Lynn Leppla1, Juliane Mielke2, Maria Kunze3, Oliver Mauthner2, Alexandra Teynor4, Sabine Valenta5, Jasper Vanhoof6, Fabienne Dobbels7, Lut Berben2, Robert Zeiser8, Monika Engelhardt8, Sabina De Geest9. 1. Institute of Nursing Science, Department Public Health, University of Basel, Switzerland; Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. 2. Institute of Nursing Science, Department Public Health, University of Basel, Switzerland. 3. Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; Department of Psychiatry and Psychotherapy, University of Freiburg, Germany. 4. University of Applied Sciences Augsburg, Faculty of Computer Science, Germany. 5. Institute of Nursing Science, Department Public Health, University of Basel, Switzerland; Department of Hematology, University Hospital Basel, Switzerland. 6. Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Belgium; Nursing Center of Excellence, University Psychiatric Center, KU Leuven, Belgium. 7. Institute of Nursing Science, Department Public Health, University of Basel, Switzerland; Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Belgium. 8. Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. 9. Institute of Nursing Science, Department Public Health, University of Basel, Switzerland; Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Belgium. Electronic address: sabina.degeest@unibas.ch.
Abstract
PURPOSE: We report on our contextual analysis's methodology, as a first step of an implementation science project aiming to develop, implement, and test the effectiveness of an integrated model of care in SteM-cell transplantatIon faciLitated by eHealth (SMILe). METHODS: We applied an explanatory sequential mixed-methods design including clinicians and patients of the University Hospital Freiburg, Germany. Data were collected from 3/2017 to 1/2018 via surveys in 5 clinicians and 60 adult allogeneic stem-cell transplantation patients. Subsequently, we conducted 3 clinician focus groups and 10 patient interviews. Data analysis followed a 3-step process: (1) creating narrative descriptions, tables, and maps; (2) mapping key observational findings per dimension of the eHealth-enhanced Chronic-Care Model; (3) reflecting on how findings affect our choice of implementation strategies. RESULTS: Current clinical practice is mostly acute care driven, with no interdisciplinarity and weak chronic illness management. Gaps were apparent in the dimensions of self-management support and delivery-system design. Health behaviors that would profit from support include medication adherence, physical activity and infection prevention. The theme "being alone and becoming an expert" underpinned patients need to increase support in hospital-to-home transitions. Patients reported insecurity about recognizing, judging and acting upon symptoms. The theme "eHealth as connection not replacement" underscores the importance of eHealth augmenting, not supplanting human contact. Synthesis of our key observational findings informed eight implementation strategies. CONCLUSION: Stakeholders are willing towards a chronic care-focused approach and open for eHealth support. The contextual information provides a basis for the SMILe model's development and implementation.
PURPOSE: We report on our contextual analysis's methodology, as a first step of an implementation science project aiming to develop, implement, and test the effectiveness of an integrated model of care in SteM-cell transplantatIon faciLitated by eHealth (SMILe). METHODS: We applied an explanatory sequential mixed-methods design including clinicians and patients of the University Hospital Freiburg, Germany. Data were collected from 3/2017 to 1/2018 via surveys in 5 clinicians and 60 adult allogeneic stem-cell transplantation patients. Subsequently, we conducted 3 clinician focus groups and 10 patient interviews. Data analysis followed a 3-step process: (1) creating narrative descriptions, tables, and maps; (2) mapping key observational findings per dimension of the eHealth-enhanced Chronic-Care Model; (3) reflecting on how findings affect our choice of implementation strategies. RESULTS: Current clinical practice is mostly acute care driven, with no interdisciplinarity and weak chronic illness management. Gaps were apparent in the dimensions of self-management support and delivery-system design. Health behaviors that would profit from support include medication adherence, physical activity and infection prevention. The theme "being alone and becoming an expert" underpinned patients need to increase support in hospital-to-home transitions. Patients reported insecurity about recognizing, judging and acting upon symptoms. The theme "eHealth as connection not replacement" underscores the importance of eHealth augmenting, not supplanting human contact. Synthesis of our key observational findings informed eight implementation strategies. CONCLUSION: Stakeholders are willing towards a chronic care-focused approach and open for eHealth support. The contextual information provides a basis for the SMILe model's development and implementation.
Authors: Susanne Stampf; Nicolas J Mueller; Christian van Delden; Manuel Pascual; Oriol Manuel; Vanessa Banz; Isabelle Binet; Sabina De Geest; Pierre-Yves Bochud; Alexander Leichtle; Stefan Schaub; Jürg Steiger; Michael Koller Journal: BMJ Open Date: 2021-12-15 Impact factor: 2.692
Authors: Sabina De Geest; Sabine Valenta; Lynn Leppla; Alexandra Teynor; Janette Ribaut; Sabine Gerull; Juliane Mielke; Michael Simon; Jana Bartakova; Klaus Kaier; Jens Eckstein Journal: BMC Health Serv Res Date: 2022-08-20 Impact factor: 2.908
Authors: Mira Parisek; Julika Loss; Ernst Holler; Anna Barata; Daniela Weber; Matthias Edinger; Daniel Wolff; Helene Schoemans; Anne Herrmann Journal: Front Public Health Date: 2021-07-01
Authors: Carrie L Kitko; Joseph Pidala; Hélène M Schoemans; Anita Lawitschka; Mary E Flowers; Edward W Cowen; Eric Tkaczyk; Nosha Farhadfar; Sandeep Jain; Philipp Steven; Zhonghui K Luo; Yoko Ogawa; Michael Stern; Greg A Yanik; Geoffrey D E Cuvelier; Guang-Shing Cheng; Shernan G Holtan; Kirk R Schultz; Paul J Martin; Stephanie J Lee; Steven Z Pavletic; Daniel Wolff; Sophie Paczesny; Bruce R Blazar; Stephanie Sarantopoulos; Gerard Socie; Hildegard Greinix; Corey Cutler Journal: Transplant Cell Ther Date: 2021-04-09