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BackgroundThe internet-based stepped-care intervention iCAN-DO, used in the multicenter randomized controlled trial AdultCan, was developed for adult patients undergoing treatment for cancer and concurrently experiencing anxiety or depressive symptoms. iCAN-DO aimed to decrease symptoms of anxiety or depression. Step 1 comprises access to a library with psychoeducational material and a peer-support section, as well as the possibility to pose questions to a nurse. Step 2 of the intervention offers treatment consisting of internet-based cognitive behavioral therapy (iCBT) to participants still experiencing anxiety or depression at 1, 4, or 7 months after inclusion. ObjectiveThe study aimed to explore user experiences of delivery, design, and structure of iCAN-DO from the perspective of people with cancer. MethodsWe studied user experiences by interviewing 15 informants individually: 10 women with breast cancer (67%), 4 men with prostate cancer (27%), and 1 man with colorectal cancer (7%) with a mean age 58.9 years (SD 8.9). The interviews focused on informants' perceptions of ease of use and of system design and structure. Informants had been included in iCAN-DO for at least 7 months. They were purposefully selected based on activity in Step 1, participation in iCBT (ie, Step 2), gender, and diagnosis. ResultsOf the 15 informants, 6 had been offered iCBT (40%). All informants used the internet on a daily basis, but 2 (13%) described themselves as very inexperienced computer users. The analysis revealed three subthemes, concerning how user experiences were affected by disease-specific factors and side effects (User experience in the context of cancer), technical problems (Technical struggles require patience and troubleshooting), and the structure and design of iCAN-DO (Appealing and usable, but rather simple). ConclusionsThe results indicate that user experiences were affected by informants’ life situations, the technical aspects and the design of iCAN-DO, and informants’ preferences. The results have generated some developments feasible to launch during the ongoing study, but if iCAN-DO is to be used beyond research interest, a greater level of tailoring of information, features, and design may be needed to improve user experiences. The use of recurrent questionnaires during the treatment period may highlight an individual’s health, but also function as a motivator showing improvements over time.

Background and context: This study investigates differences in views of girl and boy members of a CS club. Objective: Understanding differences in the views of girls and boys regarding perceived parental attitudes and values, social support, appreciation of CS, and engagement in science and CS. Understanding differences in girls' and boys' view of CS, and future study and work aspirations related to science/CS.M Method: A survey was distributed to all members of a CS club. 115 boys and 39 girls aged 9-16 completed the survey, yielding a response rate of 16.8%. Findings: Similar parental support was perceived by both genders, although girls are less likely to appreciate CS and to aspire to work or study CS. Girls tend to primarily talk to family about CS and science. Girls and boys have a similar perception of CS, but their motivation for wanting to work with CS varied. Implications: Having support, a broad understanding of CS, and a personal interest are critical aspects when it comes to girls' participation in CS, but these are insufficient in making girls aspire to work or study CS. Educators need to reflect on other aspects of CS education that can promote girls' aspiration in CS.

Introduction: We report results of a study of how ordering and reading of printouts of medical records by regular and inexperienced readers relate to how the records are used, to the health information practices of patients, and to their expectations of the usefulness of new e-Health services and online access to medical records. Method: The study is based on a combined postal- and Web-survey of a simple random sample of 1,000 patients who ordered a paper copy of their medical records from the Uppsala county council (Sweden) with a final analysed sample of 354 returned questionnaires. Analysis: The data were analysed using SPSS 21.0 using descriptive statistics, one-way analysis of variation (ANOVA) using Tamhane's T2 test, chi-squared tests and logistic regression analysis. Results: The analysis shows that individuals who had ordered a copy of their medical records in the past perceive their usefulness in broader terms than first-timers. The regular readers are also most concerned about their health and the quality of care. Conclusions: It seems that in addition to certain demographic factors, many of the variations in the data can be explained in terms of adaptive structuration theory. This is a result of a parallel structuration of patients, medical records and the paper-based and online technologies of access, and consequently how patients perceive records and the different methods of accessing and using them.

Literature on global employability signifies "enabling" learning environments where students encounter ill-formed and open-ended problems and are required to adapt and be creative. Varying forms of "projects," co-located and distributed, have populated computing curricula for decades and are generally deemed an answer to this call. We performed a qualitative study to describe how project course students are able to capitalize on the promise of enabling learning environments. This critical perspective was motivated by the circumstance of the present-day education systems being heavily regulated for the precipitated production of human capital. The students involved in our study described education system-imposed and group-imposed narratives of narrowed opportunities, as well as many self-related challenges. However, students welcomed autonomy as an enjoyable condition and linked it with motivation. Whole-group commitment and self-related attributes such as taking care of one's own learning appeared as important conditions. The results highlight targets for interventions that can counteract constraining study conditions and continue the march of projects as a means to foster complex learning for the benefit of students and professionalism in global software engineering.

