User-centred design for developing e-Health system for renal patients at home (AppNephro)

HealthCheck: A method for evaluating persuasive mobile health applications

Objectives: This paper introduces HealthCheck, a novel evaluation method for persuasive mobile health applications, aiming to fill the critical gap in quick and effective evaluation tools for this domain. Methods: Following Design Science Research, HealthCheck was developed through problem identification, solution design, implementation, evaluation, and iterative refinement. The implementation involved testing with seven experts to assess its applicability and effectiveness. Results: Feedback from the evaluators indicated that while a few heuristics in HealthCheck were considered irrelevant by some, the majority found the heuristics to be both pertinent and beneficial, especially within the caregiving context. This feedback highlights the practical value of HealthCheck and its potential to offer meaningful insights into improving the usability of persuasive eHealth applications. Conclusion: The study shows HealthCheck effectively evaluates persuasive mobile health applications, offering actionable insights to enhance usability. This validates the relevance and robustness of HealthCheck's heuristics, advancing information systems and human-computer interaction research.

Health Community 4.0: An Innovative Multidisciplinary Solution for Tailored Healthcare Assistance Management

This paper presents a co-designed solution aimed at improving community healthcare assistance management. To enhance patients' self-awareness of their health status, encouraging active participation in care process, and to support nurses in delivering patient-centered care, we have developed an innovative platform with a highly customized app. This platform was designed using a multi-disciplinary, bottom-up approach. Patient data collection and processing facilitate the automation of care timeline planning, based on real-time patients' needs and the available resources. To achieve this goal, different components have been considered: real-time health data collection and processing, patient care planning, decision support for nurses, secure communication for data transmission, and user-friendly interfaces to ensure easy access to platform functionalities.

Technology acceptance of the video game-based swallowing function training system among healthcare providers and dysphagia patients: A qualitative study

Objective

Dysphagia is highly prevalent worldwide, causing serious complications. Video-game based rehabilitation training can increase dysphagia patient motivation and adherence. However, the acceptance of video game systems by patients and healthcare providers is still not fully explored. This study aimed to explore the acceptance of the video game swallowing training system among potential users.

Methods

The in-depth interviews were conducted face-to-face between July and October 2023 at a rehabilitation center in China, with a sample size based on the principle of information saturation. Interviews were audio-recorded and transcribed verbatim, and the data were analyzed using theory-driven thematic analysis methods based on the technology acceptance model.

Results

A total of 19 participants participated in the interviews, which included 11 hospitalized dysphagia patients, three rehabilitation therapists, one doctor, and four nurses. Three themes and seven subthemes were identified. Sufficient training content, interesting interaction between the game and the rehabilitation training, intuitive page design, and efficient training modes were related to the usefulness of the system; user-friendly page design and simple interface could make it easier for participants to use the system. Overall, the availability of the video game system for use without geographical or time limitations led to a high level of participant intention to use the system, but it is still challenging to use it in the real world.

Conclusions

The results of the study showed that participants were generally accepted and willing to use the video game system for dysphagia rehabilitation training. The video game-based swallowing function training system can be helpful in assisting with dysphagia rehabilitation.

Design, Development, and Evaluation of an mHealth App for Reporting of Side Effects During Cytostatic Treatment: Usability Test and Interview Study

BACKGROUND

Using mobile health (mHealth) interventions such as smartphone apps to deliver health services is an opportunity to engage patients more actively in their own treatment. Usability tests allow for the evaluation of a service by testing it out on the relevant users before implementation in clinical practice.

OBJECTIVE

The objective of this study was to design, develop, and evaluate the user interface of an app that would aid patients with cancer in reporting a more comprehensive summary of their side effects.

METHODS

The usability test was conducted by exposing patients with cancer to a prototype of an mHealth app that allowed for reporting of side effects from a chemotherapy regimen. After solving a set of 13 tasks, the test participants completed a system usability scale questionnaire and were interviewed using a semistructured interview guide. The interviews were later transcribed and analyzed.

