How Do Health Providers Design Educational Programs for Patients and Families
Comput Inform Nurs. Author manuscript; available in PMC 2013 Jun v.
Published in final edited course as:
PMCID: PMC3673715
NIHMSID: NIHMS473300
Creating Patient and Family unit Education Web Sites
Assuring Accessibility and Usability Standards
Ms. DONNA MACAN YADRICH, MPA, CCRP, Ms. SHARON A. FITZGERALD, MPH, Ms. MARILYN WERKOWITCH, RN, BSN, and Dr. CAROL E. SMITH, PhD, RN
Abstract
This article gives details about the methods and processes used to ensure that usability and accessibility were achieved during development of the Home Parenteral Nutrition Family Caregivers Spider web site, an evidence-based health teaching Web site for the family members and caregivers of chronically ill patients. This commodity addresses comprehensive definitions of usability and accessibility and illustrates Web site development according to Section 508 standards and the national Wellness and Human Services' Research-Based Web Design and Usability Guidelines requirements.
Keywords: Accessibility, Internet, Patient teaching, Usability
Every bit the utilize of the Internet grows, and then does its employ for seeking online wellness information. Co-ordinate to the nigh contempo Pew Net and American Life Projection report, approximately 61% of adults seek online health information.1 More than than thirty million American adults provide home caregiving, and approximately 80% of these care-givers seek health information online.1,two Almost caregivers managing chronic illnesses at home look to the Cyberspace for detailed information about home care for their patients merely are less probable to seek information near caring for themselves.iii
Caregivers often fail their ain physical and mental health,4,5 with resulting fatigue, stress, and morbidities because of the conflicting demands of complex long-term caregiving, employment, family responsibilities, and increasing economic pressure level.6,7 Caregivers must care for themselves considering poor wellness may be detrimental to them and harmful to those for whom they care.eight There are many Web sites available to caregivers with general information about home care; nonetheless, there are very few Web sites that provide testify-based step-past-pace guides to assistance caregivers manage their own health while providing complex habitation care such as abode parenteral nutrition (HPN).
Home parenteral nutrition is used to treat lifelong malnutrition from intestinal failure due to underlying chronic diseases (eg, Crohn's affliction), bowel loss due to surgery or abdominal trauma, or congenital or anatomical defects.nine Home parenteral nutrition therapy consists of nutrient solutions infused over 12 to 24 hours through intravenous catheters that are surgically placed in the superior vena cava.x The research-based HPN Family Caregivers Web site was designed specifically for HPN caregivers, conveniently providing stride-by-step algorithm guides and HPN home intendance information while also providing data, activities, and algorithms for improving their own wellness.11
To utilise the data, activities, and algorithms present on the HPN Family unit Caregivers Web site, users must be able to easily perform several tasks such as reading paragraphs, lists, success stories, and other Spider web pages; hyperlinking to other Spider web sites; downloading and printing checklist diaries; viewing graphics; opening, viewing, and downloading videos; downloading, saving, and/or listening to MP3s; and filling out success story forms. In order that all persons, including those with disabilities, are able perform these tasks, a Web site must be considered accessible and usable according to federal standards and national guidelines. To reach this, our Web site implemented Section 508 accessibility standards12 and adhered to usability guidelines for user-centered Spider web site design provided by the US Department of Health and Man Services (USDHHS).13 Our Web site designers also noted two boosted guidelines they found necessary specifically to our patient population. Our Web site was designed according to these standards and guidelines, then used and evaluated past caregivers. The implementation of Department 508 accessibility standards, Enquiry-Based Web Pattern and Usability Guidelines, and our additional guidelines, as well as user satisfaction of the HPN Family Caregivers Spider web site will exist described below.
