and other neurological diseases, chromosomal alterations, cancer and long-term pain. These children were mostly admitted electively, and less frequently on an emergency basis, but no other significant differences were found during the intensive care stay. The long-term quality of life after paediatric intensive care is good for the majority of children and young people, and it is dependent on the number of chronic diagnoses and the burden of the chronic disease, especially neurological diseases.

Demographic, psychosocial, and health- and disability-related factors associated with psychological distress among people with physical disabilities.

Psychological distress among people with physical disabilities (PWPD) might affect their physical morbidity, reduce their quality and duration of life, and increase their need for health care services. Therefore, it is essential to explore the factors that might affect psychological distress among PWPD. The current study assesses the association between demographic factors (gender, education, and employment status), health- and disability-related factors (type of disability, visibility of the disability, disability duration, and self-rated health), and psychosocial factors (perceived discrimination and perceived social support), and psychological distress among PWPD in Israel. The data were collected through structured questionnaires administered to a sample of 433 PWPD. The findings suggest negative associations between education, employment status, duration of disability, self-rated health, and perceived social support, and psychological distress among PWPD. In addition, the findings indicate a positive association between perceived discrimination and psychological distress. No association was found between gender, type of disability, and visibility of the disability, and psychological distress. PWPD who are unemployed, less educated, with a shorter duration of disability and lower self-rated health, as well as those who feel more discriminated against and less social support, are more likely to experience higher levels of psychological distress. Therefore, it is important to raise PWPD's awareness of their rights and of the social possibilities and services available to them, to provide them with mental help, to engage in extensive social activities aimed at providing resources to PWPD, and to act to eliminate discrimination. (PsycINFO Database Record

The importance of ethical aspects when implementing eHealth services in healthcare: A discussion paper.

The aim of this paper was to discuss the importance of ethical aspects when implementing eHealth services in health care. Challenges in healthcare today include a growing older population and, as a consequence, an increased need for healthcare services. One possible solution is the use of eHealth services. Discussion paper. Research literature published from 2000-2017 in CINAHL, PubMed and Scopus. Implementing eHealth services in health care involves ethical challenges where different technologies can solve different problems in different ways. eHealth services should therefore be developed and implemented based on the patient's specific needs and conditions for use and in accordance with the healthcare professionals' presumption to provide high-quality care. To preserve patients' integrity, dignity and autonomy, healthcare professionals must include ethical aspects when implementing and using eHealth services in health care. Healthcare professionals have to take responsibility for the eHealth services introduced, explaining why and how they are implemented based on a person-centred approach. More knowledge is needed about ethical aspects when implementing eHealth services to improve the quality of care.