RESULTS

The 10 test participants had a mean age of 56.5 (SD 7.11) years. The mean total task completion time for the task-solving session was 240.15 (SD 166.78) seconds. The calculated system usability scale score was 92.5. Most participants solved most of the tasks without any major issues. A minority reported having difficulties using apps on smartphones in general. One patient never achieved a meaningful interaction with our app prototype. Most of those who engaged with the app approved of features that calmed them down, made them more empowered, and put them in control. They preferred to report on side effects in a detailed and concise manner. App features that provided specific advice could provoke both fear and rational action.

CONCLUSIONS

The user tests uncovered design flaws that allowed for subsequent refining of an app that has the potential to enhance the safety of patients undergoing home-based chemotherapy. However, a refined version of the app is unlikely to be of value to all patients. Some might not be able to use apps on smartphones in general, or their ability to use apps is impaired because of their disease. This finding should have implications for health care providers' overall design of their follow-up service as the service must allow for all the patients to receive safe treatment whether they can use an mHealth app or not.

Nurses' Roles in mHealth App Development: Scoping Review

BACKGROUND

Although mobile health (mHealth) apps for both health consumers and health care providers are increasingly common, their implementation is frequently unsuccessful when there is a misalignment between the needs of the user and the app's functionality. Nurses are well positioned to help address this challenge. However, nurses' engagement in mHealth app development remains unclear.

OBJECTIVE

This scoping review aims to determine the extent of the evidence of the role of nurses in app development, delineate developmental phases in which nurses are involved, and to characterize the type of mHealth apps nurses are involved in developing.

METHODS

We conducted a scoping review following the 6-stage methodology. We searched 14 databases to identify publications on the role of nurses in mHealth app development and hand searched the reference lists of relevant publications. Two independent researchers performed all screening and data extraction, and a third reviewer resolved any discrepancies. Data were synthesized and grouped by the Software Development Life Cycle phase, and the app functionality was described using the IMS Institute for Healthcare Informatics functionality scoring system.

RESULTS

The screening process resulted in 157 publications being included in our analysis. Nurses were involved in mHealth app development across all stages of the Software Development Life Cycle but most frequently participated in design and prototyping, requirements gathering, and testing. Nurses most often played the role of evaluators, followed by subject matter experts. Nurses infrequently participated in software development or planning, and participation as patient advocates, research experts, or nurse informaticists was rare.

CONCLUSIONS

Although nurses were represented throughout the preimplementation development process, nurses' involvement was concentrated in specific phases and roles.

Development and Evaluation of eHealth Services Regarding Accessibility: Scoping Literature Review

BACKGROUND

Accessibility is acknowledged as a key to inclusion in the Convention of Rights for People with Disabilities. An inaccessible design can result in exclusion from eHealth and cause disability among people who have impairments.

OBJECTIVE

This scoping literature review aimed to investigate how eHealth services have been developed and evaluated regarding accessibility for people with impairments.

METHODS

In line with Arksey and O'Malley's framework for scoping studies and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we conducted a search in 4 databases (PubMed, Scopus, IEEE, and Web of Science) in October 2020 and an update of the search in June 2022. The search strategy was structured according to the PICO model as follows: Population/Problem, digital accessibility for users with impairment; Intervention, health care delivered by any digital solution; Comparison, not applicable; Outcome, use of and adherence to (1) Web Content Accessibility Guidelines (WCAG), (2) other accessibility guidelines, and (3) other means, for designing or evaluating accessibility in eHealth services. A Boolean search was conducted by combining terms related to accessibility and eHealth. All authors participated in screening abstracts according to the eligibility criteria. Each publication, containing a potentially relevant abstract, was read (full text) and assessed for eligibility by 2 authors independently and pairwise. Publications deemed eligible were read by all authors and discussed for consensus.

RESULTS

A total of 8643 publications were identified. After abstract screening, 131 publications remained for full-text reading. Of those, 116 publications were excluded as they did not meet the eligibility criteria. Fifteen publications involving studies of 12 eHealth services were included in the study. Of the 15 publications, 2 provided a definition of accessibility, 5 provided an explanation of accessibility, and 8 did not provide any explanation. Five publications used the WCAG to evaluate accessibility when developing eHealth services. One publication used International Organization for Standardization (ISO) 29138, ISO 2941, and ISO/International Electrotechnical Commission (IEC) 30071-1 standards together with the Spanish Association for Standardization (UNE) 139803 standard. Eleven publications used other means to address accessibility, including text-level grading; literature review about accessibility; user tests, focus groups, interviews, and design workshops with target groups of patients, relatives, and health care professionals; and comparative analysis of existing technical solutions to provide information about useful requirements.

