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Haltaufderheide J, Lucht A, Strünck C, Vollmann J. Socially Assistive Devices in Healthcare-a Systematic Review of Empirical Evidence from an Ethical Perspective. SCIENCE AND ENGINEERING ETHICS 2023; 29:5. [PMID: 36729304 PMCID: PMC9894988 DOI: 10.1007/s11948-022-00419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/12/2022] [Indexed: 06/18/2023]
Abstract
Socially assistive devices such as care robots or companions have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. An important part of the ethical evaluation is to understand how users interact with these devices and how interaction influences users' perceptions and their ability to express themselves. In this review, we report and critically appraise findings of non-comparative empirical studies with regard to these effects from an ethical perspective.Electronic databases and other sources were queried using a comprehensive search strategy generating 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 22 reports on 21 datasets using a non-comparative design a narrative synthesis was performed.Data shows positive findings in regard to attitudes and emotional reactions of users. Varying perception of a social relation and social presence are the most commonly observed traits of interaction. Users struggle with understanding technical complexities while functionality of the devices is limited. This leads to a behavioral alignment of users towards the requirements of the devices to be able to make use of them.This evidence adds to three important ethical debates on the use of socially assistive devices in healthcare in regard to (1) reliability of existing empirical evidence to inform normative judgements, (2) ethical significance of the social presence of devices and (3) user autonomy in regard to behavioral alignment.
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Affiliation(s)
- Joschka Haltaufderheide
- Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum, Markstr. 258a, 44799, Bochum, Germany.
| | - Annika Lucht
- Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum, Markstr. 258a, 44799, Bochum, Germany
| | - Christoph Strünck
- School of Life Sciences, University of Siegen, Siegen, Germany
- Institute of Gerontology, Technical University Dortmund, Dortmund, Germany
| | - Jochen Vollmann
- Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum, Markstr. 258a, 44799, Bochum, Germany
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Bernardo J, Apóstolo J, Loureiro R, Santana E, Yaylagul NK, Dantas C, Ventura F, Duque FM, Jøranson N, Zechner M, van Staalduinen W, De Luca V, Illario M, Silva R. eHealth Platforms to Promote Autonomous Life and Active Aging: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15940. [PMID: 36498018 PMCID: PMC9738367 DOI: 10.3390/ijerph192315940] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
New technologies, namely eHealth platforms, are being used more than ever before. These platforms enable older people to have a more independent lifestyle, enhance their participation, and improve their well-being. Information and communication technologies are expected to be linked to the triad of aging, social inclusion, and active participation, which is in line with the implementation of Smart Healthy and Age-Friendly Environments. This scoping review aimed to map eHealth platforms designed to promote autonomous life and active aging. The Joanna Briggs Institute methodology and the PRISMA-ScR checklist were used. A search was conducted on MEDLINE (via PubMed), CINAHL Complete (via EBSCOhost), Scopus, Cochrane Database of Systematic Reviews (via EBSCOhost), SciELO, DART-Europe, CAPES, and MedNar databases. Fourteen studies were included. This scoping review synthesized information on eHealth platforms designed to promote active living, their domains of intervention, and the outcomes assessed in those studies that have implemented and evaluated these eHealth platforms.
