Development and Evaluation of Theory-Based Diabetes Support Services

Technology-enabled support services for diabetes can fulfill patient demand to care for diabetes independently. Patients benefit from such services after greater adoption of the services in healthcare systems. Unfortunately, conventional service development fails to thoroughly understand patient care support, making it difficult to achieve the desired design, and posing substantial challenges in adopting these services. Thus, previously developed services in many cases are not as patients expected, as evidenced by their low acceptance among patients. To solve this problem, adequate strategies must be developed by incorporating theoretical knowledge as a solid foundation in order to improve service design. This study develops technology-enabled diabetes support services based on the self-care theory. A set of self-care service scenarios is also established and combined with theoretical concepts. The developed services consist of a nurse-led consultation service and a mobile application service. Additionally, user acceptance is confirmed by assessing patient perceptions of the diabetes support services in a group of patients with diabetes (N = 27). Results of analysis reveal that patients respond favorably toward the services. Patient preference and perceived ease of use attest to their intention to use the services. Greater adoption of the services can be anticipated, owing to a higher levels of preference and higher perceived ease of use. This study demonstrated that the self-care theory can be linked to nursing informatics research and chronic care clinical practices.

[1]  Rong-Rong Chen,et al.  Developing a Web 2.0 Diabetes Care Support System with Evaluation from Care Provider Perspectives , 2012, Journal of Medical Systems.

[2]  Hayoung Park,et al.  Service design attributes affecting diabetic patient preferences of telemedicine in South Korea. , 2011, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[3]  W. Otten,et al.  E-health applications and services for patient empowerment: directions for best practices in The Netherlands. , 2010, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[4]  K. Bhuyan,et al.  Health promotion through self-care and community participation: Elements of a proposed programme in the developing countries , 2004, BMC public health.

[5]  B. Costa,et al.  Effectiveness of IT-based diabetes management interventions: a review of the literature , 2009, BMC family practice.

[6]  Malcolm Maclure,et al.  Information system support as a critical success factor for chronic disease management: Necessary but not sufficient , 2006, Int. J. Medical Informatics.

[7]  Katherine McLaughlin Renpenning,et al.  Self-Care Theory in Nursing Selected Papers of Dorothea Orem , 2003 .

[8]  Y. Jang,et al.  Standards of Medical Care in Diabetes-2010 by the American Diabetes Association: Prevention and Management of Cardiovascular Disease , 2010 .

[9]  G. Widdershoven,et al.  Patient autonomy in nurse-led shared care: a review of theoretical and empirical literature. , 2007, Journal of advanced nursing.

[10]  John D. Piette,et al.  National Standards for Diabetes Self-Management Education , 2011, Diabetes Care.

[11]  Nicol Nijland,et al.  Factors Influencing the Use of a Web-Based Application for Supporting the Self-Care of Patients with Type 2 Diabetes: A Longitudinal Study , 2011, Journal of medical Internet research.

[12]  Kumanan Wilson,et al.  The reporting of theoretical health risks by the media: Canadian newspaper reporting of potential blood transmission of Creutzfeldt-Jakob disease , 2004, BMC public health.

[13]  Alun D. Preece,et al.  Bridging two translation gaps: A new informatics research agenda for telemonitoring of chronic disease , 2011, Int. J. Medical Informatics.

[14]  Shoko Tani,et al.  Development of a Health Management Support System for Patients with Diabetes Mellitus at Home , 2010, Journal of Medical Systems.

[15]  V. Basevi.  Standards of Medical Care in Diabetes—2010 , 2010, Diabetes Care.

[16]  Richard H Osborne,et al.  Enhancing patient engagement in chronic disease self‐management support initiatives in Australia: the need for an integrated approach , 2008, The Medical journal of Australia.

[17]  Russell E. Glasgow,et al.  What patients want: relevant health information technology for diabetes self-management , 2012, Health and Technology.

[18]  Peter Bower,et al.  Support for self care for patients with chronic disease , 2007, BMJ : British Medical Journal.

