Use of Online Self-Management Diaries in Asthma and COPD: A Qualitative Study of Subjects' and Professionals' Perceptions and Behaviors.
BACKGROUND
Online self-management diaries are used to support patients' self-management skills and facilitate associated behavioral changes. Although web-based diaries are well-known as a potential self-management tool, reasons that patients use (or do not use) self-management diaries, as well as perceptions and behaviors related to diary use, remain largely unknown.


METHODS
Semistructured interviews (n = 30) were conducted with health-care professionals and subjects to understand perceptions and behaviors related to self-management diary use for asthma and COPD in 2 hospitals in Rotterdam, The Netherlands.


RESULTS
Subjects in this study used self-management diaries to improve their knowledge of the disease, cope more consciously with their disease, feel in control, and discuss outcomes from the self-management diaries with their health-care professionals. Two subjects reported that they used the self-management diary to cope more effectively with their disease and recognized an exacerbation and acted by adjusting their medications. Both health-care professionals and subjects experienced practical barriers in integrating self-management diaries into their regular practices. Subjects' reasons for nonuse were related to the intervention, the disease, and subject-provider contact.


CONCLUSIONS
Health-care professionals should help patients use self-management diaries by collaboratively developing an individual treatment plan and by showing patients how to use the diaries to recognize and act on an exacerbation. Together with the suggestions made for improving the self-management diaries, this will aid in the integration of self-management diaries into regular health-care practice and enhance patients' self-management of their disease.
Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Valerie
V
van Kruijssen
Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands. vanstaa@bmg.eur.nl.
AnneLoes
A
van Staa
Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
Jolanda
J
Dwarswaard
Department of Pulmonology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Johannes Ccm
JC
In 't Veen
Harbor Hospital, Rotterdam, The Netherlands.
Bianka
B
Mennema
Tilburg Institute for Law, Technology, and Society, Tilburg University, Tilburg, The Netherlands.
Samantha A
SA
Adams
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000523:psychology* / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D020407:Internet; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D008875:Middle Aged; D010347:Patient Care Planning; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology* / Q000628:therapy; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
COPD; asthma; chronic disease; health-care technology; online self-management diaries; patient education; self-management