Maritta Anneli Välimäki*, University of Turku, Finland, Turku, Finland Heli Hätönen, University of Turku, Turku, Finland Lauri Kuosmanen, University of Turku, Turku, Finland Marita Koivunen, University of Turku, Turku, Finland Minna Anttila, University of Turku, Turku, Finland Anneli Pitkänen, University of Turku, Turku, Finland Track: Research Presentation Topic: Health information on the web: Supply and Demand Presentation Type: Oral presentation Submission Type: Single Presentation Building: LKSC Conference Center Stanford Room: Lower Auditorium 130 Date: 2011-09-17 04:30 PM – 06:00 PM Last modified: 2011-08-12

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Background: e-Health has been increasingly used in the field on mental health care. Major difficulties may still arise when introducing new web-based health information into routine daily practice. Psychiatric nurses have less often used computers or Internet with patients and their information and communication technology (ICT) skills may be low. Substantial evidence suggests that to change behaviour is possible, but this change generally requires comprehensive approaches at different levels (nurses, doctors, team practice, hospital, wider environment), tailored to specific settings and target groups.
Objective: To describe and evaluate the implementation process of Web-based portal into daily clinical practice on psychiatric wards.
Methods: We developed an interactive multi-service online portal application (in English Mental.Net) to support their knowledge level of their own illness and treatment and self-management skills. The portal is meant for patients with schizophrenia spectrum psychosis (F20-29, ICD-10) and their professional carers. The portal can be used independently by patients or in collaboration with patient and nurse. It aims to offer health information to support patients’ self-management skills and to update nurses’ knowledge level. The portal was implemented in two acute psychiatric hospital wards (n = 9) with a six-step implementation model. The study population consisted of all registered and practical nurses working on nine acute psychiatric wards (N = 89) and patients admitted in the study wards during the data collection period (n = 100). Patients’ feedback was collected through interviews (N =32). Nurses attitudes toward computers and IT use were evaluated regarding motivation, beliefs and satisfaction with computers, computer use and Internet use (Burges 1991) at Baseline and 18 months after the implementation of the portal. In addition, analysis of 93 patient education sessions were conducted.
Results: This study showed that it is possible to implement Web-based portal into daily clinical practice with systematic implementation process. Out of 100 possible patients, 93 used the portal during their hospital stay. Patients’ reported that portal supported their individual information management process. They we more aware of the existing methods used to deliver information to patients. However, some concerns were also rised related to the safe Internet use, such as privacy and security issues. In generally, nurses’ attitudes were at quite a neutral level toward computers at the baseline and the follow-up assessment. Further, IT use did not changed significantly during the study period.
Based on analysis of 93 patient education sessions, nurses’ reported barriers restricting the use of the portal to support patient health information. These were a lack of computers, a lack of time for patients, nurses’ negative attitudes towards computer use and a lacking ICT skills. The main facilitators for portal use were appropriate technological resources, easy Internet access, enough time for portal use, and high level of motivation among staff to use computers.
Conclusions: This project showed that ICT based e-Health has potential to contribute to improvements in empowerment of people with severe mental illnesses and their carers. However, it is important that plans for change will be based on characteristics of the evidence and barriers and facilitators to change. Future research should explore the various structures, formats, and interventions of implementation in psychiatric care.