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Qiu YF, Hu JS, Wu M, Liu JL, Li CY, Yu YQ, Zeng LJ, Yang F, Zheng L. The effects of tele-based interventions for depression and anxiety symptoms in patients with Chronic Obstructive Pulmonary Disease (COPD): A systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 91:143-150. [PMID: 39481315 DOI: 10.1016/j.genhosppsych.2024.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 10/11/2024] [Accepted: 10/21/2024] [Indexed: 11/02/2024]
Abstract
BACKGROUND Depression and anxiety are common psychiatric symptoms in patients with Chronic Obstructive Pulmonary Disease (COPD). While face-to-face psychotherapy is a common option, tele-based interventions provide a more accessible alternative. However, a comprehensive synthesis of evidence from clinical trials for COPD patients has yet to be conducted. OBJECTIVE This study aims to evaluate the effects of tele-based interventions in reducing depressive and anxiety symptoms in patients with COPD. METHODS A systematic search of PubMed, EMBASE, the Cochrane Library, Web of Science, PsycINFO, and MEDLINE databases was conducted from inception to May 5, 2024. Eligible studies included Randomized Controlled Trials (RCTs) of people with COPD patients receiving tele-based interventions reporting on the outcomes of depression or anxiety. Data extraction and quality assessment were performed independently by two researchers. The quality of the included studies was assessed using the Cochrane risk-of-bias tool. Meta-analysis was performed using RevMan (version 5.4) and Stata (version 18.0) software. RESULTS Following the search, 9 RCTs with a total of 2064 patients with COPD were included. The meta-analysis revealed that tele-based interventions reduced depressive symptoms in patients with COPD (Standardized Mean Difference [SMD] = -0.15, 95 % CI -0.24 to -0.06; P = 0.001). The subgroup analysis indicated that the PHQ-9 (SMD = -0.24, 95 % CI -0.37 to -0.10; P = 0.001) was better at detecting changes in depressive symptoms compared to other scales; the first 3 months of intervention (SMD = -0.36, 95 % CI -0.52 to -0.19; P < 0.001) was the most pronounced improvement; and telehealth interventions were more effective (SMD = -0.30, 95 % CI -0.46 to -0.15; P < 0.001) than telemonitoring interventions. Tele-based interventions also reduced anxiety symptoms in patients with COPD (SMD = -0.12, 95 % CI -0.22 to -0.02; P = 0.02). CONCLUSIONS The evidence supports the efficacy of tele-based interventions in alleviating depression and anxiety symptoms in COPD patients. However, further large-scale and rigorously designed studies are warranted to strengthen the evidence.
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Affiliation(s)
- Yu-Fei Qiu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Ji-Sheng Hu
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical college, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - Man Wu
- Department of Gastroenterology, The Third People' s Hospital of Chengdu, Chengdu 610014, China
| | - Jia-Li Liu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Chao-Yang Li
- Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Yi-Qing Yu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Li-Juan Zeng
- School of Nursing, Hubei University of Chinese Medicine, Wuhan 430065, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan 430065, China; Hubei Shizhen Laboratory, Wuhan 430065, China.
| | - Lan Zheng
- Hubei Shizhen Laboratory, Wuhan 430065, China; Department of Internal Medicine, the First School of Clinical Medicine, Hubei University of Chinese Medicine, Wuhan 430060, China; Section of Respiratory Medicine, Department of Internal Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, China.
