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Zhang M, Zhang L, Zhi X, Cheng F, Yao Y, Deng R, Liu C, Wang Y. Demand analysis of health care services for community-dwelling breast cancer survivors based on the Kano model: A cross-sectional study. Int J Nurs Sci 2024; 11:171-178. [PMID: 38707692 PMCID: PMC11064550 DOI: 10.1016/j.ijnss.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/19/2024] [Accepted: 03/10/2024] [Indexed: 05/07/2024] Open
Abstract
Objectives Providing satisfactory healthcare services for breast cancer survivors can effectively reduce their burden and the pressure on medical resources. The aim of this study was to explore health care service demands for community-dwelling breast cancer survivors using the Kano model. Methods A cross-sectional survey was conducted from January to March 2023 among breast cancer survivors discharged from a tertiary cancer hospital. Participants were asked to fill out a self-designed questionnaire involving the Kano model, which helped to categorize and prioritize the attributes of healthcare services. The questionnaire included 30 health care services. Additionally, their social demographic characteristics were collected during the survey. Results A total of 296 valid questionnaires were collected, and demand attributes of the 30 health care services were evaluated. The findings revealed that one of 30 services was classified as "must-be attributes" (body image management), 13 as "one-dimensional attributes" (focused on medical security support, health management, and health counseling), 3 as "attractive attributes" (focused on communication needs and telehealth services), and 11 as "indifferent attributes" (mainly in the area of psycho-social services). Conclusions Breast cancer survivors in the community have different levels of need for various health care services. It's crucial for healthcare providers to identify these needs and devise effective strategies to deliver the appropriate services. Services with must-be and one-dimensional attributes should be given priority, and efforts should be made to provide services with attractive attributes, hence improving the quality of life of breast cancer survivors.
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Affiliation(s)
- Maomao Zhang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Liuliu Zhang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Xiaoxu Zhi
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Fang Cheng
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Yufeng Yao
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Rong Deng
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Chunli Liu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Yan Wang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
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Yao X, Li J, He J, Zhang Q, Yu Y, He Y, Wu J, Tang W, Ye C. A Kano model-based demand analysis and perceived barriers of pulmonary rehabilitation interventions for patients with chronic obstructive pulmonary disease in China. PLoS One 2023; 18:e0290828. [PMID: 38109304 PMCID: PMC10727440 DOI: 10.1371/journal.pone.0290828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/17/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) has been recognized to be an effective therapy for chronic obstructive pulmonary disease (COPD). However, in China, the application of PR interventions is still less promoted. Therefore, this cross-sectional study aimed to understand COPD patients' intention to receive PR, capture the potential personal, social and environmental barriers preventing their willingness of receiving PR, and eventually identify demanding PR services with the highest priority from patients' point of view. METHODS In total 237 COPD patients were recruited from 8 health care facilities in Zhejiang, China. A self-designed questionnaire was applied to investigate patients' intention to participate in PR and potentially associated factors, including personal dimension such as personal awareness, demographic factors, COPD status and health-related literacy/behaviors, as well as social policies and perceived environmental barriers. The demand questionnaire of PR interventions based on the Kano model was further adopted. RESULTS Among the 237 COPD patients, 75.1% of COPD patients were willing to participate in PR interventions, while only 62.9% of the investigated patients had heard of PR interventions. Over 90% of patients believed that the cost of PR services and the ratio of medical insurance reimbursement were potential obstacles hindering them from accepting PR services. The multiple linear regression analysis indicated that the PR skills of medical staff, knowledge promotion and public education levels of PR in the community, patients' transportation concerns and degree of support from family and friends were significantly associated with willingness of participation in PR interventions. By using the Kano model, the top 9 most-requisite PR services (i.e., one-dimensional qualities) were identified from patients' point of view, which are mainly diet guidance, education interventions, psychological interventions and lower limb exercise interventions. Subgroup analysis also revealed that patients' demographics, such as breathlessness level, age, education and income levels, could influence their choice of priorities for PR services, especially services related to exercise interventions, respiratory muscle training, oxygen therapy and expectoration. CONCLUSIONS This study suggested that PR-related knowledge education among patients and their family, as well as providing basic package of PR services with the most-requisite PR items to COPD patients, were considerable approaches to promote PR attendance in the future.
