Measuring patient experiences in a Children's hospital with a medical clowning intervention: a case-control study.

BACKGROUND: Because the healthcare sector is shifting to a customer-oriented approach, it is important to understand experiences of children as users of healthcare services. So far, studies that measure the influence of medical clowning on patient experiences are scarce. This study aims to measure experiences of children and their parents during day-surgery in hospital setting. METHODS: A case-control study was conducted in a large Finnish children's hospital. Seventy children aged 4-17 years coming for a minor operative procedure including pre-operative cannula insertion prior to surgery were included. Thirty-eight children were exposed to the medical clowning intervention and 32 children (the reference group) did not receive exposure to medical clowning. A novel digital survey tool was used to measure patient experiences before and after the insertion of a venous cannula needed for anaesthesia. The children were asked about their emotions, anxiety levels, the pain from the cannula insertion and the best and worst things about the hospital. The parents were asked about their emotions, expectations and the fluency of the procedure and the hospital day. RESULTS: Before the procedure, 32% or 36% of the children in the intervention group and 44% or 28% of those in the reference group expressed positive or neutral emotions, respectively. After the procedure, 76% or 63% of children in the intervention group or reference group, respectively, expressed positive emotions. The intervention group rated the medical clowns as the best aspect of the hospital day. Both groups reported that the best aspects of the hospital day were related to the nurses and food and the worst were related to waiting and pain. Most commonly the parents felt uncertainty, anxiety or calmness before the procedure and relief afterwards. Their expectations towards the procedure related to its success and the certainty of the diagnosis. CONCLUSIONS: The results show a trend towards more positive emotions in children with exposure to medical clowning. The digital survey tool was suitable for gathering information about the experiences of children and their parents. Information on emotions and expectations of children and parents during a procedure is useful when improving the quality of healthcare services. TRIAL REGISTRATION: Current Controlled Trials NCT04312217, date of registration 17.03.2020. Retrospectively registered.

Patient Experience from an eHealth Perspective: A Scoping Review of Approaches and Recent Trends.

OBJECTIVES: Patients' experiences are increasingly gaining interest in multiple research fields. Researchers have applied various approaches to studying patient experience (PX); however, there is no commonly agreed-upon definition of PX. This scoping review focuses on PX from an eHealth perspective. Our aim was to: 1) describe how PX has been defined, 2) investigate which factors influencing PX and components of PX have been identified and researched, 3) explore the methods used in studying PX, and 4) find out the recent trends in PX research from an eHealth perspective. METHODS: We selected six major journals covering the fields of health informatics, PX, and nursing informatics. Using the search terms "patient experience" and technology-related terms (e.g., digital, eHealth), we searched for articles published between 2019 and 2021. From 426 articles, 44 were included in the analysis. RESULTS: Multiple concepts and meanings are used to refer to PX. Few articles include vague descriptions of the concept. Numerous eHealth factors are influencing PX, as well as components considering PX. The influencing factors were related to eHealth solutions' type and quality, and care process, when the components of PX were related to communication, remote interaction, risks and concerns, and patients' attitudes towards telehealth. Surveys were the main method used to study PX, followed by interviews. CONCLUSIONS: PX is a complex and multifaceted phenomenon, and it is described as a synonym for patient satisfaction and telehealth experiences. Further multidisciplinary research is needed to understand PX as a phenomenon and to outline a framework for the research.

Remote Interviews and Visual Timelines with Patients: Lessons Learned.

This article aims to support the design of remote user studies in the healthcare and well-being field. We introduce lessons learned from conducting remote interviews and using visual timelines as pretasks involving patients from two eHealth projects. Based on our experience, we conclude that remote interviews and visual timelines can provide rich data about user needs. However, careful planning is required. Building trust, rapport, confidentiality, and privacy requires extra effort from the researcher in studies involving sensitive topics. In this paper, we present a list of practical tips for planning qualitative health-related user studies.

Encouraging the Use of eHealth Services: A Survey of Patients' Experiences.

To promote eHealth services effectively, it is important to understand what motivates people to use these services and how they can be further supported. Our aim was to explore user experiences with eHealth services from the viewpoint of patients with chronic illnesses. The survey data included responses from 397 patients actively using eHealth services in Finland. Most of them had positive experiences using the services. We found that these positive experiences and the perceived benefits of eHealth services encouraged patients to continue using the services. In order to bolster the use of eHealth services, patients and other potential users must be informed about the new services and how to access them. Healthcare personnel play a key role in introducing eHealth services to patients and instructing them on their use.

Development of the Patient Experience Questionnaire for Parents of Pediatric Patients (PEQP).

Patient experience (PX) is an important evaluation criterion for quality in healthcare. Compared to patient satisfaction, however less research has focused on the development of instruments to measure experiences of patients and their families. In the article, we describe the process of developing a PX questionnaire for the parents of pediatric patients in the context of children's hospital and illustrate the questionnaire items for measuring PX. The phases of the development process included retrospective interviews, description of the themes influencing PX and the metrics for measuring PX, as well as iterative development of three versions of questionnaires including data gathering and factor analysis. The final versions of the surveys suggested for implementation at the hospitals include eight PX statements for the outpatient clinic and five statements for the ward. Compared to satisfaction surveys, the developed surveys emphasize the aspects of parent's attitude towards the illness, support for families, and daily arrangements with a child patient.

Improving Patient Experience in a Children's Hospital: New Digital Services for Children and Their Families.

Digital services are increasingly being developed for the healthcare sector. In Finland, the five university hospitals in 2016 launched a virtual hospital platform, Healthvillage.fi that includes several portals. The aim of this study is to explore the needs of children and their families related to digital services in the context of a children's hospital in Finland. Two methods were used to examine the needs and expectations of children and their families: a web-based survey for parents and video diaries for children. We identified nine categories of needs and noticed they were related to better communication between families, healthcare professionals, and peers. These observations were used to further analyze possible novel digital services for child patients' families to support and to complement the recently launched Healthvillage.fi platform.

Selfies of Sickness: The Use of Video Diaries with Chronically Ill Children.

This paper describes the use of video diaries as a tool for understanding children's patient experience and as a potential method for directly gathering patient experience information from children. It was hypothesized that this method would uncover otherwise hidden knowledge about children ages 10-16 years with chronic illnesses. The aim of this paper is to assess the potential applicability of this method as a standalone tool for the public healthcare sector to capture and better understand the patient experiences as a basis for continuous service development. Therefore, this paper does not describe the results on children's patient experiences. The video diaries proved to offer rich data, but certain shortcomings were also identified. Motivating teens, especially boys, was found to be difficult. Needed changes are addressed, and suggestions for future work are presented.