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Peng W, Zhu G, Chen Z, Hou T, Luo Y, Huang L, Qiao J, Li Y. Digital Technology Use in US Community-Dwelling Seniors With and Without Homebound Status. J Am Med Dir Assoc 2024; 25:105284. [PMID: 39322186 DOI: 10.1016/j.jamda.2024.105284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVES To examine (1) the prevalence of digital technology use, including information and communication technology devices, everyday technology use, and digital health technology use among community-dwelling older adults with or without homebound status and (2) the associations of digital technology use with homebound status. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS We used the 2022 National Health and Aging Trends Study (NHATS) data that included 5510 community-dwelling older adults. METHODS Digital technology use was assessed using self-reported outcomes of the technological environment component of the NHATS, including information and communication technology devices, everyday technology use, and digital health technology use. Homebound status was measured with 4 mobility-related questions regarding the frequency, independence, and difficulties of leaving home. Survey-weighted, binomial logistic regression was used to examine the associations of 17 technological-related outcomes and homebound status. RESULTS Overall, the prevalence of homebound older adults was 5.2% (95% CI, 4.4%-6.1%), representing an estimated 2,516,403 people. The prevalence of digital technology use outcomes varied according to homebound status. The prevalence of any technology used in homebound, semi-homebound, and non-homebound populations was 88.5%, 93.3%, and 98.5%, respectively. Compared with non-homebound older adults, semi-homebound older adults had lower odds of emailing (OR, 0.71; 95% CI, 0.53-0.94), using the internet for any other reason (OR, 0.70; 95% CI, 0.49-0.99), visiting medical providers (OR, 0.68; 95% CI, 0.48-0.95), and handling insurance (OR, 0.75; 95% CI, 0.56-0.99); homebound older adults had lower odds of using a phone (OR, 0.41; 95% CI, 0.28-0.59), using any everyday technology (OR, 0.58; 95% CI, 0.38-0.89), visiting medical providers (OR, 0.52; 95% CI, 0.35-0.76), and handling insurance (OR, 0.57; 95% CI, 0.38-0.86). CONCLUSIONS AND IMPLICATIONS Non-homebound older adults are more likely to use digital technology than those who are semi-homebound or homebound. Public health care providers should prioritize efforts to enhance digital inclusion to ensure that all older adults can benefit from the advantages of digital technology.
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Affiliation(s)
- Wenting Peng
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China; de Tornyay Center for Healthy Aging, School of Nursing, University of Washington-Seattle, Seattle, WA, USA; School of Nursing, University of Washington-Seattle, Seattle, WA, USA
| | - Gangjiao Zhu
- School of Public Health, Wuhan University, Wuhan, China
| | - Zengyu Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China; School of Nursing, University of Washington-Seattle, Seattle, WA, USA
| | - Tianxue Hou
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yuqian Luo
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Lihua Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China; Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jianfeng Qiao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China; Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China.
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
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Franklin ME, Engelmann JM, Bulkes NZ, Horvath G, Piacsek K, Osterlund E, Freeman J, Schwartz RA, Himle MB, Riemann BC. Intensive Cognitive-Behavioral Therapy Telehealth for Pediatric Obsessive-Compulsive Disorder During the COVID-19 Pandemic: Comparison With a Matched Sample Treated in Person. JAACAP OPEN 2024; 2:26-35. [PMID: 39554698 PMCID: PMC11562416 DOI: 10.1016/j.jaacop.2023.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 11/19/2024]
Abstract
Objective This naturalistic, nonblinded, nonrandomized study examined the efficacy of multimodal treatment including intensive cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) delivered via telehealth (TH) compared with a matched sample of youth treated in person (IP). Method Patients included 1,286 youth ages 7 to 17 inclusive (643 TH, 643 IP) who received TH or IP in either partial hospitalization (n = 818) or intensive outpatient (n = 468) programs. Changes in patient-rated OCD symptoms and quality of life from pretreatment to posttreatment were examined. Results TH patients were discharged with a statistically higher Children's Yale-Brown Obsessive-Compulsive Scale Self-Report score than IP patients, although this group difference (1.4) was not clinically significant. Quality-of-life scores at discharge did not significantly differ between TH patients and IP patients. Treatment response was robust attesting to the broad applicability of the treatment model. Conclusion Youth receiving CBT via TH responded both well and comparably to youth treated IP, offering a viable access path forward. These findings extend the reach of CBT for pediatric OCD. Concerted efforts must now be made to improve CBT availability for families for whom financial, insurance, geographical, and other barriers preclude access at present. Diversity & Inclusion Statement We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.