CONCLUSIONS

Although a clear definition of accessibility can enhance operationalization and thus measurability when evaluating accessibility in eHealth services, accessibility was insufficiently defined in most of the included studies. Further, accessibility guidelines and standards were used to a very limited extent in the development and evaluation of eHealth services. Guidelines for developing complex interventions that include guidance for accessibility are motivated to ensure that accessibility will be considered systematically in eHealth services.

Augmented reality-The way forward in patient education for intracranial aneurysms? A qualitative exploration of views, expectations and preferences of patients suffering from an unruptured intracranial aneurysm regarding augmented reality in patient education

Objectives: The goal of this project is to explore the views, expectations and preferences of patients with an unruptured intracranial aneurysm regarding the use of AR in patient education. Methods: To gain an in-depth understanding of the patients' perspective, a face-to-face interview study was conducted using an interview protocol with a predefined topic list. All interviews were audio-recorded and transcribed verbatim afterwards. Transcripts were analyzed using thematic content analyses. Coding was performed using Atlas.ti software. Results: Seventeen interviews were conducted. The views, expectations and preferences of patients regarding patient education with AR could be subdivided into 15 categories, which could be grouped into 4 general themes: 1) experiences with current patient education, 2) expectations of AR in patient education, 3) opportunities and limitations of AR, and 4) out-of-hospital use of an AR application. Patients' expectations were predominantly positive regarding improving patients' understanding of their medical situation and doctor-patient communication. Discusssion: This study suggests that patients with unruptured intracranial aneurysms are open to receive patient education regarding their disease with AR. Patients expect that AR models can help patients with intra-cranial aneurysms better understand their disease, treatment options and risks. Additionally, patients expect AR could improve doctor-patient communication.

Smart product-service systems in the healthcare industry: Intelligent connected products and stakeholder communication drive digital health service adoption

Smart product-service systems (PSSs) have emerged as a solution for the ongoing digitalization of products and services, especially during the COVID-19 pandemic and under social distancing. However, the conditions for smart PSS adoption remain unclear, requiring the identification of driving attributes and the interrelationships of the attributes for smart PSS implementation in the healthcare industry. This study contributes by determining the cause-effect interrelationship among smart PSS attributes and by identifying and prioritizing the criteria that drive smart PSS adoption in chronic disease management. The study constructed a five-aspect theoretical model to deepen the understanding of digital health service adoption drivers. Data were collected from 233 healthcare industry practitioners to validate the smart PSS adoption attributes. Exploratory factor analysis (EFA) determined the structure of the attributes, the reliability of the criteria, and the validity of the aspects. The EFA result suggested 24 valid and reliable criteria drivers of smart PSS adoption in the healthcare industry, and they were grouped into five aspects. Following the smart PSS literature and stakeholder theory, the aspects are named digital health service adoption, intelligent connected products, stakeholder communication, environmental benefits, and use schemes. In addition, 17 practitioners treating patients with chronic conditions were interviewed to understand the interrelationships among the aspects and criteria. The fuzzy decision-making trial and evaluation laboratory (FDEMATEL) determined the cause-effect interrelationships based on their dependence and driving power. The FDEMATEL results indicated that intelligent connected products and stakeholder communication are the causal and focal attributes of improving digital health service adoption and providing alternative use schemes. For patients and physicians, the driving criteria include managing data, multifunctionality, data reliability, interoperability, patient communication, and resource efficiency. The theoretical and managerial implications are discussed.

Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review

BACKGROUND

Home health monitoring shows promise in improving health outcomes; however, navigating the literature remains challenging given the breadth of evidence. There is a need to summarize the effectiveness of monitoring across health domains and identify gaps in the literature. In addition, ethical and user-centered frameworks are important to maximize the acceptability of health monitoring technologies.

OBJECTIVE

This review aimed to summarize the clinical evidence on home-based health monitoring through a scoping review and outline ethical and user concerns and discuss the challenges of the current user-oriented conceptual frameworks.

