"There Is Something We Need to Tell You ": Communicating Health-Screening Results to Older Adults via the Internet.

BACKGROUND: With the introduction of online health screenings, guidelines describing how to communicate about a person's health need to be adapted for a digital setting. This study aimed to uncover older adults' preferences regarding such online messages. MATERIALS AND METHODS: Thirty older adults (aged 65 to 75 years) viewed four versions of the results message of a screening aimed at identifying frailty: a standard, empathic, tailored, or both empathic and tailored message. After each version, they were interviewed about what they (dis)liked about the message. They also ranked the four versions according to preference. Ranks were analyzed with a Friedman's test and a Wilcoxon's signed-rank test. RESULTS: There was no significant difference for message-type preference when the outcome was positive. For the prefrail or frail outcome, message-type preferences differed (χ2 = 10.51, p = 0.02 and χ2 = 13.56, p < 0.01, respectively). Overall, for the prefrail and frail outcome, the tailored version was appreciated most. Participants commented that the tailored version made them feel appreciated more as a person. Some found the empathic additions comforting, others found these unnecessary. CONCLUSIONS: When communicating the results of an online health screening to older adults via the Internet, one should primarily tailor the message toward personal characteristics. The effect of empathic elements in results messages appeared to be limited. Whether a message should be adapted depends on whether the outcome is positive or negative.

Participatory eHealth development to support nurses in antimicrobial stewardship.

BACKGROUND: Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put antimicrobial treatment into effect. To optimally support nurses in ASPs, they should have access to information that supports them in their preparation, administration and monitoring tasks. In addition, it should help them to detect possible risks or adverse events associated with antimicrobial therapy. In this formative study, we investigate how nurses' can be supported in ASPs by means of an eHealth intervention that targets their information needs. METHODS: We applied a participatory development approach that involves iterative cycles in which health care workers, mostly nurses, participate. Focus groups, observations, prototype evaluations (via a card sort task and a scenario-based information searching task) and interviews are done with stakeholders (nurses, managers, pharmacist, and microbiologist) on two pulmonary wards of a 1000-bed teaching hospital. RESULTS: To perform the complex antimicrobial-related tasks well, nurses need to consult various information sources on a myriad of occasions. In addition, the current information infrastructure is unsupportive of ASP-related tasks, mainly because information is not structured to match nurse tasks, is hard to find, out of date, and insufficiently supportive of awareness. Based our findings, we created a concept for a nurse information application. We attuned the application's functionality, content, and structure to nurse work practice and tasks. CONCLUSIONS: By applying a participatory development approach, we showed that task support is a basic need for nurses. Participatory development proved useful regarding several aspects. First, it allows for combining bottom-up needs (nurses') and top-down legislations (medical protocols). Second, it enabled us to fragmentise and analyse tasks and to reduce and translate extensive information into task-oriented content. Third, this facilitated a tailored application to support awareness and enhance patient safety. Finally, the involvement of stakeholders created commitment and ownership, and helped to weigh needs from multiple perspectives.