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  • 1.
    Dziak, D.
    et al.
    Faculty of Electrical and Control Engineering, Gdansk University of Technology, Gabriela Narutowicza 11/12, Gdansk, Poland.
    Jachimczyk, B.
    Faculty of Electrical and Control Engineering, Gdansk University of Technology, Gabriela Narutowicza 11/12, Gdansk, Poland.
    Kulesza, Wlodek
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för tillämpad signalbehandling.
    Wirelessly interfacing objects and subjects of healthcare system - IoT approach2016Ingår i: Elektronika ir Elektrotechnika, ISSN 1392-1215, Vol. 22, nr 3, s. 66-73Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Wireless sensor networks, WSN, for which development has begun by military applications, are nowadays applied to all human activities; e.g. in medicine for patience monitoring or to reduce the effects of disasters. Therefore, the WSNs area has been also one of the emerging and fast growing scientific fields. Increasing interest of WSNs is even caused by equally intense growth of interest in the Internet of Things domain, IoT, in which WSNs constitute a significant part. These reasons have brought about developing low cost, low-power and multi-function sensor nodes. However, the major fact that sensor nodes run quickly out of energy has been an issue and many energy efficient routing protocols have been proposed to solve this problem. Case study presented in this paper concern design of WSN in IoT concept from system lifetime perspective. A hierarchical routing technique, which shows energy efficiency, has been validated. Simulation results show that chosen technique prolongs the lifetime of the WSN compared to other investigated clustering schemes. The advantages of this method are validated by comparative studies. Index Terms - Energy efficiency; Internet of Things, routing protocol; wireless sensor networks.

  • 2.
    Dziak, Damian
    et al.
    Politechnika Gdanska, POL.
    Jachimczyk, Bartosz
    BetterSolutions S.A., POL.
    Kulesza, Wlodek
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för tillämpad signalbehandling.
    IoT-based information system for healthcare application: Design methodology approach2017Ingår i: Applied Sciences, E-ISSN 2076-3417, Vol. - 7, nr - 6, artikel-id 596Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    - Over the last few decades, life expectancy has increased significantly. However, elderly people who live on their own often need assistance due to mobility difficulties, symptoms of dementia or other health problems. In such cases, an autonomous supporting system may be helpful. This paper proposes the Internet of Things (IoT)-based information system for indoor and outdoor use. Since the conducted survey of related works indicated a lack of methodological approaches to the design process, therefore a Design Methodology (DM), which approaches the design target from the perspective of the stakeholders, contracting authorities and potential users, is introduced. The implemented solution applies the three-axial accelerometer and magnetometer, Pedestrian Dead Reckoning (PDR), thresholding and the decision trees algorithm. Such an architecture enables the localization of a monitored person within four room-zones with accuracy; furthermore, it identifies falls and the activities of lying, standing, sitting and walking. Based on the identified activities, the system classifies current activities as normal, suspicious or dangerous, which is used to notify the healthcare staff about possible problems. The real-life scenarios validated the high robustness of the proposed solution. Moreover, the test results satisfied both stakeholders and future users and ensured further cooperation with the project. © 2017 by the authors.

  • 3. Eivazzadeh, Shahryar
    Health Information Systems Evaluation2015Licentiatavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background

    Health information systems have emerged as a major component in our response to the trends of rising demands in health care. The insight being gained from the evaluation of those systems can critically influence the shaping of the response. Summative or formative evaluation of health information systems assesses their quality, acceptance, and usefulness, creates insight for improvement, discriminates between options, and refines future development strategies. But the evaluation of health information systems can be challenging due to the propagation of their impacts through multiple socio-technological layers till the ultimate recipients, their heterogeneity and fast evolvement, and the complexity of health care settings and systems.

    Aim

    This thesis tries to explain the challenges of evaluation of health information systems with a narrow down on determining evaluation aspects and to propose relevant solutions. The thesis goes for solutions that mitigate heterogeneity and incomparability, recruit or extend available evaluation models, embrace a wide context of application, and promote automation.