Department 508
Section 508, an amendment to the United States Rehabilitation Act, mandates that electronic and information technology created or purchased by a federal agency must be attainable by people with disabilities.12 While our Web site was not created or purchased by a federal agency, we still found Department 508 to be advisable and necessary for our patient population. Our Web site was designed to comply with Department 508 by using hypertext markup language (HTML) and a cascading style sheet (CSS) layout. Text equivalents were included for all image, audio, and visual files.
The CSS layout guarantees that information is presented in a standard format across the World wide web and allows the employ of adaptive equipment and assistive engineering science to translate written, visual text to Braille or spoken words. Apply of cascading style sheets allows adaptive equipment and assistive technology to differentiate recurring features of the Web site from unique content displayed on private Web pages. Based on each user's preference (usually indicated by pressing a button), recurring content can be interpreted in written form such as Braille or verbally repeated each instance each Web page is viewed. If preferred, recurring information can be interpreted in writing or verbally when information technology is initially viewed, then skipped over as content on each new page is relayed. Examples of recurring content on the HPN Family Caregivers Web site included (1) the top margin containing the championship of the Web site, (ii) the left margin list the menu of Web site contents, and (3) the bottom margin displaying the Health on the Internet (HON) and World wide web Consortium (W3C) certifications, as well equally the creating establishment'south information and the date the content was last updated.
Web sites tin can validate their compliance with Section 508 through the W3C online validation service for HTML and CSS.13 The W3C online validation programme provides immediate analysis and a detailed report. Our Web site was found to be in compliance with CSS level 2.1 of Section 508 via the W3C14 validation programme.
RESEARCH-BASED WEB Pattern AND USABILITY GUIDELINES
In addition to implementing Section 508 accessibility standards, Web sites should too exist designed to enhance the user's power to complete the tasks dictated by the Spider web site. The designers of the HPN Family Caregivers Web site followed the Research-Based Web Design and Usability Guidelines compiled by the USDHHS. These 18 guidelines for user-centered blueprint are based on an extensive process of research and review.xiii
The Enquiry-Based Web Blueprint and Usability Guidelines include (1) design procedure and evaluation; (2) optimizing user experience; (3) accessibility; (4) hardware and software; (5) the domicile page; (six) page layout; (7) navigation; (8) headings, titles, and labels; (9) scrolling and paging; (10) text appearance; (11) lists; (12) screen-based controls (widgets); (thirteen) links; (14) search capability; (fifteen) graphics, images, and multimedia; (xvi) writing Web content; (17) content organization; and (eighteen) usability testing. All of these guidelines were followed and are described below. Some of the guidelines volition be described together considering of overlapping or similar features within each guideline.
Design Process and Evaluation
Web site designers should set up articulate and concise goals and guidelines for their Spider web site before commencement its design. The International Usability Professionals' Clan defines usability as "the degree to which something—software, hardware or anything else—is easy to use and a proficient fit for the people who use information technology."15 Therefore, a Spider web site must accept a population-specific purposeful design, that is, a blueprint with a clear purpose related to the needs of its prospective users.
The goal of the HPN Family unit Caregivers Web site was to provide caregivers with information about managing HPN without neglecting to care for themselves. To reach this goal, our Web site designers included the most current and usually accustomed science-based principles and guidelines for home care, including (1) clinical standards for home intendance regimens; (2) prescribed medical and handling-specific guidelines; (3) instruments, activities, and algorithms to aid monitor patient and caregiver symptoms; and (4) guidelines to prevent or resolve home care problems with prove-based information, algorithms, and activities.11
Optimizing User Feel
To optimize the user experience, Web sites should "facilitate and encourage efficient and effective human-computer interactions."xiii This is achieved by (1) minimizing page-loading time, (ii) having the ability to easily print information, and (iii) non "pushing" unsolicited windows or graphics to users. Pushing refers to displaying distracting graphics or pop-ups that may deter users from focusing on a Web site's principal content.
