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      Preferences, Needs, and Values of Patients With Chronic Obstructive Pulmonary Disease Attending a Telehealth Service: Qualitative Interview Study

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          Abstract

          Background

          Digitally assisted health care services and technologies are gaining popularity. They assist patients in managing their conditions, thereby reducing the burden on health care staff. Digital health care enables individuals to receive care that is more tailored to their needs and preferences. When implemented properly, it can promote equity by considering each person’s opportunities and limitations in the context of health care needs, preferences, values, and capabilities.

          Objective

          This study aims to understand the needs, values, and preferences of individuals with chronic obstructive pulmonary disease (COPD) who are provided with a 24/7 digital health care service. Furthermore, we aim to understand the dynamics of the communities to which they belong and how these communities intersect. This will provide us with the essential knowledge to establish new methods of providing education, including the development of educational activities for health professionals to engage, train, and empower people living with COPD.

          Methods

          The study included 7 informants diagnosed with COPD who received 24/7 digital health care service support from a regional project in Region Zealand, Denmark. The informants were visited 4 times during 2 months, including a “Hello” visit, a day with a semistructured interview, and 2 days with field observations. The informants participated in a semistructured interview, following participant observation and an ethnographic approach. The interview content was analyzed using an inductive methodology to categorize the empirical data.

          Results

          Using the inductive approach, we identified 3 main categories related to the informants’ needs, values, and preferences: (1) Health, (2) Value Creation, and (3) Resources. These 3 main categories were based on 9 subcategories: (1) health and barriers, (2) self-monitoring, (3) medication, (4) behavior, (5) motivation, (6) hobbies, (7) social networks, (8) health professionals, and (9) technology. These findings revealed that the informants placed value on maintaining their daily activities and preserving their sense of identity before the onset of COPD. Furthermore, they expressed a desire not to be defined by their COPD, as conversations about COPD often shifted away from the topic.

          Conclusions

          Digital health solutions and the health care professionals who offer them should prioritize the individuals they serve, considering their needs, values, and preferences rather than solely focusing on the medical condition. This approach ensures the highest level of daily living and empowerment for those living with long-term health conditions. The communities surrounding individuals must engage in constant interaction and collaboration. They should work together to incorporate people’s needs, values, and preferences into future digital health services, thereby promoting empowerment and self-management. New educational programs aimed at developing the digital health service competencies of registered nurses should facilitate collaboration between the 2 communities. This collaboration is essential for supporting patients with long-term health conditions in their daily activities.

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          Most cited references34

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          The qualitative content analysis process.

          This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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            Sample Size in Qualitative Interview Studies: Guided by Information Power

            Sample sizes must be ascertained in qualitative studies like in quantitative studies but not by the same means. The prevailing concept for sample size in qualitative studies is "saturation." Saturation is closely tied to a specific methodology, and the term is inconsistently applied. We propose the concept "information power" to guide adequate sample size for qualitative studies. Information power indicates that the more information the sample holds, relevant for the actual study, the lower amount of participants is needed. We suggest that the size of a sample with sufficient information power depends on (a) the aim of the study, (b) sample specificity, (c) use of established theory, (d) quality of dialogue, and (e) analysis strategy. We present a model where these elements of information and their relevant dimensions are related to information power. Application of this model in the planning and during data collection of a qualitative study is discussed.
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              Situated Learning

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                Author and article information

                Contributors
                Journal
                JMIR Hum Factors
                JMIR Hum Factors
                JMIR Human Factors
                JMIR Human Factors
                JMIR Publications (Toronto, Canada )
                2292-9495
                2024
                21 June 2024
                : 11
                : e53131
                Affiliations
                [1 ] Medical Department Holbæk Sygehus Region Zealand Holbæk Denmark
                [2 ] Section of Health Services Research University of Copenhagen Copenhagen Denmark
                [3 ] Innovation and Research Centre for Multimorbidity Slagelse Hospital Region Zealand Slagelse Denmark
                [4 ] Department of Public Health University of Copenhagen Copenhagen Denmark
                Author notes
                Corresponding Author: Camilla Wong Schmidt cws@ 123456sund.ku.dk
                Author information
                https://orcid.org/0009-0006-9361-4408
                https://orcid.org/0000-0003-1721-936X
                https://orcid.org/0000-0002-0500-9923
                https://orcid.org/0000-0002-0909-4088
                Article
                v11i1e53131
                10.2196/53131
                11226923
                38905629
                7fc1591d-9760-4627-9b71-2f8e8bd08ae5
                ©Camilla Wong Schmidt, Karen Borgnakke, Anne Frølich, Lars Kayser. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 21.06.2024.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on https://humanfactors.jmir.org, as well as this copyright and license information must be included.

                History
                : 27 September 2023
                : 31 December 2023
                : 29 April 2024
                : 24 May 2024
                Categories
                Original Paper
                Original Paper

                people with long-term health condition,patient education,copd,digital health,ethnography,inductive,ethnographic,chronic,lung,lungs,pulmonary,respiratory,self-management,interview,interviews,qualitative,experience,experiences,attitude,attitudes,opinion,perception,perceptions,perspective,perspectives,acceptance

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