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Vöcking M, Karrenbrock A, Beckmann A, Vondeberg C, Obert L, Hemming B, Minartz P, Bleck C, Cürlis D, Kuske S. Emotional and Psychological Safety in Healthcare Digitalization: A Design Ethnographic Study. Int J Public Health 2024; 69:1607575. [PMID: 39310719 PMCID: PMC11414544 DOI: 10.3389/ijph.2024.1607575] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/19/2024] [Indexed: 09/25/2024] Open
Abstract
Objectives Emotional and psychological safety is important during the use of digital technologies in healthcare. We aimed to gain comprehensive insight into needs, influencing factors and outcomes in the context of perceived safety and digital technologies in healthcare. Methods We employed a participatory, design ethnographic research approach with 16 participants in 10 use cases. The methods included in an iterative process were, think-aloud, guideline-based interviews, process mapping, storyboard creation, and photo documentation. A qualitative, primarily inductive data analysis and synthesis was performed. Results Perceived safety is influenced by various factors and unmet needs. Increased perceived safety can positively support the use of digital technologies, whereas low perceived safety can limit or even hinder its use. Conclusion The needs of the different target groups should be considered throughout the entire process of digital technology development and healthcare provision to support their implementation. These findings support further research by providing specific aspects of emotional and psychological safety regarding target groups, settings, and ages and those with different levels of affinity for digital technologies.
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Affiliation(s)
- Mara Vöcking
- Fliedner Fachhochschule Düsseldorf, Düsseldorf, Germany
| | | | | | | | - Laura Obert
- Fliedner Fachhochschule Düsseldorf, Düsseldorf, Germany
| | | | - Peter Minartz
- Fliedner Fachhochschule Düsseldorf, Düsseldorf, Germany
| | - Christian Bleck
- Department of Social and Cultural Sciences, Hochschule Düsseldorf, University of Applied Sciences Düsseldorf, Düsseldorf, Germany
| | - Diana Cürlis
- Department Münster School of Design, FH Münster, University of Applied Sciences, Münster, Germany
| | - Silke Kuske
- Fliedner Fachhochschule Düsseldorf, Düsseldorf, Germany
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Brands MR, Haverman L, Muis JJ, Driessens MHE, Meijer S, van der Meer FJM, de Jong M, van der Bom JG, Cnossen MH, Fijnvandraat K, Gouw SC. Toward Personalized Care and Patient Empowerment and Perspectives on a Personal Health Record in Hemophilia Care: Qualitative Interview Study. JMIR Hum Factors 2024; 11:e48359. [PMID: 39226550 PMCID: PMC11408883 DOI: 10.2196/48359] [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: 04/20/2023] [Revised: 11/07/2023] [Accepted: 06/28/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND To enable personalized treatment and shared decision-making in chronic care, relevant health information is collected. However, health information is often fragmented across hospital information systems, digital health apps, and questionnaire portals. This also pertains to hemophilia care, in which scattered information hampers integrated care. We intend to co-design a nationwide digital personal health record (PHR) for patients to help manage their health information. For this, user perspectives are crucial. OBJECTIVE This study aims to assess patients' and health care providers' perspectives regarding the use of a PHR in hemophilia care in the Netherlands, required functionalities, and expectations and concerns. METHODS In this semistructured interview study, 19 pediatric and adult persons with hemophilia, parents, and women with other inherited bleeding disorders, as well as 18 health care providers working within and outside of hemophilia treatment centers, participated. Perspectives of patients and providers were explored separately. To explore requirements, participants were asked to prioritize functionalities. RESULTS Participants expected a PHR would increase the transparency of health information, improve patients' understanding of their illness, and help the coordination of care between health care providers and institutions. Prioritized functionalities included the integration of relevant health information and patient-entered data. Formulated expectations and concerns focused on 4 themes: usability, safety, inclusiveness, and implementation. While patients expressed worries over medicalization (ie, more confrontational reminders of their illness), providers were concerned about an increased workload. CONCLUSIONS People with hemophilia, their parents, and health care providers welcomed the development of a PHR, as they expected it would result in better coordinated care. Formulated expectations and concerns will contribute to the successful development of a PHR for persons with hemophilia, and ultimately, for all persons with a chronic condition.