METHODS

A total of 2 literature reviews were conducted. We conducted a scoping review of systematic reviews in Scopus, MEDLINE, Embase, and CINAHL in July 2021. We included reviews examining the effectiveness of home-based health monitoring in older adults. The exclusion criteria included reviews with no clinical outcomes and lack of monitoring interventions (mobile health, telephone, video interventions, virtual reality, and robots). We conducted a quality assessment using the Assessment of Multiple Systematic Reviews (AMSTAR-2). We organized the outcomes by disease and summarized the type of outcomes as positive, inconclusive, or negative. Second, we conducted a literature review including both systematic reviews and original articles to identify ethical concerns and user-centered frameworks for smart home technology. The search was halted after saturation of the basic themes presented.

RESULTS

The scoping review found 822 systematic reviews, of which 94 (11%) were included and of those, 23 (24%) were of medium or high quality. Of these 23 studies, monitoring for heart failure or chronic obstructive pulmonary disease reduced exacerbations (4/7, 57%) and hospitalizations (5/6, 83%); improved hemoglobin A1c (1/2, 50%); improved safety for older adults at home and detected changing cognitive status (2/3, 66%) reviews; and improved physical activity, motor control in stroke, and pain in arthritis in (3/3, 100%) rehabilitation studies. The second literature review on ethics and user-centered frameworks found 19 papers focused on ethical concerns, with privacy (12/19, 63%), autonomy (12/19, 63%), and control (10/19, 53%) being the most common. An additional 7 user-centered frameworks were studied.

CONCLUSIONS

Home health monitoring can improve health outcomes in heart failure, chronic obstructive pulmonary disease, and diabetes and increase physical activity, although review quality and consistency were limited. Long-term generalized monitoring has the least amount of evidence and requires further study. The concept of trade-offs between technology usefulness and acceptability is critical to consider, as older adults have a hierarchy of concerns. Implementing user-oriented frameworks can allow long-term and larger studies to be conducted to improve the evidence base for monitoring and increase the receptiveness of clinicians, policy makers, and end users.

Meaningful patient and public involvement in digital health innovation, implementation and evaluation: A systematic review

Introduction

The importance of meaningfully involving patients and the public in digital health innovation is widely acknowledged, but often poorly understood. This review, therefore, sought to explore how patients and the public are involved in digital health innovation and to identify factors that support and inhibit meaningful patient and public involvement (PPI) in digital health innovation, implementation and evaluation.

Methods

Searches were undertaken from 2010 to July 2020 in the electronic databases MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus and ACM Digital Library. Grey literature searches were also undertaken using the Patient Experience Library database and Google Scholar.

Results

Of the 10,540 articles identified, 433 were included. The majority of included articles were published in the United States, United Kingdom, Canada and Australia, with representation from 42 countries highlighting the international relevance of PPI in digital health. 112 topic areas where PPI had reportedly taken place were identified. Areas most often described included cancer (n = 50), mental health (n = 43), diabetes (n = 26) and long‐term conditions (n = 19). Interestingly, over 133 terms were used to describe PPI; few were explicitly defined. Patients were often most involved in the final, passive stages of an innovation journey, for example, usability testing, where the ability to proactively influence change was severely limited. Common barriers to achieving meaningful PPI included data privacy and security concerns, not involving patients early enough and lack of trust. Suggested enablers were often designed to counteract such challenges.

Conclusions

PPI is largely viewed as valuable and essential in digital health innovation, but rarely practised. Several barriers exist for both innovators and patients, which currently limits the quality, frequency and duration of PPI in digital health innovation, although improvements have been made in the past decade. Some reported barriers and enablers such as the importance of data privacy and security appear to be unique to PPI in digital innovation. Greater efforts should be made to support innovators and patients to become meaningfully involved in digital health innovations from the outset, given its reported benefits and impacts. Stakeholder consensus on the principles that underpin meaningful PPI in digital health innovation would be helpful in providing evidence‐based guidance on how to achieve this.

