How Veterans With Post-Traumatic Stress Disorder and Comorbid Health Conditions Utilize eHealth to Manage Their Health Care Needs: A Mixed-Methods Analysis
Mental health conditions are prevalent among US veterans and pose a number of self-management and health care navigation challenges. Post-Traumatic Stress Disorder (PTSD) with comorbid chronic medical conditions (CMCs) is especially common, in both returning Iraq or Afghanistan and earlier war-era v...
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description | Mental health conditions are prevalent among US veterans and pose a number of self-management and health care navigation challenges. Post-Traumatic Stress Disorder (PTSD) with comorbid chronic medical conditions (CMCs) is especially common, in both returning Iraq or Afghanistan and earlier war-era veterans. Patient-facing electronic health (eHealth) technology may offer innovative strategies to support these individuals' needs.
This study was designed to identify the types of eHealth tools that veterans with PTSD and comorbid CMCs use, understand how they currently use eHealth technology to self-manage their unique health care needs, and identify new eHealth resources that veterans feel would empower them to better manage their health care.
A total of 119 veterans with PTSD and at least one CMC who have used the electronic personal health record system of the US Department of Veterans Affairs (VA) responded to a mailed survey about their chronic conditions and preferences related to the use of technology. After the survey, 2 focus groups, stratified by sex, were conducted with a subgroup of patients to explore how veterans with PTSD and comorbid CMCs use eHealth technology to support their complex health care needs. Focus groups were transcribed verbatim and analyzed using standard content analysis methods for coding textual data, guided by the "Fit between Individual, Task, and Technology" framework.
Survey respondents had a mean age of 64.0 (SD 12.0) years, 85.1% (97/114) were male, 72.4% (84/116) were white, and 63.1% (70/111) had an annual household income of < US $50,000. Mean score on a measure of eHealth literacy was 27.7 (SD 9.8). Of the respondents, 44.6% (50/112) used health-related technology 1 to 3 times per month and 21.4% (24/112) used technology less than once per month. Veterans reported using technology most often to search for health information (78.9%, 90/114), communicate with providers (71.1%, 81/114), and track medications (64.9%, 74/114). Five major themes emerged that describe how eHealth technology influences veterans with PTSD and comorbid CMCs: (1) interactions with social support, (2) condition management, (3) access to and communication with providers, (4) information access, and (5) coordination of care.
The "Fit between Individual, Task, and Technology" model provided a useful framework to examine the clinical tasks that arose for veterans and their resourceful adoption of eHealth tools. This study suggests that veterans who |
doi_str_mv | 10.2196/jmir.5594 |
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This study was designed to identify the types of eHealth tools that veterans with PTSD and comorbid CMCs use, understand how they currently use eHealth technology to self-manage their unique health care needs, and identify new eHealth resources that veterans feel would empower them to better manage their health care.
A total of 119 veterans with PTSD and at least one CMC who have used the electronic personal health record system of the US Department of Veterans Affairs (VA) responded to a mailed survey about their chronic conditions and preferences related to the use of technology. After the survey, 2 focus groups, stratified by sex, were conducted with a subgroup of patients to explore how veterans with PTSD and comorbid CMCs use eHealth technology to support their complex health care needs. Focus groups were transcribed verbatim and analyzed using standard content analysis methods for coding textual data, guided by the "Fit between Individual, Task, and Technology" framework.
Survey respondents had a mean age of 64.0 (SD 12.0) years, 85.1% (97/114) were male, 72.4% (84/116) were white, and 63.1% (70/111) had an annual household income of < US $50,000. Mean score on a measure of eHealth literacy was 27.7 (SD 9.8). Of the respondents, 44.6% (50/112) used health-related technology 1 to 3 times per month and 21.4% (24/112) used technology less than once per month. Veterans reported using technology most often to search for health information (78.9%, 90/114), communicate with providers (71.1%, 81/114), and track medications (64.9%, 74/114). Five major themes emerged that describe how eHealth technology influences veterans with PTSD and comorbid CMCs: (1) interactions with social support, (2) condition management, (3) access to and communication with providers, (4) information access, and (5) coordination of care.