To minimize page-loading time and permit users to be able to quickly read, download, or perform other tasks, simple graphics were used sparingly and multimedia files were limited to MP3 and video files. This required less data to exist uploaded to each page, thus increasing the speed of loading. All MP3 files could be played directly through the Web site or downloaded and saved to a reckoner hard drive or external device to exist played without requiring the user to be online. Video files were optimized to stream in progressive download style for quick viewing via browsers that supported video playback.
Additionally, all Web site pages were designed in print format so that information would impress out exactly as seen on the computer screen. Using this format allowed any user to print a re-create identical to the image on the Web page, regardless of their personal computer hardware, software, or printing device.
Too, users must exist able to focus on the Web site'south content to fulfill the purpose of the site. Our Web site was designed to avert unnecessary sound or visual information to ensure that users are non distracted from the essential aspects of the content. Therefore, no advertising was immune within the Spider web site.
Accessibility
This USDHHS guideline states that Web sites should implement Section 508, allowing everyone, including those who have difficulty seeing, hearing, and making precise movements, to be able to use them. The creators of the HPN Family Caregivers Spider web site decided to implement and comply with Section 508 earlier becoming aware of this guideline.
Accessibility can also refer to a Web site's availability. According to Princeton Academy, availability is "handiness: the quality of being at mitt when needed."sixteen While availability is not straight mentioned in the Inquiry-Based Web Design and Usability Guidelines, our Spider web site designers thought it was important to ensure that accessibility was further fulfilled past making the information, activities, and algorithms on our Web site available to all persons at all times. Our Web site was available 24 hours a mean solar day, seven days a calendar week.
A usable Spider web site should be dependable and involve quick resolution of common bug (such as disability to load pages or wearisome loading times), and any site closure due to maintenance should be kept at a minimum.17 The HPN Family unit Caregivers Web site was never closed due to maintenance. All maintenance was completed offline, and whatever pages that required troubleshooting were replaced with the pages completed offline.
Hardware and Software
Usability also refers to access to the hardware (computer type, speed) and software (operating system, Cyberspace speed, Net browser) necessary for getting online.eighteen While many patients and family unit members have computers in their home, Internet access for those who lack home computers can be a challenge.xix Users who reported having no home computer were directed to a local library or other facility with publicly available computers. Considering there is no confidential patient information found on the HPN Family unit Caregivers Web site, access to the site in public areas did not pose a threat to patient confidentiality. Notwithstanding, if patients were non comfortable viewing this data in a public area, or if they had no means of access to publicly available computers, they were given a dwelling computer on a temporary basis. AWeb site User Guide containing detailed training on how to set up and apply the computer and the Internet was offered to all participants, although most stated they did not need such a guide.
The Home Folio
The home page provides the first impression of the Web site and therefore should be well-designed to clearly communicate the rationale of the site. The purpose the HPN Family Caregivers Web site was to provide bear witness-based educational materials to caregivers on how to manage HPN at home without neglecting their ain wellness.11,20
Spider web site users were made enlightened that all evidence-based information, activities, and algorithms were to be used as an adjunct to the guidance and directives provided by the patient'due south primary healthcare team. The home page featured the following argument: "The information provided on this Website is designed to back up, non replace, the relationship that exists between a patient or family fellow member and his or her physician."
Additionally, all Web site content was accessible from the home page. A table of contents located in the left margin of the page included links to each of the 5 Web site sections: (1) Caring for Yourself, (2) Managing HPN, (3) Success Stories, (iv) Other Resources, and (5) Our History. Also present on the dwelling page were links to the HON and W3C certifications.xi
Page Layout
To enhance usability, all Web page designs should list the most of import items offset. The statement advising users that the data, activities, and algorithms establish on the Web sites were only to be used in conjunction with their medico's orders was accounted the most of import and placed at the top of the domicile page.
