BACKGROUNDInternet use became an integral part of the healthcare relationship. Literature indicates that the illness trajectory plays a role in the use of Internet as a health information tool. This study focuses on infants admitted to a neonatal intensive care unit.AIMThis study aims to understand how the illness trajectory triggers the use of Internet by parents of infants admitted to a neonatal intensive care unit, using a conceptual framework influenced by Corbin and Strauss' illness trajectory.DESIGNThis study was based on a qualitative longitudinal multiple-case study design.METHODSFrom July 2007-August 2008 and from June 2009-May 2010, parents with newborns were prospectively interviewed over a period of 10 months. Parents were recruited in four neonatal intensive care units. The interviews were subject of a thematic content analysis.RESULTSThe multi-layered illness trajectory triggers Internet use. Parents' online health information behaviour interacts with other information channels too (such as interaction with healthcare professionals). Parents accumulate knowledge along the illness trajectory affecting their information needs. The sickness trajectory helps to understand the complexity of the information behaviour. Labels have a major impact on the effectiveness of search strategies.CONCLUSIONSNursing and other healthcare professionals should become more aware about the complex relationship between information needs and Internet use along the illness trajectory of an infant. As such, they will be more able to assist parents in finding and evaluating high-quality online information at the right time.

This article explores the concepts 'information behaviour' and 'illness trajectory' at the neonatal intensive care unit (NICU). On the basis of literature review and exploratory interviews with neonatologists and head nurses of Belgian NICUs a conceptual framework is presented. The 'information behaviour' of parents of infants admitted to a NICU is analytically divided into five dimensions: ways of getting information; interpersonal information sources; time-related issues; location of information transfer; and content of information. The conceptual framework equally takes the 'illness trajectory' into account. Following Corbin and Strauss the illness trajectory at a NICU is analysed in three sub-trajectories: disease course; healthcare trajectory; and sickness trajectory. By combining the respective categories of information behaviour and illness trajectory, an analytical tool is presented under the form of a classification matrix for scrutinizing the mediating role of the illness trajectory on the information behaviour of parents of infants admitted to a NICU.

Objective: This literature review focuses on information and communication needs of parents of children admitted to the NICU and on their use of information sources in the illness trajectories at NICU.Methods: Literature search in 4 electronic databases (Ovid Medline, PsycINFO, CINAHL and Sociological Abstracts), covering 1990-March 2008.Results: The seventy-eight included articles revealed that NICU parents have high information needs. The illness trajectory mediates parental information needs and induces a changing pattern in information use and information needs. Most attention is paid to the prenatal and acute phases, while information behaviour in sudden events and later phases receives limited attention.Conclusions: In-depth studies on information needs and corresponding use of information sources are lacking. More longitudinal studies are needed, taking the illness trajectory into account and investigating the determinants and outcomes of the information and communication needs of NICU parents.Practice implications: Healthcare professionals should adapt their information provision along the illness trajectory. The development of guidelines of information provision during the illness trajectory at NICU would support all professionals. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

Background: Epidemiological shifts, financial pressures and changing policy priorities in healthcare initiate reflections on innovative ways to deliver care. Technologies offer opportunities to change health services delivery. one of the emerging fields is telehomecare-applications. Yet, these applications are not always adapted to the user needs and characteristics of the homecare setting, resulting in "system failure".Objectives: We describe a generic methodological model to incorporate user perspectives in the design and development process of e-health systems. The model aims at grounding the choice of the technology in a clear understanding of the homecare field, and on interactive reflections with the technology developers.Methods and results: The methodological model develops over three phases. A first phase aims to identify and to select potential patient groups for which the technology will be developed: It holds (a) gathering of epidemiological data; (b) identifying relevant inclusion criteria to select patient groups; (c) qualitative weighting based on the inclusion criteria to include potential patient groups and (d) plenary discussion with the technology developers. In a second phase, the particular needs of the selected patient groups are assessed through literature review, document analysis and explorative interviews with key informants. in the third phase, "social" use cases are developed in which the use of potential technologies is written as virtual storylines. The writing of the use cases is prepared through a semi-structured questionnaire for all partners listing the "visions and expectations on the technology and user context". The use cases are the source documents for a plenary discussion with the technology developers in which priorities are set for functionalities of the e-homecare platform. The methodological approach is illustrated within the Coplintho-project. It is a Flemish initiative developing an e-homecare platform offering a package of services on a dedicated device to support the social integration and 'independent living' of people in their home environment.Discussion: Our methodological approach provides a practical framework for understanding and considering user perspectives. The application of the method within the development of the Coplintho-e-homecare platform demonstrated its usefulness. The experience within the Coplintho-pilot project learned important lessons about the operational use of the method. The methodology is time-consuming and requires scientific input to assess and to document potential user needs, requiring specific means and human resources. The method also requires a very explicit project management of the preparatory phase. (C) 2007 Elsevier Ireland Ltd. All rights reserved.