    Method

    The literature on health information systems evaluation, methods of dealing with heterogeneity in other disciplines of information systems, and ontology engineering were surveyed. Based on the literature survey, the UVON method, based on ontology engineering, was first developed in study 1. The method was applied in FI-STAR, a European Union project in e-Health with 7 use-cases, for summative evaluation of the individual and whole e-health applications. Study 2, extended the UVON method for a formative evaluation during the design phase.

    Results

    Application of the UVON method resulted in evaluation aspects that were delivered to the seven use-cases of the FI-STAR project in the form of questionnaires. The resulted evaluation aspects were considered sensible and with a confirming overlap with another highly used method in this field (MAST). No significant negative feedback from the FI-STAR use-case owners (n=7) or the respondents (n=87 patients and n=30 health professionals) was received or observed.

    Conclusion

    In the evaluation of health information systems --possibly also in other similarly characterized systems-- ontology engineering methods, such as the proposed UVON method, can be applied to create a flexible degree of unification across a heterogeneous set of evaluation aspects, import evaluation aspects from other evaluation methods, and prioritize between quality aspects in design phase. Ontologies, through their semantic network structures, can capture the extracted knowledge required for evaluation, facilitate computation of that knowledge, promote automation of evaluation, and accommodate further extensions of the related evaluation methods by adding new features to their network structure.

     

  • 4.
    Eivazzadeh, Shahryar
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Sanmartin Berglund, Johan
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Larsson, Tobias
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för maskinteknik.
    Fiedler, Markus
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för teknik och estetik.
    Anderberg, Peter
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Most Influential Qualities in Creating Satisfaction Among the Users of Health Information Systems: A Study in Seven EU Countries2018Ingår i: JMIR Medical Informatics, Vol. 6, nr 4, s. 3-21Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Several models suggest how the qualities of a product or service influence user satisfaction. Models, such as the Customer Satisfaction Index (CSI), Technology Acceptance Model (TAM), and Delone and McLean Information Systems Success (D&M IS), demonstrate those relations and have been used in the context of health information systems.

    Objective:

    We want to investigate which qualities foster greater satisfaction among patient and professional users. In addition, we are interested in knowing to what extent improvement in those qualities can explain user satisfaction and if this makes user satisfaction a proxy indicator of those qualities.

    Methods:

    The Unified eValuation using ONtology (UVON) method was utilised to construct an ontology of the required qualities for seven e-health applications being developed in the FI-STAR project, a European Union (EU) project in e-health. The e-health applications were deployed across seven EU countries. The ontology included and unified the required qualities of those systems together with the aspects suggested by the Model for ASsessment of Telemedicine applications (MAST) evaluation framework. Two similar questionnaires, for 87 patient users and 31 health professional users, were elicited from the ontology. In the questionnaires, user was asked if the system has improved the specified qualities and if the user was satisfied with the system. The results were analysed using Kendall correlation coefficients matrices, incorporating the quality and satisfaction aspects. For the next step, two Partial Least Squares Structural Equation Modelling (PLS-SEM) path models were developed using the quality and satisfaction measure variables and the latent construct variables that were suggested by the UVON method.

    Results:

    Most of the quality aspects grouped by the UVON method are highly correlated. Strong correlations in each group suggest that the grouped qualities can be measures which reflect a latent quality construct. The PLS-SEM path analysis for the patients reveals that the effectiveness, safety, and efficiency of treatment provided by the system are the most influential qualities in achieving and predicting user satisfaction. For the professional users, effectiveness and affordability are the most influential. The parameters of the PLS-SEM that are calculated allow for the measurement of a user satisfaction index similar to CSI for similar health information systems.

    Conclusions:

    For both patients and professionals, the effectiveness of systems highly contributes to their satisfaction. Patients care about improvements in safety and efficiency, while professionals care about improvements in the affordability of treatments with health information systems. User satisfaction is reflected more in the users' evaluation of system output and fulfilment of expectations, but slightly less in how far the system is from ideal. Investigating satisfaction scores can be a simple, fast way to infer if the system has improved the abovementioned qualities in treatment and care.