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Affiliation(s)
- Joana Bernardo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3030 Coimbra, Portugal
| | - João Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3030 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3030 Coimbra, Portugal
| | - Ricardo Loureiro
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3030 Coimbra, Portugal
| | - Elaine Santana
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3030 Coimbra, Portugal
| | | | | | - Filipa Ventura
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3030 Coimbra, Portugal
| | - Filipa Margarida Duque
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3030 Coimbra, Portugal
| | - Nina Jøranson
- Faculty of Health Studies, VID Specialized University, N-3019 Oslo, Norway
| | - Minna Zechner
- Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland
| | | | - Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80138 Naples, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80138 Naples, Italy
| | - Rosa Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3030 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3030 Coimbra, Portugal
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Garani-Papadatos T, Natsiavas P, Meyerheim M, Hoffmann S, Karamanidou C, Payne SA. Ethical Principles in Digital Palliative Care for Children: The MyPal Project and Experiences Made in Designing a Trustworthy Approach. Front Digit Health 2022; 4:730430. [PMID: 35373180 PMCID: PMC8971573 DOI: 10.3389/fdgth.2022.730430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/03/2022] [Indexed: 12/31/2022] Open
Abstract
This paper explores the ethical dimension of the opportunity to offer improved electronic patient-reported outcome (ePRO) systems addressing personal needs of pediatric cancer patients, their parents and caregivers, with regard to technological advance of digital health. This opportunity has been explored in the MyPal research project, which aims to assess a patient-centered service for palliative care relying on the adaptation and extension of digital health tools and concepts available from previous projects. Development and implementation of ePROs need to take place in a safe, secure and responsible manner, preventing any possible harm and safeguarding the integrity of humans. To that end, although the final results will be published at the end of the project, this paper aims to increase awareness of the ethical ramifications we had to address in the design and testing of new technologies and to show the essentiality of protection and promotion of privacy, safety and ethical standards. We have thus reached a final design complying with the following principles: (a) respect for the autonomy of participants, especially children, (b) data protection and transparency, (c) fairness and non-discrimination, (d) individual wellbeing of participants in relation to their physical and psychological health status and e) accessibility and acceptability of digital health technologies for better user-engagement. These principles are adapted from the Ethics Guidelines for a trustworthy Artificial Intelligence (AI) which provide the framework for similar interventions to be lawful, complying with all applicable laws and regulations, ethical, ensuring compliance to ethical principles and values and robust, both from a technical and social perspective.
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Affiliation(s)
- Tina Garani-Papadatos
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | | | - Marcel Meyerheim
- Faculty of Medicine, Clinic of Pediatric Oncology and Hematology, Saarland University Hospital and Saarland University, Homburg, Germany
| | - Stefan Hoffmann
- Serious Games Solutions, a Division of Promotion Software GmbH, Tuebingen, Germany
| | | | - Sheila A Payne
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
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Frennert S, Erlingsdóttir G, Muhic M, Rydenfält C, Milos Nymberg V, Ekman B. Embedding and Integrating a Digital Patient Management Platform Into Everyday Primary Care Routines: Qualitative Case Study. JMIR Form Res 2022; 6:e30527. [PMID: 35191845 PMCID: PMC8905477 DOI: 10.2196/30527] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/21/2021] [Accepted: 01/06/2022] [Indexed: 02/05/2023] Open
Abstract
Background Traditional primary care is characterized by patient consultations via phone and physical visits. However, the current development in Swedish primary care is to blend digital solutions with traditional solutions. This paper addresses this development by examining the normalization of embedding and integrating a digital health care platform into everyday care routines in a primary care clinic. The digital health care platform enables both synchronous (video calls) and asynchronous (chat) communication, as well as self-registration of patient data using automated questions and forms requiring the patient’s input. Objective This study aims to explore the work that health care professionals (HCPs) have to undertake to implement and sustain a digital health care platform as part of their everyday work practice. Methods HCPs were observed and interviewed to assess their individual and collective engagement and the mechanisms involved in the implementation of the digital platform and its effects on everyday work routines. The normalization process theory (NPT) was used to frame the data analysis. Results The analysis identified several themes related to the four NPT constructs: coherence, cognitive participation, collective action, and reflexive monitoring. The use of these constructs enabled the analysis to identify ways of supporting implementation. For example, it showed the benefits of having implementation champions and scheduling work hours for HCPs to use the platform. The analysis also revealed a theme of materiality that deviated from the NPT constructs, as NPT gives ontological priority to human actors and social structures. Conclusions Digital health care platform implementation is a complex process. Our findings provide insights into how individual and collective actions can be supported to embed and integrate a digital platform into everyday care routines. Primary health care organizations need to involve HCPs throughout the implementation process by reorganizing work and providing frequent feedback loops. HCPs are more likely to engage with and commit to changing practices if they perceive the digital platform to be beneficial compared with the current practice. However, they also need resources (eg, time, training, and continuous support) to put the platform into practice. Patient engagement and appraisal are important elements in implementation. Unless patients are willing to use the platform, there is no motivation for HCPs to embed the digital platform into everyday care practice.