Furthermore, designers must decide whether to consistently utilise longer lines with more text (more information per line) or shorter lines with fewer words (less information per line). Near users prefer shorter line lengths as it facilitates scanning.13 Therefore, this Web site was designed with shorter, succinct lines and the ability to expand certain lines when more than information was desired. Additionally, the site was designed so that all pages followed the aforementioned format, considering usability is enhanced when the format of each page is consistent.13
Navigation, Headings, Titles, and Labels
A well-designed Web site must also accept elementary navigation with articulate headings, titles, and labels to maximize usability. Our Web site was designed for users who might non be familiar with navigating Web sites. A user-friendly link on the abode folio labeled "click here for tips on moving around these websites" took users directly to a page with navigation tips in laymen's terms understandable past an Net novice (see Effigy ane).
This effigy shows the type of data that should be viewable when a user clicks a link for tips on navigating around a particular Web site. The information should be similar to this merely vary slightly depending on the Web site.
Navigation of this Web site was designed to take specific links open up in the current window and others open in a new, split up window. All patient and family pedagogy information, activities, and algorithms opened in the current window, allowing users to click the "dorsum" button to return to the previous page. Because usability is enhanced when users know where they are on a Web site and how to render to the dwelling house folio, users were able to link back to the home page from any page inside the Spider web site.13
Any links to external resource created by other institutions (eg, American Academy of Family Physicians, US National Library of Medicine, US Department of Wellness and Human being Services) opened in a carve up window then that the users were not distracted from the primary content of the site. Closing the separate window only closed the external data and not the HPN Family Caregivers Spider web site.
Web pages should have a table of contents accessible through the home page and subsequent pages.13 Our design immune for piece of cake access to each major content section via a table of contents on the left margin of each page.11 Users could click on a labeled link to view the details inside major content sections. Each of these sections had page titles, page headings, and labels named to correspond to its specific content. The page title refers to the text visible in the summit left margin of the Internet browser. The page heading is the text located at the top of the page (within the Spider web page), and label refers to the hyperlink text present on the link which a user clicks (see Figure 2). The use of consequent terminology for the title, heading, and characterization enhances usability as it decreases ambiguity and allows users to identify exactly which section topic is being viewed. All of our headings, titles, and labels contained the same terms so that users were able to effectively and efficiently locate and link to destination pages.
The title, heading, and characterization of a "Caring for Yourself" Web folio.
Users often browse all Spider web site information first and then make up one's mind which sections to read. For this reason, designers should create specific descriptive titles that volition allow users to select the content that best fits their needs. For example, one major content section of the HPN Family unit Caregivers Web site is Caring for Yourself. This section provides caregivers with myriad evidence-based information, activities, and algorithms designed to assist them care for themselves (such as cocky-monitoring emotions and fatigue) while managing a patient requiring HPN.11 Each page within the section repeated the heading and title Caring for Yourself, so users would know which content they were viewing (see Figure 2).
Scrolling and Paging
The scrolling and paging criterion suggests that Web site designers should decide whether to blueprint a few long pages with lots of information on each folio or several pages with less information. There are benefits to each of these designs. Fewer pages result in less navigation, making it less probable that a user will lose his/her place on the site. All the same, this requires a user to curl up and downwardly on a page to find information. More pages with less information on each page crave more than navigation, referred to as paging. Paging is beneficial in that all data tin be viewed within i screen shot, and users do non have to roll up or down to view data on a folio.13
Ease of use is profoundly enhanced when a user is non required to scroll up and down or side to side to view information.13 Therefore, the HPN Family Caregivers Spider web site was designed to have more than pages with data captured in 1 screen shot.21 Pages with more information than could be viewed within one screen shot were condensed into a listing of links. If users decided they wanted more in-depth data on a particular topic, they could view the additional information past clicking the link. This also allowed the user experience to be optimized by creating faster folio-loading times and allowing users to print screen shots exactly as seen on the computer monitor.