Patient or Public Contribution

This review has received extensive patient and public contributions with a representative from the Patient Experience Library involved throughout the review's conception, from design (including suggested revisions to the search strategy) through to article production and dissemination. Other areas of patient and public contributor involvement include contributing to the inductive thematic analysis process, refining the thematic framework and finalizing theme wording, helping to ensure relevance, value and meaning from a patient perspective. Findings from this review have also been presented to a variety of stakeholders including patients, patient advocates and clinicians through a series of focus groups and webinars. Given their extensive involvement, the representative from the Patient Experience Library is rightly included as an author of this review.

Enhancing System Acceptance through User-Centred Design: Integrating Patient Generated Wellness Data

Gestational diabetes mellitus (GDM) is a condition that appears during pregnancy and is expected to be a temporary one. While patients are encouraged to manage it themselves, research findings indicate that GDM may negatively affect the foetus; in addition, there is an increased risk of women with GDM subsequently developing Type 2 diabetes. To alleviate the risks, women with GDM are advised to maintain a record of their diet and blood glucose levels and to attend regular clinical reviews. Rather than using a paper diary, women with GDM can maintain a record of their blood glucose level readings and other relevant data using a wellness mobile application (app). However, such apps are developed for general use and may not meet the specific needs of clinical staff (physicians, dietitians, obstetricians and midwives) involved in managing GDM; for example, an app may record glucose readings but not the details of a meal taken before or after the glucose reading. Second, the apps do not permanently store the data generated by the patient and do not support the transfer of these data to a clinical system or information portal. The mobile health (mHealth) system designed and developed in this research allows one to integrate different types of user generated wellness data into a centralised database. A user-centered design (UCD) approach informed by the technology acceptance model (TAM) was adopted. This paper investigates and evaluates the effectiveness of the approach with regard to facilitating system acceptance and future adoption through an early focus on enhancing system usefulness and ease of use. The functional system requirements of the proposed system were refined through a series of interviews with the perspective of clinical users; ease-of-use and usability issues were resolved through 'think aloud' sessions with clinicians and GDM patients.

Formative Usability of the Kidneytime Online Live Donor Kidney Transplant Education Tool Among Transplant Candidates

BACKGROUND

Web-based education may be a powerful tool to support transplant candidates' learning and communication about live donor kidney transplantation. Few educational interventions are web-based and have education sharing for living donor transplant as a primary goal.

METHODS

Through user-centered design and iterative usability testing, we developed a web platform, called KidneyTIME, to support an educational intervention for adult transplant candidates. KidneyTIME delivers animated videos to improve candidate knowledge, motivation, and self-efficacy to pursue living donor transplantation and to promote outreach through video sharing. The animated-video educational content was previously produced by the researchers. We conducted a formative usability evaluation of the KidneyTIME web platform to enable users to find, view, and share the previously produced videos. A total of 30 kidney transplant candidates were involved in 4 rounds of testing at one transplant center, with amendments made after each round.

RESULTS

Transplant candidates were predominantly White non-Hispanic; 47% had incomes <$30 000 and >43% had vision or motor impairment. Readability, navigation, and failure to find videos were the main usability issues identified. Substantial improvements were found in the usability of most functions after implementing certain features, such as enlarging text and buttons, enhancing contrast, and simplifying presentation. Participants reported that the intervention was user friendly and easy to navigate.

CONCLUSION

Considering feedback from a wide spectrum of users has improved the usability of KidneyTIME. A salient concern for End stage kidney disease populations is ensuring online accessibility despite vision and motor impairments.

Edge Devices for Internet of Medical Things: Technologies, Techniques, and Implementation

The health sector is currently experiencing a significant paradigm shift. The growing number of elderly people in several countries along with the need to reduce the healthcare cost result in a big need for intelligent devices that can monitor and diagnose the well-being of individuals in their daily life and provide necessary alarms. In this context, wearable computing technologies are gaining importance as edge devices for the Internet of Medical Things. Their enabling technologies are mainly related to biological sensors, computation in low-power processors, and communication technologies. Recently, energy harvesting techniques and circuits have been proposed to extend the operating time of wearable devices and to improve usability aspects. This survey paper aims at providing an overview of technologies, techniques, and algorithms for wearable devices in the context of the Internet of Medical Things. It also surveys the various transformation techniques used to implement those algorithms using fog computing and IoT devices.