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Affiliation(s)
- Martin E. Franklin
- Rogers Behavioral Health, Oconomowoc, Wisconsin
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | | | - Nyssa Z. Bulkes
- Molson-Coors Beverage Company, Chicago, Illinois
- Rogers Behavioral Health, Oconomowoc, Wisconsin
| | - Gregor Horvath
- University of Michigan, Ann Arbor, Michigan
- Rogers Behavioral Health, Oconomowoc, Wisconsin
| | | | | | - Jennifer Freeman
- Alpert Medical School at Brown University, Providence, Rhode Island
| | - Rachel A. Schwartz
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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Wu M, Li C, Hu T, Zhao X, Qiao G, Gao X, Zhu X, Yang F. Effectiveness of Telecare Interventions on Depression Symptoms Among Older Adults: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2024; 12:e50787. [PMID: 38231546 PMCID: PMC10831591 DOI: 10.2196/50787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/01/2023] [Accepted: 12/22/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Depression is the most common psychiatric disorder among older adults. Despite the effectiveness of pharmacological and psychological therapies, many patients with late-life depression (LLD) are unable to access timely treatment. Telecare has been shown to be effective in addressing patients' psychosocial issues, while its effectiveness in serving patients with LLD remains unclear. OBJECTIVE This study aimed to evaluate the effectiveness of telecare in reducing depression and anxiety symptoms and improving quality of life (QoL) in patients with LLD. METHODS Databases including the Cochrane Library, Web of Science, PubMed, Embase, and EBSCO were searched for randomized controlled trials (RCTs) evaluating the effectiveness of telecare for LLD from database establishment to December 28, 2022. RESULTS A total of 12 RCTs involving 1663 participants were identified in this study. The meta-analysis showed that (1) telecare significantly reduced depressive symptoms in patients with LLD compared to those in usual care (UC; standardized mean difference [SMD]=-0.46, 95% CI -0.53 to -0.38; P<.001), with the best improvement observed within 3 months of intervention (SMD=-0.72, 95% CI -1.16 to -0.28; P<.001); (2) other scales appeared more effective than the Patient Health Questionnaire-9 for LLD in telecare interventions (SMD=-0.65, 95% CI -0.96 to -0.35; P<.001); (3) telecare was more effective than telephone-based interventions for remote monitoring of LLD (SMD=-1.13, 95% CI -1.51 to -0.76; P<.001); (4) the reduction of depressive symptoms was more pronounced in patients with LLD with chronic conditions (SMD=-0.67, 95% CI -0.89 to -0.44; P<.001); (5) telecare was more effective for LLD in Europe and the Americas than in other regions (SMD=-0.73, 95% CI -0.99 to -0.47; P<.001); (6) telecare significantly reduced anxiety symptoms in patients with LLD (SMD=-0.53, 95% CI -0.73 to -0.33; P=.02); and (7) there was no significant improvement in the psychological components of QoL in patients with LLD compared to those receiving UC (SMD=0.30, 95% CI 0.18-0.43; P=.80). CONCLUSIONS Telecare is a promising modality of care for treatment, which can alleviate depression and anxiety symptoms in patients with LLD. Continued in-depth research into the effectiveness of telecare in treating depression could better identify where older patients would benefit from this intervention.
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Affiliation(s)
- Man Wu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Chaoyang Li
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ting Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xueyang Zhao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Guiyuan Qiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xiaolian Gao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinhong Zhu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Hubei Shizhen Laboratory, Wuhan, China
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Peng R, Li X, Guo Y, Ning H, Huang J, Jiang D, Feng H, Liu Q. Barriers and facilitators to acceptance and implementation of eMental-health intervention among older adults: A qualitative systematic review. Digit Health 2024; 10:20552076241234628. [PMID: 38444518 PMCID: PMC10913496 DOI: 10.1177/20552076241234628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
Objective Electronic mental health interventions are effective but not well promoted currently among older adults. This study sought to systematically review and summarize the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults. Methods We comprehensively retrieved six electronic databases from January 2012 to September 2022: PubMed, Web of Science, Embase, Scopus, PsycINFO, and CINAHL. The JBI-QARI was used to assess the quality of the research methodology of each publication. Eligible studies underwent data coding and synthesis aligned to inductive and deductive methods. The Consolidated Framework for Implementation Research 2.0 was used as a deductive framework to guide a more structured analysis. Results The systematic review screened 4309 articles, 17 of which were included (eight with mixed methods and nine with qualitative methods). We identified and extracted the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults: (1) innovation: technology challenges, optimized functions, and contents, security and privacy; (2) outer setting: community engagement and partnerships, financing; (3) inner setting: leadership engagement, available resources, incompatibility, intergenerational support, training and guidance; (4) individuals: perceptions, capability, motivation of older adults and healthcare providers; and (5) implementation process: recruit, external assistance, and team. Conclusion These findings are critical to optimizing, promoting, and expanding electronic mental health interventions among older adults. The systematic review also provides a reference for better evidence-based implementation strategies in the future.