Text Appearance
Text advent can make information technology easier for users to read information on Spider web pages, thus enhancing the usability of the site. National guidelines suggest applying familiar fonts that are at least 12 points in a nighttime color on a plain, loftier-dissimilarity background.13 The HPN Family Intendance-givers Web site used Verdana equally the default font. If users did non have Verdana on their machines, the closest sans serif font was applied (unremarkably Arial or Helvetica). Font size ranged from 12- to xvi-point type with letters mostly in dark blue or black and links a lighter shade of blueish (the standard default color common to all browsers). The background was light yellow. No attending-attracting features (such as blitheness) that increase site-loading time and distract from Web site content were used.
Lists
Many Web sites contain lists. Usability guidelines suggest that lists should be clearly introduced and accept a descriptive headline to facilitate the task of reading a list. Items on each list should be placed in guild of importance with more important items at the pinnacle of the list. The HPN Family unit Caregivers Web site independent many lists including, simply not limited to, common health concerns, suggested activities, and external resource that might be helpful for caregivers managing HPN. Just as users scan pages for content, they often scan lists rather than read them word for word. On our Web site, list items were concise, with links available for data needing more than in-depth explanations.
Screen-Based Controls (Widgets), Links, and Search Adequacy
Interactive Web sites require the use of screen-based controls. These include links, pushbuttons, radio buttons, check boxes, drop-downward lists, and entry fields. Screen-based controls, oft chosen widgets, heighten usability as they facilitate navigation and utilise of Spider web site information, activities, and algorithms.13
The widgets created for our Spider web site were elementary. They included links, pushbuttons, and entry fields. Links were found on every Web site page for ease of navigation within and between major content sections. Links allow users to open new pages containing new content. Link labels should be meaningful and consistent with their target pages and should also indicate when they have been clicked. Our link labels were titled to correspond to the championship of the target folio. Links were initially displayed in blue text and then changed to purple after they had been clicked for viewing. This is the standard default for most Cyberspace browsers.
Pushbuttons were applied to audio and video files. Familiar symbols commonly constitute on audio and video players were used to place "play," "pause," "fast frontward," "rewind," "stop," and volume controls.
An entry field, or search box, was used for the Web site search office. The search benchmark states that "each page of a website should allow users to conduct a search."13 Entering one or more central words in an entry field should allow users to find whatever pages within a Web site containing those cardinal words. Our Web site pages contained an internal search bar allowing users to search for specific information throughout the unabridged Spider web site, therefore enhancing usability. In addition, the search function was not case-sensitive, which provided flexibility within the search domain.
Graphics, Images, and Multimedia
The advisable utilize of graphics can facilitate learning; however, graphics can besides cause an increase in the time required to load a folio. Therefore, graphics were limited to report logos (with which participants were familiar) and images for certifications for compliance with HON (a prepare of principles adult to ensure that Web sites contain trustworthy health information)22 and W3C (a validation service confirming our Web sites adhere to Section 508 of the Rehabilitation Act).13
Users who are familiar with the Cyberspace and Web pages frequently ignore graphics they consider to be advertising.13 Although this largely depends on the content and specific user preferences, our Web site was careful to create and place images in such a manner that they would not exist mistaken for advertisements.
Writing and Organizing Web Content
Content is the most of import aspect of any Web site. A Web site that does not provide the information needed by users will be of piddling value no affair how like shooting fish in a barrel it is to read information, play audio and video files, and so forth. Spider web site content should exist written with familiar words and avert jargon that may be disruptive to some users.13 The HPN Family Caregivers Web site defined all acronyms and abbreviations and was designed to be succinct past limiting the number of words in each judgement, too as the number of sentences in each paragraph. Content was also presented with critical information at the peak of each page and all related content grouped together inside its appropriate section on the same page.