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Affiliation(s)
- Martijn R Brands
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Child and Adolescent Psychiatry & Psychological Care, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Jelmer J Muis
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Child and Adolescent Psychiatry & Psychological Care, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | | | - Stephan Meijer
- Netherlands Hemophilia Patient Society, Nijkerk, Netherlands
| | - Felix J M van der Meer
- HemoNED Foundation, Leiden, Netherlands
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | | | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Marjon H Cnossen
- Department of Pediatric Hematology and Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Department of Molecular Cellular Hemostasis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
| | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction & Development, Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden University, Leiden, Netherlands
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Mohanraj R, Akil Prasath RV, Balaramdas KR, Amjad KT. Bioavailable fractions of heavy metals in the road dust during infrastructure construction at urban Coimbatore and its potential health implications, India. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:264. [PMID: 38951364 DOI: 10.1007/s10653-024-02040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/19/2024] [Indexed: 07/03/2024]
Abstract
Over the past two decades the Global South is witnessing unprecedented economic transformation and Asian Cities in particular have a remarkable upsurge. Coimbatore, an industrial city in Southern India with an estimated population of 2 million (in 2022) is witnessing a rapid transition in terms of infrastructure development. In this context, the present study attempts to assess the particulate matter (PM10 and PM2.5) emissions at road network construction sites and the heavy metal fractionation in the road dust/sediment samples with a core focus to quantify the bioavailable fraction of metals (Fe, Cu, Cr, Cd, Pb and Ni) and its source apportionment in the road side dust/sediment samples. About 60 composite road dust/sediment samples were collected for heavy metal fractionation analysis in the six arterial roads that undergo core developments like construction of road over bridges, additional road incorporation and street expansions. PM monitoring revealed that 24 h average PM2.5 (47 µg/m3) and PM10 (69 µg/m3) concentrations at many construction sites exceeded 24 h average recommended by WHO guidelines [PM2.5 (15 µg/m3) and PM10 (45 µg/m3), respectively]. The bioavailable fractions of Fe, Cu, Cr and Cd are notably higher in the roadside sediment samples at road construction sites. Health Risk assessment, such as carcinogenic risks (Children-4.41 × 10-2, Adult-3.598 × 10-6) and non-carcinogenic risks, inferred substantial risks at high intensity construction sites with statistical analyses, including PCA and cluster analysis, indicating considerable anthropogenic influences in the heavy metal fractions.
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Affiliation(s)
- Rangaswamy Mohanraj
- Department of Environmental Science and Management, Bharathidasan University, Tiruchirappalli, 620024, India.
| | | | | | - Kaya Thirikkal Amjad
- Department of Environmental Science and Management, Bharathidasan University, Tiruchirappalli, 620024, India
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Patel PN, Patel PA, Ahmed H, Lai KE, Mackay DD, Mollan SP, Truong-Le M. Assessment of the Quality, Accountability, and Readability of Online Patient Education Materials for Optic Neuritis. Neuroophthalmology 2024; 48:257-266. [PMID: 38933748 PMCID: PMC11197904 DOI: 10.1080/01658107.2024.2301728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 12/31/2023] [Indexed: 06/28/2024] Open
Abstract
Most cases of optic neuritis (ON) occur in women and in patients between the ages of 15 and 45 years, which represents a key demographic of individuals who seek health information using the internet. As clinical providers strive to ensure patients have accessible information to understand their condition, assessing the standard of online resources is essential. To assess the quality, content, accountability, and readability of online information for optic neuritis. This cross-sectional study analyzed 11 freely available medical sites with information on optic neuritis and used PubMed as a gold standard for comparison. Twelve questions were composed to include the information most relevant to patients, and each website was independently examined by four neuro-ophthalmologists. Readability was analyzed using an online readability tool. Journal of the American Medical Association (JAMA) benchmarks, four criteria designed to assess the quality of health information further were used to evaluate the accountability of each website. Freely available online information. On average, websites scored 27.98 (SD ± 9.93, 95% CI 24.96-31.00) of 48 potential points (58.3%) for the twelve questions. There were significant differences in the comprehensiveness and accuracy of content across websites (p < .001). The mean reading grade level of websites was 11.90 (SD ± 2.52, 95% CI 8.83-15.25). Zero websites achieved all four JAMA benchmarks. Interobserver reliability was robust between three of four neuro-ophthalmologist (NO) reviewers (ρ = 0.77 between NO3 and NO2, ρ = 0.91 between NO3 and NO1, ρ = 0.74 between NO2 and NO1; all p < .05). The quality of freely available online information detailing optic neuritis varies by source, with significant room for improvement. The material presented is difficult to interpret and exceeds the recommended reading level for health information. Most websites reviewed did not provide comprehensive information regarding non-therapeutic aspects of the disease. Ophthalmology organizations should be encouraged to create content that is more accessible to the general public.
