So I sent the link out for my final project…

The almighty mouse by lastquest, on Flickr
Creative Commons Attribution-Share Alike 2.0 Generic License  by  lastquest 

I have been working on my final project for a while. During this time I have received wonderful support. Nurses from the heart failure clinic will be reviewing and commenting on the site- the only problem is that one is not able to sign in to NING. I phoned her and went over how to sign in to the platform over the phone but it did not work. I was thinking that maybe it would have to do with the firewall at her place of employment?? She is going to try to access the NING site from home to see if that works. Has anyone else had this experience? If so what have you done to correct this? One other participant has signed on and they do work at the same place. Any suggestions would be greatly appreciated! Thanks in advance…

As my final project is developing a site where patients, family members, friends and health care providers could come together to discuss issues, questions, treatments about heart failure as well as a place where patients and family members could share stories if they wish, I focused the health related information to someone newly diagnosed with heart failure. Topics included describing what heart failure is, managing symptoms, how to track symptoms, diet considerations (low sodium/salt), taking medications, emotional health of living with a chronic condition. I will also include topics such as losing weight, weight loss procedures, advanced health care directives. If you knew someone with heart failure- what information would like to know?

Based on research, signs and symptoms was ranked the most important topic for learning followed by prognosis, risk factors, medications, general information, diet, psychological factors and activity (Boyde et al., 2009b). These findings were supported by Nahm et al. (2008) who found the heart failure patients wanted to have up-to-date information on research findings, medications and laboratory tests, rather than general information about heart failure. Patients liked to have immediate access to information in order to verify if they are still following the recommendations as prescribed (Boyde et al., 2009a) and found it useful to continue web-based communication over long periods (Delgado et al., 2003). Caregivers want equal access to web-based information to help their loved ones and to provide better care (Nahm et al., 2008; Piette et al., 2008). When given access the Web-based applications, caregivers reported that the program was helpful in providing assistance and additional information about heart failure (Piette et al., 2008).

References
Boyde, M., Tuckett, A., Peters, R., Thompson, D., Turner, C., & Stewart, S. (2009). Learning for heart failure patient (The L-HF patient study). Journal of Clinical Nursing, 18, 2030-2039. doi:10.1111/j.1365-2702.2008.02716.x
Boyde, M., Tuckett, A., Peters, R., Thompson, D., Turner, C., & Stewart, S. (2009). Learning style and learning needs of heart failure patients (The Need2Know-HF patient study). European Journal of Cardiovascular Nursing, 8, 316-322. doi:10.1016/j.ejcnurse.2009.05.003
Delgado, D., Costigan, J., Wu, R., & Ross, H. J. (2003). An interactive Internet site for the management of patients with congestive heart failure. Canadian Journal of Cardiology, 19(12), 1381-1385.
Heart failure. (n.d.). In heart and stroke foundation. Retrieved September 29, 2010, from the World Wide Web: http://www.heartandstroke.com
Heo, S., Moser, D. K., Lennie, T. A., Riegel, B., Chung, M. L. (2008). Gender differences in and factors related to self-care behaviors: A cross-sectional, correlational study of patients with heart failure. International Journal of Nursing Studies, 45, 1807-1815. doi:10.1016/j.ijnurstu.2008.05.008
Munhall, P. L. (2007). Nursing research: A qualitative perspective. Sudbury, MA: Jones and Bartlett Publishers.
Nahm, E., Blum, K., Scharf, B., Friedmann, E., Thomas, S., Jones, D., & Gottlieb, S. S. (2008). Exploration of patients’ readiness for an eHealth management program for chronic heart failure: A preliminary study. Journal of Cardiovascular Nursing, 23(6), 463-470.
Piette, J. D., Gregor, M. Share, D., Heisler, M., Bernstein, S. J., Koelling, T., & Chan, P. (2008). Improving heart failure self-management support by actively engaging out-of-home caregivers: Results of a feasibility study. Congestive Heart Failure, January February, 12-18.
Strömberg, A., Dahlström, U., & Fridlund, B. (2006). Computer-based education for patients with chronic heart failure: A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life. Patient Education and Counseling, 64, 128-135. doi:10.1016/j.pec.2005.12.007
Westlake, C., Evangelista, L. S., Strömberg, A., Ter-Galstanyan, A., Vazirani, S., & Dracup, K. (2007). Evaluation of a web-based education and counseling pilot program for older heart failure patients. Progress in Cardiovascular Nursing, Winter, 20-26.

To SWIM?

Last night, in EC&I 831 we had a guest speaker, George Siemens who introduced us to the acromyn SWIM in open online courses. SWIM stands for sensemaking wayfinding information model. Sensemaking is  a process of making connections, however it is more than connecting the dots, it is also about learning which dots are important to focus on and which dots are not important (considering dots as pieces of information).  As previously discussed, I would like to develop an open community for patients with heart failure and their caregivers so that they may have the opportunity to share their knowledge and experience with each other. Health care professionals would also be part of the group and will be able to share their knowledge and experience with the patients and caregivers as well.  Sensemaking and wayfinding is an important aspect to consider. I am looking at further advancing the Theory of Online Social Support by Sheryl Perreault LaCoursiere when I eventually write my comprehensive exams and develop a proposal for my research (still very much a work in progress).

