Personalization of eHealth systems is a promising technique for improving patients' adherence. This paper explores the possibility of personalisation based on the patients' medical health situation... Show morePersonalization of eHealth systems is a promising technique for improving patients' adherence. This paper explores the possibility of personalisation based on the patients' medical health situation and on their health literacy. The study is set within the context of a self-management support system (SMSS) for renal transplant patients. A SMSS is designed with layering, nudging, emphaticizing, and focusing principles. It has two communication styles: (1) a guided style that provided more interpretation support and addressed emotional needs; and (2) a factual style that showed only measurement history, medical information, and recommendations. To evaluate the design, 49 renal transplant patients with three different experience levels participated in a lab study, in which they used the system in imaginary scenarios to deal with three medical health situations (alright, mild concern, and concern). A 96% understanding and 87% adherence rate was observed, with a significant interaction effect on adherence between patient group and health situation. Furthermore, compared to recently transplanted patients, not recently transplanted patients were relatively more positive towards the factual than the guided communication style in the "alright" condition. Furthermore, additional medical information was searched more often in health situations that causes mild concern and a majority of patients did not change the communication style to their preferred styles. By attuning the communication style to patient's experience and medical health situation according to the applied principles and acquired insights, SMSSs are expected to be better used. Show less
Increased patient involvement has been show to result in better clinical outcomes and increased autonomy and to offer a way to control volume and costs of chronic healthcare. The main research... Show moreIncreased patient involvement has been show to result in better clinical outcomes and increased autonomy and to offer a way to control volume and costs of chronic healthcare. The main research question of this thesis was whether part of the kidney transplant aftercare can be delegated to patients without loss of quality of care. The results of the studies described show that self-monitoring kidney function after transplantation is an attractive option to kidney transplant patients and can lead to a significant decrease in number of outpatient visits without compromising on quality of care. Further, self-monitoring could offer a relatively cheap way to increase monitoring frequency, which could lead to earlier detection and treatment of complications and, consequently, improved clinical outcomes. To unravel the full potential of self-monitoring kidney function after transplantation, it is recommended to use accurate measurement devices that both patients and healthcare professionals have confidence in, design a protocol with the involvement of a multidisciplinary group that is truly representative of all stakeholders (including patients and physicians that are more critical of self-monitoring) and choose a study design that includes formative evaluations instead of summative evaluations alone. Show less
Lint, C.L. van; Boog, P.J.M. van der; Wang, W.; Brinkman, W.P.; Rovekamp, T.J.M.; Neerincx, M.A.; ... ; Dijk, S. van 2015
