Experiences from patients in mental healthcare accessing their electronic health records: results from a cross-national survey in Estonia, Finland, Norway, and Sweden.

BACKGROUND: Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users' overall experiences with national PAEHR services. METHODS: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. RESULTS: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information. CONCLUSIONS: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.

Relational V-code conditions in a child and adolescent population do warrant treatment.

It is often argued that relational V-code conditions are less serious than classical psychiatric disorders, and that they should therefore receive lower clinical priority or diminished levels of treatment funding. Despite these common assertions, there have been virtually no studies that have used actual case data to evaluate whether such problems are in fact less serious and less worthy of treatment funding. We used actual case data from a universally funded child and family clinic to evaluate these questions. Results showed that both classical diagnoses and relational problems were significantly related to markers of clinical severity. As with previous research, family therapy was not differentially associated with a larger number of treatment sessions.

Some fundamental studies on clinical measurement conditions in acoustic rhinometry.

Acoustic rhinometry is a new method to measure the patency of the nasal airway. In this study the clinical measuring conditions were systematically evaluated. The test-retest validity was analysed by repeated measurements in ordinary, not specially trained patients and was found to be at the level of approximately 15%. The need for acclimatization before measurements was tested by making a series of measurements on two separate occasions: one after a rest period following the patient's arrival at the nose laboratory, and a second in another session where no rest was allowed for. Statistically, no significant differences between the repeated measurements in the two occasions were found. However, there was a tendency towards smaller nasal volumes in the measures of the repeated recordings made without an acclimatization period. Therefore, it seems to be advisable to have an acclimatization period before acoustic rhinometry measurements.

Equivalence of computerized and standard administration of the Piers-Harris Children's Self-Concept Scale.

Two hundred seventy-nine 8- to 17-year-old children and adolescents were randomly assigned to complete paper-and-pencil or computer-administered versions of the Piers-Harris Children's Self-Concept Scale. The equivalence of these two administration modes was assessed by evaluating the comparability of scale means, variances, reliabilities, and validities. Results indicate that, of 27 comparisons, only 1 produced a statistically significant difference. We concluded that the computerized administration of the Piers-Harris scale did not affect its psychometric properties and that paper-and-pencil and computerized modes of testing for this questionnaire may be regarded as equivalent.