Smartphone-Based Patient Education in Plastic Surgery

The Effectiveness of Patient Education on Laparoscopic Surgery Postoperative Outcomes to Determine Whether Direct Coaching Is the Best Approach: Systematic Review of Randomized Controlled Trials

BACKGROUND

As of 2022, patient adherence to postoperative guidelines can reduce the risk of complications by up to 52.4% following laparoscopic abdominal surgery. With the availability of various preoperative education interventions (POEIs), understanding which POEI results in improvement in patient outcomes across the procedures is imperative.

OBJECTIVE

This study aims to determine which POEI could be the most effective on patient outcomes by systematically reviewing all the POEIs reported in the literature.

METHODS

In total, 4753 articles investigating various POEIs (eg, videos, presentations, mobile apps, and one-on-one education or coaching) were collected from the PubMed, Embase, and Scopus databases. Inclusion criteria were adult patients undergoing abdominal laparoscopic surgery, randomized controlled trials, and studies that provided postoperative outcomes. Exclusion criteria included studies not published in English and with no outcomes reported. Title and abstract and full-text articles with POEI randomized controlled studies were screened based on the above criteria through a blinded, dual review using Covidence (Veritas Health Innovation). Study quality was assessed through the Cochrane Risk of Bias tool. The included articles were analyzed for educational content, intervention timing, intervention type, and postoperative outcomes appropriate for a particular surgery.

RESULTS

Only 17 studies matched our criteria, with 1831 patients undergoing laparoscopic cholecystectomy, bariatric surgery (gastric bypass and gastric sleeve), and colectomy. In total, 15 studies reported a statistically significant improvement in at least 1 patient postoperative outcome. None of these studies were found to have an overall high risk of bias according to Cochrane standards. In total, 41% (7/17) of the included studies using direct individual education improved outcomes in almost all surgery types, while educational videos had the greatest statistically significant impact for anxiety, nausea, and pain postoperatively (P<.01). Direct group education demonstrated significant improvement in weight, BMI, exercise, and depressive symptoms in 33% (2/6) of the laparoscopic gastric bypass studies.

CONCLUSIONS

Direct education (individual or group based) positively impacts postoperative laparoscopic surgery outcomes.

TRIAL REGISTRATION

PROSPERO CRD42023438698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=438698.

A Scoping Review of Mobile Apps in Plastic Surgery: Patient Care, Trainee Education, and Professional Development

Over the past 10 years, smartphones have become ubiquitous, and mobile apps serve a seemingly endless number of functions in our everyday lives. These functions have entered the realm of plastic surgery, impacting patient care, education, and delivery of services. This article reviews the current uses of plastic surgery mobile apps, app awareness within the plastic surgery community, and the ethical issues surrounding their use in patient care.

Methods

A scoping review of electronically available literature within PubMed, Embase, and Scopus databases was conducted in two waves in November and May 2022. Publications discussing mobile application use in plastic surgery were screened for inclusion.

Results

Of the 80 nonduplicate publications retrieved, 20 satisfied the inclusion criteria. Articles acquired from the references of these publications were reviewed and summarized when relevant. The average American Society of Plastic Surgeons evidence rating of the publications was 4.2. Applications could be categorized broadly into three categories: patient care and surgical applications, professional development and education, and marketing and practice development.

Conclusions

Mobile apps related to plastic surgery have become an abundant resource for patients, attending surgeons, and trainees. Many help bridge gaps in patient care and surgeon-patient communication, and facilitate marketing and practice development. Others make educational content more accessible to trainees and performance assessment more efficient and equitable. The extent of their impact on patient decision-making and expectations has not been completely elucidated.

Factors Affecting Engagement in Web-Based Health Care Patient Information: Narrative Review of the Literature

BACKGROUND

Web-based content is rapidly becoming the primary source of health care information. There is a pressing need for web-based health care content to not only be accurate but also be engaging. Improved engagement of people with web-based health care content has the potential to inform as well as influence behavioral change to enable people to make better health care choices. The factors associated with better engagement with web-based health care content have previously not been considered.

OBJECTIVE

The aims of this study are to identify the factors that affect engagement with web-based health care content and develop a framework to be considered when creating such content.

