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Cajander, Åsa, ProfessorORCID iD iconorcid.org/0000-0001-7472-2215
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Publications (10 of 169) Show all publications
Hagström, J., Blease, C., Scandurra, I., Moll, J., Cajander, Å., Rexhepi, H. & Hägglund, M. (2024). Adolescents’ reasons for accessing their health records online, perceived usefulness and experienced provider encouragement: a national survey in Sweden. BMJ Paediatrics Open, 8(1)
Open this publication in new window or tab >>Adolescents’ reasons for accessing their health records online, perceived usefulness and experienced provider encouragement: a national survey in Sweden
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2024 (English)In: BMJ Paediatrics Open, Vol. 8, no 1Article in journal (Refereed) Published
Abstract [en]

Background Having online access to electronic health records (EHRs) may help patients become engaged in their care at an early age. However, little is known about adolescents using patient portals. A national survey conducted within the Nordic eHealth project NORDeHEALTH provided an important opportunity to advance our understanding of adolescent users of patient portals. The present study explored reasons for reading the EHRs, the perceived usefulness of information and functions in a patient portal and the association between frequency of use and encouragement to read the EHR.Methods Data were collected in a survey using convenience sampling, available through the Swedish online health portal during 3 weeks in January and February 2022. This study included a subset of items and only respondents aged 15–19. Demographic factors and frequencies on Likert-style questions were reported with descriptive statistics, while Fisher’s exact test was used to explore differences in use frequency based on having been encouraged to read by a healthcare professional (HCP).Results Of 13 008 users who completed the survey, 218 (1.7%) were unique users aged 15–19 (females: 77.1%). One-fifth (47/218, 21.6%) had been encouraged by HCPs to read their records, and having been encouraged by HCPs was related to higher use frequency (p=0.018). All types of information were rated high on usefulness, while some functions were rated low, such as blocking specific clinical notes from HCPs and managing services for family members. The main reason for reading their health records online was out of curiosity.Conclusions Adolescents who read their records online perceive it to be useful. Encouragement by HCPs can lead to increased use of patient portals among adolescents. Findings should be considered in the future design of patient portals for adolescents.Data are available upon reasonable request.

National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Medical Informatics
Identifiers
urn:nbn:se:uu:diva-524864 (URN)10.1136/bmjpo-2023-002258 (DOI)
Funder
NordForsk, 100477
Available from: 2024-03-12 Created: 2024-03-12 Last updated: 2024-03-12
Kujala, S., Simola, S., Wang, B., Soone, H., Hagström, J., Bärkås, A., . . . Johansen, M. A. (2024). Benchmarking usability of patient portals in Estonia, Finland, Norway, and Sweden. International Journal of Medical Informatics, 181, Article ID 105302.
Open this publication in new window or tab >>Benchmarking usability of patient portals in Estonia, Finland, Norway, and Sweden
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2024 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 181, article id 105302Article in journal (Refereed) Published
Abstract [en]

Introduction

Poor usability is a barrier to widespread adoption of electronic health records (EHR). Providing good usability is especially challenging in the health care context, as there is a wide variety of patient users. Usability benchmarking is an approach for improving usability by evaluating and comparing the strength and weaknesses of systems. The main purpose of this study is to benchmark usability of patient portals across countries.

Methods

A mixed-methods survey approach was applied to benchmark the national patient portals offering patient access to EHR in Estonia, Finland, Norway, and Sweden. These Nordic countries have similar public healthcare systems, and they are pioneers in offering patients access to EHR for several years. In a survey of 29,334 patients, both patients’ quantitative ratings of usability and their qualitative descriptions of very positive and very negative peak experiences of portal use were collected.

Results

The usability scores ranged from good to fair level of usability. The narratives of very positive and very negative experiences included the benefits of the patient portals and experienced usability issues. The regression analysis of results showed that very positive and negative experiences of patient portal use explain 19–35% of the variation of usability scores in the four countries. The percentage of patients who reported very positive or very negative experiences in each country was unrelated to the usability scores across countries.

