Hege Wathne

Aim: To explore patients and nurses' experiences of digital self‐management support following participation in a remote patient monitoring intervention. Design: An exploratory qualitative multimethod study. Methods: The study was conducted at two Norwegian university hospitals between January 2022 and February 2023. Data were obtained through semistructured interviews of 17 patients with heart failure, 10 patients surgically treated for colorectal cancer and eight nurses. The data collection also included excerpts from chat messages between patients and nurses obtained from the digital platform during January and February 2024. Data were analysed using abductive thematic analysis. Results: The analysis revealed three themes: (1) raising illness awareness through RPM technology, (2) establishing a mutual collaboration in self‐management challenges and (3) fostering a continued engagement in health behaviour change. The themes captured patients and nurses' experiences of receiving and providing digital self‐management support. The analysis also identified a unifying key theme: ‘bridging technology and self‐management support through remote caring encounters’, which firmly connected the three themes. Conclusion: Remote patient monitoring appeared to benefit both patients and nurses by altering patients' self‐management routines and the nurses' workflows. Furthermore, applying the theory of technological competency as caring in nursing to remote patient monitoring interventions may help ensure that the patient–nurse relationship is not weakened as technology advances. Implications for the Profession and Patient Care: Remote patient monitoring interventions have the potential to become a valuable tool in modern healthcare, enabling effective communication and collaboration between patients and nurses while also ensuring patient‐centred care. However, future development of remote patient monitoring interventions should include nursing support. Impact: This study addresses remote patient monitoring and digital self‐management support from the perspectives of both patients and nurses. The findings may have an impact on remote nursing, patient satisfaction and strategies to improve digital follow‐up care for patients with long‐term illnesses. Reporting Method: The authors adhered to the EQUATOR guidelines through the SRQR reporting method. Patient or Public Contribution: No patient or public contribution.

Introduction: Colorectal cancer (CRC) creates elevated self-management demands and unmet support needs post-discharge. Follow-up care through eHealth post-primary surgery may be an effective means of supporting patients’ needs. This integrative review describes the evidence regarding eHealth interventions post-hospital discharge focusing on delivery mode, user-interface and content, patient intervention adherence, impact on patient-reported outcomes and experiences of eHealth. Methods: A university librarian performed literature searches in 2021 using four databases. After screening 1149 records, the authors read 30 full-text papers and included and extracted data from 26 papers. Two authors analysed the extracted data using the ‘framework synthesis approach’. Results: The 26 papers were published between 2012 and 2022. The eHealth interventions were mainly delivered by telephone with the assistance of healthcare professionals, combined with text messages or video conferencing. The user interfaces included websites, applications and physical activity (PA) trackers. The interventions comprised the monitoring of symptoms or health behaviours, patient information, education and counselling. Evidence showed a better psychological state and improved PA. Patients reported high satisfaction with eHealth. However, patient adherence was inadequately reported. Conclusions: eHealth interventions may positively impact CRC patients’ anxiety and PA regardless of the user interface. Patients prefer technology combined with a human element.