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Affiliation(s)
- Prem N. Patel
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Parth A. Patel
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Harris Ahmed
- Department of Ophthalmology, Loma Linda University Medical Center, Loma Linda, California, USA
| | - Kevin E. Lai
- Departments of Neurology, Ophthalmology, and Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Ophthalmology Service, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
- Neuro-Ophthalmology Section, Midwest Eye Institute, Carmel, Indiana, USA
- Circle City Neuro-Ophthalmology, Carmel, Indiana, USA
- Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Devin D. Mackay
- Departments of Neurology, Ophthalmology, and Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Susan P. Mollan
- Queen Elizabeth Hospital, Department of Ophthalmology, Birmingham, UK
| | - Melanie Truong-Le
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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McAlpine RG, Sacchet MD, Simonsson O, Khan M, Krajnovic K, Morometescu L, Kamboj SK. Development of a digital intervention for psychedelic preparation (DIPP). Sci Rep 2024; 14:4072. [PMID: 38374177 PMCID: PMC10876638 DOI: 10.1038/s41598-024-54642-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/14/2024] [Indexed: 02/21/2024] Open
Abstract
Psychedelic substances induce profound alterations in consciousness. Careful preparation is therefore essential to limit adverse reactions, enhance therapeutic benefits, and maintain user safety. This paper describes the development of a self-directed, digital intervention for psychedelic preparation. Drawing on elements from the UK Medical Research Council (MRC) framework for developing complex interventions, the design was informed by a four-factor model of psychedelic preparedness, using a person-centred approach. Our mixed-methods investigation consisted of two studies. The first involved interviews with 19 participants who had previously attended a 'high-dose' psilocybin retreat, systematically exploring their preparation behaviours and perspectives on the proposed intervention. The second study engaged 28 attendees of an ongoing psilocybin retreat in co-design workshops, refining the intervention protocol using insights from the initial interviews. The outcome is a co-produced 21-day digital course (Digital Intervention for Psychedelic Preparation (DIPP)), that is organised into four modules: Knowledge-Expectation, Psychophysical-Readiness, Safety-Planning, and Intention-Preparation. Fundamental components of the course include daily meditation practice, supplementary exercises tied to the weekly modules, and mood tracking. DIPP provides a comprehensive and scalable solution to enhance psychedelic preparedness, aligning with the broader shift towards digital mental health interventions.
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Affiliation(s)
- Rosalind G McAlpine
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Otto Simonsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Maisha Khan
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
| | - Katarina Krajnovic
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
| | - Larisa Morometescu
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sunjeev K Kamboj
- Clinical Psychopharmacology Unit, Clinical, Educational and Health Psychology, University College London, London, UK
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Šlapáková Losová V, Dvouletý O. The role of open innovation in addressing resource constraints in healthcare: a systematic literature review. J Health Organ Manag 2024; ahead-of-print. [PMID: 38270394 DOI: 10.1108/jhom-06-2023-0203] [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] [Indexed: 01/26/2024]
Abstract
PURPOSE The resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to understand what motivates the stakeholders to join the healthcare innovation ecosystem and what value such an ecosystem brings to healthcare. DESIGN/METHODOLOGY/APPROACH A systematic literature review following the PRISMA framework method was applied to reach the research objective. Out of a total of 509 identified articles published till 2021, 25 were selected as relevant for this review. FINDINGS Six categories of actors were identified, including innovation intermediaries, which were so far neglected in the healthcare innovation literature. Furthermore, patients, healthcare providers, innovation suppliers, investors and influencers were described. The authors also distinguished internal and external stakeholders. The authors show why and how open innovation projects contribute to involving external stakeholders and resources in healthcare delivery by contributing to patient autonomy, relationship building, knowledge transfer, improving collaborative mindset and culture, advancing know-how and bringing additional finances. ORIGINALITY/VALUE This article is the first one to systematically describe the value of open innovation in healthcare. The authors challenge the positivist approach in value presented by value-based healthcare. The authors show how openness contributes to addressing the resource crisis by involving new stakeholders and resources in the care delivery process.