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Affiliation(s)
- Xinmeng Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jinmei Li
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jialu He
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Qinzhun Zhang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yi Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yinan He
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jinghua Wu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Weihong Tang
- Department of Gastroenterology, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Chengyin Ye
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
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Müller SD, Tsirozidis G, Mathiasen M, Nordenhof L, Jakobsen D, Mahler B. Eliciting Information Needs of Child Patients: Adapting the Kano Model to the Design of mHealth Applications. Methods Inf Med 2022; 61:123-138. [PMID: 36220108 DOI: 10.1055/s-0042-1749359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Health care services are increasingly being digitized, but extant literature shows that digital technologies and applications are often developed without careful consideration of user needs. Research is needed to identify and investigate best-in-class methods to support user-centered design of mHealth applications. OBJECTIVES The article investigates how the Kano model can be adapted and used for the purpose of eliciting child patients' information needs during the design phase of mHealth application development. The aim is to demonstrate its applicability for collecting and analyzing patient-centered data that are key to designing technology-supported solutions for health management. METHODS The article is based on a mixed-methods case study, which includes interviews with 21 patients aged 6 to 18. Structured interviews are analyzed based on prescriptions of the Kano model. Semi-structured interviews about child patients' information needs are analyzed thematically. RESULTS The results demonstrate several improvements to the Kano model that take into account the difficulties of effectively communicating with child patients. The combination of two types of interviews offers unique insights into the what, how, and why of patients' needs. Adaptation of the Kano model, simplification of response options, and participation of child patients' parents in interviews facilitate data collection. CONCLUSIONS The article shows how the Kano model can be adapted to provide an effective means of eliciting child patients' needs. Adapting the model by combining structured and semi-structured interviews makes it a powerful tool in designing mHealth applications.
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Affiliation(s)
- Sune Dueholm Müller
- Department of Informatics, University of Oslo, Ole-Johan Dahls Hus, Oslo, Norway
| | | | | | - Louise Nordenhof
- Department of Management, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Daniel Jakobsen
- Department of Management, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Birgitte Mahler
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
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Yuan Y, Tao C, Yu P, Wang Y, Kitayama A, Takashi E, Yanagihara K, Liang J. Demand analysis of telenursing among empty-nest elderly individuals with chronic diseases based on the Kano model. Front Public Health 2022; 10:990295. [PMID: 36249233 PMCID: PMC9555810 DOI: 10.3389/fpubh.2022.990295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/16/2022] [Indexed: 01/26/2023] Open
Abstract
Aim The increase in empty-nest elderly individuals with chronic diseases poses a major challenge to the provision of public health services in China. Telenursing can effectively relieve the pressure of public health services to a certain extent. This study aims to explore the telenursing needs of empty-nest elderly individuals with chronic diseases based on the Kano model to provide references for improving the quality of telenursing. Methods Participants were selected from five rural communities and five urban communities in Yangzhou and Nantong, Jiangsu Province, China. A total of 348 empty-nest elderly individuals with chronic diseases were included. The participants received a sociodemographic characteristics questionnaire, and their telenursing needs were surveyed and analyzed based on the Kano model. Results Of the 15 quality attributes evaluated by the participants, 3 telenursing services were categorized as "must-be quality", 5 were categorized as "one-dimensional quality", 5 were categorized as "attractive quality", and 2 were categorized as "indifferent quality". The proportion of individuals who desired telenursing services ranged from 47.41 to 83.62%, the better values (satisfaction) ranged from 35.29-83.98%, and the worse values (dissatisfaction) ranged from 10.91 to 63.27%. There were no significant differences in any items of telenursing needs for between participants in Yangzhou and Nantong (all P > 0.05), and there were also no significant differences in all items between rural and urban communities (all P > 0.05). Conclusion Based on the Kano model, it was found that empty-nest elderly individuals with chronic diseases had a positive attitude toward telenursing and that they had different levels of need for different telenursing services. These findings provided a theoretical basis for medical decision-makers to formulate medical policies and provided a scientific foundation for nursing managers to improve telenursing services to meet the needs of the empty-nest elderly individuals with chronic diseases.