  • 5.
    Georgsson, Mattias
    et al.
    Blekinge Tekniska Högskola, Fakulteten för datavetenskaper, Institutionen för kreativa teknologier.
    Staggers, Nancy
    Summit Health Informatics, USA.
    Årsand, Eirik
    University Hospital of North Norway, NOR.
    Kushniruk, André
    University of Victoria, CAN.
    Employing a user-centered cognitive walkthrough to evaluate a mHealth diabetes self-management application: A case study and beginning method validation2019Ingår i: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 91, artikel-id 103110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Self-management of chronic diseases using mobile health (mHealth) systems and applications is becoming common. Current evaluation methods such as formal usability testing can be very costly and time-consuming; others may be more efficient but lack a user focus. We propose an enhanced cognitive walkthrough (CW) method, the user-centered CW (UC-CW), to address identified deficiencies in the original technique and perform a beginning validation with think aloud protocol (TA) to assess its effectiveness, efficiency and user acceptance in a case study with diabetes patient users on a mHealth self-management application. Materials and methods: A total of 12 diabetes patients at University of Utah Health, USA, were divided into UC-CW and think aloud (TA) groups. The UC-CW method included: making the user the main evaluator for detecting usability problems, having a dual domain facilitator, and using three other improved processes: validated task development, higher level tasks and a streamlined evaluation process. Users interacted with the same mHealth application for both methods. Post-evaluation assessments included the NASA RTLX instrument and a set of brief interview questions. Results: Participants had similar demographic characteristics. A total of 26 usability problems were identified with the UC-CW and 20 with TA. Both methods produced similar ratings: severity across all views (UC-CW = 2.7 and TA = 2.6), numbers of problems in the same views (Main View [UC-CW = 11, TA = 10], Carbohydrate Entry View [UC-CW = 4, TA = 3] and List View [UC-CW = 3, TA = 3]) with similar heuristic violations (Match Between the System and Real World [UC-CW = 19, TA = 16], Consistency and Standards [UC-CW = 17, TA = 15], and Recognition Rather than Recall [UC-CW = 13, TA = 10]). Both methods converged on eight usability problems, but the UC-CW group detected five critical issues while the TA group identified two. The UC-CW group identified needed personalized features for patients’ disease needs not identified with TA. UC-CW was more efficient on average time per identified usability problem and on the total evaluation process with patients. NASA RTLX scores indicated that participants experienced the UC-CW half as cognitively demanding. Common themes from interviews indicated the UC-CW as enjoyable and easy to perform while TA was considered somewhat awkward and more cognitively challenging. Conclusions: UC-CW was effective for finding severe, recurring usability problems and it highlighted the need for personalized user features. The method was also efficient and had high user acceptance. These results indicate UC-CW's utility and user acceptance in evaluating a mHealth self-management application. It provides an additional usability evaluation technique for researchers. © 2019

