eHealth Program to Empower Patients in Returning to Normal Activities and Work After Gynecological Surgery: Intervention Mapping as a Useful Method for Development
Open accessAbstract
BACKGROUND: Full recovery after gynecological surgery takes much longer than expected regardless of surgical technique or the level of invasiveness. After discharge, detailed convalescence recommendations are not provided to patients typically, and postoperative care is fragmented, poorly coordinated, and given only on demand. For patients, this contributes to irrational beliefs and avoidance of resumption of activities and can result in a prolonged sick leave. OBJECTIVE: To develop an eHealth intervention that empowers gynecological patients during the perioperative period to obtain timely return to work (RTW) and prevent work disability. METHODS: The intervention mapping (IM) protocol was used to develop the eHealth intervention. A literature search about behavioral and environmental conditions of prolonged sick leave and delayed RTW in patients was performed. Patients' needs, attitudes, and beliefs regarding postoperative recovery and resumption of work were identified through focus group discussions. Additionally, a literature search was performed to obtain determinants, methods, and strategies for the development of a suitable interactive eHealth intervention to empower patients to return to normal activities after gynecological surgery, including work. Finally, the eHealth intervention was evaluated by focus group participants, medical doctors, and eHealth specialists through questionnaires. RESULTS: Twenty-one patients participated in the focus group discussions. Sufficient, uniform, and tailored information regarding surgical procedures, complications, and resumption of activities and work were considered most essential. Knowing who to contact in case of mental or physical complaints, and counseling and tools for work reintegration were also considered important. Finally, opportunities to exchange experiences with other patients were a major issue. Considering the determinants of the Attitude-Social influence-self-Efficacy (ASE) model, various strategies based on a combination of theory and evidence were used, resulting in an eHealth intervention with different interactive functionalities including tailored convalescence recommendations and a video to communicate the most common pitfalls during the perioperative period to patients and employers. Fifteen patients in the focus groups, 11 physicians, and 3 eHealth specialists suggested points for improvement to optimize the usability of the eHealth intervention and judged it an approachable, appropriate, and attractive eHealth intervention to empower gynecological patients. CONCLUSIONS: The IM protocol was a useful method to develop an eHealth intervention based on both theory and evidence. All patients and stakeholders judged the eHealth intervention to be a promising tool to empower gynecological patients during the perioperative period and to help them to return to normal activities and work.
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Two included studies reported on preventive interventions targeting older people and one on a programme to empower patients undergoing gynaecological surgery during the perioperative period.
“Two studies reported on preventive interventions targeting older people [24, 50] and one on a programme to empower patients undergoing gynaecological surgery during the perioperative period [43].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [43]
Two included studies adopted the intervention mapping framework developed by Bartholomew and colleagues in 1998.
“Two studies adopted the intervention mapping framework [41] developed by Bartholomew and colleagues in 1998 [42, 43]”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [43]
The involvement of stakeholders was identified as a strength by several studies, as stakeholders play a key role in the implementation of interventions into practice.
“The involvement of stakeholders was identified as a strength by several studies, as stakeholders play a key role in the implementation of interventions into practice [30, 32, 33, 42, 43, 45].”
From Optimisation of complex health interventions prior to a randomised controlled trial: a scoping review of strategies used (2016) · cites this paper as [43]
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- Authors
- Vonk Noordegraaf, A., Huirne, J. A. F., Pittens, C. A., van Mechelen, W., Broerse, J. E. W., Brölmann, H. A. M., & Anema, J. R.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Vrije Universiteit Amsterdam (NL)
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2012-10-19
- Volume
- 14
- Issue
- 5
- Pages
- e124
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC3510728
- OpenAlex
- W1974232493
- Cited by
- 54
- References
- 79
- Citations by year
- 2025: 2 · 2022: 1 · 2021: 1 · 2020: 18 · 2019: 2 · 2018: 10 · 2017: 2 · 2016: 6 · 2015: 4 · 2014: 5 · 2013: 2 · 2012: 1
- FWCI
- 6.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- ZonMw (150020037)
- Vrije Universiteit Amsterdam
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- digital health interventions, gynecologic surgery, return to work, return to normal activity, postoperative recovery, sick leave, work disability prevention, patient empowerment, intervention mapping, work reintegration, patient education, postoperative care
- MeSH terms
- Employment, Female, Humans, Power, Psychological, Gynecologic Surgical Procedures, Focus Groups, Sick Leave, Self Efficacy, Internet
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