Barriers and facilitators to the use of e-health by older adults: a scoping review

Background

Limited attention has been paid to how and why older adults choose to engage with technology-facilitated health care (e-health), and the factors that impact on this. This scoping review sought to address this gap.

Methods

Databases were searched for papers reporting on the use of e-health services by older adults, defined as being aged 60 years or older, with specific reference to barriers and facilitators to e-health use.

Result

14 papers were included and synthesised into five thematic categories and related subthemes. Results are discussed with reference to the Unified Theory of Acceptance and Use of Technology2. The most prevalent barriers to e-health engagement were a lack of self-efficacy, knowledge, support, functionality, and information provision about the benefits of e-health for older adults. Key facilitators were active engagement of the target end users in the design and delivery of e-health programs, support for overcoming concerns privacy and enhancing self-efficacy in the use of technology, and integration of e-health programs across health services to accommodate the multi-morbidity with which older adults typically present.

Conclusion

E-health offers a potential solution to overcome the barriers faced by older adults to access timely, effective, and acceptable health care for physical and mental health. However, unless the barriers and facilitators identified in this review are addressed, this potential will not be realised.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11623-w.

Pharmaceutical mobile application for visually-impaired people in Thailand: development and implementation

BACKGROUND

Most mobile pharmaceutical applications produced for people with visual disabilities in Thailand fail to meet the required standard due to poor-quality regulations, defective design, lack of user support and impracticality; as a result, visually-impaired people are unable to use them. This research is motivated by the limited use of this technology in primary medical services and its aim is to enable people with disabilities to access effective digital health information. The research objective is to analyse, design and develop a mobile pharmaceutical application with functions that are appropriate for visually-impaired users, and test its usability.

RESULTS

Based on the design and development of the application, it contained five necessary functions. When testing the usability and users' satisfaction, it was found that the input or fill of information in the application was of low usability. According to the test results, the medicinal database function was missing 71 times and the voice command function was missing 34 times. Based on users' satisfaction results, users who had the highest level of usage gave higher average scores to users' attitude, users' confidence, user interface and system performance than those with lower levels of usage. The scores of both groups were found to be the same when discussing the implementation of the development.

CONCLUSIONS

This mobile application, which was developed based on the use of smart technology, will play an important role in supporting visually-impaired people in Thailand by enhancing the efficacy of self-care. The design and development of the application will ensure the suitability of many functions for visually-impaired users. However, despite the high functional capacity of the application, the gap in healthcare services between the general public and disabled groups will still exist if users have inadequate IT skills.

Evaluating health service outcomes of public involvement in health service design in high-income countries: a systematic review

BACKGROUND

Internationally, it is expected that health services will involve the public in health service design. Evaluation of public involvement has typically focused on the process and experiences for participants. Less is known about outcomes for health services. The aim of this systematic review was to a) identify and synthesise what is known about health service outcomes of public involvement and b) document how outcomes were evaluated.

METHODS

Searches were undertaken in MEDLINE, EMBASE, The Cochrane Library, PsycINFO, Web of Science, and CINAHL for studies that reported health service outcomes from public involvement in health service design. The review was limited to high-income countries and studies in English. Study quality was assessed using the Mixed Methods Appraisal Tool and critical appraisal guidelines for assessing the quality and impact of user involvement in health research. Content analysis was used to determine the outcomes of public involvement in health service design and how outcomes were evaluated.

RESULTS

A total of 93 articles were included. The majority were published in the last 5 years, were qualitative, and were located in the United Kingdom. A range of health service outcomes (discrete products, improvements to health services and system/policy level changes) were reported at various levels (service level, across services, and across organisations). However, evaluations of outcomes were reported in less than half of studies. In studies where outcomes were evaluated, a range of methods were used; most frequent were mixed methods. The quality of study design and reporting was inconsistent.

CONCLUSION

When reporting public involvement in health service design authors outline a range of outcomes for health services, but it is challenging to determine the extent of outcomes due to inadequate descriptions of study design and poor reporting. There is an urgent need for evaluations, including longitudinal study designs and cost-benefit analyses, to fully understand outcomes from public involvement in health service design.