Conclusions

The survey approach could be used to evaluate usability with a wide variety of users and it supported learning from comparison across the countries. The combination of quantitative and qualitative data provided an approximation of the level of the perceived usability, and identified usability issues to be improved and useful features that patients appreciate. Further work is needed to improve the comparability of the varied samples across countries.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Electronic health records, Patient-accessible electronic health records, PAEHR, Online record access, ORA, Patient portal, Usability benchmarking, Cross-national, Survey
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Medical Informatics
Identifiers
urn:nbn:se:uu:diva-516689 (URN)10.1016/j.ijmedinf.2023.105302 (DOI)001126157900001 ()38011806 (PubMedID)
Funder
NordForsk, 100477Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-01229Academy of Finland, 352501Academy of Finland, 352503
Note

De två sista författarna delar sistaförfattarskapet

Available from: 2023-11-27 Created: 2023-11-27 Last updated: 2024-01-15Bibliographically approved
Ahmad, A., Premanandan, S. & Cajander, Å. (2024). Improving Remote Examination Formats: Addressing Challenges and Providing Recommendations for University Educators in the Age of ChatGPT. In: : . Paper presented at Teknisk-naturvetenskapliga Fakultetens Universitetspedagogiska Konferens (TUK).
Open this publication in new window or tab >>Improving Remote Examination Formats: Addressing Challenges and Providing Recommendations for University Educators in the Age of ChatGPT
2024 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

The availability of Large Language Models (LLM), such as the widely accessible ChatGPT, has raised concerns regarding the reliability of assessment formats in university education. This presentation sheds light on the potential impact of ChatGPT on existing remote examination formats and offers recommendations to overcome associated challenges. Through interviews with three computer science educators and an analysis of insights from blog posts, social media platforms, and academic forums, we gathered diverse opinions and experiences related to ChatGPT's impact on university assessment formats. Our findings reveal challenges, particularly in cheating prevention, prompting the need for educators to adapt their teaching methods to this evolving landscape. While GPT performs well in answering open-ended questions, it struggles with calculations and problem-solving, with multiple-choice questions posing additional challenges. Incorporating interactive activities and oral examinations should be prioritized in this context. As ChatGPT gains traction, institutions must address concerns to maintain academic integrity.

Keywords
Large language models, LLM, ChatGPT, GPT, assessment formats
National Category
Educational Sciences
Identifiers
urn:nbn:se:uu:diva-527781 (URN)
Conference
Teknisk-naturvetenskapliga Fakultetens Universitetspedagogiska Konferens (TUK)
Available from: 2024-05-08 Created: 2024-05-08 Last updated: 2024-05-08
Premanandan, S., Ahmad, A. & Cajander, Å. (2024). Restructuring Teaching/Learning and Assessment Activities in an Online Course to Ensure Constructive Alignment. In: : . Paper presented at Teknisk-naturvetenskapliga Fakultetens Universitetspedagogiska Konferens (TUK).
Open this publication in new window or tab >>Restructuring Teaching/Learning and Assessment Activities in an Online Course to Ensure Constructive Alignment
2024 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

This study explores the importance of constructive alignment in enhancing student engagement and learning outcomes in online courses, focusing on an online Human-Computer Interaction (HCI) course. We interviewed teaching assistants and reviewed the course feedback from students to identify challenges faced by teaching assistants and students, including unclear learning objectives, lack of engaging content, and insufficient assessment diversity. Drawing on feedback from both groups, we propose restructuring the course based on constructive alignment principles. Recommendations include incorporating recorded lectures, podcasts, seminars, and group discussions; restructuring assignments into smaller groups with clear guidelines and self-introduction videos; and diversifying assessment methods with design projects, final examinations, and quizzes. Additionally, we emphasize the importance of timely and clear feedback, explicit assignment instructions, and well-defined course guidelines. Implementing these recommendations aims to address existing challenges, enhance student engagement, and ensure clear alignment between teaching, learning, and assessment in the online HCI course.