Usability Testing
The HPN Family unit Caregivers Web site underwent extensive usability testing. Given the variety of choices for computer hardware and software bachelor beyond the written report setting (the U.s.a. and Canada), it was important to ensure accessibility and usability for all users.xiii,xviii,23 A variety of computers were selected to test admission to all pages of our Web sites to emulate users' experiences. Graduate students, research team staff members, nurse content experts, and Cyberspace development specialists tested our Web site to ensure accessibility and ease of use with computers of various ages, speeds, monitor sizes, video output definitions (eg, high definition and standard definition), Web browsers, plug-ins, and Net service providers. These pre–site testers verified that all pages loaded with ease and also provided feedback on means to improve site appearance, role, and clarity. Most suggestions focused on word choice, suggesting replacing words that might be seen as jargon with more common lay terms.
Additional GUIDELINES
In addition to post-obit Section 508 and the USDHHS Enquiry-Based Web Pattern and Usability Guidelines, two additional guidelines were determined to be necessary for our patient population. These included (i) scientific relevance and (2) compatibility with mobile devices.
Scientific Relevance
The HPN Family Caregivers Spider web site independent show-based content obtained from previous enquiry. This Web site provided a centralized repository of credible and electric current information tailored to fulfill the specialized needs of individuals managing HPN home care regimes.eleven With education as the primary purpose of this Web site, it was important to focus on the scientific rationale for the featured data using reference citations to verify the content's scientific relevance. Each featured scientific theme included links to a peer-reviewed journal publication validating the presented content.
Compatibility With Mobile Devices
With the growing employ of mobile devices and smart phones to view Web pages, our Spider web site creators decided that our pages should be designed to exist viewable on mobile devices. The HPN Family Caregivers Web site was designed to present as much essential information as possible within ane screen shot. Pages were set up to be readily viewed on a standard desk top monitor (see Effigy 3) and on a mobile device with a screen measuring only 3.5 in. in diameter (see Figure iv). The content on each folio was centered to allow for viewing on a diverseness of monitor sizes.
A screenshot of the HPN Family Caregivers home folio on a standard desktop monitor.
A screenshot of the HPN Family Caregivers home page on a mobile device measuring three.v in. in bore.
USER SATISFACTION
The Web Communications and New Media Division of the Us Department of Health and Human Services defines usability equally "how well users can learn and utilize a production to achieve their goals and how satisfied they are with that procedure."18 Usability has likewise been defined in recent years equally the effectiveness, efficiency, and satisfaction with which users tin apply a Web site.24 To determine if users were satisfied with the user-centered blueprint and found the Web site to have acceptable usability and accessibility, each unique visitor who accessed the HPN Family unit Caregivers Web site (n = 41) was asked to charge per unit his/her satisfaction with the site. Specifically, users were asked to complete a survey, answering questions with Likert-type responses, besides as an open up-concluded question asking them to list things they liked and did not like nearly the Web site.
Most users (56.ane%) reported that they were not likely to use the Net for HPN information before receiving access to the HPN Family Caregivers Spider web site. Because nigh of our users were novices at finding HPN data on the Internet, it was important to ensure that they found our Spider web site to exist usable. Users were given the statement "I had a hard time accessing this website" with Likert responses ranging from "ane, strongly disagree" to "4, strongly hold." 70 per centum of participants disagreed, pregnant they did non have difficulty accessing the Web site. Users who agreed with this statement were constitute to take difficulty accessing the site considering they incorrectly typed the URL, their username, or password.
Users too responded to the argument, "This website was available any time I wanted to look at its information" with the same Likert responses. Eighty-five percent of participants agreed. Users who disagreed were the same participants who had difficulty accessing the Web site considering of mistyping the URL, username, or password.
Approximately 73% of caregivers stated that they would exist willing to pay for access to the Web site, with responses ranging from "less than $x" to "more than $25" per month. When asked most insurance covering access to the Web site, approximately 85% of participants thought insurance should pay for access.
Most of the responses to the open-concluded question were specific to the content of the site. However, there were a few comments on usability, such every bit "the site was simple and easy to navigate" and "I like the website because I can access it at my ain convenience."