  • 6.
    Hofflander, Malin
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Implementing video conferencing in discharge planning sessions: leadership and organizational culture when designing IT support for everyday work in nursing practice2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The overall aim of this thesis has been to study the implementation process concerning the use of video conferencing in discharge planning, during and after a development project in a region in southeast Sweden. The research approach has been developed within a new interdisciplinary research area, Applied Health Technology. The main focus of the research has been on how the new IT solution has affected everyday work, and in what ways management supported staff during the implementation process. The study design has a qualitative approach. Phenomenological hermeneutics, content analysis and Participatory Action Research (PAR) have been used in the analysis process. Study I aimed to describe  primary healthcare nursing staff’s experiences of discharge planning, along with their concerns about using video conferencing in discharge planning sessions. It was found that there is need for improvement in communication and understanding between nursing staff working in hospitals and in primary healthcare, and need for nursing staff to obtain more information about how IT solutions could support their work. The aim of Study II was to examine the implementation process of using video conferencing in discharge planning, according to a theoretical framework composed from theories about implementation processes. It was found that implementation frameworks can be useful, and that framing the implementation process supports the exposure of factors and highlights relationships and states of dependency between those factors which may affect implementation. Study III set out to describe managers’ reflections about leading the implementation process of using video conferencing in the discharge planning session. The results indicate that managers experienced two leadership perspectives when they reflected on the implementation process. On one hand, they described a desired way of leading implementation, on the other hand they described an actual way of leading implementation. The aim of Study IV was to describe the reflections of professionals about what is needed in order to create what should become a new best practice using videoconferencing in the discharge planning sessions. The results indicate that the professionals experienced lack of knowledge and understanding about each other’s everyday work and that the absence of well-functioning common routines obstructed the process. The results also indicate that there is a lack of common arenas to enable discussions, negotiations and agreements about adopting new routines as the discharge planning process changes over time. This thesis contributes to the much-needed discussions about how to manage the many ongoing IT implementation processes in Swedish healthcare organizations, by highlighting challenges and difficulties that both healthcare professionals and managers have experienced during an implementation process. The results indicate that implementation frameworks can be useful when new IT solutions are introduced in healthcare, and that there is a need for dedicating time, space and support for involved professionals in designing their everyday work.

  • 7.
    Lilje, Stina
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Aspects of musculoskeletal pain interfering with normal life and naprapathic manual therapy from a health technology assessment perspective2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction

    Musculoskeletal pain is one of the most common reasons for seeking health care. If a patient’s disorders remain after conventional primary care, a referral to secondary care is often made, yet many referrals on the waiting lists concern patients who are not in need of surgery. Manual therapy has a lot of “proved experience” but is not routine in the Swedish national health care system today. There is a lack of scientific evidence for its treatment and cost effects.

    Aims

    The overall aim of this thesis was to increase the knowledge of musculoskeletal pain that interferes with normal life. Specific aims were to investigate if musculoskeletal pain in older adults is associated with heavy physical and negative psychosocial workloads through life, and to deepen the knowledge of the treatment and cost effects of naprapathic manual therapy (NMT), and of older adults' experiences of reminders of home exercises through mHealth.

    Methods

    Study I is a cross sectional study (n=641) that investigates associations between musculoskeletal pain interfering with normal life in older adults and physical and psychological loads through life. Study II is a randomised controlled trial (n=78) that compares NMT with standard orthopaedic care for “low priority” orthopaedic outpatients. Study III (n=1) is a case study that describes the treatment effects of NMT in a patient diagnosed with adhesive capsulitis. Study IV is a cost consequence analysis (n=78), where the costs and the health economic gains in study II were analyzed. Study V is a qualitative interview study (n=8) exploring older adults’ experiences of text messages as reminders of home exercises after NMT.

    Results

    The results in Study I were that psychosocial and physical workloads are associated with musculoskeletal pain that interferes with normal life in older adults. NMT for low priority orthopaedic outpatients yielded larger improvements in pain, physical function and perceived recovery compared with standard orthopaedic care (Study II). NMT for the acromio-clavicular joint, for adhesive capsulitis resulted in significant pain relief and perceived recovery, decreased sleeping disorders and medication (Study III). The health gains for naprapathy were higher compared with standard orthopaedic care, and the costs significantly lower (Study IV). Study V concluded that the use of SMS:s as reminders of home exercises after NMT were appreciated by the patients, and stimulated them to practice memorising and to create.

    Conclusion

    This thesis suggests that pain in older adults is associated with heavy physical and negative psychosocial workloads through life. NMT may be cost effective for low priority orthopaedic outpatients of working age with musculoskeletal disorders that are not likely to benefit from orthopaedic surgery, and was effective in a patient diagnosed with adhesive capsulitis. mHealth used to remind older adults of home exercises stimulates the patients to create own routines for continued compliance.  