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Affiliation(s)
- Ruotong Peng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yongzhen Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jundan Huang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Dian Jiang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Oceanwide Health Management Institute, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Korkmaz Yaylagul N, Kirisik H, Bernardo J, Dantas C, van Staalduinen W, Illario M, De Luca V, Apóstolo J, Silva R. Trends in Telecare Use among Community-Dwelling Older Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416672. [PMID: 36554553 PMCID: PMC9779196 DOI: 10.3390/ijerph192416672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 06/08/2023]
Abstract
A scoping review was conducted to map and analyze the concept of telecare services and the trends in telecare use. This scoping review was conducted according to Arksey and O'Malley's framework. A search was conducted in CINAHL (via EBSCO), ERIC, Academic Search Ultimate, and MEDLINE/PubMed databases. This scoping review considered quantitative (e.g., analytical observational studies, including prospective and retrospective cohort studies, case-control, analytical cross-sectional, and descriptive-observational studies), qualitative (e.g., phenomenology, grounded theory, ethnography, and action research), and mixed-method primary studies. Forty research articles published from 1 January 2012, to 1 January 2022 were included in this review, these studies met the eligibility criteria as all were focused on telecare and targeting older adults over 65 living at home. The reviewers coded the data in an Excel spreadsheet, including the articles' title, year, author, journal information and subject, research methods, sample size, location, and summary. Then, the researchers analyzed the conceptual definitions, measurement techniques, and findings in detail and the findings were grouped into categories. The trends around the concept of telecare are independent living, remote care, aging in place, and safety. Telecare research focuses mainly on service use, chronic illness, ethics, and cost-effectiveness. Technology acceptance among older individuals is a critical factor for telecare use. The results found in the literature about the cost-effectiveness of telecare are inconsistent.
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Affiliation(s)
- Nilufer Korkmaz Yaylagul
- Department of Gerontology, Faculty of Health Sciences, University of Akdeniz, Antalya 07070, Turkey
| | - Hande Kirisik
- Elderly Care Program, Vocational School of Haymana, University of Ankara, Ankara 06860, Turkey
| | - Joana Bernardo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
| | | | | | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - João Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3000-232 Coimbra, Portugal
| | - Rosa Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3000-232 Coimbra, Portugal
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Wang T, Wang W, Liang J, Nuo M, Wen Q, Wei W, Han H, Lei J. Identifying major impact factors affecting the continuance intention of mHealth: a systematic review and multi-subgroup meta-analysis. NPJ Digit Med 2022; 5:145. [PMID: 36109594 PMCID: PMC9476418 DOI: 10.1038/s41746-022-00692-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/01/2022] [Indexed: 11/24/2022] Open
Abstract
The mobile health (mHealth) industry is an enormous global market; however, the dropout or continuance of mHealth is a major challenge that is affecting its positive outcomes. To date, the results of studies on the impact factors have been inconsistent. Consequently, research on the pooled effects of impact factors on the continuance intention of mHealth is limited. Therefore, this study aims to systematically analyze quantitative studies on the continuance intention of mHealth and explore the pooled effect of each direct and indirect impact factor. Until October 2021, eight literature databases were searched. Fifty-eight peer-reviewed studies on the impact factors and effects on continuance intention of mHealth were included. Out of the 19 direct impact factors of continuance intention, 15 are significant, with attitude (β = 0.450; 95% CI: 0.135, 0.683), satisfaction (β = 0.406; 95% CI: 0.292, 0.509), health empowerment (β = 0.359; 95% CI: 0.204, 0.497), perceived usefulness (β = 0.343; 95% CI: 0.280, 0.403), and perceived quality of health life (β = 0.315, 95% CI: 0.211, 0.412) having the largest pooled effect coefficients on continuance intention. There is high heterogeneity between the studies; thus, we conducted a subgroup analysis to explore the moderating effect of different characteristics on the impact effects. The geographic region, user type, mHealth type, user age, and publication year significantly moderate influential relationships, such as trust and continuance intention. Thus, mHealth developers should develop personalized continuous use promotion strategies based on user characteristics.
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Affiliation(s)
- Tong Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Wei Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Jun Liang
- IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China
- Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Mingfu Nuo
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
| | - Qinglian Wen
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Wei Wei
- Department of Gastroenterology, Wangjing hospital, Beijing, China
- Key Laboratory of Traditional Chinese Medicine Treatment of Functional Gastrointestinal Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongbin Han
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China.
| | - Jianbo Lei
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China.
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China.
- School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, Sichuan Province, China.