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Affiliation(s)
| | | | - Mirella Muhic
- Department of Informatics, Umeå University, Umeå, Sweden
| | | | | | - Björn Ekman
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
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Saab MM, Landers M, Murphy D, O'Mahony B, Cooke E, O'Driscoll M, Hegarty J. Nursing students' views of using virtual reality in healthcare: A qualitative study. J Clin Nurs 2021; 31:1228-1242. [PMID: 34296483 DOI: 10.1111/jocn.15978] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study explored nursing students' views of using virtual reality in healthcare. BACKGROUND The popularity and use of virtual reality in healthcare delivery and education is on the rise. Yet, the views of future nurses regarding this technology remain underexplored. DESIGN This is a qualitative descriptive study guided by a naturalistic inquiry and reported using the Standards for Reporting Qualitative Research checklist. METHODS Nursing students (n = 26) were recruited using convenience and snowball sampling. They were first exposed to a virtual reality intervention aimed to enhance men's awareness of testicular diseases. This was attempted to familiarise participants with the technology and initiate conversations around its use in healthcare. Participants were then interviewed face-to-face, either individually or within focus groups. Data were analysed using thematic analysis. RESULTS Four themes were identified: (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality. Participants described this technology as novel, enjoyable, immersive, memorable and inclusive. They questioned, however, the suitability of virtual reality for older adults, reported minor technical difficulties and stressed the importance of prior preparation in the use of the technology. Virtual reality was recommended for use in outpatient healthcare settings, schools and the community. Participants suggested using virtual reality in health promotion, disease prevention and management, and to promote nurses' empathy towards patients. CONCLUSIONS Findings highlight the potential role of virtual reality in assisting nurses in promoting health and managing disease. Future research is needed to establish the long-term effect of virtual reality interventions among more diverse participants. RELEVANCE TO CLINICAL PRACTICE Virtual reality can be implemented in outpatient, educational and community settings in order to promote health, prevent disease, enhance disease and self-management, and increase nurses' empathy towards patients.
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Affiliation(s)
- Mohamad M Saab
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Margaret Landers
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - David Murphy
- School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Billy O'Mahony
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.,School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Michelle O'Driscoll
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.,School of Pharmacy, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Usage of eHealth/mHealth Services among Young Czech Adults and the Impact of COVID-19: An Explorative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137147. [PMID: 34281084 PMCID: PMC8297197 DOI: 10.3390/ijerph18137147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/20/2022]
Abstract
Various mHealth/eHealth services play an increasingly important role in healthcare systems and personal lifestyle management. Yet, the relative popularity of these services among the young population of the Czech Republic was not known. Therefore, we carried out an on-line survey with a convenience sample (n = 299) of young adults aged 18–29 and living in the Czech Republic. To this end, we adapted the survey instrument which was previously used in a similar study conducted in a different cultural context (Hong Kong). In our study, we found out that health tutorial activities (i.e., acquiring information on diet, exercise, fitness) were the most common among our respondents (M = 2.81, SD = 1.14). These were followed by health information seeking activities (i.e., acquiring information on medical problems) (M = 2.63, SD = 0.89) and medical services (i.e., the eHealth/mHealth services that provide infrastructural support, such as ePrescription and doctor appointment organizers) (M = 2.18, SD = 0.97). Based on the grouping according to gender and existing health condition, pairwise comparisons showed statistically significant differences. We also briefly analyzed the influence of the COVID-19 pandemic on the examined activities. Based on their relative popularity, we suggest leveraging the potential of health tutorial activities to improve public health.
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Khehra A, Cohenca N, Cehreli ZC, Levin L. The International Association of Dental Traumatology ToothSOS mobile app: A 2-year report. Dent Traumatol 2020; 37:145-150. [PMID: 32940392 DOI: 10.1111/edt.12609] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND/AIM The shift in health care and technology calls for innovation through mobile applications as free educational resources for the masses. The International Association of Dental Traumatology (IADT) created ToothSOS, an app (software application for mobile devices) to provide dental trauma information for patients and professionals. The app contains information on the emergency management and prevention of dental injuries, as well as treatment guidelines for dental practitioners. The aim of this study was to assess public utilization of the ToothSOS app in the first 2 years since its launch. METHODS The ToothSOS app was launched by the IADT in the first week of April 2018. Data regarding the number of downloads and usage of the app in the first 2 years (from April 2018 to May 2020) were collected and analyzed. RESULTS The total number of ToothSOS downloads over the 2 years was 47 725. The number of downloads peaked in the first month when the app was initially released. Thereafter, the number of downloads decreased to an average of 1423 ± 363 downloads every month. Europe was the territory with the greatest number of downloads followed by the United States and Canada, Asia, Latin America and the Caribbean, and Africa, the Middle East, and India. CONCLUSIONS Within as short a period as 2 years, the ToothSOS app continues to gain public interest. Further attempts and public campaigns should be made in order to increase the visibility of the app. Dental professionals should encourage patients and communities to use the app in order to increase awareness for the prevention and proper emergency management of traumatic dental injuries.
