title: Managing Everyday Life: A Qualitative Study of Patients' Experiences of a Web-Based Ulcer Record for Home-Based Treatment.
abstract: Chronic skin ulcers are a significant challenge for patients and health service resources, and ulcer treatment often requires the competence of a specialist. Although e-health interventions are increasingly valued for ulcer care by giving access to specialists at a distance, there is limited research on patients' use of e-health services for home-based ulcer treatment. This article reports an exploratory qualitative study of the first Norwegian web-based counselling service for home-based ulcer treatment, established in 2011 by the University Hospital of North Norway (UNN). Community nurses, general practitioners (GPs) and patients are offered access to a web-based record system to optimize ulcer care. The web-based ulcer record enables the exchange and storage of digital photos and clinical information, by the use of which, an ulcer team at UNN, consisting of specialized nurses and dermatologists, is accessible within 24 h. This article explores patients' experiences of using the web-based record for their home-based ulcer treatment without assistance from community nurses. Semi-structured interviews were conducted with a total of four patients who had used the record. The main outcomes identified were: autonomy and flexibility; safety and trust; involvement and control; and motivation and hope. These aspects improved the patients' everyday life during long-term ulcer care and can be understood as stimulating patient empowerment.
authors.affiliation: Norwegian Centre for Integrated Care and Telemedicine (NST), University Hospital of North Norway (UNN), P.O. Box 35, N-9038 Troms&#248;, Norway. marianne.trondsen@telemed.no.
authors.forename: Marianne V
authors.initials: MV
authors.lastname: Trondsen
keywords: e-health; empowerment; home-based treatment; professional-patient interaction; qualitative study; teledermatology; ulcer care; web-based record