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Castaño Díaz CM, Berrío García N, Alba-Marrugo MA, Sánchez Escudero JP, Marín-Cortés A, Tungjitcharoen W. Mental Health of People Under Isolation During the covid-19 Outbreak: An Exploratory Study. REVISTA COLOMBIANA DE PSICOLOGÍA 2022. [DOI: 10.15446/rcp.v31n2.89960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We conducted an exploratory study using a survey inquiring on seven topics on how people were reacting to the covid-19 pandemic of 2020 aiming to trace a map of symptoms and feelings related to mental health and isolation. 1785 people participated in the survey. Additionally, we applied two psychological scales to analyze depression and stress (prevalent in previous studies). We found that people in isolation during the pandemic presented symptoms related to dissociative disorders, negative affect, and anxiety syndrome. Also, depression and stress had a high prevalence compared to the average rates indicated by the World Health Organisation and the Colombian Ministry of Health. The results indicated an association between depression and stress and being previously diagnosed with a mental health problem, and job and financial situation. Our results highlight the need to design prevention and intervention programmes to reduce the negative consequences of isolation.
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Ejdys J, Gulc A. Factors influencing the intention to use assistive technologies by older adults. HUMAN TECHNOLOGY 2022. [DOI: 10.14254/1795-6889.2022.18-1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Society is ageing at an unprecedented pace worldwide creating implications for the health and social care. Gerontechnology has been recognized as a solution that increases and supports the independency and well-being of older adults at home. This article aims to identify the most critical success factors effecting the adoption of an assistive gerontechnology by older adults in Poland. The object of the authors' interest was Rudy robot, an AI-enabled mobile solution helping users remain physically healthy, mentally sharp, and socially connected. The data was collected among Polish citizens using the CATI technique between November and December 2020. The number of returned questionnaires amounted to 824. The authors used Generalized Least Squares (GLS) of Structural Equation Modelling (GLS-SEM) to verify the hypotheses. The obtained results confirmed statistically significant relationships between the variables of perceived usefulness of Rudy robot and attitude reflecting the willingness to use this technology, as well as between perceived ease of use and perceived usefulness of robot. However, relationship between perceived ease of use and inclination to use this technology in the future was not statistically significant. The conducted research confirmed that the functionality of the analysed Rudy robot for older-adult care positively influences their intension to use it in the future for their own needs or family members. The obtained results confirmed usefulness of robots as assistive technology helping older adults.
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Balasuriya L, Quinton JK, Canavan ME, Holland ML, Edelman EJ, Druss BG, Ross JS. The Association Between History of Depression and Access to Care Among Medicare Beneficiaries During the COVID-19 Pandemic. J Gen Intern Med 2021; 36:3778-3785. [PMID: 34405350 PMCID: PMC8370448 DOI: 10.1007/s11606-021-06990-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/16/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Depression is associated with a higher risk for experiencing barriers to care, unmet social needs, and poorer economic and mental health outcomes. OBJECTIVE To determine the impact of COVID-19 on ability to access care, social and economic needs, and mental health among Medicare beneficiaries with and without depression. DESIGN AND PARTICIPANTS Cross-sectional study using data from the 2020 Medicare Current Beneficiary Survey COVID-19 Summer Supplement Public Use File. MAIN MEASURES Access to medical care, inability to access food, medications, household supplies, pay rent or mortgage, feelings of economic security, and mental health effects since COVID-19, risk-adjusted for sociodemographic and clinical characteristics. KEY RESULTS Participants were 11,080 Medicare beneficiaries (nationally representative of 55,960,783 beneficiaries), 27.0% with and 73.0% without a self-reported history of depression. As compared to those without a history of depression, Medicare beneficiaries with a self-reported history of depression were more likely to report inability to get care because of COVID-19 (aOR = 1.28, 95% CI, 1.09, 1.51; P = 0.003), to get household supplies such as toilet paper (aOR = 1.32, 95% CI, 1.10, 1.58; P = 0.003), and to pay rent or mortgage (aOR = 1.64, 95% CI, 1.07, 2.52; P = 0.02). Medicare beneficiaries with a self-reported history of depression were more likely to report feeling less financially secure (aOR = 1.43, 95% CI, 1.22, 1.68; P < 0.001), more stressed or anxious (aOR = 1.68, 95% CI, 1.49, 1.90; P < 0.001), more lonely or sad (aOR = 1.97, 95% CI, 1.68, 2.31; P < 0.001), and less socially connected (aOR = 1.27, 95% CI, 1.10, 1.47; P = 0.001). CONCLUSION A self-reported history of depression was associated with greater inability to access care, more unmet social needs, and poorer economic and mental health outcomes, suggesting greater risk for adverse health outcomes during COVID-19.