The Theory of online social support was developed by LaCoursiere to describe the process of online social support through interpersonal relationships with other persons who are mostly unknown to each other. The theory includes the four concepts of nursing’s metaparadigm which consists of nursing, person, environment and health. Nursing comprises the thoughts and behaviors of the nurse who engages in online social support activities. The person is represented by the individual or groups of individuals, who seek online social support and engage in health-seeking behavior. The environment is virtual as it includes cyberspace and online environments. Health is viewed as a dynamic process that fluctuates over time and may include both chronic or acute health conditions that may affect the health status or health perception of the individual.

The two focal concepts of the online social support theory include online social support and linking. Online social support is defined as the “cognitive, perceptual, and transactional process of initiating, participating in, and developing electronic interactions to seek beneficial outcomes in health care status, perceived health, or psychosocial processing ability”(p. 66) and is represented as a trajectory that considers health status in relation to support needs.

Linking is the second focal concept and is defined as the “conscious and/or unconscious process of relating and weaving emerging awareness to previously learned thoughts or information” (p 67). It is described as a process similar to navigating a web page. Information and thoughts are sorted and retrieved as needed when situations occur over time. The individual builds a collection of information which provides support through transactions with other individuals in the online group and by the nature of the information itself.

I believe that by exploring coherence, it will help to further advance this theory

For my final project…

For my final project, I am interested in using NING to develop a community for patients with heart failure and their support persons. As a Registered Nurse, I see patients readmitted with a diagnosis of exacerbation of heart failure on a regular basis. We are fortunate in Saskatchewan to have 2 heart failure clinics, one in Regina and another in Saskatoon however at the present time not everyone has equal access to the services and the majority of patients only receive information from their doctor. Web-based interventions have been shown to be effective for this patient population as they provide education, social support,increased knowledge and up to date information. In studies done to date, the patients and caregivers only have access to the information for short periods of time. Thus I would like to develop a site where patients and caregivers can receive current information and support from others within a community. I will be developing this site based upon current guidelines but will not be able to have patients or caregivers access this site at this time. In order for patients and caregivers to access the site, I will need to obtain Ethics approval from several sites which will take longer than my time in the course. However I hope to have feedback from Registered Nurses and others working with heart failure patients. I will also reflect on my journey creating the site so please follow me as I begin…

References:

Boyde, M., Tuckett, A., Peters, R., Thompson, D., Turner, C., & Stewart, S. (2009). Learning for heart failure patient (The L-HF patient study). Journal of Clinical Nursing, 18, 2030-2039. doi:10.1111/j.1365-2702.2008.02716.x
Boyde, M., Tuckett, A., Peters, R., Thompson, D., Turner, C., & Stewart, S. (2009). Learning style and learning needs of heart failure patients (The Need2Know-HF patient study). European Journal of Cardiovascular Nursing, 8, 316-322. doi:10.1016/j.ejcnurse.2009.05.003
Delgado, D., Costigan, J., Wu, R., & Ross, H. J. (2003). An interactive Internet site for the management of patients with congestive heart failure. Canadian Journal of Cardiology, 19(12), 1381-1385.
Heo, S., Moser, D. K., Lennie, T. A., Riegel, B., Chung, M. L. (2008). Gender differences in and factors related to self-care behaviors: A cross-sectional, correlational study of patients with heart failure. International Journal of Nursing Studies, 45, 1807-1815. doi:10.1016/j.ijnurstu.2008.05.008
Nahm, E., Blum, K., Scharf, B., Friedmann, E., Thomas, S., Jones, D., & Gottlieb, S. S. (2008). Exploration of patients’ readiness for an eHealth management program for chronic heart failure: A preliminary study. Journal of Cardiovascular Nursing, 23(6), 463-470.
Piette, J. D., Gregor, M. Share, D., Heisler, M., Bernstein, S. J., Koelling, T., & Chan, P. (2008). Improving heart failure self-management support by actively engaging out-of-home caregivers: Results of a feasibility study. Congestive Heart Failure, January February, 12-18.
Strömberg, A., Dahlström, U., & Fridlund, B. (2006). Computer-based education for patients with chronic heart failure: A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life. Patient Education and Counseling, 64, 128-135. doi:10.1016/j.pec.2005.12.007
Westlake, C., Evangelista, L. S., Strömberg, A., Ter-Galstanyan, A., Vazirani, S., & Dracup, K. (2007). Evaluation of a web-based education and counseling pilot program for older heart failure patients. Progress in Cardiovascular Nursing, Winter, 20-26.