The "Fit between Individual, Task, and Technology" model provided a useful framework to examine the clinical tasks that arose for veterans and their resourceful adoption of eHealth tools. This study suggests that veterans who use the Web are eager to incorporate eHealth technology into their care and self-management activities. Findings illustrate a number of ways in which the VA and eHealth technology developers can refine existing applications, develop new resources, and better promote tools that address challenges experienced by veterans with PTSD and comorbid CMCs.</description><identifier>ISSN: 1438-8871</identifier><identifier>ISSN: 1439-4456</identifier><identifier>EISSN: 1438-8871</identifier><identifier>DOI: 10.2196/jmir.5594</identifier><identifier>PMID: 27784650</identifier><language>eng</language><publisher>Canada: Gunther Eysenbach MD MPH, Associate Professor</publisher><subject>Access ; Chronic illnesses ; Communication ; Comorbidity ; Content analysis ; Coordination ; Disease Management ; Family income ; Female ; Focus groups ; Health information ; Health Literacy - methods ; Health Services ; Humans ; Information technology ; Literacy ; Male ; Medical conditions ; Medical technology ; Mental disorders ; Mental health ; Middle Aged ; Mixed methods research ; Navigation ; Original Paper ; Personal health ; Polls & surveys ; Post traumatic stress disorder ; Principal components analysis ; Self Care ; Selfmanagement ; Sex crimes ; Social networks ; Social research ; Social support ; Software ; Stress Disorders, Post-Traumatic - psychology ; Stress Disorders, Post-Traumatic - therapy ; Surveys and Questionnaires ; Technological change ; Telemedicine ; Telemedicine - methods ; United States ; Veterans ; Veterans - statistics & numerical data</subject><ispartof>Journal of medical Internet research, 2016-10, Vol.18 (10), p.e280-e280</ispartof><rights>2016. This work is licensed under http://creativecommons.org/licenses/by/2.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Julia M Whealin, Emily C Jenchura, Ava C Wong, Donna M Zulman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.10.2016. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-d3dd2d9dd2b1b6b1de633981bef4b0b73e60da2dc7724acb25b5ab1565b95bf73</citedby><cites>FETCH-LOGICAL-c436t-d3dd2d9dd2b1b6b1de633981bef4b0b73e60da2dc7724acb25b5ab1565b95bf73</cites><orcidid>0000-0003-1777-219X ; 0000-0002-2876-6783 ; 0000-0001-8904-2810 ; 0000-0001-9171-0283</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,727,780,784,864,885,12846,27924,27925,30999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27784650$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Whealin, Julia M</creatorcontrib><creatorcontrib>Jenchura, Emily C</creatorcontrib><creatorcontrib>Wong, Ava C</creatorcontrib><creatorcontrib>Zulman, Donna M</creatorcontrib><title>How Veterans With Post-Traumatic Stress Disorder and Comorbid Health Conditions Utilize eHealth to Manage Their Health Care Needs: A Mixed-Methods Analysis</title><title>Journal of medical Internet research</title><addtitle>J Med Internet Res</addtitle><description>Mental health conditions are prevalent among US veterans and pose a number of self-management and health care navigation challenges. Post-Traumatic Stress Disorder (PTSD) with comorbid chronic medical conditions (CMCs) is especially common, in both returning Iraq or Afghanistan and earlier war-era veterans. Patient-facing electronic health (eHealth) technology may offer innovative strategies to support these individuals' needs.
This study was designed to identify the types of eHealth tools that veterans with PTSD and comorbid CMCs use, understand how they currently use eHealth technology to self-manage their unique health care needs, and identify new eHealth resources that veterans feel would empower them to better manage their health care.
A total of 119 veterans with PTSD and at least one CMC who have used the electronic personal health record system of the US Department of Veterans Affairs (VA) responded to a mailed survey about their chronic conditions and preferences related to the use of technology. After the survey, 2 focus groups, stratified by sex, were conducted with a subgroup of patients to explore how veterans with PTSD and comorbid CMCs use eHealth technology to support their complex health care needs. Focus groups were transcribed verbatim and analyzed using standard content analysis methods for coding textual data, guided by the "Fit between Individual, Task, and Technology" framework.