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Affiliation(s)
- Yuan Yuan
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, China,Nagano College of Nursing, Komagane, Japan
| | - Chunhua Tao
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, China
| | - Ping Yu
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | | | | | - En Takashi
- Nagano College of Nursing, Komagane, Japan
| | | | - Jingyan Liang
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China,Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China,*Correspondence: Jingyan Liang
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Cheng X, Zhang L. Health Service Needs from a Household Perspective: An Empirical Study in Rural Empty Nest Families in Sinan and Dangyang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020628. [PMID: 35055450 PMCID: PMC8775500 DOI: 10.3390/ijerph19020628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/29/2021] [Accepted: 12/31/2021] [Indexed: 02/04/2023]
Abstract
This study aimed to explore the health service needs of empty nest families from a household perspective. A multistage random sampling strategy was conducted to select 1606 individuals in 803 empty nest households in this study. A questionnaire was used to ask each individual about their health service needs in each household. The consistency rate was calculated based on their consistent answers to the questionnaire. We used a collective household model to analyze individuals’ public health service needs on the family level. According to the results, individuals’ consistency rates of health service needs in empty nest households, such as diagnosis and treatment service (H1), chronic disease management service (H2), telemedicine care (H3), physical examination service (H4), health education service (H5), mental healthcare (H6), and traditional Chinese medicine service (H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Therefore, family-level health service needs could be studied from a family level. Health service needs of H1, H3, H4, H5, and H7 for individuals in empty nest households have significant correlations with each other (r = 0.404, 0.177, 0.286, 0.265, 0.220, p < 0.001). This will be helpful for health management in primary care in rural China; the concordance will alleviate the pressure of primary care and increase the effectiveness of doctor–patient communication. Health service needs in empty nest households who took individuals’ public needs as household needs (n = 746) included the H4 (43.3%) and H5 (24.9%) and were always with a male householder (94.0%) or at least one had chronic diseases (82.4%). Health service needs in empty nest households that considered one member’s needs as household needs (n = 46) included the H1 (56.5%), H4 (65.2%), H5 (63.0%), and H7 (45.7%), and the member would be the householder of the family (90.5%) or had a disease within two weeks (100.0%). In conclusion, family members’ roles and health status play an important role in health service needs in empty nest households. Additionally, physical examination and health education services are the two health services that are most needed by empty nest households, and are suitable for delivering within a household unit.
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Affiliation(s)
- Xueyan Cheng
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai 200032, China;
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- School of Political Science and Public Administration, Wuhan University, Wuhan 430030, China
- Correspondence:
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Wu Y, Liu Y, Su Z, Sun S, Liu C, Ding W, Gao Y. Demands for Telenursing-Based Long-Term Care Among Disabled Older Adults in Qingdao, China: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:1981-1990. [PMID: 34522091 PMCID: PMC8434935 DOI: 10.2147/ppa.s326413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/25/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of the present study was to investigate the current status of and factors influencing the demands for telenursing-based long-term care in disabled older adults. METHODS In this cross-sectional study, data from 213 participants from five districts of Qingdao, China, were investigated using multistage stratified sampling. The assessment scale of the long-term care demands level and the questionnaire of the demands of telenursing-based long-term care for disabled older adults were used to estimate the demands for telenursing-based long-term care for older adults with disabilities in Qingdao. RESULTS Of the participants, 60.51% were willing to receive telenursing-based long-term care. The item with the highest score was "Internet +" information management and first aid (3.77 ± 0.71); the item with the lowest score was "Internet +" daily care (2.97 ± 0.72). Average family income (P < 0.001), age (P = 0.004) and educational level (P = 0.003) were significant factors influencing the demands for telenursing-based long-term care. CONCLUSION Disabled older adults had a high demand for telenursing-based long-term care. Urgent actions are needed to integrate telenursing with long-term care as soon as possible. In the development of telenursing-based long-term care, it is necessary to fully consider the average family income, age and educational level of disabled older adults.
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Affiliation(s)
- Yu Wu
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Yuxiu Liu
- School of Nursing, Weifang Medical University, Weifang, People’s Republic of China
| | - Zhe Su
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Songwei Sun
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
| | - Cuiping Liu
- School of Nursing, Qingdao University, Qingdao, People’s Republic of China
| | - Wei Ding
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
| | - Yufang Gao
- The Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
- Correspondence: Yufang Gao The Affiliated Hospital of Qingdao University, Qingdao, 266000, People’s Republic of ChinaTel +86-19863737553 Email
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