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Affiliation(s)
| | - Ondřej Dvouletý
- Department of Entrepreneurship, Prague University of Economics and Business, Prague, Czech Republic
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Larkin C, Tulu B, Djamasbi S, Garner R, Varzgani F, Siddique M, Pietro J, Boudreaux ED. Comparing the Acceptability and Quality of Intervention Modalities for Suicidality in the Emergency Department: Randomized Feasibility Trial. JMIR Ment Health 2023; 10:e49783. [PMID: 37874619 PMCID: PMC10630858 DOI: 10.2196/49783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Emergency departments (EDs) manage many patients with suicide risk, but effective interventions for suicidality are challenging to implement in this setting. ReachCare is a technology-facilitated version of an evidence-based intervention for suicidal ED patients. Here, we present findings on the acceptability and quality of ReachCare in the ED, as well as a comparison of these measures across 3 potential delivery modalities. OBJECTIVE Our aim was to test the feasibility of the ReachCare intervention in its entirety through conducting a pilot study with patients presenting with suicidality to the ED. We tested three different ways of receiving the ED-based components of ReachCare: (1) self-administered on the tablet app using a chatbot interface, (2) administered by an in-person clinician, or (3) administered by a telehealth clinician. METHODS In total, 47 ED patients who screened positive for suicide risk were randomly allocated to receive one of three delivery modalities of ReachCare in the ED: (1) self-administered on the patient-facing tablet app with a chatbot interface, (2) delivered by an in-person clinician, or (3) delivered by a telehealth clinician, with the latter two using a clinician-facing web app. We measured demographic and clinical characteristics, acceptability and appropriateness of the intervention, and quality and completeness of the resulting safety plans. RESULTS Patients assigned high ratings for the acceptability (median 4.00/5, IQR 4.00-4.50) and appropriateness (median 4.00/5, IQR 4.00-4.25) of ReachCare's ED components, and there were no substantial differences across the 3 delivery modalities [H(acceptability)=3.90, P=.14; H(appropriateness)=1.05, P=.59]. The self-administered modality took significantly less time than the 2 clinician modalities (H=27.91, P<.001), and the usability of the self-administered version was in the "very high" range (median 93.75/100, IQR 80.00-97.50). The safety plans created across all 3 modalities were high-quality (H=0.60, P=.74). CONCLUSIONS Patients rated ReachCare in the ED as highly acceptable and appropriate regardless of modality. Self-administration may be a feasible way to ensure patients with suicide risk receive an intervention in resource constrained EDs. Limitations include small sample size and demographic differences between those enrolled versus not enrolled. Further research will examine the clinical outcomes of patients receiving both the in-ED and post-ED components of ReachCare. TRIAL REGISTRATION ClinicalTrials.gov NCT04720911; https://clinicaltrials.gov/ct2/show/NCT04720911.