Survey respondents had a mean age of 64.0 (SD 12.0) years, 85.1% (97/114) were male, 72.4% (84/116) were white, and 63.1% (70/111) had an annual household income of < US $50,000. Mean score on a measure of eHealth literacy was 27.7 (SD 9.8). Of the respondents, 44.6% (50/112) used health-related technology 1 to 3 times per month and 21.4% (24/112) used technology less than once per month. Veterans reported using technology most often to search for health information (78.9%, 90/114), communicate with providers (71.1%, 81/114), and track medications (64.9%, 74/114). Five major themes emerged that describe how eHealth technology influences veterans with PTSD and comorbid CMCs: (1) interactions with social support, (2) condition management, (3) access to and communication with providers, (4) information access, and (5) coordination of care.
The "Fit between Individual, Task, and Technology" model provided a useful framework to examine the clinical tasks that arose for veterans and their resourceful adoption of eHealth tools. This study suggests that veterans who use the Web are eager to incorporate eHealth technology into their care and self-management activities. Findings illustrate a number of ways in which the VA and eHealth technology developers can refine existing applications, develop new resources, and better promote tools that address challenges experienced by veterans with PTSD and comorbid CMCs.</description><subject>Access</subject><subject>Chronic illnesses</subject><subject>Communication</subject><subject>Comorbidity</subject><subject>Content analysis</subject><subject>Coordination</subject><subject>Disease Management</subject><subject>Family income</subject><subject>Female</subject><subject>Focus groups</subject><subject>Health information</subject><subject>Health Literacy - methods</subject><subject>Health Services</subject><subject>Humans</subject><subject>Information technology</subject><subject>Literacy</subject><subject>Male</subject><subject>Medical conditions</subject><subject>Medical technology</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Mixed methods research</subject><subject>Navigation</subject><subject>Original Paper</subject><subject>Personal health</subject><subject>Polls & surveys</subject><subject>Post traumatic stress disorder</subject><subject>Principal components analysis</subject><subject>Self Care</subject><subject>Selfmanagement</subject><subject>Sex crimes</subject><subject>Social networks</subject><subject>Social research</subject><subject>Social support</subject><subject>Software</subject><subject>Stress Disorders, Post-Traumatic - 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methods</topic><topic>Health Services</topic><topic>Humans</topic><topic>Information technology</topic><topic>Literacy</topic><topic>Male</topic><topic>Medical conditions</topic><topic>Medical technology</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Mixed methods research</topic><topic>Navigation</topic><topic>Original Paper</topic><topic>Personal health</topic><topic>Polls & surveys</topic><topic>Post traumatic stress disorder</topic><topic>Principal components analysis</topic><topic>Self Care</topic><topic>Selfmanagement</topic><topic>Sex crimes</topic><topic>Social networks</topic><topic>Social research</topic><topic>Social support</topic><topic>Software</topic><topic>Stress Disorders, Post-Traumatic - psychology</topic><topic>Stress Disorders, Post-Traumatic - therapy</topic><topic>Surveys and Questionnaires</topic><topic>Technological change</topic><topic>Telemedicine</topic><topic>Telemedicine - methods</topic><topic>United States</topic><topic>Veterans</topic><topic>Veterans - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Whealin, Julia M</creatorcontrib><creatorcontrib>Jenchura, Emily C</creatorcontrib><creatorcontrib>Wong, Ava C</creatorcontrib><creatorcontrib>Zulman, Donna M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Library & Information Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Library & Information Sciences Abstracts (LISA)</collection><collection>Library & Information Science Abstracts (LISA)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Library Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of medical Internet research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Whealin, Julia M</au><au>Jenchura, Emily C</au><au>Wong, Ava C</au><au>Zulman, Donna M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How Veterans With Post-Traumatic Stress Disorder and Comorbid Health Conditions Utilize eHealth to Manage Their Health Care Needs: A Mixed-Methods Analysis</atitle><jtitle>Journal of medical Internet research</jtitle><addtitle>J Med Internet Res</addtitle><date>2016-10-26</date><risdate>2016</risdate><volume>18</volume><issue>10</issue><spage>e280</spage><epage>e280</epage><pages>e280-e280</pages><issn>1438-8871</issn><issn>1439-4456</issn><eissn>1438-8871</eissn><abstract>Mental health conditions are prevalent among US veterans and pose a number of self-management and health care navigation challenges. Post-Traumatic Stress Disorder (PTSD) with comorbid chronic medical conditions (CMCs) is especially common, in both returning Iraq or Afghanistan and earlier war-era veterans. Patient-facing electronic health (eHealth) technology may offer innovative strategies to support these individuals' needs.
