Healthcare professionals' digital health competence profiles and associated factors: A cross-sectional study.

AIMS: To identify healthcare professionals' digital health competence profiles and explore associated factors to digital health competence in healthcare settings. DESIGN: A cross-sectional study. METHODS: Data were collected from 817 healthcare professionals from nine organizations with an electronic questionnaire by using Digital Health Competence instrument (42 items) and Aspects Associated with Digital Health instrument (15 items) between 1st March and 31st July 2022. K-means clustering was used to describe digital health competence profiles. Binary logistic regression analysis was used to explore associated factors. RESULTS: Analysis revealed three digital health competence profiles: A - high competence (n = 336), B - intermediate competence (n = 352) and C - low competence (n = 129). Between the profiles, digital health competence showed significant differences (p < .001). Recent graduation year, working in outpatient environments and leader or specialist position were associated with higher digital health competence. Organizational practices and the influence from colleagues improved competence in human-centred remote counselling, digital solutions as part of work, competence in utilizing and evaluating digital solutions and ethical competence. Support from management improved digital solutions as part of work and ethical competence. CONCLUSION: Nursing and allied health professionals working in other than outpatient environments should be specifically acknowledged when digital health competence development initiatives are designed and targeted. The positive influence from colleagues could be harnessed by enhancing their involvement in digital health competence development methods such as orientation, mentoring or coaching. Additionally, managers should take a stronger role in supporting different areas of digital health competence. IMPACT: This was the first study that explored healthcare professionals' digital health competence profiles and associated factors. The detection of healthcare professionals' digital health competence profiles guides the development of digital health education according to different needs in healthcare environments. REPORTING METHOD: The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Conditions for uptake of evidence-based knowledge in municipal care for older people in Sweden: a developmental evaluation.

OBJECTIVE: The objective of this paper is to describe the initial phase of a long-term collaboration initiative between a municipality and the Faculty of Medicine at a university in Sweden. The overall ambition of the collaboration is to strengthen the quality of care for older people. The concrete goal is to equip academically trained registered health care professionals (HCP) with tools for transferring evidence-based knowledge into practice. As municipal healthcare for older people is mainly carried out by staff lacking academic education, reg. HCP are key actors to bring in and consolidate an evidence-based approach in this setting. Developmental evaluation (DE) has been used to evaluate four separate activities in the initial phase. The activities where sequenced in a cumulative design to provide knowledge for further development of adequate tools. RESULTS: The cumulative design originally planned did not fit the internal logic of the municipality. Therefore, workflow and pace adjustments were made to proceed towards the joint ambition; the creation of fruitful conditions for the uptake of evidence-based knowledge. Long-term collaboration between academia and organizations outside academia demands a sensitive and flexible research approach, recognizing that collaboration implies mutuality and restricts the sovereignty of academia in designing research.

Healthcare professionals' perceptions of digital health competence: A qualitative descriptive study.

AIMS AND OBJECTIVES: This study aims to provide insight into healthcare professionals' lived experiences of digital health competence with the objective of improving the knowledge of how digital health competence is perceived by healthcare professionals. BACKGROUND: Healthcare professionals need to adjust to the digital era to provide quality and ethical care. Previous research has rarely adopted a healthcare professional's standpoint to describe their perceptions of digital health competence, even though their perspective in how new care practices are designed and implemented is vital. DESIGN: A qualitative descriptive study. METHODS: Healthcare professionals (nurses and allied health professionals) from versatile healthcare settings were recruited for individual semi-structured interviews in Sweden (n = 5) and Finland (n = 15) (spring 2019-summer 2020). Purposive and convenience sampling was used. Participants' backgrounds were in the public and private sectors. The interviews were transcribed for inductive content analysis. The SRQR guideline guided the study process. RESULTS: Healthcare professionals' perceptions of digital health competence are connected to competence to provide patient-centric care through digital channels, using technology and digital health systems, interacting with the patient through digital means, evaluating what digital health is and combining digital and traditional methods. Professionals' perceptions of their own digital health competence were divided, with the participants either reporting sufficient competence or perceiving a lack of skills in some specific areas. CONCLUSIONS: Healthcare professionals' perceptions of digital health competence focus on the ability to provide patient-centric care by evaluating the need and possibilities for using digital health services jointly with more traditional methods. This study provides a sound basis for digital health research, but future studies should focus on elucidating factors which affect digital health competence and competence development. RELEVANCE TO CLINICAL PRACTICE: The results of this study can guide healthcare practices and digital health implementation, as well as function as a basis for instrument or theory development. Health care and nursing leaders should enable the resources to hybrid practices in patient-centric care provision.

Old Overnight: Experiences of Age-Based Recommendations in Response to the COVID-19 Pandemic in Sweden.

The Swedish response to the COVID-19 pandemic included age-based recommendations of voluntary quarantine specifically for those 70 years of age or older. This paper investigates the experiences of a sudden change of policy in the form of an age restriction that trumped the contemporary active aging ideal. A web-based qualitative survey was conducted in April 2020. Through manual coding of a total of 851 responses, six different ways of relating to the age-based recommendations were identified. The results show that age is not an unproblematic governing principle. Instead, in addition to protecting a vulnerable group, the age-based recommendation meant deprivation of previously assigned individual responsibility and, consequently, autonomy. It is shown how respondents handled this tension through varying degrees of compliance and resistance. Findings highlight the importance of continuously tracking the long-term consequences of age-based policy to avoid negative self-image and poorer health among older adults.

Pushing for miracles, pulling away from risk: An ethnographic analysis of the force dynamics at Senior Summer Camps in Sweden.

With an ageing population and a discourse of active ageing guiding welfare policies, initiatives to engage older people in health promoting activities have been established. One growing phenomenon is Senior Summer Camps, arranged all over Sweden in beautiful natural environments close to water. Their main purpose is to enable older people to participate in outdoor activities in an institutionalized setting. Although many professionals consider acts of infantilization as highly inappropriate, research has shown that still this is frequently done in institutional settings targeting older people. This paper wish to contribute to this field of research. The objective is to study how the camp leaders handle the dilemma of on the one hand, wanting to push senior campers into participating in challenging activities, and on the other, needing to pull them away, to reduce risk and ensure their safety, as well as how senior campers experience alternately being pushed into and pulled away from activities. What strategies are used by the camp leaders to push the campers to challenge themselves without taking unnecessary risks, and what consequences do these strategies have for the campers? The study was conducted in the form of ethnographic observations at two different camps. During one week at each camp we stayed with the participants, alternately being a silent observer and listener in the background, and an active participant in conversations and activities. Narratives, direct quotes, descriptions and reflections were written down in a field diary that forms the empirical basis for the analysis. Various modes of pushing and pulling were identified and defined as cheering, tricking, compelling, monitoring and restricting. These different modes of pushing and pulling were analyzed as manifestations of force, exerted by the camp leaders within a certain age-based force dynamic that resulted in different responses among the campers, especially in terms of how they "did age" in relation to notions on autonomy and vulnerability. It is shown that manifestations of force involve the risk of putting the campers in a position of vulnerability, regardless of whether or not they are actually vulnerable. The main argument in this paper is that initiatives that in an institutionalized context aim to promote a prolonged health and well-being, targeting "older people" in a general sense, run the risk of getting the exact opposite result, namely instead learned vulnerability is implicitly promoted by removing or downplaying the agency and autonomy of the campers.