In total, 425 questionnaires were sent out to 85 hospital departments responsible for CHF care, e.g. cardiology or medicine departments, in all 21 counties and regions in Sweden. The number of departments in each county or region depends on their size. The largest regions, with almost 35% of the departments, are Västra Götaland, Skåne and Stockholm. One department, Sahlgrenska University Hospital/Östra, in Västra Götaland region was excluded because of risk for project collaboration bias.
Envelopes containing 5 printed questionnaires with an information letter and a self-addressed (stamped) envelope were addressed to the head of department at each of the 85 departments along with a letter requesting their help to administer the forms to relevant personnel. A link was included in each questionnaire for those who preferred to answer the form on Internet. After 4 weeks a reminder was sent out to each department by post.
This method of distribution was chosen since it was impossible to get access to an address list or other source containing relevant information on staff working with care of CHF at hospitals in Sweden. Obviously, this is not an optimal method of distribution. Bias, such as the head of department choosing respondents that have a predisposed attitude towards ICT, is one big issue. Also, as the amount of employees at each department is unknown, there is no way to be sure that 5 questionnaires is an appropriate amount. However, in order to reach a large population, both in terms of amount of respondents and geographical spread, this method was considered adequate for the purpose of the study.
Anonymity of the respondents was assured by not including name or other personal information in the questionnaire. Moreover, hospital affiliation was not included to further ensure anonymity. The respondents were urged to answer all questions, but they were not required to.
The questionnaire, which was written in Swedish, included 33 questions divided into 4 categories: background, attitudes to ICT tools in healthcare, opinions on follow-up at home, and other. In the category “background”, questions were asked on age, sex, occupational title, county, and computer experience at work and at home. The category “attitudes to ICT-tools in healthcare” asked general questions regarding ICT as a tool in healthcare today and in the future, possibilities of patient monitoring at a distance, whether distance monitoring can result in better self-care, provide healthcare professionals with possibilities to administer better care, reduce costs and save time, and general reliance to ICT as a tool in healthcare.
Further, in “opinions on follow-up at home” questions were asked on if patients with CHF were appropriate for follow-up at home, which patients that were best suited, and which were the best ways of performing the follow-up. Free text fields made it possible for the respondents to give additional information
In the last category, “Other”, the respondents were asked if they had any prior knowledge in the area or had any additional information they wanted to share. The respondents were also given the possibility to leave contact information in case they would like further information, or were interested in participating in future trials. This last question was separated from the others and put in a separate pile before analysis in order to preserve anonymity.
Approximately 10 weeks after sending out the questionnaires, the retrieved results were compiled and analysed. Responses received after this time were archived and not included in the study. Due to the uncertainty in the method of dispatch, no conclusions will be drawn on the general opinions of the population as a whole. Moreover, since the intention of this study was not to perform a hypothesis test advanced statistical analysis methods were not used. Instead, we present data in diagrams and tables, with percentages of the total. Due to rounding errors, some results will add up to more than 100%. All questionnaires can be retrieved from the project homepage .
In order to analyse the data, the occupation was divided into groups: physicians and nurses, men and women. The group “physicians” consisted of cardiologists, other specialist physicians and GP (General Practitioner). Nurses specialized in heart diseases as well as in other specialties, registered nurses and assistant nurses made up the “nurse” group. Those who had entered both “head of department” and “physician” were allocated to the physician group. The other duplicates did not affect the physician and nurse groups since they had chosen both “cardiology/heart” and “other”, but stayed within the group of physician/nurse.