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Affiliation(s)
- Celine Larkin
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Bengisu Tulu
- The Business School, Worcester Polytechnic Institute, Worcester, MA, United States
| | - Soussan Djamasbi
- The Business School, Worcester Polytechnic Institute, Worcester, MA, United States
| | - Roscoe Garner
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Fatima Varzgani
- The Business School, Worcester Polytechnic Institute, Worcester, MA, United States
| | - Mariam Siddique
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - John Pietro
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Edwin D Boudreaux
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Gould DJ, Dowsey MM, Glanville-Hearst M, Spelman T, Bailey JA, Choong PFM, Bunzli S. Patients' Views on AI for Risk Prediction in Shared Decision-Making for Knee Replacement Surgery: Qualitative Interview Study. J Med Internet Res 2023; 25:e43632. [PMID: 37721797 PMCID: PMC10546266 DOI: 10.2196/43632] [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: 10/18/2022] [Revised: 05/04/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND The use of artificial intelligence (AI) in decision-making around knee replacement surgery is increasing, and this technology holds promise to improve the prediction of patient outcomes. Ambiguity surrounds the definition of AI, and there are mixed views on its application in clinical settings. OBJECTIVE In this study, we aimed to explore the understanding and attitudes of patients who underwent knee replacement surgery regarding AI in the context of risk prediction for shared clinical decision-making. METHODS This qualitative study involved patients who underwent knee replacement surgery at a tertiary referral center for joint replacement surgery. The participants were selected based on their age and sex. Semistructured interviews explored the participants' understanding of AI and their opinions on its use in shared clinical decision-making. Data collection and reflexive thematic analyses were conducted concurrently. Recruitment continued until thematic saturation was achieved. RESULTS Thematic saturation was achieved with 19 interviews and confirmed with 1 additional interview, resulting in 20 participants being interviewed (female participants: n=11, 55%; male participants: n=9, 45%; median age: 66 years). A total of 11 (55%) participants had a substantial postoperative complication. Three themes captured the participants' understanding of AI and their perceptions of its use in shared clinical decision-making. The theme Expectations captured the participants' views of themselves as individuals with the right to self-determination as they sought therapeutic solutions tailored to their circumstances, needs, and desires, including whether to use AI at all. The theme Empowerment highlighted the potential of AI to enable patients to develop realistic expectations and equip them with personalized risk information to discuss in shared decision-making conversations with the surgeon. The theme Partnership captured the importance of symbiosis between AI and clinicians because AI has varied levels of interpretability and understanding of human emotions and empathy. CONCLUSIONS Patients who underwent knee replacement surgery in this study had varied levels of familiarity with AI and diverse conceptualizations of its definitions and capabilities. Educating patients about AI through nontechnical explanations and illustrative scenarios could help inform their decision to use it for risk prediction in the shared decision-making process with their surgeon. These findings could be used in the process of developing a questionnaire to ascertain the views of patients undergoing knee replacement surgery on the acceptability of AI in shared clinical decision-making. Future work could investigate the accuracy of this patient group's understanding of AI, beyond their familiarity with it, and how this influences their acceptance of its use. Surgeons may play a key role in finding a place for AI in the clinical setting as the uptake of this technology in health care continues to grow.
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Affiliation(s)
- Daniel J Gould
- St Vincent's Hospital, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Michelle M Dowsey
- St Vincent's Hospital, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Australia
| | | | - Tim Spelman
- St Vincent's Hospital, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - James A Bailey
- School of Computing and Information Systems, University of Melbourne, Melbourne, Australia
| | - Peter F M Choong
- St Vincent's Hospital, Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Samantha Bunzli
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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McNamara J, Connor SJ, Andrews JM. The Evolving Role of Technology in Delivering Patient-centric, Empowered Health Care in Inflammatory Bowel Disease: Patient Experience Using Crohn's Colitis Care e-Health Consumer Platform. Inflamm Bowel Dis 2023; 29:1510-1511. [PMID: 37490509 DOI: 10.1093/ibd/izad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Jack McNamara
- Department of Gastroenterology and Hepatology, Liverpool Hospital, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Crohn's Colitis Cure, Pyrmont, NSW, Australia
| | - Susan J Connor
- Department of Gastroenterology and Hepatology, Liverpool Hospital, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- Crohn's Colitis Cure, Pyrmont, NSW, Australia
- University of New South Wales, SWS Clinical School, Liverpool, NSW, Australia