     

  • 8.
    Shaheen, Shakira
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för tillämpad signalbehandling.
    Mohammed, Abbas
    Grbic, Nedelko
    Mobile Services for Diabetic Patients' Sustainable Lifestyle2015Ingår i: mHealth Multidisciplinary Verticals / [ed] Adibi, S, CRC Press, 2015, s. 51-61Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 9.
    Stridsman, Caroline
    et al.
    Luleå tekniska universitet, Medicinsk vetenskap.
    Skär, Lisa
    Luleå tekniska universitet, Omvårdnad.
    Hedman, Linnea
    Luleå tekniska universitet, Omvårdnad.
    Rönmark, Eva
    Norrbottens Läns Landsting.
    Lindberg, Anne
    OLIN studies, Norrbotten County Council.
    Fatigue affects health status and predicts mortality among subjects with COPD-report from the population-based OLIN COPD study2015Ingår i: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 12, nr 2, s. 199-206Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: COPD is associated to increased fatigue, decreased health status and mortality. However, these relationships are rarely evaluated in population-based studies. Aims: To describe the relationship between health status, respiratory symptoms and fatigue among subjects with and without COPD. Further, to evaluate whether fatigue and/or health status predicts mortality in these groups. Methods: Data were collected in 2007 from the population-based OLIN COPD study. Subjects participated in lung function tests and structured interviews, and 434 subjects with and 655 subjects without COPD were identified. Fatigue was assessed by FACIT-Fatigue and health status by the generic SF-36 questionnaire including physical (PCS) and mental (MCS) components. Mortality data until February 2012 were collected. Results: Fatigue greatly impacts the physical and mental dimensions of health status, both among subjects with and without COPD. Among subjects with clinically significant fatigue, COPD subjects had significantly lower PCS-scores compared to non-COPD subjects. Fairly strong correlations were found between FACIT-F, SF-36 PCS and MCS, respectively. In multivariate models adjusting for covariates, increased fatigue, decreased physical and mental dimensions of health status were all associated to mortality in subjects with COPD (OR 1.06, CI 1.02-1.10, OR 1.04, CI 1.01-1.08 and OR 1.06, CI 1.02-1.10), but not in non-COPD. Conclusions: Fatigue and decreased health status were closely related among subjects with and without COPD. Not only physical health status, but also fatigue and mental health predicted mortality among subjects with COPD. Fatigue assessed by FACIT-F, can be a useful instrument of prognostic value in the care of subjects with COPD.

  • 10.
    Stridsman, Caroline
    et al.
    Luleå tekniska universitet, Medicinsk vetenskap.
    Zingmark, Karin
    Luleå tekniska universitet, Omvårdnad.
    Lindberg, Anne
    NLL.
    Skär, Lisa
    Luleå tekniska universitet, Omvårdnad.
    Creating a balance between breathing and viability: Experiences of well-being when living with chronic obstructive pulmonary disease2015Ingår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, nr 1, s. 42-52Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim To describe experiences of well-being among people with moderate to very severe chronic obstructive pulmonary disease (COPD). BACKGROUND: Living with COPD is related to a complex life situation, and quality of life (QOL) is shown to decrease because of respiratory symptoms and fatigue. However, studies describing well-being in COPD as a subjective description of QOL are rare. METHODS: Ten participants with moderate to very severe COPD from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD study were interviewed about their experiences of well-being. A latent qualitative content analysis was used to analyse the data. Findings To achieve well-being despite breathlessness, the participants had to adapt to their limitations and live towards the future. They created a balance between breathing and viability by adjusting to a lifelong limitation, handling variations in illness, relying on self-capacity and accessibility to a trustful care. The participants adjusted to lifelong limitations through acceptance and replacement of former activities. They handled variations in illness by taking advantage of the good days and using emotional adaptation strategies. The participants relied on their own self-capacity, feeling that smoking cessation, physical activity and breathing fresh air increased their well-being. They requested accessibility to a trustful care and highlighted the need for continuous care relationships and access to medications. These findings can enhance health-care professionals' understanding of the possibilities for increased well-being for people living with COPD.

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