National Category
Educational Sciences
Research subject
Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-527775 (URN)
Conference
Teknisk-naturvetenskapliga Fakultetens Universitetspedagogiska Konferens (TUK)
Available from: 2024-05-08 Created: 2024-05-08 Last updated: 2024-05-08
Hagström, J., Åhlfeldt, R.-M., Blease, C., Cajander, Å., Rexhepi, H., Moll, J., . . . Hägglund, M. (2024). Security and Privacy of Online Record Access: A Survey of Adolescents’ Views and Experiences in Sweden. Journal of Adolescent Health
Open this publication in new window or tab >>Security and Privacy of Online Record Access: A Survey of Adolescents’ Views and Experiences in Sweden
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2024 (English)In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972Article in journal (Refereed) Published
Abstract [en]

Purpose Ensuring security of online health records and patients’ perceptions of security are concerns in adolescent healthcare. Little is known about adolescents’ perceptions about healthcare’s ability to protect online health records. This article explores adolescents’ perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information. Methods This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15–19 years. Gender and health status differences were calculated using the Kruskal-Wallis test. Results Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%). Discussion In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems.

Keywords
Adolescents, Adolescent health, Security, Privacy, Patient accessible electronic health record (PAEHR), Electronic health record (EHR), Usability, Patient portal, National survey, eHealth
National Category
Other Health Sciences
Research subject
Medical Informatics
Identifiers
urn:nbn:se:uu:diva-522954 (URN)10.1016/j.jadohealth.2023.12.027 (DOI)
Projects
NORDeHEALTH
Funder
NordForsk, 100477
Available from: 2024-02-13 Created: 2024-02-13 Last updated: 2024-02-13
Johansson, B., Cajander, Å., Ahmad, A., Ohlsson-Nevo, E., Fransson, P., Granström, B., . . . Tiblom Ehrsson, Y. (2024). The effect of internet-administered support (carer eSupport) on preparedness for caregiving in informal caregivers of patients with head and neck cancer compared with support as usual: a study protocol for a randomized controlled trial. BMC Cancer, 24(1), Article ID 494.
Open this publication in new window or tab >>The effect of internet-administered support (carer eSupport) on preparedness for caregiving in informal caregivers of patients with head and neck cancer compared with support as usual: a study protocol for a randomized controlled trial
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2024 (English)In: BMC Cancer, E-ISSN 1471-2407, Vol. 24, no 1, article id 494Article in journal (Refereed) Published
Abstract [en]

BackgroundInformal caregivers (ICs) of patients with cancer provide essential and mainly uncompensated care. A self-perceived preparedness to care for the patient is associated with a lower caregiver burden, described as the extent to which caregiving is perceived as having adverse effects on IC functioning and well-being. ICs’ well-being is associated with patient-perceived quality of care, suggesting that interventions to optimize ICs’ health are essential in order to improve patient care. Head and neck cancer (HNC) is the seventh most common malignant disease in the world. The disease and its treatment have a significant negative impact on the patient’s health and quality of life. Symptoms usually interfere with swallowing, food and fluid intake, breathing, speaking, and communication. ICs frequently manage patients’ symptoms and side effects, especially problems related to nutrition and oral pain, without being properly prepared. Carer eSupport is an Internet-administered intervention, based on focus group discussions with ICs, developed in collaboration with ICs and healthcare professionals, tested for feasibility, and deemed feasible. This study protocol outlines the methods of investigating the effects of Carer eSupport plus support as usual (SAU) on self-reported preparedness for caregiving, caregiver burden, and well-being in the ICs of patients with HNC, compared with ICs receiving SAU only.

Methods and analysisIn this randomized controlled trial, 110 ICs of patients with HNC, undergoing radiotherapy combined with surgery and/or medical oncological treatment, will be randomized (1:1) to Carer eSupport plus SAU or SAU only. Data will be collected at baseline (before randomization), post-intervention (after 18 weeks), and 3 months after post-intervention. The primary outcome is self-reported preparedness for caregiving. Secondary outcomes are self-reported caregiver burden, anxiety, depression, and health-related quality of life. The effect of Carer eSupport plus SAU on preparedness for caregiving and secondary outcomes, compared with SAU only, will be evaluated by intention to treat analyses using linear regression models, mixed-model regression, or analysis of covariance.

DiscussionIf proven effective, Carer eSupport has the potential to significantly improve ICs’ preparedness for caregiving and their wellbeing, thereby improving patient-perceived quality of care and patient wellbeing.

Trial registrationClinicalTrials.gov; NCT06307418, registered 12.03.2024 (https://clinicaltrials.gov/search? term=NCT06307418).