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Affiliation(s)
- Anahat Khehra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Nestor Cohenca
- University of Washington and Seattle Children's Hospital, Seattle, WA, USA
| | | | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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de Boer B. Experiencing objectified health: turning the body into an object of attention. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2020; 23:401-411. [PMID: 32246387 PMCID: PMC7426282 DOI: 10.1007/s11019-020-09949-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
In current phenomenology of medicine, health is often understood as a state of transparency in which our body refrains from being an object of explicit attention. In this paper, I argue that such an understanding of health unnecessarily presupposes an overly harmonious alignment between subjective and objective body, resulting in the idea that our health remains phenomenologically inaccessible. Alternatively, I suggest that there are many occasions in which one's body in health does become an object of attention, and that technologies mediate how a relation with one's body is formed. First, I show prominent accounts in current phenomenology of medicine understand health in terms of a harmonious alignment between objective and subjective body. Second, I argue that there are many occasions in which there is a disharmony between objective and subjective body, and suggest that also in health, we cannot escape being an object that we often relate to. Then, I draw on postphenomenology to show how technologies such as digital self-tracking applications and digital twins can be understood as mediating the relationship with one's own body in a specific way. In conclusion, I argue that both technologies make present the objective body as a site for hermeneutic inquiry such that it can be interacted with in terms of health parameters. Furthermore, I point to some relevant differences in how different technologies make aspects of our own body phenomenologically present.
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Affiliation(s)
- Bas de Boer
- Philosophy Department, University of Twente, Enschede, The Netherlands.
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Harerimana A, Mtshali NG. Using Exploratory and Confirmatory Factor Analysis to understand the role of technology in nursing education. NURSE EDUCATION TODAY 2020; 92:104490. [PMID: 32516637 DOI: 10.1016/j.nedt.2020.104490] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/26/2020] [Accepted: 05/27/2020] [Indexed: 05/23/2023]
Abstract
AIM The study aimed to establish the role played by technology in nursing education through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). METHODS 150 student nurses participated, with data being collected using a structured questionnaire with 14 items on a 5-point Likert scale. Parallel Analysis (PA) and Exploratory Factor Analysis (EFA) were conducted to identify the factors for the role of technology in nursing education, Confirmatory Factor analysis (CFA) was used to ascertain the model fit. ANOVA, t-test and binary regression analysis were used to identify among the factors the differences within the level of the study, and perceived abilities to use the computer. RESULTS The EFA identified five factors from 14 items, and through the CFA, the results indicated that the model was supported by the following indices: Comparative Fit Index (CFI) = 0.968 (>0.95); Incremental Fit Index (IFI) = 0.969 (>0.95); Tucker-Lewis Index (TLI) = 0.957 (>0.95); Root Mean Squared Error of Approximation (RMSEA) = 0.077 (<0.080); and SRMR = 0.0396 (<0.08). These results were within acceptable ranges, which indicated that the five factors obtained from EFA were validated. However, Chi-square goodness of fit statistics was not statistically significant (χ2 = 126.312, d.f = 67, p = .000). Overall, 89.3% (n = 134) nursing students had a positive perception of the role of technology in nursing education. Binary regression analysis indicated that 1st year nursing students positively perceived the role of technology 6.7 times more than other levels (OR = 6.710, 95% CI: 1.33-33.63, p = .021). Students with good ability to use the computers (92.9%) were 5.3 more likely to have a positive perception towards the role of technology in nursing than those with the poor ability (OR = 5.35, 95%CI = 1.76-16.26, p = .003). CONCLUSION Using innovative teaching strategies and ensuring that nursing students are skilled is essential to the future of the nursing profession. The five-factor model would be a useful tool to assess the perception of students towards the role of technology in nursing education.