Interdisciplinary collaboration between nursing and engineering in health care: A scoping review

BACKGROUND

Due to the rapid advancements in precision medicine and artificial intelligence, interdisciplinary collaborations between nursing and engineering have emerged. Although engineering is vital in solving complex nursing problems and advancing healthcare, the collaboration between the two fields has not been fully elucidated.

OBJECTIVES

To identify the study areas of interdisciplinary collaboration between nursing and engineering in health care, particularly focusing on the role of nurses in the collaboration.

METHODS

In this study, a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews was performed. A comprehensive search for published literature was conducted using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, ScienceDirect, Institute of Electrical and Electronics Engineers Digital Library, and Association for Computing Machinery Digital Library from inception to November 22, 2020. Data screening and extraction were performed independently by two reviewers. Any discrepancies in results were resolved through discussions or in consultation with a third reviewer. Data were analyzed by descriptive statistics and content analysis. Results were visualized in an interdisciplinary collaboration model.

RESULTS

We identified 6,752 studies through the literature search, and 60 studies met the inclusion criteria. The study areas of interdisciplinary collaboration concentrated on patient safety (n = 18), symptom monitoring and health management (n = 18), information system and nursing human resource management (n = 16), health education (n = 5), and nurse-patient communication (n = 3). The roles of nurses in the interdisciplinary collaboration were divided into four themes: requirement analyst (n = 21), designer (n = 22), tester(n = 37) and evaluator (n = 49). Based on these results, an interdisciplinary collaboration model was constructed.

CONCLUSIONS

Interdisciplinary collaborations between nursing and engineering promote nursing innovation and practice. However, these collaborations are still emerging and in the early stages. In the future, nurses should be more involved in the early stages of solving healthcare problems, particularly in the requirement analysis and designing phases. Furthermore, there is an urgent need to develop interprofessional education, strengthen nursing connections with the healthcare engineering industry, and provide more platforms and resources to bring nursing and engineering disciplines together.

Evaluation of two mobile health apps for patients with breast cancer using the Mobile Application Rating Scale

BACKGROUND

Breast cancer is one of the most frequently diagnosed cancers worldwide. Screening, education about signs and symptoms, and improved access to treatment has helped reduce mortality. An understanding of the informational needs of women with breast cancer can help identify areas where mobile apps can further improve the experience of this patient group.

METHODS

Personas are a commonly used tools in user centred design to help represent particular user archetypes. Knowledge of existing informational needs and prior research using personas in breast cancer app design were used to create two different personas through which to source apps for evaluation. The Mobile Application Rating Scale, a common evaluation framework, was used to evaluate the mobile apps across several important domains.

RESULTS

Becca and OWise, two apps for breast cancer, were found through a discovery process in line with the personas described. Overall, both apps scored highly on the Mobile Application Rating Scale. Both apps had limited or no research to support their use in this patient group, and had issues related to data privacy. Becca scored particularly highly in domains related to accessibility while OWise's extensive range of features scored highly for functionality.

CONCLUSIONS

Both apps demonstrate the ability to fill an informational needs gap as evidenced in the existing literature. As with many mobile health apps, more clinical evidence and improved data handling would help support the widespread recommendation of their use in women who are undergoing or have completed treatment for breast cancer.

Influential Factors of Knowledge Sharing of Multinational E-Health Service Based on 24HrKF

In order to solve the problem of cross-time and cross-regional medical collaboration and distributed knowledge sharing across patients and medical teams for 24 hours a day in the context of global resource allocation, a new 24HrKF e-health service model is proposed and a key knowledge model of 24HrKF e-health team knowledge sharing is established based on existing research results combined with 24HrKF distributed team characteristics. Finally, the questionnaire data of 338 multinational medical team members are used to verify the impact of key factors on the knowledge sharing of medical teams. The results shows that factors such as information and communication technology, the hospital's cultural characteristics, cross-cultural communication, medical knowledge and skills, and trust all have a significantly positive impact on knowledge sharing among team members especially information and communication technology and medical knowledge and skills. However, the degree of time-span separation across time zones has no significant effect on the knowledge sharing among team members.

Considerations on equity in management of end-stage kidney disease in low- and middle-income countries

Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research.