| | - Jane M Andrews
- Crohn's Colitis Cure, Pyrmont, NSW, Australia
- Central Adelaide Health Network, Adelaide, SA, Australia
- University of Adelaide, Faculty of Health and Medical Sciences, Adelaide, SA, Australia
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10
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Fisher M, Aher A, Araga M, Franks B. Patient Factors in the Dose Selection of Oral Sumatriptan for Acute Migraine: A Post Hoc Analysis of Two Randomized Controlled Studies. Pain Ther 2023; 12:853-861. [PMID: 37103731 PMCID: PMC10134697 DOI: 10.1007/s40122-023-00511-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/30/2023] [Indexed: 04/28/2023] Open
Abstract
INTRODUCTION Patients are seeking greater involvement in their healthcare. It therefore may be beneficial to provide guidance on initial oral sumatriptan dose selection for the treatment of acute migraine in nontraditional settings, such as telehealth and other remote forms of medical care. We sought to determine whether clinical or demographic factors are predictive of oral sumatriptan dose preference. METHODS This was a post hoc analysis of two clinical studies designed to determine preference for 25, 50, or 100 mg oral sumatriptan. Patients were aged 18-65 years with at least a 1 year history of migraine and experienced, on average, between one and six severe or moderately severe migraine attacks per month, with or without aura. Predictive factors were demographic measures, medical history, and migraine characteristics. Possibly predictive factors were identified using three analyses: classification and regression tree analysis, marginal significance (P < 0.1) within a full-model logistic regression, and/or selection within a forward-selection procedure in a logistic regression. A reduced model containing the variables identified in the preliminary analyses was developed. Due to differences in study design, data were not combined. RESULTS A dose preference was expressed by 167 patients in Study 1 and 222 patients in Study 2. Gender and medical history of urologic and/or psychological conditions in Study 1 and duration of migraine history, height, and medical history of endocrine or neurologic disease and headache severity in Study 2 were identified as possibly predictive. The predictive model showed low positive predictive value (PPV; 23.8%) and low sensitivity (21.7%) for Study 1. For Study 2, the model showed moderate PPV (60.0%) but low sensitivity (10.9%). CONCLUSIONS No clinical or demographic characteristics alone or in combination were consistently or strongly associated with preference for oral sumatriptan dose level. TRIAL REGISTRATION The studies on which this paper is based were conducted before trial registration indexes were introduced.
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Affiliation(s)
- Matt Fisher
- Haleon, 184 Liberty Corner Road, Warren, NJ, 07059, USA.
| | - Abhay Aher
- Haleon, 184 Liberty Corner Road, Warren, NJ, 07059, USA
| | - Mako Araga
- Haleon, 184 Liberty Corner Road, Warren, NJ, 07059, USA
| | - Billy Franks
- GlaxoSmithKline Consumer Healthcare B.V., Amersfoort, Netherlands
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Nogueira-Leite D, Cruz-Correia R. Attitudes of Physicians and Individuals Toward Digital Mental Health Tools: Protocol for a Web-Based Survey Research Project. JMIR Res Protoc 2023; 12:e41040. [PMID: 36917172 PMCID: PMC10131781 DOI: 10.2196/41040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Digital transformation is impacting health care delivery. Great market dynamism is bringing opportunities and concerns alike into public discussion. Digital health apps are a vibrant segment where regulation is emerging, with Germany paving the way with its DiGA (Digitale Gesundheitsanwendungen, in German, meaning digital health apps) program. Simultaneously, mental ill-health constitutes a global health concern, and prevalence is expected to worsen due to the COVID-19 pandemic and its containment measures. Portugal and its National Health System may be a useful testbed for digital health interventions. OBJECTIVE The paper outlines the protocol for a research project on the attitudes of physicians and potential users toward digital mental health apps to improve access to care, patient outcomes, and reduce the burden of disease of mental ill-health. METHODS Web surveys will be conducted to acquire data from the main stakeholders (physicians and the academic community). Data analysis will replicate the statistical analysis performed in the studies from Dahlhausen and Borghouts to derive conclusions regarding the relative acceptance and likelihood of successful implementation of digital mental health apps in Portugal. RESULTS The findings of the proposed studies will elicit important information on how physicians and individuals perceive digital mental health app interventions to improve access to care, patient outcomes, and reduce the burden of disease of mental ill-health. Data collection ran between September 26 and November 6, 2022, for the first study and September 20 and October 20, 2022, for the second study. We obtained 160 responses to the first study's survey and 539 answers to the second study's survey. Data analysis is concluded, and both studies' results are expected to be published in 2023. CONCLUSIONS The results of the studies projected in this research protocol will have implications for researchers and academia, industry, and policy makers concerning the adoption and implementation of digital health mental apps and associated interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41040.