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
National Category
Cancer and Oncology
Research subject
Caring Sciences; Oncology
Identifiers
urn:nbn:se:uu:diva-526849 (URN)10.1186/s12885-024-12273-y (DOI)001205523400002 ()38637744 (PubMedID)
Funder
Uppsala University
Available from: 2024-04-19 Created: 2024-04-19 Last updated: 2024-05-03Bibliographically approved
Van Den Drische, K. & Cajander, Å. (2023). Collective Collaboration Mapping’ towards Knowledge Commons. In: : . Paper presented at The CHIWORK conference. Oldenburg
Open this publication in new window or tab >>Collective Collaboration Mapping’ towards Knowledge Commons
2023 (English)Conference paper, Oral presentation with published abstract (Refereed)
Place, publisher, year, edition, pages
Oldenburg: , 2023
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:uu:diva-507016 (URN)
Conference
The CHIWORK conference
Available from: 2023-06-30 Created: 2023-06-30 Last updated: 2023-06-30
Larusdottir, M. & Cajander, Å. (2023). Contextual Think Aloud: Method for Understanding Users and Their Digital Work Environment. In: : . Paper presented at Workshop on "Human-Centered Software Engineering: Rethinking the Interplay of Human–Computer Interaction and Software Engineering in the Age of Digital Transformation" at 19th IFIP TC13 International Conference, INTERACT.
Open this publication in new window or tab >>Contextual Think Aloud: Method for Understanding Users and Their Digital Work Environment
2023 (English)Conference paper, Published paper (Refereed)
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:uu:diva-512699 (URN)
Conference
Workshop on "Human-Centered Software Engineering: Rethinking the Interplay of Human–Computer Interaction and Software Engineering in the Age of Digital Transformation" at 19th IFIP TC13 International Conference, INTERACT
Available from: 2023-09-28 Created: 2023-09-28 Last updated: 2023-09-28
Premanandan, S., Ahmad, A., Cajander, Å., Ågerfalk, P. & van Gemert-Pijnen, L. (2023). Design Suggestions for a Persuasive E-coaching Application: A Study on Informal Caregivers' Needs. Digital Health, 9, 1-12
Open this publication in new window or tab >>Design Suggestions for a Persuasive E-coaching Application: A Study on Informal Caregivers' Needs
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2023 (English)In: Digital Health, E-ISSN 2055-2076, Vol. 9, p. 1-12Article in journal (Refereed) Published
Abstract [en]

Objective: Informal caregivers such as relatives or close friends of patients are essential for caregiving at home. However, caregiving is a complex experience that may affect the caregivers’ well-being. Therefore, there is a need to provide support for caregivers, which we address in this article by proposing design suggestions for an e-coaching application. This study identifies the unmet needs of caregivers in Sweden and provides design suggestions for an e-coaching application using the persuasive system design (PSD) model. The PSD model offers a systematic approach to designing IT interventions.

Methods: A qualitative research design was used, and semi-structured interviews were conducted with 13 informal caregivers from different municipalities in Sweden. A thematic analysis was performed to analyze the data. The PSD model was used to map the needs emerging from this analysis to propose design suggestions for an e-coaching application for caregivers.

Results: Six needs were identified, and based on them, we proposed design suggestions for an e-coaching application using the PSD model. These unmet needs are monitoring and guidance, assistance to avail formal care services, access to practical information without being overwhelmed, feeling of community, access to informal support, and grief acceptance. The last two needs could not be mapped using the existing PSD model, resulting in an extended PSD model.

Conclusion: This study revealed the important needs of informal caregivers based on which design suggestions for an e-coaching application were presented. We also proposed an adapted PSD model. This adapted PSD model can be further used for designing digital interventions in caregiving.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
E-coaching, informal caregivers, e-health, designing application, user needs, persuasive system design, online intervention
National Category
Information Systems
Research subject
Information Systems
Identifiers
urn:nbn:se:uu:diva-503768 (URN)10.1177/20552076231177129 (DOI)000999816600001 ()37284014 (PubMedID)
Funder
EU, Horizon 2020Swedish Research CouncilSwedish Cancer Society, 814 072Swedish Cancer Society, 2019-01231Swedish Cancer Society, 20 1014 PjF
Available from: 2023-06-08 Created: 2023-06-08 Last updated: 2024-01-17Bibliographically approved
Premanandan, S., Ahmad, A., Cajander, Å., Ågerfalk, P., Dolezel, M. & van Gemert-Pijnen, L. (2023). Designing a Mobile e-Coaching App for Immigrant Informal Caregivers: Qualitative Study Using the Persuasive System Design Model. JMIR mhealth and uhealth, 11, Article ID e50038.
Open this publication in new window or tab >>Designing a Mobile e-Coaching App for Immigrant Informal Caregivers: Qualitative Study Using the Persuasive System Design Model
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2023 (English)In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 11, article id e50038Article in journal (Refereed) Published
Abstract [en]