DISCUSSION
Accessible and usable patient teaching Web sites are beneficial media that can efficiently keep patients informed of current developments in their healthcare regimens and can besides provide the best possible Spider web-based information that serves as a supplemental healthcare resource. Using national standards and guidelines allowed users to be able to easily complete the tasks dictated by the Web site and therefore gain the maximum benefit from the site'due south data, activities, and algorithms.
Users were satisfied with the content and pattern of the education Web sites and institute them to take acceptable usability. All the same, one limitation researchers discovered with the evaluation data was that its questions focused more on the Web site content and design than its usability and accessibility. If usability and accessibility are to be further examined in the future, questions focusing more precisely on usability and accessibility should be asked.
A major limitation of this Web site was that it was only available in English language, equally information technology was created for patients in a enquiry studies with an inclusion criterion that all participants must be able to speak and read English language. To make this Web site bachelor to more diverse populations, it should be available in other languages.
Our Web site likewise used very few widgets, or screen-based controls. For the purposes of this Web site, the widgets used were adequate. However, futurity Web site design will probable need to focus on the apply of more wid-gets because online or computerized data collection may exist utilized more in hereafter research and healthcare.
The HPN Family Caregivers Web site was also password protected, allowing merely study participants with active user names and passwords provided by the Spider web site'south creating institution to admission the site. To increase accessibility of sites such as this, users must non be restricted to those who have assigned user names and passwords. In the instances where it is necessary to protect access, users should be able to create their own user names and passwords on their personal computers or mobile devices.
Also, this Spider web site could not ensure the readability of all hyperlinked pages. Any federally created or owned Web sites to which the HPN Family Caregivers Spider web site linked were guaranteed to follow Section 508 legislation; however, not all of the sites were federally created or owned. This could exist frustrating to users who wish to view other pages using adaptive equipment.
It as well would have been beneficial to consider the chore-engineering science fit model when determining how to create a usable and accessible patient and family education Web site. Job-technology fit is defined as the caste to which technology assists an individual in performing tasks.25,26 Many aspects of this model can be plant in the Research-Based Web Design and Usability Guidelines but should exist further examined upon creation of future patient and family education Web sites.
Determination
When designing any Spider web site, national accessibility standards and usability guidelines should exist followed, with special attending paid to the specific educational needs of the target population. Further research should focus on patients and family unit members with varying usability needs and populations where English language is not the primary written or oral communication.
Acknowledgments
We are grateful for the recommendations and clinical expertise contributed to this trial by Karen Chinn, BJ; Janis Scheifelbein RN, PhD; Emily Duaz RN, DNS; Jennifer Fisher, BA; Noreen C. Thompson RN, MSN; and the University of Kansas. Funding for testing diverse Web sites is from National Institutes of Health and University of Kansas Inquiry Plant.
Footnotes
Disclaimer: The project described is office of a larger study supported by the National Establish of Nursing Research (NINR) grants NR040494 and NR09078 and the Kansas Enquiry Establish grant G5581027: C. Smith, PI. The content is solely the responsibility of the authors and does non necessarily represent the official views of the NINR, the National Institutes of Health, or the Kansas Enquiry Institute.
The authors have disclosed that they take no meaning relationship with, or financial involvement in, whatever commercial companies pertaining to this article.