Background: For patients with noncommunicable diseases (NCDs; eg, heart failure [HF] and colorectal cancer [CRC]), eHealth interventions could meet their posthospital discharge needs and strengthen their ability to self-manage. However, inconclusive evidence exists regarding how to design eHealth services to meet the complex needs of patients. To foster patient acceptability and ensure the successful development and implementation of eHealth solutions, it is beneficial to include different stakeholders (ie, patients and health care professionals) in the design and development phase of such services. The involvement of different stakeholders could contribute to ensuring feasible, acceptable, and usable solutions and that eHealth services are developed in response to users’ supportive care needs when transitioning to home after hospitalization. This study is the first step of a larger complex intervention study aimed at meeting the postdischarge needs of 2 NCD populations. Objective: This study aimed to explore the perspectives of patients with HF and CRC and health care professionals on patient self-management needs following hospital discharge and investigate how a future nurse-assisted eHealth service could be best designed to foster patient acceptability, support self-management, and smooth the transition from hospital to home. Methods: A qualitative, explorative, and descriptive approach was used. We conducted 38 semistructured interviews with 10 patients with HF, 9 patients surgically treated for CRC with curative intent, 6 registered nurses recruited as nurse navigators of a planned eHealth service, and 13 general practitioners experienced in HF and CRC treatment and follow-up care. Patients were recruited conveniently from HF and CRC outpatient clinics, and the nurses were recruited from the cardiology and gastro-surgical departments at a university hospital in the southwest of Norway. The general practitioners were recruited from primary care in surrounding municipalities. Semistructured interview guides were used for data collection, and the data were analyzed using thematic analysis. Results: In total, 3 main themes were derived from the data analysis: expecting information, reassurance, and guidance when using eHealth for HF and CRC self-management; expecting eHealth to be comprehensible, supportive, and knowledge promoting; and recognizing both the advantages and disadvantages of eHealth for HF and CRC self-management. The data generated from this interview study depicted the diverse needs for self-management support of patients with CRC and HF after hospital discharge. In addition, valuable suggestions were identified regarding the design and content of the eHealth service. However, participants described both possible advantages and disadvantages of a remote eHealth service. Conclusions: This study is the first step in the development of an eHealth service for posthospitalization self-management support for long-term illnesses. It concerns patients’ supportive care needs and user requirements of an eHealth service. The findings of this study may add value to the planning and development of eHealth interventions for patients with NCDs.

BACKGROUND For patients with long-term chronic illnesses, such as heart failure (HF) and colorectal cancer (CRC), eHealth interventions have the potential to meet the patients´ post-hospital discharge needs and strengthen their ability for self-management. To ensure the successful implementation of eHealth services, a user-centered co-design approach is suggested to establish the services´ usefulness and acceptability. Co-design could ensure that the eHealth intervention is developed in response to users´ supportive care needs when transitioning to home after treatment in the hospital. Therefore, by involving different stakeholders (ie, patients, health care professionals [HCPs]) in co-design processes throughout the development phase of eHealth interventions, feasible, acceptable, and usable solutions may emerge. OBJECTIVE The objective of this study was to explore the perspectives of patients with HF, patients with CRC and HCPs on self-management needs following discharge from the hospital, and to investigate how a nurse-assisted eHealth service could best be designed to ensure acceptability and usefulness. METHODS A qualitative, explorative, and descriptive approach was used. We conducted 38 semi- structured interviews with 10 patients with HF, nine patients surgically treated for CRC with curative intent, six registered nurses recruited as nurse navigators (NNs) of a planned eHealth service and 13 general practitioners (GPs) experienced with HF and CRC treatment and follow-up care. Patients were recruited from HF and CRC out-patient clinics and nurses were recruited from the cardiology and gastro-surgical departments of a university hospital in the south-western region of Norway. The GPs were recruited from primary care centers in surrounding municipalities. Semi-structured interview guides were used for data collection, and the data were analyzed using thematic analysis. RESULTS Three main themes were derived from the data analysis: 1) expecting information, reassurance and guidance when using eHealth for HF and CRC self-management, 2) expecting eHealth to be comprehensible, supportive and knowledge-promoting and, 3) both benefits and disadvantages are expected when using eHealth for HF and CRC self-management. Each main theme were supported by two sub-themes. The data generated from the interviews described the diverse needs for self-management support of patients with CRC and patients with HF after discharge from the hospital, such as unmet information and psychosocial needs. Furthermore, valuable suggestions regarding the design and content of the eHealth service were noted. However, there were differing opinions on whether the eHealth service would be beneficial to all patients during the transition from hospital to home. CONCLUSIONS Accessibility, usability, personalization, and interaction with support from HCP are important facilitators for the use of eHealth. The findings from this study add value to the planning and development of eHealth interventions for patients with long-term chronic illnesses.