This study was designed to identify the types of eHealth tools that veterans with PTSD and comorbid CMCs use, understand how they currently use eHealth technology to self-manage their unique health care needs, and identify new eHealth resources that veterans feel would empower them to better manage their health care.
A total of 119 veterans with PTSD and at least one CMC who have used the electronic personal health record system of the US Department of Veterans Affairs (VA) responded to a mailed survey about their chronic conditions and preferences related to the use of technology. After the survey, 2 focus groups, stratified by sex, were conducted with a subgroup of patients to explore how veterans with PTSD and comorbid CMCs use eHealth technology to support their complex health care needs. Focus groups were transcribed verbatim and analyzed using standard content analysis methods for coding textual data, guided by the "Fit between Individual, Task, and Technology" framework.
Survey respondents had a mean age of 64.0 (SD 12.0) years, 85.1% (97/114) were male, 72.4% (84/116) were white, and 63.1% (70/111) had an annual household income of < US $50,000. Mean score on a measure of eHealth literacy was 27.7 (SD 9.8). Of the respondents, 44.6% (50/112) used health-related technology 1 to 3 times per month and 21.4% (24/112) used technology less than once per month. Veterans reported using technology most often to search for health information (78.9%, 90/114), communicate with providers (71.1%, 81/114), and track medications (64.9%, 74/114). Five major themes emerged that describe how eHealth technology influences veterans with PTSD and comorbid CMCs: (1) interactions with social support, (2) condition management, (3) access to and communication with providers, (4) information access, and (5) coordination of care.
The "Fit between Individual, Task, and Technology" model provided a useful framework to examine the clinical tasks that arose for veterans and their resourceful adoption of eHealth tools. This study suggests that veterans who use the Web are eager to incorporate eHealth technology into their care and self-management activities. Findings illustrate a number of ways in which the VA and eHealth technology developers can refine existing applications, develop new resources, and better promote tools that address challenges experienced by veterans with PTSD and comorbid CMCs.</abstract><cop>Canada</cop><pub>Gunther Eysenbach MD MPH, Associate Professor</pub><pmid>27784650</pmid><doi>10.2196/jmir.5594</doi><orcidid>https://orcid.org/0000-0003-1777-219X</orcidid><orcidid>https://orcid.org/0000-0002-2876-6783</orcidid><orcidid>https://orcid.org/0000-0001-8904-2810</orcidid><orcidid>https://orcid.org/0000-0001-9171-0283</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Access Chronic illnesses Communication Comorbidity Content analysis Coordination Disease Management Family income Female Focus groups Health information Health Literacy - methods Health Services Humans Information technology Literacy Male Medical conditions Medical technology Mental disorders Mental health Middle Aged Mixed methods research Navigation Original Paper Personal health Polls & surveys Post traumatic stress disorder Principal components analysis Self Care Selfmanagement Sex crimes Social networks Social research Social support Software Stress Disorders, Post-Traumatic - psychology Stress Disorders, Post-Traumatic - therapy Surveys and Questionnaires Technological change Telemedicine Telemedicine - methods United States Veterans Veterans - statistics & numerical data |
title | How Veterans With Post-Traumatic Stress Disorder and Comorbid Health Conditions Utilize eHealth to Manage Their Health Care Needs: A Mixed-Methods Analysis |
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