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Research article
Development of an Ehealth and GP Assisted Programme for Persistent Physical Symptoms: Qualitative Exploration of Users’ Needs
Pernille Ravn Jakobsen
UC SYD
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0199-1972
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The prevalence of patients with persistent physical symptoms (PPS) in general practice is estimated to be 17%. Hence, general practitioners (GPs) play a central role in both diagnostic assessment and management of PPS. However, a large body of literature indicates a need to improve GP strategies and ways to support patient self-help. Additionally, the use of eHealth in the field of general practice is growing. Therefore, this study aims to explore users’ needs in order to understand their requirements to an eHealth and GP assisted self-help programme for PPS in general practice.
Methods
Seven days of field studies in general practice and twenty semi-structured interviews (6 GPs and 14 patients with PPS) were conducted in the Region of Southern Denmark. Interviews were audiotaped, transcribed verbatim and analysed using a five-step thematic analysis. Analysis was done inductively and separately for patients and GPs. The identified themes were mapped to the COM-B behaviour change model to allow translation from GPs´ and patients´ needs to the development of an eHealth intervention.
Results
The analysis identified 11 subthemes in the patient interviews and 7 subthemes in the GP interviews. They were mapped into the three COM-B components: capability, opportunity and motivation. The main themes from patients and GPs corresponded and focused on understanding and explanation of symptoms, timing of this, uncertainty and consultation premises. Furthermore, important motivational elements for an eHealth programme were identified – especially the need for hope was emphasised.
Conclusions
The identified themes provide insight into potential behavioural interventions to facilitate self-care among patients with PPS in primary care settings through eHealth. Key learnings include: 1) a need to bring PPS into play early on in the consultation and take a more bio-psycho-social approach in the management of PPS. 2) Patients and GPs need better skills to manage uncertainty. 3) Patients need guidance from their GP in how to self-manage their PPS. Our design of a new eHealth and GP assisted self-help program for patients with PPS will target these identified key factors.
Keywords
eHealth, General Practice, Persistent Physical Symptoms (PPS), Self-care, Self-help, COM-B model
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CURRENT STATUS: Under Revision
Version 1
Posted 21 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 06 Nov, 2020
Review #2 received
Received 04 Nov, 2020
Review #1 received
Received 16 Oct, 2020
Reviewer #2 agreed
On 15 Oct, 2020
Reviewer #1 agreed
On 06 Oct, 2020
Reviewers invited
Invitations sent on 28 Sep, 2020
Editor assigned
On 28 Sep, 2020
Submission checks complete
On 18 Sep, 2020
Editor invited
On 16 Sep, 2020
First submitted
On 10 Sep, 2020
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Subject Areas
General Practice
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This preprint is under consideration at BMC Family Practice. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Development of an Ehealth and GP Assisted Programme for Persistent Physical Symptoms: Qualitative Exploration of Users’ Needs
Pernille Ravn Jakobsen
UC SYD
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0199-1972
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 21 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 06 Nov, 2020
Review #2 received
Received 04 Nov, 2020
Review #1 received
Received 16 Oct, 2020
Reviewer #2 agreed
On 15 Oct, 2020
Reviewer #1 agreed
On 06 Oct, 2020
Reviewers invited
Invitations sent on 28 Sep, 2020
Editor assigned
On 28 Sep, 2020
Submission checks complete
On 18 Sep, 2020
Editor invited
On 16 Sep, 2020
First submitted
On 10 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Practice
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The prevalence of patients with persistent physical symptoms (PPS) in general practice is estimated to be 17%. Hence, general practitioners (GPs) play a central role in both diagnostic assessment and management of PPS. However, a large body of literature indicates a need to improve GP strategies and ways to support patient self-help. Additionally, the use of eHealth in the field of general practice is growing. Therefore, this study aims to explore users’ needs in order to understand their requirements to an eHealth and GP assisted self-help programme for PPS in general practice.
Methods
Seven days of field studies in general practice and twenty semi-structured interviews (6 GPs and 14 patients with PPS) were conducted in the Region of Southern Denmark. Interviews were audiotaped, transcribed verbatim and analysed using a five-step thematic analysis. Analysis was done inductively and separately for patients and GPs. The identified themes were mapped to the COM-B behaviour change model to allow translation from GPs´ and patients´ needs to the development of an eHealth intervention.
Results
The analysis identified 11 subthemes in the patient interviews and 7 subthemes in the GP interviews. They were mapped into the three COM-B components: capability, opportunity and motivation. The main themes from patients and GPs corresponded and focused on understanding and explanation of symptoms, timing of this, uncertainty and consultation premises. Furthermore, important motivational elements for an eHealth programme were identified – especially the need for hope was emphasised.
Conclusions
The identified themes provide insight into potential behavioural interventions to facilitate self-care among patients with PPS in primary care settings through eHealth. Key learnings include: 1) a need to bring PPS into play early on in the consultation and take a more bio-psycho-social approach in the management of PPS. 2) Patients and GPs need better skills to manage uncertainty. 3) Patients need guidance from their GP in how to self-manage their PPS. Our design of a new eHealth and GP assisted self-help program for patients with PPS will target these identified key factors.