[19]  R. Glasgow,et al.  The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. , 2000, Diabetes care.

[20]  T. Skinner,et al.  Personal models of diabetes in relation to self-care, well-being, and glycemic control. A prospective study in adolescence. , 2001, Diabetes care.

[21]  I. Perry,et al.  Self-care coping strategies in people with diabetes: a qualitative exploratory study , 2009, BMC endocrine disorders.

[22]  Teresa J. Sakraida,et al.  Design, feasibility, and acceptability of an intervention using personal digital assistant-based self-monitoring in managing type 2 diabetes. , 2008, Contemporary clinical trials.

[23]  Rn Árún K Sigurðardóttir.  Self-care in diabetes: model of factors affecting self-care , 2005 .

[24]  Richard E. Scott,et al.  Moving research into practice: A decision framework for integrating home telehealth into chronic illness care , 2006, Int. J. Medical Informatics.

[25]  Fred D. Davis.  Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[26]  Stanton Newman,et al.  A systematic review of the effectiveness of mobile health interventions for the management of diabetes , 2011 .

[27]  Bernadette Szajna,et al.  Empirical evaluation of the revised technology acceptance model , 1996 .

[28]  Chun-Ja Kim,et al.  Utility of a Web-based Intervention for Individuals With Type 2 Diabetes: The Impact on Physical Activity Levels and Glycemic Control , 2006, Computers, informatics, nursing : CIN.

[29]  Ju Young Kim,et al.  Ubiquitous healthcare service using Zigbee and mobile phone for elderly patients , 2009, Int. J. Medical Informatics.

[30]  Fred D. Davis,et al.  A Theoretical Extension of the Technology Acceptance Model: Four Longitudinal Field Studies , 2000, Management Science.

[31]  A. Sigurdardottir,et al.  Self-care in diabetes: model of factors affecting self-care. , 2005, Journal of clinical nursing.

[32]  Linda M. Gallant,et al.  Exploring the Technology Adoption Needs of Patients Using E-Health , 2009 .

[33]  E. Vance Wilson,et al.  Current Trends in Patients' Adoption of Advanced E-Health Services , 2010, 2010 43rd Hawaii International Conference on System Sciences.

[34]  N. Saranummi,et al.  Rethinking Health: ICT-Enabled Services to Empower People to Manage Their Health , 2011, IEEE Reviews in Biomedical Engineering.

[35]  Per E. Pedersen,et al.  Adoption of Mobile Internet Services: An Exploratory Study of Mobile Commerce Early Adopters , 2005, J. Organ. Comput. Electron. Commer..

[36]  M. Hart,et al.  A Theory of Dependent-Care: A Corollary Theory to Orem’s Theory of Self-Care , 2001, Nursing science quarterly.

[37]  James O Prochaska,et al.  Changes in diabetes self-care behaviors make a difference in glycemic control: the Diabetes Stages of Change (DiSC) study. , 2003, Diabetes care.

[38]  E. Vance Wilson,et al.  Modeling patients' acceptance of provider-delivered e-health. , 2004, Journal of the American Medical Informatics Association : JAMIA.

[39]  Christoph U. Lehmann,et al.  Consumer health informatics: results of a systematic evidence review and evidence based recommendations , 2011, Translational behavioral medicine.

[40]  E. Seydel,et al.  Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications , 2008, Journal of medical Internet research.

[41]  F. Burge,et al.  Can the introduction of an integrated service model to an existing comprehensive palliative care service impact emergency department visits among enrolled patients? , 2009, Journal of palliative medicine.

[42]  Robert M. Anderson,et al.  The Problem With Compliance in Diabetes , 2000 .

[43]  Ben-Tzion Karsh,et al.  Review Paper: A Systematic Review of Patient Acceptance of Consumer Health Information Technology , 2009, J. Am. Medical Informatics Assoc..

[44]  David Carrell,et al.  Research Paper: Patient Web Services Integrated with a Shared Medical Record: Patient Use and Satisfaction , 2007, J. Am. Medical Informatics Assoc..