METHODS

A comprehensive search of the PubMed and MEDLINE database was performed from January 1, 1946, to January 5, 2020. The reference lists of all included studies were also searched. The Medical Subject Headings database was used to derive the following keywords: "patient information," "online," "internet," "web," and "content." All studies in English pertaining to the factors affecting engagement in web-based health care patient information were included. No restrictions were set on the study type. Analysis of the themes arising from the results was performed using inductive content analysis.

RESULTS

The search yielded 814 articles, of which 56 (6.9%) met our inclusion criteria. The studies ranged from observational and noncontrolled studies to quasi-experimental studies. Overall, there was significant heterogeneity in the types of interventions and outcome assessments, which made quantitative assessment difficult. Consensus among all authors of this study resulted in six categories that formed the basis of a framework to assess the factors affecting engagement in web-based health care content: easy to understand, support, adaptability, accessibility, visuals and content, and credibility and completeness.

CONCLUSIONS

There is a paucity of high-quality data relating to the factors that improve the quality of engagement with web-based health care content. Our framework summarizes the reported studies, which may be useful to health care content creators. An evaluation of the utility of web-based content to engage users is of significant importance and may be accessible through tools such as the Net Promoter score. Web 3.0 technology and development of the field of psychographics for health care offer further potential for development. Future work may also involve improvement of the framework through a co-design process.

Artificial Intelligent Virtual Assistant for Plastic Surgery Patient's Frequently Asked Questions: A Pilot Study

BACKGROUND

Artificial Intelligent Virtual Assistants (AIVA) is a segment of artificial intelligence that is rapidly developing. However, its utilization to address patients' frequently asked questions remains unexplored.

METHODS

We developed an AIVA to answer questions related to 10 frequent topics asked by plastic surgery patients in our institution. Between July 27, 2018, and August 10 of 2018, we recruited subjects with administrative positions at our health care institution to chat with the virtual assistant. They asked, with their own words, 1 question for each topic and filled out a satisfaction questionnaire. Postsurvey analysis of questions and answers allowed assessment of the virtual assistant's accuracy.

RESULTS

Thirty participants completed the survey. The majority was female (70%), and the mean age was 27.76 years (SD, 8.68 [19-51] years). The overall accuracy of the plastic surgery AIVA was 92.3% (277/294 questions), and participants considered the answer correct in 83.3% of the time (250/294 answers). Most of the participants considered the AIVA easy to use, answered adequately, and could be helpful for patients. However, when asked if this technology could replace a human assistant, they stayed neutral.

Trends, Technologies, and Key Challenges in Smart and Connected Healthcare

Cardio Vascular Diseases (CVD) is the leading cause of death globally and is increasing at an alarming rate, according to the American Heart Association's Heart Attack and Stroke Statistics-2021. This increase has been further exacerbated because of the current coronavirus (COVID-19) pandemic, thereby increasing the pressure on existing healthcare resources. Smart and Connected Health (SCH) is a viable solution for the prevalent healthcare challenges. It can reshape the course of healthcare to be more strategic, preventive, and custom-designed, making it more effective with value-added services. This research endeavors to classify state-of-the-art SCH technologies via a thorough literature review and analysis to comprehensively define SCH features and identify the enabling technology-related challenges in SCH adoption. We also propose an architectural model that captures the technological aspect of the SCH solution, its environment, and its primary involved stakeholders. It serves as a reference model for SCH acceptance and implementation. We reflected the COVID-19 case study illustrating how some countries have tackled the pandemic differently in terms of leveraging the power of different SCH technologies, such as big data, cloud computing, Internet of Things, artificial intelligence, robotics, blockchain, and mobile applications. In combating the pandemic, SCH has been used efficiently at different stages such as disease diagnosis, virus detection, individual monitoring, tracking, controlling, and resource allocation. Furthermore, this review highlights the challenges to SCH acceptance, as well as the potential research directions for better patient-centric healthcare.

Smartphone Applications in Plastic Surgery: A Cross-Sectional Survey of 577 Plastic Surgeons, Fellows, Residents, and Medical Students

BACKGROUND

There are now over 2.2 million mobile applications (apps) in existence, with more than 250 identifiable by searching "plastic surgery." Unfortunately, only 30% of these are academically relevant, which makes finding useful plastic surgery apps both challenging and inefficient.

OBJECTIVES

The authors sought to evaluate the use of digital resources and awareness of available apps within plastic surgery to improve their clinical/educational utilization.

