Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study
Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study
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DOI：
10.1136/bmj.328.7449.1159
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发表时间：
2004-05-15
影响因子：
105.7
通讯作者：
Goldberg, HI
中科院分区：
文献类型：
--
作者：
Ralston, JD;Revere, D;Goldberg, HI
目的描述2型糖尿病患者在基于交互式电子病历的网络疾病管理计划中的经历。对登记在糖尿病护理模块中的患者进行定性分析，包括访问他们的电子病历、安全电子邮件、上传血糖读数的能力、带有认可内容的教育网站以及用于输入运动、饮食和药物的交互式在线日记。在美国华盛顿州设置患者的家庭。9名参与者完成了他们使用该计划前后的访谈。结果产生了6个主题：感觉非急性关注是唯一有价值的；对健康和保健的安全感增强；对未实现的期望感到沮丧；感觉更有能力管理；重视反馈；难以将方案纳入日常生活活动。三个主题-评估非急性关注、安全感和未满足的期望-与基于网络的工具的设计和使用特别相关，用于护理糖尿病患者和慢性疾病患者。结论参与者的经验支持进一步研究开放获取电子病历和患者与其护理提供者之间的在线交流。制定基于网络的疾病管理方案应考虑到患者的具体需求和期望，患者和提供者应坦率地讨论基于网络的护理可以提供什么，不能提供什么。
Objective To describe the experiences of patients with type 2 diabetes in a web based disease management programme based on an interactive electronic medical record.Design Qualitative analysis of semistructured interviews with patients enrolled in a diabetes care module that included access to their electronic medical record, secure email, ability to upload blood glucose readings, an education site with endorsed content, and an interactive online diary for entering exercise, diet, and medication.Setting Patients' homes in Washington state, United States.Participants Nine participants aged 45-65 completed interviews before and after they used the programme.Results Six themes emerged: feeling that non-acute concerns are uniquely valued; enhanced sense of security about health and health care; frustration with unmet expectations; feeling more able to manage; valuing feedback; and difficulty fitting the programme into activities of daily life. Three themes-valuing non-acute concerns, feeling secure, and unmet expectations-have particular relevance to the design and use of web based tools for care of patients with diabetes and chronic medical conditions.Conclusion Participants' experiences support further study of open access to the electronic medical record and online communication between patients and their care providers. The development of web based disease management programmes should take into account the specific needs and expectations of patients, and patients and providers should have candid discussions about what web based care can and cannot provide.