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Affiliation(s)
- Lilanthi Balasuriya
- Yale National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA.
| | - Jacob K Quinton
- UCLA National Clinician Scholars Program, UCLA Department of General Internal Medicine, New Haven, CT, USA
| | - Maureen E Canavan
- Cancer Outcomes Public Policy and Effectiveness Research (COPPER) Center, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - E Jennifer Edelman
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | | | - Joseph S Ross
- Yale National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
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11
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Shi J, Yan X, Wang M, Lei P, Yu G. Factors Influencing the Acceptance of Pediatric Telemedicine Services in China: A Cross-Sectional Study. Front Pediatr 2021; 9:745687. [PMID: 34733810 PMCID: PMC8558490 DOI: 10.3389/fped.2021.745687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pediatrician workforce shortages have aroused great attention from health authorities in China. Telemedicine services have been known to enhance the management of children's health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear. Objective: The purpose of this empirical study was to evaluate the reliability and validity of a technology acceptance measurement instrument applied in healthcare, to investigate the perception of telemedicine services on the provider-side and demand-side, and to determine the factors that may drive individuals to adopt telemedicine services. Methods: A cross-sectional survey study based at Shanghai Children's Hospital, Shanghai Jiao Tong University, was conducted in March 2020. A total of 456 valid responses were obtained by convenience sampling. The internal consistency of items was assessed by Cronbach's alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both the reliability and validity of the questionnaire. Structural equation modeling analysis was used to test and verify the interrelationships among relevant variables. Results: Price value is the strongest predictor (β = 0.30, p = 0.02), facilitating conditions (β = 0.28, p = 0.01) and hedonic motivation (β = 0.13, p = 0.04) also have significantly positive direct effects on telemedicine acceptance. The results showed the perception of child patients' families were significantly more acceptable to telemedicine services than pediatricians (t = -2.99, p < 0.01). Participants with no prior experience and lower education may be more willing to adopt telemedicine. Conclusion: Telemedicine will likely continue to have an integral role in pediatric health care delivery, and the findings can assist policy makers and hospital administrators in determining the more valued characteristics of telemedicine services from a behavioral perspective. Future attention will be paid to the pricing, training and service quality of telemedicine in China.
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Affiliation(s)
- Jingjin Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xueming Yan
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Miao Wang
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ping Lei
- Institut Franco-Chinois pour la Santé, Chambéry, France
| | - Guangjun Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
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12
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Wong AKC, Wong FKY, Chow KKS, Wong SM, Lee PH. Effect of a Telecare Case Management Program for Older Adults Who Are Homebound During the COVID-19 Pandemic: A Pilot Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2123453. [PMID: 34499135 PMCID: PMC8430449 DOI: 10.1001/jamanetworkopen.2021.23453] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Older adults who are homebound can be difficult to reach owing to their functional limitations and social distancing during the COVID-19 pandemic, leaving their health needs unrecognized at an earlier stage. OBJECTIVE To determine the effectiveness of a telecare case management program for older adults who are homebound during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted among 68 older adults in Hong Kong from May 21 to July 20, 2020, with a last follow-up date of October 20, 2020. Inclusion criteria were being 60 years or older, owning a smartphone, and going outside less than once a week in the previous 6 months. INTERVENTIONS Participants in the telecare group received weekly case management from a nurse supported by a social service team via telephone call and weekly video messages covering self-care topics delivered via smartphone for 3 months. Participants in the control group received monthly social telephone calls. MAIN OUTCOMES AND MEASURES The primary outcome was the change in general self-efficacy from before the intervention to after the intervention at 3 months. Self-efficacy was measured by the Chinese version of the 10-item, 4-point General Self-efficacy Scale, with higher scores representing higher self-efficacy levels. Analysis was performed on an intention-to-treat basis. RESULTS A total of 68 participants who fulfilled the criteria were enrolled (34 in the control group and 34 in the intervention group; 56 [82.4%] were women; and mean [SD] age, 71.8 [6.1] years). At 3 months, there was no statistical difference in self-efficacy between the telecare group and the control group. Scores for self-efficacy improved in both groups (β = 1.68; 95% CI, -0.68 to 4.03; P = .16). No significant differences were found in basic and instrumental activities of daily living, depression, and use of health care services. However, the telecare group showed statistically significant interactions of group and time effects on medication adherence (β = -8.30; 95% CI, -13.14 to -3.47; P = .001) and quality of life (physical component score: β = 4.99; 95% CI, 0.29-9.69; P = .04). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, participants who received the telecare program were statistically no different from the control group with respect to changes in self-efficacy, although scores in both groups improved. After the intervention, the telecare group had better medication adherence and quality of life than the control group, although the small sample size may limit generalizability. A large-scale study is needed to confirm these results. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04304989.