Informal caregivers (ICs), including the patient's spouse, close relatives, or friends, play an important role in caregiving individuals with head and neck cancer (HNC). AI-based chatbots might offer information and assistance related to caregiving. This study presents the viewpoints of ICs and healthcare professionals (HCPs) on using AI-based chatbots in caring for individuals with HNC. A total of six focus groups were conducted with 15 ICs and 13 HCPs from three Swedish university hospitals. The study uncovers a widespread hesitancy toward the intention to use AI-based chatbots among ICs and HCPs. Factors contributing to this reluctance include their distrust in chatbot-provided information, negative past experiences of using chatbots, and lack of human connection in chatbot interactions. Embracing a holistic approach is crucial when designing chatbots, ensuring active user engagement and incorporating their perspectives into the design process. [ABSTRACT FROM AUTHOR]

The rapid shift to digital healthcare, accelerated by the COVID-19 pandemic, holds promise for sustainable healthcare delivery and climate change mitigation. This study evaluates the Alltid öppet application through the lens of usability and patient satisfaction and their correlation with the intention for continued use. A cross-sectional analysis of primary care patients revealed that alignment with user needs significantly predicts long-term adoption, while frustration during use discourages it. Ease of use did not significantly affect the intention to continue, suggesting that usability alone is insufficient to drive sustained engagement. These findings highlight user-centred design's importance in digital healthcare solutions, suggesting that enduring adoption hinges on value perception and reducing user frustration. As the healthcare sector navigates its digital future, this study offers crucial insights into the design and implementation strategies that could underpin the environmental sustainability and resilience of healthcare systems. [ABSTRACT FROM AUTHOR]

Informal caregivers, crucial contributors to healthcare, face myriad challenges in supporting individuals with health needs. While IT applications offer promising solutions, some caregivers hesitate to adopt them, favoring traditional communication approaches with healthcare and support providers. This study, conducted in Sweden, presents why caregivers are reluctant to use IT applications. Through a qualitative approach involving group interviews with caregiver association members, four key themes emerged, namely, need for in-person support with grief and stress, need for private support spaces, cognitive impairment, and financial constraints. Understanding these barriers is crucial for developing inclusive caregiving strategies that balance IT-based solutions with in-person assistance, promoting a sustainable caregiving support ecosystem. [ABSTRACT FROM AUTHOR]

The implementation of Open Notes in Sweden, granting patients access to their clinical records, has been a complex and nuanced endeavor, marked by regional variations in strategy and challenges arising from the diverging needs of healthcare providers and patients. This paper presents an interview study with managers about the implementation process in five of the 21 regions in Sweden. The aim of this study is to explore the experiences and strategies of these managers in navigating the implementation challenges. The study sheds light on the prevalent theme of uncertainty throughout the implementation journey and the strategies used to balance conflicting perspectives. The findings contribute to our understanding of Open Notes implementation and offer policymakers and healthcare organizations insights about enhancing the implementation process to optimize patient care. [ABSTRACT FROM AUTHOR]

As the complexity of IT systems increases, the demand for methods taking the whole work situation into account grows. The Vision Seminar (VS) process addresses the future usage of technologies in complex digital work environments. This paper describes the experiences of conducting the VS process in the context of a large IT project to improve study-administrative work. The participants and stakeholders' experiences of participating in VS workshops were studied as the effect the participants and stakeholders believed the vision might have. Data were gathered through interviews and a survey. The participants were confident that the time spent on workshops was worthwhile and that achieving the future described in the resulting vision was feasible. The stakeholders perceived the VS process as rigorous. They were happily surprised by the positive spirit and engagement displayed by the participants. The utility of the resulting vision not being obvious was the most notable weakness mentioned. [ABSTRACT FROM AUTHOR]

Being an informal caregiver is not easy, and might cause physical and psychosocial burden, especially in the long run. However, the formal health care system has little support for informal caregivers who experience abandonment and lack information. Mobile health can potentially be an efficient and cost-effective way of supporting informal caregivers. However, research has shown that mHealth systems often have problems with usability, and people do not use the systems for more than a short period. Therefore, this paper explores the design of an mHealth app using Persuasive Design, an established design framework. This paper presents the design of the first version of the e-coaching application using the persuasive design framework and unmet needs of informal caregivers from the literature. This prototype version will be updated based on interview data from informal caregivers in Sweden. [ABSTRACT FROM AUTHOR]