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Affiliation(s)
- Alexis Harerimana
- Nursing and Midwifery, College of Healthcare Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
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Morley J, Floridi L. The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem. SCIENCE AND ENGINEERING ETHICS 2020; 26:1159-1183. [PMID: 31172424 PMCID: PMC7286867 DOI: 10.1007/s11948-019-00115-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/28/2019] [Indexed: 05/03/2023]
Abstract
This article highlights the limitations of the tendency to frame health- and wellbeing-related digital tools (mHealth technologies) as empowering devices, especially as they play an increasingly important role in the National Health Service (NHS) in the UK. It argues that mHealth technologies should instead be framed as digital companions. This shift from empowerment to companionship is advocated by showing the conceptual, ethical, and methodological issues challenging the narrative of empowerment, and by arguing that such challenges, as well as the risk of medical paternalism, can be overcome by focusing on the potential for mHealth tools to mediate the relationship between recipients of clinical advice and givers of clinical advice, in ways that allow for contextual flexibility in the balance between patiency and agency. The article concludes by stressing that reframing the narrative cannot be the only means for avoiding harm caused to the NHS as a healthcare system by the introduction of mHealth tools. Future discussion will be needed on the overarching role of responsible design.
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Affiliation(s)
- Jessica Morley
- Oxford Internet Institute, University of Oxford, 1 St Giles, Oxford, OX1 3JS, UK.
| | - Luciano Floridi
- Oxford Internet Institute, University of Oxford, 1 St Giles, Oxford, OX1 3JS, UK
- The Alan Turing Institute, 96 Euston Road, London, NW1 2DB, UK
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Ake A, Arcand M. The impact of mobile health monitoring on the evolution of patient-pharmacist relationships. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2020. [DOI: 10.1108/ijphm-04-2019-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Increasingly popular mobile health technology is creating a new paradigm for the delivery of care to patients involving a role of the pharmacist. This study aims to propose a renewed patient–pharmacist relationship in this environment and present an empirical case study investigating the influence of key variables, including the consumer’s attitude toward personalized monitoring performed by the pharmacist, on the intention to adopt a mobile health app. Other drivers identified were ease of use and perceived usefulness of the app, individual and health-related factors (perceived vulnerability and severity of health condition, social norms and innovativeness with technology) and quality of relationship with the pharmacist.
Design/methodology/approach
A self-administered online survey was completed by 356 Canadian mobile device owners of more than 40 of age. Analyses were performed using structural equation modeling.
Findings
The main factor driving adoption intentions was perceived usefulness followed by the respondent’s innovativeness with technology and perceived vulnerability of his/her health condition. Attitude toward personalized monitoring depends primarily on the relationship with the pharmacist. No relationship was found between adoption intentions and attitude toward personalized monitoring.
Originality/value
This research features a multidisciplinary approach by using variables from relational marketing, information technology and health and inclusion of the pharmacist (vs physician) as a health consultant, offering relevant marketing avenues for pharmacists.
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Ahmadvand A, Kavanagh D, Clark M, Drennan J, Nissen L. Trends and Visibility of "Digital Health" as a Keyword in Articles by JMIR Publications in the New Millennium: Bibliographic-Bibliometric Analysis. J Med Internet Res 2019; 21:e10477. [PMID: 31855190 PMCID: PMC6940860 DOI: 10.2196/10477] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/21/2019] [Accepted: 10/17/2019] [Indexed: 01/04/2023] Open
Abstract
Background Digital health has become an advancing phenomenon in the health care systems of modern societies. Over the past two decades, various digital health options, technologies, and innovations have been introduced; many of them are still being investigated and evaluated by researchers all around the globe. However, the actual trends and visibility of peer-reviewed publications using “digital health” as a keyword to reflect the topic, published by major relevant journals, still remain to be quantified. Objective This study aimed to conduct a bibliographic-bibliometric analysis on articles published in JMIR Publications journals that used “digital health” as a keyword. We evaluated the trends, topics, and citations of these research publications to identify the important share and contribution of JMIR Publications journals in publishing articles on digital health. Methods All JMIR Publications journals were searched to find articles in English, published between January 2000 and August 2019, in which the authors focused on, utilized, or discussed digital health in their study and used “digital health” as a keyword. In addition, a bibliographic-bibliometric analysis was conducted using the freely available Profiles Research Networking Software by the Harvard Clinical and Translational Science Center. Results Out of 1797 articles having “digital health” as a keyword, published mostly between 2016 and 2019, 277 articles (32.3%) were published by JMIR Publications journals, mainly in the Journal of Medical Internet Research. The most frequently used keyword for the topic was “mHealth.” The average number of times an article had been cited, including self-citations, was above 2.8. Conclusions The reflection of “digital health” as a keyword in JMIR Publications journals has increased noticeably over the past few years. To maintain this momentum, more regular bibliographic and bibliometric analyses will be needed. This would encourage authors to consider publishing their articles in relevant, high-visibility journals and help these journals expand their supportive publication policies and become more inclusive of digital health.