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Affiliation(s)
| | | | | | - Siu Man Wong
- The Hong Kong Lutheran Social Service, Homantin, Hong Kong
| | - Paul Hong Lee
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
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Rao G, Singh A, Gandhotra P, Meraj P, Jauhar S, Kuvin J, Epstein L, Naidu S, Arora R, Kaplan B, Jauhar R. Paradigm Shifts in Cardiac Care: Lessons Learned From COVID-19 at a Large New York Health System. Curr Probl Cardiol 2020; 46:100675. [PMID: 32888698 PMCID: PMC7833557 DOI: 10.1016/j.cpcardiol.2020.100675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 12/19/2022]
Abstract
The coronavirus disease-2019 (COVID-19) pandemic has overwhelmed healthcare systems around the world, resulting in morbidity, mortality, and a dramatic economic downturn In the United States. Urgent responses to the pandemic halted routine hospital workflow in an effort to increase hospital capacity, maintain staffing, and ration protective gear. Most notably, New York saw the largest surge of COVID-19 cases nationwide. Healthcare personnel and physician leaders at Northwell Health, the largest healthcare system in New York, have worked together to successfully implement operational changes resulting in a paradigm shift in cardiac care delivery. In this manuscript, we detail specific protocol adjustments made in our cardiology department, cardiology service line, and healthcare system in the face of the COVID-19 pandemic. We discuss the sustainability of this shift moving forward and the opportunity to optimize care for cardiovascular patients in the post COVID-19 era.
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Exploring the Systematic Attributes Influencing Gerontechnology Adoption for Elderly Users Using a Meta-Analysis. SUSTAINABILITY 2020. [DOI: 10.3390/su12072864] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to explore the key systematic attributes influencing the acceptance of gerontechnology by seniors in response to global aging and rapid technological progress. A meta-analysis was carried out to quantitatively synthesize the results of 25 empirical studies published from 2010 to 2020. After standardized coding and descriptive statistics, as well as tests and analysis of main effects and heterogeneity, publication bias. The following results were obtained: Perceived usefulness and perceived ease of use have a significant positive impact on the user’s attitude and behavioral intention; performance expectancy, effort expectancy, trust, technical performance and subjective norm have a significant positive correlation with the user’s behavioral intention; social influence, facilitating conditions have a positive correlation with the user’s behavioral intention; anxiety has a significant negative correlation to the user’s behavioral intention. The key systematic influencing attributes are classified into three categories: (1) User individual characteristics; (2) product and technical characteristics; and (3) environmental characteristics. This study provides researchers and practitioners with a systematic evidence-based basis to reduce the gap in decision-making for gerontechnology practices.
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Using Neighborhood Rough Set Theory to Address the Smart Elderly Care in Multi-Level Attributes. Symmetry (Basel) 2020. [DOI: 10.3390/sym12020297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The neighborhood rough set theory was adopted for attributes reduction and the weight distribution of condition attributes based on the concept of importance level. Smart elderly care coverage rate is low in China. A decisive role in the adoption of smart elderly care is still a problem that needs to be addressed. This study contributes to the adoption of smart elderly care was selected as the decision attribute. The remaining attributes are used as conditional attributes and the multi-level symmetric attribute set for assessing acceptance of smart elderly care. Prior studies are not included smart elderly care adoption attributes in multi-levels; hence, this problem needs to be addressed. The results of this study indicate that the condition attribute of gender has the greatest influence on the decision attribute. The condition attribute of living expenses for smart elderly care has the second largest impact on decision attribute. Children’s support for the elderly decency of the novel elderly care system and the acceptance of non-traditional elderly care methods belong to the primary condition attribute of traditional concept. The result indicates traditional concepts have a certain impact on the adoption of smart elderly care and a condition attribute of residence also has a slight influence on the symmetric decision attribute. The sensitivity analysis shows the insights for uncertainties and provides as a basis for the analysis of the attributes in the smart elderly care service adoption.
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