METHODS

An extensive search of the Apple and Android databases was performed to identify all relevant plastic surgery apps. An American Society of Plastic Surgeons-sponsored survey was distributed to a random cohort of American Society of Plastic Surgeons members (practicing surgeons, fellows, and residents) and students applying to an integrated plastic surgery residency. The survey queried utilization of resources to access medical information and awareness of apps relevant to clinical/educational plastic surgery.

RESULTS

A total 153 relevant applications were identified between the Apple iTunes and Google Play stores. Of the 577 respondents (273 practicing surgeons, 117 residents, 11 fellows, and 177 medical students), 99.31% own a smartphone/tablet. Furthermore, medical students and residents/fellows utilized both smartphones and computers more frequently than practicing physicians (P < 0.0001 and P = 0.0022, respectively). Digital resources were also utilized more frequently than printed material (P < 0.00001). For app awareness, 82.1% of respondents reported knowing of fewer than 10 apps relevant to plastic surgery, and only 8.41% were aware of more than 20.

CONCLUSIONS

Smartphone usage is nearly ubiquitous among plastic surgeons, and most utilize these devices daily to access medical information. However, awareness of the many available and relevant plastic surgery apps is extremely limited.

Survey on medication information literacy and influencing factors among pregnant Chinese women

BACKGROUND

The use of medication during pregnancy is very common. Medication safety has been a great concern among pregnant women and is highly influenced by women's medication information literacy (MIL). There have been few studies focusing on MIL of pregnant women in China. The misuse of medication during pregnancy may impose on risks on pregnancy.

OBJECTIVES

The focus of this study was to investigate the MIL of pregnant Chinese women and to identify influencing factors.

METHODS

Convenience sampling was used following the distribution of a researcher-designed questionnaire to pregnant women at obstetric clinics. A scale was developed to evaluate participants' MIL which included medication information needs, medication information sources, medication information quality discrimination, medication information source awareness, and medication-taking behavior. Demographic characteristics of participants, health status and medication use during pregnancy were also collected.

RESULTS

Questionnaires were completed by 570 participants, yielding a 99% response rate. The total score on the Pregnant Women's Medication Information Literacy Scale ranged from 47 to 96 with a mean score of 74.25 ± 8.22. A total score of 80% or higher indicated the participants' have sufficient medication information literacy which was achieved by 28.2% of the sample. Rate of participants who have sufficient MIL on subscale domains were: medication information needs (76.6%), medication-taking behavior (49.9%), medication information source awareness (26.8%), medication information quality discrimination (17.3%) and medication information sources (15.3%). Significant differences were found in the MIL of participants related to education level, location of residence, occupation, household income, age, weeks of gestation and medication history (p < .05). Binary logistic regression analysis indicated that education, income level, location of residence, occupation, and weeks of gestation affected participants' MIL.

CONCLUSIONS

The overall MIL is low among pregnant Chinese women, which suggests a need for healthcare professionals focusing on medication safety teaching to pregnant women. Interventions by health care professionals in obstetric clinics that promote MIL and prevent adverse events related to medications should be individualized based upon pregnant woman's education level, financial resources, community of residence, occupation and week of gestation.

Smartphone Application as an Education Platform in Hepato-Pancreato-Biliary Surgery

Background. There are no data to assess the need for smartphone applications (SA) as an educational tool in hepato-pancreato-biliary (HPB) surgery. The primary objective of this study was to assess if SA can be used as an educational tool in HPB surgery. The secondary objective was to assess if SA can help as a decision-making tool for fellowship applicants in HPB surgery. Methods. A preapproved questionnaire was e-mailed by International Hepato-Pancreato-Biliary Association to all its 2350 members. Results. Two hundred seventy-one surgeons responded to the survey. Eight were excluded for incomplete data. A total of 48.7% of responders were between 28 and 43 years old (generation X) and 45.2% between 44 and 62 years old (baby boomers). A total of 37.6% of the responders considered SA as an effective method to teach future trainees, and there were slightly higher odds of choosing SA as a teaching tool if the responder considered themselves as an innovator (odds ratio: 2.24). A total of 87.8% of the responders believe that SA in HPB surgery can be directed toward surgical trainees' education, and 91.6% believed SA can be directed toward a fellow. Ninety-five percent of the responders believed that SA in HPB surgery can possibly help a future applicant to choose an HPB fellowship program. Conclusion. SA can complement other teaching techniques and educational tools in HPB surgery. In addition, it can potentially be used as a platform for HPB surgery fellowship by helping in making a decision regarding appropriate fellowship programs.