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Affiliation(s)
- Alireza Ahmadvand
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - David Kavanagh
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Michele Clark
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Judy Drennan
- School of Advertising, Marketing, and Public Relations, QUT Business School, Queensland University of Technology, Brisbane, Australia
| | - Lisa Nissen
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Boers SN, Jongsma KR, Lucivero F, Aardoom J, Büchner FL, de Vries M, Honkoop P, Houwink EJF, Kasteleyn MJ, Meijer E, Pinnock H, Teichert M, van der Boog P, van Luenen S, van der Kleij RMJJ, Chavannes NH. SERIES: eHealth in primary care. Part 2: Exploring the ethical implications of its application in primary care practice. Eur J Gen Pract 2019; 26:26-32. [PMID: 31663394 PMCID: PMC7034078 DOI: 10.1080/13814788.2019.1678958] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: eHealth promises to increase self-management and personalised medicine and improve cost-effectiveness in primary care. Paired with these promises are ethical implications, as eHealth will affect patients’ and primary care professionals’ (PCPs) experiences, values, norms, and relationships. Objectives: We argue what ethical implications related to the impact of eHealth on four vital aspects of primary care could (and should) be anticipated. Discussion: (1) EHealth influences dealing with predictive and diagnostic uncertainty. Machine-learning based clinical decision support systems offer (seemingly) objective, quantified, and personalised outcomes. However, they also introduce new loci of uncertainty and subjectivity. The decision-making process becomes opaque, and algorithms can be invalid, biased, or even discriminatory. This has implications for professional responsibilities and judgments, justice, autonomy, and trust. (2) EHealth affects the roles and responsibilities of patients because it can stimulate self-management and autonomy. However, autonomy can also be compromised, e.g. in cases of persuasive technologies and eHealth can increase existing health disparities. (3) The delegation of tasks to a network of technologies and stakeholders requires attention for responsibility gaps and new responsibilities. (4) The triangulate relationship: patient–eHealth–PCP requires a reconsideration of the role of human interaction and ‘humanness’ in primary care as well as of shaping Shared Decision Making. Conclusion: Our analysis is an essential first step towards setting up a dedicated ethics research agenda that should be examined in parallel to the development and implementation of eHealth. The ultimate goal is to inspire the development of practice-specific ethical recommendations.
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Affiliation(s)
- Sarah N Boers
- Julius Centre for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Karin R Jongsma
- Julius Centre for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Federica Lucivero
- Ethox and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jiska Aardoom
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.,National eHealth Living Lab (NELL), Leiden, the Netherlands
| | - Frederike L Büchner
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Martine de Vries
- Department of Medical Ethics and Health Law, Leiden University Medical Centre, Leiden, the Netherlands
| | - Persijn Honkoop
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.,Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
| | - Elisa J F Houwink
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.,National eHealth Living Lab (NELL), Leiden, the Netherlands
| | - Eline Meijer
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.,National eHealth Living Lab (NELL), Leiden, the Netherlands
| | - Hilary Pinnock
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Martina Teichert
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Paul van der Boog
- Department of Nephrology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Sanne van Luenen
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.,National eHealth Living Lab (NELL), Leiden, the Netherlands
| | - Rianne M J J van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.,National eHealth Living Lab (NELL), Leiden, the Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.,National eHealth Living Lab (NELL), Leiden, the Netherlands
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15
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Strieder AP, Aguirre PEA, Lotto M, Cruvinel AFP, Cruvinel T. Digital behavior surveillance for monitoring the interests of Google users in amber necklace in different countries. Int J Paediatr Dent 2019; 29:603-614. [PMID: 30920686 DOI: 10.1111/ipd.12500] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/21/2019] [Accepted: 02/20/2019] [Indexed: 12/23/2022]
Abstract
AIM To determine the interests of Google users in information about amber necklace in distinct countries over time. DESIGN This longitudinal retrospective study analyzed the amber necklace-related computational data generated from the activity of Google users from17 countries, by the application of Google Trends. Four search strategies were defined in English, Spanish, Portuguese, and Italian, for retrieving the monthly variation of relative search volume (RSV) between January 2004 and September 2018, including all categories and sources of search. Trends and 12-month predictive interests of users were analyzed by forecasting autoregressive integrated moving average models, while the influences of seasonality were evaluated by generalized additive models. The most popular queries employed for Google users were determined to qualitative analysis. P values < 0.05 were considered significant. RESULTS In general, RSV curves were characterized by uptrends in most studied countries over the years, without the influence of monthly or quarterly seasonality. The queries were frequently associated with a desire for additional information, with respect to the definition, usability, and teething symptoms relief promoted by amber jewelries. CONCLUSIONS These findings indicate an increasing interest of Google users in amber necklace-related topics in different countries.
