title: Expectations and needs of patients with a chronic disease toward self-management and eHealth for self-management purposes.
abstract: Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patients' expectations and needs regarding self-management and eHealth. The objectives of this study are to investigate expectations and needs of people with a chronic condition regarding self-management and eHealth for self-management purposes, their willingness to use eHealth, and possible differences between patient groups regarding these topics.
  
  
  
  Five focus groups with people with diabetes (n = 14), COPD (n = 9), and a cardiovascular condition (n = 7) were conducted in this qualitative research. Separate focus groups were organized based on patients' chronic condition. The following themes were discussed: 1) the impact of the chronic disease on patients' daily life; 2) their opinions and needs regarding self-management; and 3) their expectations and needs regarding, and willingness to use, eHealth for self-management purposes. A conventional content analysis approach was used for coding.
  
  
  
  Patient groups seem to differ in expectations and needs regarding self-management and eHealth for self-management purposes. People with diabetes reported most needs and benefits regarding self-management and were most willing to use eHealth, followed by the COPD group. People with a cardiovascular condition mentioned having fewer needs for self-management support, because their disease had little impact on their life. In all patient groups it was reported that the patient, not the care professional, should choose whether or not to use eHealth. Moreover, participants reported that eHealth should not replace, but complement personal care. Many participants reported expecting feelings of anxiety by doing measurement themselves and uncertainty about follow-up of deviant data of measurements. In addition, many participants worried about the implementation of eHealth being a consequence of budget cuts in care.
  
  
  
  This study suggests that aspects of eHealth, and the way in which it should be implemented, should be tailored to the patient. Patients' expected benefits of using eHealth to support self-management and their perceived controllability over their disease seem to play an important role in patients' willingness to use eHealth for self-management purposes.
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. m.huygens@maastrichtuniversity.nl.|Centre for Care Technology Research, Maastricht, The Netherlands. m.huygens@maastrichtuniversity.nl.
authors.forename: Martine W J
authors.initials: MW
authors.lastname: Huygens
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.|Centre for Care Technology Research, Maastricht, The Netherlands.
authors.forename: Joan
authors.initials: J
authors.lastname: Vermeulen
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.|Centre for Care Technology Research, Maastricht, The Netherlands.
authors.forename: Ilse C S
authors.initials: IC
authors.lastname: Swinkels
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.|Tilburg School of Social and Behavioral Sciences, Tilburg University, Tranzo, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.|Centre for Care Technology Research, Maastricht, The Netherlands.
authors.forename: Roland D
authors.initials: RD
authors.lastname: Friele
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of Family Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.|Centre for Care Technology Research, Maastricht, The Netherlands.
authors.forename: Onno C P
authors.initials: OC
authors.lastname: van Schayck
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.|Research Center Technology and Care, Zuyd University of Applied Sciences, P.O. Box 550, 6400 AN, Heerlen, The Netherlands.|Centre for Care Technology Research, Maastricht, The Netherlands.
authors.forename: Luc P
authors.initials: LP
authors.lastname: de Witte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D036301:Qualitative Research; D012648:Self Care; D017216:Telemedicine
keywords: Chronic disease; Health services needs and demand; Patients; Primary health care; Self-care; Telemedicine