Haptic Hybrid Prototyping (HHP): An AR Application for Texture Evaluation with Semantic Content in Product Design

The manufacture of prototypes is costly in economic and temporal terms and in order to carry this out it is necessary to accept certain deviations with respect to the final finishes. This article proposes haptic hybrid prototyping, a haptic-visual product prototyping method created to help product design teams evaluate and select semantic information conveyed between product and user through texturing and ribs of a product in early stages of conceptualization. For the evaluation of this tool, an experiment was realized in which the haptic experience was compared during the interaction with final products and through the HHP. As a result, it was observed that the answers of the interviewees coincided in both situations in 81% of the cases. It was concluded that the HHP enables us to know the semantic information transmitted through haptic-visual means between product and user as well as being able to quantify the clarity with which this information is transmitted. Therefore, this new tool makes it possible to reduce the manufacturing lead time of prototypes as well as the conceptualization phase of the product, providing information on the future success of the product in the market and its economic return.

Effectiveness of health web-based and mobile app-based interventions designed to improve informal caregiver's well-being and quality of life: A systematic review

BACKGROUND

Internet-based interventions can help empower caregivers of people with chronic diseases and can develop solutions to decrease the physical and psychological consequences resulting from caregiving.

OBJECTIVE

Analysing the effectiveness of health web-based and/or mobile app-based interventions with regard to the level of well-being and quality of life of informal caregivers in charge of people with chronic diseases.

MATERIALS AND METHODS

Systematic review of the following databases: Pubmed, Apa PsycINFO, ProQuest Health & Medical Complete and Scopus. Quality standards established by PRISMA and Joanna Briggs Institute Systematic Review Approach have been followed. The two phases of the selection process were carried out independently and a cross-case comparative analysis by three reviewers.

RESULTS

A total of 17 studies met inclusion criteria. The analysis shows that almost all studies involved web-based interventions with the exception of one which concerned a mobile app-based intervention. Most of them prove their effectiveness in the overall well-being of the caregiver and more specifically in the mental dimension, highlighting a decrease in caregivers' anxiety and/or distress, depression symptoms and sense of competence.

CONCLUSIONS

The findings support that web-based interventions have an impact mainly on caregivers' well-being. Nevertheless, other dimensions that are necessary for caregiving, such as physical, mental and social dimension, have been scarcely explored. More studies on mobile app-based interventions are needed to know their effectiveness.

Design and evaluation of a mobile application for monitoring patients with Alzheimer's disease: A day center case study

BACKGROUND AND OBJECTIVE

This paper presents Alzheed, a mobile application for monitoring patients with Alzheimer's disease at day centers as well as a set of design recommendations for the development of healthcare mobile applications. The Alzheed project was conducted at Day Center "Dorita de Ojeda" that is focused on the care of patients with Alzheimer's disease.

MATERIALS AND METHODS

A software design methodology based on participatory design was employed for the design of Alzheed. This methodology is both iterative and incremental and consists of two main iterative stages: evaluation of low-fidelity prototypes and evaluation of high-fidelity prototypes. Low-fidelity prototypes were evaluated by 11 day center's healthcare professionals (involved in the design of Alzheed), whereas high-fidelity prototypes were evaluated using a questionnaire based on the technology acceptance model (TAM) by the same healthcare professionals plus 30 senior psychology undergraduate students uninvolved in the design of Alzheed.

RESULTS

Healthcare professional participants perceived Alzheed as extremely likely to be useful and extremely likely to be usable, whereas senior psychology undergraduate students perceived Alzheed as quite likely to be useful and quite likely to be usable. Particularly, the median and mode of the TAM questionnaire were 7 (extremely likely) for healthcare professionals and 6 (quite likely) for psychology students (for both constructs: perceived usefulness and perceived ease of use). One-sample Wilcoxon signed-rank tests were performed to confirm the significance of the median for each construct.

CONCLUSIONS

From the experience of designing Alzheed, it can be concluded that co-designing with healthcare professionals leads to (i) fostering group endorsement, which prevents resistance to change and (ii) helps to meet the needs of both healthcare professionals and patients, guaranteeing the usefulness of the application. In addition, evaluation of mobile healthcare applications by users involved and uninvolved in the application's design process helps to improve the ease of use of the application.