Patients' perceptions of use, needs, and preferences related to a telemedicine solution for HIV care in a Norwegian outpatient clinic: a qualitative study.

BACKGROUND: Telemedicine in outpatient services for people living with human immunodeficiency virus (PLHIV) was scaled up during the COVID-19 pandemic as services transitioned to remote care. Many studies have reported on the challenges and advantages of telemedicine care during the pandemic. However, there is limited research on the provision of telemedicine human immunodeficiency virus (HIV) care beyond the COVID-19 pandemic, which entails different telemedicine components and focuses on ways to improve the telemedicine experience for patients. This study aimed to explore PLHIV's perceptions of use, needs, and preferences related to a telemedicine solution for HIV care in an outpatient clinic in Norway. The telemedicine solution included a pre-consultation questionnaire, asynchronous digital messages, and video consultation. METHODS: Qualitative interviews were conducted with 12 PLHIV. The interviews were analysed using thematic analysis. RESULTS: We identified four main themes that covered the participants' perceptions, needs, and preferences: (1) perceived usability, (2) maintaining confidentiality, (3) accommodating personal preferences, and (4) perceived usefulness. Some participants had difficulty logging into the telemedicine solution. Other participants suggested additional functionalities, such as picture sharing and access to test result. Telemedicine care enabled the avoidance of stigmatising clinic experiences, although a few participants reported concerns about confidentiality and data security. Accommodating personal preferences and needs in terms of the type of consultations (in-person or video) and frequency of visits was essential to the participants. With telemedicine care, participants felt more in control of their own lives, perceiving that it increased their perceived quality of life and saved them both time and money for travelling to the clinic. CONCLUSIONS: Our study identified several specific needs and preferences related to the assessed technical solution and the provision of current and future telemedicine care services. Nevertheless, the telemedicine solution was perceived as a usable, flexible, and person-centred approach to HIV care, contributing to accommodating the participants' personal preferences. However, healthcare professionals need to ensure that individual requirements and preferences are consistent with evidence-based follow-up and supported by person-centred care. Thus, the practice of shared decision making is important in telemedicine care.

'A potentially ticking time bomb' - barriers for prevention, diagnosis, and treatment of cardiovascular disease in people with intellectual disabilities.

BACKGROUND: Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. METHOD: We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. RESULTS: We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability overshadows other possible diagnoses. CONCLUSION: This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.

'Look mommy, I'm eating the plate model!' Biopedagogies and coping with obesity through objectification.

Childhood obesity is increasing in many parts of the world. For the child, obesity often involves major social challenges. Within the framework of social studies of children and childhood and employing the concept of biopedagogies, I explore how children with severe obesity who participate in a long-term rehabilitation programme changed the perception of their bodies from 'being fat' to 'suffering from obesity' by embracing the biopedagogies involved. Due to this transformation, 'obesity' was made into an entity - 'a thing' that the children could work on -, which was used for coping and change. The article is based on an ethnographic field study of a Norwegian randomized medical intervention trial for children with obesity. A virtual abstract of this paper can be viewed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA.

Perceptions of height and weight screening and associations with body image: a cross-sectional study in early primary school children.

BACKGROUND: Despite parental concern, few studies have investigated children's experiences with school-based screening of growth deviations. This study aimed to explore perceptions of height and weight screening and associations with body size dissatisfaction (BSD) among third-grade children aged 8-9 years in central Norway. METHODS: In a cross-sectional study between November 2021 and April 2022, perceptions of height and weight screening and BSD were assessed individually among 209 children (49% girls) through researcher-assisted interviews. RESULTS: Most children indicated satisfaction with the screening by selecting a happy emoji, whereas only 1% indicated dissatisfaction, by selecting an unhappy emoji. However, 23%-30% selected a neutral emoji, indicating either neutrality or a response between satisfaction and dissatisfaction. No difference in the perception of height and weight screening was found between genders or body mass index (BMI). Children with parents from non-Western countries had a higher risk of being less satisfied with the height screening (OR=3.0, 95% CI 1.2 to 7.3) than those from Western origin, and children attending schools with lower socioeconomic status (SES) had increased risk of being less satisfied with both height (OR=5.5, 95% CI 2.2 to 13.5) and weight screening (OR=4.0, 95% CI 1.7 to 9.3), compared with children from schools with medium-high SES. Twenty-three percent reported BSD, in which 14% and 9% desired a thinner or larger body, respectively, independent of gender and BMI. No association was found between BSD and the perception of weighing (OR=1.1, 95% CI 0.6 to 2.4), however, BSD was associated with being more satisfied with height screening (OR=0.3, 95% CI 0.1 to 0.8). CONCLUSION: In the present sample, most children indicated satisfaction with school-based height and weight screening, with no differences between gender or BMI category. However, more children of non-Western origin and from areas with low SES reported less satisfaction with the screening, independent of BSD.