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Affiliation(s)
- Anna Paola Strieder
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Patricia Estefania Ayala Aguirre
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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16
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Li KHC, White FA, Tipoe T, Liu T, Wong MC, Jesuthasan A, Baranchuk A, Tse G, Yan BP. The Current State of Mobile Phone Apps for Monitoring Heart Rate, Heart Rate Variability, and Atrial Fibrillation: Narrative Review. JMIR Mhealth Uhealth 2019; 7:e11606. [PMID: 30767904 PMCID: PMC6396075 DOI: 10.2196/11606] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/06/2018] [Accepted: 11/25/2018] [Indexed: 12/19/2022] Open
Abstract
Background Mobile phone apps capable of monitoring arrhythmias and heart rate (HR) are increasingly used for screening, diagnosis, and monitoring of HR and rhythm disorders such as atrial fibrillation (AF). These apps involve either the use of (1) photoplethysmographic recording or (2) a handheld external electrocardiographic recording device attached to the mobile phone or wristband. Objective This review seeks to explore the current state of mobile phone apps in cardiac rhythmology while highlighting shortcomings for further research. Methods We conducted a narrative review of the use of mobile phone devices by searching PubMed and EMBASE from their inception to October 2018. Potentially relevant papers were then compared against a checklist for relevance and reviewed independently for inclusion, with focus on 4 allocated topics of (1) mobile phone monitoring, (2) AF, (3) HR, and (4) HR variability (HRV). Results The findings of this narrative review suggest that there is a role for mobile phone apps in the diagnosis, monitoring, and screening for arrhythmias and HR. Photoplethysmography and handheld electrocardiograph recorders are the 2 main techniques adopted in monitoring HR, HRV, and AF. Conclusions A number of studies have demonstrated high accuracy of a number of different mobile devices for the detection of AF. However, further studies are warranted to validate their use for large scale AF screening.
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Affiliation(s)
- Ka Hou Christien Li
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).,Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).,Faculty of Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Timothy Tipoe
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).,Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Martin Cs Wong
- Division of Family Medicine and Primary Health Care, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Aaron Jesuthasan
- Faculty of Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Adrian Baranchuk
- Division of Cardiology, Kingston General Hospital, Queen's University, Kington, ON, Canada
| | - Gary Tse
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).,Division of Cardiology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Bryan P Yan
- Division of Cardiology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong).,Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China (Hong Kong).,Institute of Vascular Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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17
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Crico C, Renzi C, Graf N, Buyx A, Kondylakis H, Koumakis L, Pravettoni G. mHealth and telemedicine apps: in search of a common regulation. Ecancermedicalscience 2018; 12:853. [PMID: 30079115 PMCID: PMC6057658 DOI: 10.3332/ecancer.2018.853] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Indexed: 12/13/2022] Open
Abstract
Developments in information and communication technology have changed the way healthcare processes are experienced by both patients and healthcare professionals: more and more services are now available through computers and mobile devices. Smartphones are becoming useful tools for managing one’s health, and today, there are many available apps meant to increase self-management, empowerment and quality of life. However, there are concerns about the implications of using mHealth and apps: data protection issues, concerns about sharing information online, and the patients’ capacity for discerning effective and valid apps from useless ones. The new General Data Protection Regulation has been introduced in order to give uniformity to data protection regulations among European countries but shared guidelines for mHealth are yet to develop. A unified perspective across Europe would increase the control over mHealth exploitation, making it possible to think of mHealth as effective and standard tools for future medical practice.
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Affiliation(s)
- Chiara Crico
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan 20141, Italy
| | - Chiara Renzi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan 20141, Italy
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg/Saar, Germany
| | - Alena Buyx
- Department of Biomedical Ethics, Institute of Experimental Medicine, University of Kiel, Germany
| | | | | | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan 20141, Italy
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