Previous research has established that leaders in information and communication technology (ICT) are crucial for establishing a user-centred systems design perspective in ICT for work-related tasks. This paper therefore describes the perspectives of 18 ICT leaders in three kinds of leadership roles (managers, project leaders and specialists) in order to understand their views of user-centred systems design concerning ICT. It uses the concept of technological frames of reference to analyse three domains: technology-in-use, technology strategy and nature of technology. The results show that many specialists see user involvement as a critical factor in successfully establishing new information and communication technologies, but that these systems are currently built around the needs of management rather than end users. Looking forward, all three relevant social groups are optimistic about how ICT will become more user-centred and more strategically aligned in the future. However, changes in ICT are described as extremely energy-consuming and difficult – akin to 'walking in the jungle with a machete'. Finally, we discuss the relevance of technological frames and present some implications for the successful establishment of user-centred system design as a perspective in organisations. [ABSTRACT FROM AUTHOR]

Several Nordic and Baltic countries are forerunners in the digitalization of patient ehealth services and have since long implemented psychiatric records as parts of the ehealth services. There are country-specific differences in what clinical information is offered to patients concerning their online patient accessible psychiatric records. This study explores national differences in Sweden, Norway, Finland, and Estonia in patient access to their psychiatric records. Data was collected through a socio-technical data collection template developed during a workshop series and then analyzed in a cross-country comparison focusing on items related to psychiatry records online. The results show that psychiatric records online are offered to patients in all four countries, and provide the same functionality and similar psychiatry information. Overall, the conclusion is that experiences of various functionalities should be scrutinized to promote transparency of psychiatric records as part of the national eHealth services to increase equality of care and patient empowerment. [ABSTRACT FROM AUTHOR]

This study explores patients' perspectives on sharing their personal health data, which is traditionally shared through discussions with peers and relatives. However, other possibilities for sharing have emerged through the introduction of online services such as Patient Accessible Electronic Health Records (PAEHR). In this article, we investigate strategies that patients adopt in sharing their PAEHR. Data were collected through a survey with 2587 patients and through 15 semi-structured interviews with cancer patients. Results show that surprisingly few patients share their information, and that older patients and patients with lower educational levels share more frequently. A large majority of patients trust the security of the system when sharing despite the high sensitivity of health information. Finally, we discuss the design implications addressing identified problems when sharing PAEHR, as well as security and privacy issues connected to sharing. [ABSTRACT FROM AUTHOR]

The work environment for nurses is challenging, and even though new technology has major advantages, it has often also caused new stressors and problems for nurses. When Patient Accessible Electronic Health Records (PAEHR) was introduced in Sweden, research showed that nurses were worried about possible negative effects for patients as well as on their work. However, to this date there are very few follow up studies on the more long term effects of PAEHR, despite research pointing to the fact that reactions after long term use might differ from initial experiences. In this paper we present an interview study to fill this research gap. An analysis based on interviews with physicians and nurses in Oncology care reveals three areas where nurses’ work is experienced to have been affected: 1) nurses receive more questions from patients after PAEHR has been introduced, 2) nurses have changed their documentation practices and 3) the log list functionality has made nurses feel questioned. Finally, these results are discussed in relation to nurses’ work environment from a sociotechnical and gender perspective. [ABSTRACT FROM AUTHOR]

Patient accessible electronic health records have been launched in many countries, and generally, health-care professionals have had strong initial concerns related to the areas patient contact, documentation practices and quality of care. Especially, oncology care was discussed in media when launching patient accessible electronic health records in Sweden. However, few studies have investigated clinician-perceived effects several years after the launch. A survey covering these areas, as well as supposed effects for patients, was distributed to oncology health-care professionals 6 years after the launch of patient accessible electronic health records and answered by N = 176. Results show that patient accessible electronic health records have had small effects within the covered areas, and that the area most affected was documentation practices. Very few significant differences could be found between physicians and nurses. A comparison with results from interviews and surveys conducted shortly after the launch of patient accessible electronic health records clearly indicates that the experienced negative effects are not as big as originally feared. [ABSTRACT FROM AUTHOR]

Patients’ access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients’ attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital. [ABSTRACT FROM AUTHOR]

In 2012 Patients Accessible Electronic Health Records (PAEHR) was introduced in Region Uppsala, Sweden. When PAEHR was introduced heath care professionals were very concerned especially in relation to potential negative effects on their work environment. However, few studies exist that investigate in what way work environments have been affected, and no studies have focused on the nurses' working in primary care. Hence, the purpose of this study was to fill this gap through seven interviews with primary care nurses that were transcribed and thematically analysed. The study shows that the nurses' experiences an altered contact as patients accessing PAEHR came prepared to meetings with more informed questions. They also experienced that the service had increased their work load and that it creates uncertainty for nurses who do not know when to inform the patient about test results etc. Finally, some implications are discussed in relation to the patients' role in shared decision making. [ABSTRACT FROM AUTHOR]