References
2. Gibson MJ, Houser A. Valuing The Invaluable: A New Await At The Economic Value Of Family Caregiving. Issue Cursory. Washington, DC: Public Policy Institution, American Association of Retired Persons; 2007. pp. 1–12. [PubMed] [Google Scholar]
3. Baker 50, Wagner TH, Singer S, Bundorf MK. Use of the Internet and email for health intendance data: results from a national survey. JAMA. 2003;289(eighteen):2400–2406. [PubMed] [Google Scholar]
iv. Mittleman MS, Haley We, Dirt OJ, Roth DL. Improving care-giver well-being delays nursing home placement of patients with Alzheimer disease. Neurology. 2006;67(9):592–599. [PubMed] [Google Scholar]
5. Pinquart M, Sorensen S. Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. Gerontologist. 2005;45(1):90–106. [PubMed] [Google Scholar]
6. Schulz R, Beach SR. Caregiving as a run a risk factor for mortality: the Caregiver Health Effects Study. JAMA. 1999;282(23):2215–2219. [PubMed] [Google Scholar]
vii. Schulz R, Sherwood PR. Physical and mental health effects of family unit caregiving. Am J Nurs. 2008;108(9):23–27. [PMC free commodity] [PubMed] [Google Scholar]
eight. Writer YYYY. Land of the science: professional person partners supporting family caregivers. Am J Nurs. 2008;108(9):64–68. [Google Scholar]
nine. Bozetti F, Staun K, Van Gossum A, editors. Home Parenteral Diet. Cambridge, MA: CABI; 2006. [Google Scholar]
10. McCloskey WM, McCarthy RL. Domicile Intendance. 4. Sudbury, MA: Jones & Bartlett; 2007. [Google Scholar]
xi. Fitzgerald SA, Yadrich DM, Werkowitch M, Piamjariyakul U, Smith CE. Creating patient and family unit education websites: design and content of the HPN Family Caregivers Website [published online alee of print August 2011] Comput Inform Nurs. 2011 In printing. [PMC free article] [PubMed] [Google Scholar]
12. United States Government. Section 508 of the Rehabilitation Deed: 1998. Washington, DC: US Congress; 1998. [Google Scholar]
13. US Department of Health and Homo Services. [Accessed June ten, 2010]; Research-based Web Blueprint and Usability Guidelines. www.usability.gov.
17. Kaufman DR, Patel VL, Hillman C, et al. Usability in the real globe: assessing medical information technologies in patients' homes. J Biomed Inform. 2003;36(i–ii):45–60. [PubMed] [Google Scholar]
18. Kushniruk AW, Patel VL, Cimino JJ. Evaluation of web-based patient information resources: application in the assessment of a patient clinical data system. Proceedings of the AIMA Symposium; Washington, DC. 2000. pp. 443–447. [PMC free commodity] [PubMed] [Google Scholar]
20. Smith CE, Cha J, Puno F, Magee JD, Bingham J, Van Gorp M. Quality balls processes for designing patient education websites. Comput Inform Nurs. 2002;xx(5):191–200. [PubMed] [Google Scholar]
21. Lehoux P. Patients' perspectives on high-tech dwelling house intendance: a qualitative research to the user-friendliness of four technologies. BMC Health Serv Res. 2004;4(i):28. [PMC gratuitous article] [PubMed] [Google Scholar]
22. Health on the Internet Foundation. [Accessed June ten, 2010]; HON Projects and Initiatives. http://www.hon.ch/Project/HONcode.html. Updated Nov six, 2008.
23. Andre TS, Hartson 60 minutes, Williges RC. Determining the effectiveness of the usability problem inspector: a theory-based model and tool for finding usability bug. Hum Factors. 2003;45(iii):455–482. [PubMed] [Google Scholar]
24. Duaz Due east, Moore J, Smith CE, Puno F, Schaag H. Installing computers in older adults' homes and teaching them to access a patient education website: a systematic approach. Comput Inform Nurs. 2004;22(5):266–272. [PubMed] [Google Scholar]
25. Goodhue DL, Thompson RL. Chore-engineering science fit and individual performance. MIS Q. 1995;19(2):213–236. [Google Scholar]
26. Goodhue D. The model underlying the measurement of the impacts of the IIC on the end-users. J Am Soc Inform Sci. 1997;48(5):449–453. [Google Scholar]
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673715/
0 Response to "How Do Health Providers Design Educational Programs for Patients and Families"
Postar um comentário