Background: Informal caregivers are vital in caring for their family and friends at home who may have illnesses or disabilities. In particular, the demands for caregiving can be even more challenging for those with limited resources, support systems, and language barriers, such as immigrant informal caregivers. They face complex challenges in providing care for their relatives. These challenges can be related to sociocultural diversity, language barriers, and health care system navigation. Acknowledging the global context of the increasing number of immigrants is essential in designing inclusive mobile health apps.

Objective: This study aims to investigate the needs of immigrant informal caregivers in Sweden and discuss the application of the Persuasive System Design Model (PSDM) to develop an e-coaching prototype. By addressing the unique challenges faced by immigrant informal caregivers, this study will contribute to the development of more effective and inclusive mobile health apps.

Methods: The participants were considered immigrants and included in the study if they and their parents were born outside of Sweden. Through various channels, such as the National Association of Relatives, rehabilitation departments at municipalities, and immigrant groups, we recruited 13 immigrant informal caregivers. These immigrant informal caregivers were primarily women aged 18 to 40 years. Most participants belonged to the Middle Eastern region whereas some were from North Africa. However, all of them spoke Arabic. We used semistructured interviews to gather data from the participants in Arabic, which were translated into English. Data were analyzed using thematic analysis and discussed in relation to the extended PSDM. The needs of the caregivers were compared with the description of persuasive design principles, and a design principle was chosen based on the match. The PSDM was extended if the need description did not match any principles. Several brainstorming and prototyping sessions were conducted to design the mobile e-coaching app.

Results: Immigrant informal caregivers have various needs in their caregiving role. They reported a need for training on the illness and future caregiving needs, assistance with understanding the Swedish language and culture, and help with accessing internet-based information and services. They also required recognition and appreciation for their efforts, additional informal support, and easy access to health care services, which can be important for their mental health. The PSDM was adapted to the informal caregiving context by adding “facilitating conditions” and “verbal encouragement” as additional persuasive design principles. This study also presents the subsequent mobile e-coaching app for immigrant informal caregivers in Sweden.

Conclusions: This study revealed important immigrant informal caregivers’ needs based on which design suggestions for a mobile e-coaching app were presented. We also proposed an adapted PSDM, for the informal caregiving context. The adapted PSDM can be further used to design digital interventions for caregiving.

Place, publisher, year, edition, pages
JMIR Publications, 2023
National Category
Information Systems, Social aspects
Research subject
Information Systems
Identifiers
urn:nbn:se:uu:diva-515872 (URN)10.2196/50038 (DOI)001114803200002 ()37943598 (PubMedID)
Funder
EU, Horizon 2020, 814 072Swedish Research CouncilSwedish Cancer Society, 2019-01231Swedish Cancer Society, 20 1014 PjF
Available from: 2023-11-13 Created: 2023-11-13 Last updated: 2024-01-23Bibliographically approved
Projects
Effects of Innovations in Education in an International Open Ended Project Course with a Focus on Professional Competences [2010-07058_VR]; Uppsala UniversityDevelopment of a Competencies Frame Set for the Evaluation of Universities in the Field of IT Profession [2011-07570_VR]; Uppsala UniversityDeployment of Online Medical Records and E-Health Services (DOME) [2012-02233_ VINNOVA]; Uppsala UniversityDeployment of Online Medical Records and E-health Services (DOME) [2013-04518_ VINNOVA]; Uppsala UniversityTactics for Activity Based Usability (TABU) [2014-03074_ VINNOVA]; Uppsala UniversityThe effects of digitalization on the work environment of nurses. (DISA) [2016-07153_Forte]; Uppsala University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7472-2215

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