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Affiliation(s)
- Diogo Nogueira-Leite
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal.,Nova School of Business and Economics Health and Economics Knowledge Center, New University of Lisbon, Lisbon, Portugal.,Programme in Health Data Science, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ricardo Cruz-Correia
- Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research, Porto, Portugal
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Denysyuk HV, Pinto RJ, Silva PM, Duarte RP, Marinho FA, Pimenta L, Gouveia AJ, Gonçalves NJ, Coelho PJ, Zdravevski E, Lameski P, Leithardt V, Garcia NM, Pires IM. Algorithms for automated diagnosis of cardiovascular diseases based on ECG data: A comprehensive systematic review. Heliyon 2023; 9:e13601. [PMID: 36852052 PMCID: PMC9958295 DOI: 10.1016/j.heliyon.2023.e13601] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 02/12/2023] Open
Abstract
The prevalence of cardiovascular diseases is increasing around the world. However, the technology is evolving and can be monitored with low-cost sensors anywhere at any time. This subject is being researched, and different methods can automatically identify these diseases, helping patients and healthcare professionals with the treatments. This paper presents a systematic review of disease identification, classification, and recognition with ECG sensors. The review was focused on studies published between 2017 and 2022 in different scientific databases, including PubMed Central, Springer, Elsevier, Multidisciplinary Digital Publishing Institute (MDPI), IEEE Xplore, and Frontiers. It results in the quantitative and qualitative analysis of 103 scientific papers. The study demonstrated that different datasets are available online with data related to various diseases. Several ML/DP-based models were identified in the research, where Convolutional Neural Network and Support Vector Machine were the most applied algorithms. This review can allow us to identify the techniques that can be used in a system that promotes the patient's autonomy.
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Key Words
- AI, Artificial Intelligence
- BNN, Binarized Neural Network
- CNN, Concolutional Neural Networks
- Cardiovascular diseases
- DL, Deep Learning
- DNN, Deep Neural Networks
- Diagnosis
- ECG sensors
- ECG, Electrocardiography
- GAN, Generative Adversarial Networks
- GMM, Gaussian Mixture Model
- GNB, Gaussian Naive bayes
- GRU, Gated Recurrent Unit
- LASSO, Least Absolute Shrinkage and Selection Operator
- LDA, Linear Discriminant Analysis
- LR, Linear Regression
- LSTM, Long Short-Term Memory
- ML, Machine Learning
- MLP, Multiplayer Perceptron
- MLR, Multiple Linear Regression
- NLP, Natural Language Processing
- POAF, Postoperative Atrial Fibrillation
- RF, Random Forest
- RNN, Recurrent Neural Network
- SHAP, SHapley Additive exPlanations
- SVM, Support Vector Machine
- Systematic review
- WHO, World Health Organization
- kNN, k-nearest neighbors
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Affiliation(s)
| | - Rui João Pinto
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Pedro Miguel Silva
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Rui Pedro Duarte
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Francisco Alexandre Marinho
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Luís Pimenta
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - António Jorge Gouveia
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Norberto Jorge Gonçalves
- Escola de Ciências e Tecnologia, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Paulo Jorge Coelho
- Polytechnic of Leiria, Leiria, Portugal
- Institute for Systems Engineering and Computers at Coimbra (INESC Coimbra), Coimbra, Portugal
| | - Eftim Zdravevski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, Macedonia
| | - Petre Lameski
- Faculty of Computer Science and Engineering, University Ss Cyril and Methodius, 1000 Skopje, Macedonia
| | - Valderi Leithardt
- VALORIZA, Research Center for Endogenous Resources Valorization, Instituto Politécnico de Portalegre, 7300-555 Portalegre, Portugal
- COPELABS, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | - Nuno M. Garcia
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal
| | - Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal
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13
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Mavragani A, Schoonman GG, Maat B, Habibović M, Krahmer E, Pauws S. Patients Managing Their Medical Data in Personal Electronic Health Records: Scoping Review. J Med Internet Res 2022; 24:e37783. [PMID: 36574275 PMCID: PMC9832357 DOI: 10.2196/37783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/31/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Personal electronic health records (PEHRs) allow patients to view, generate, and manage their personal and medical data that are relevant across illness episodes, such as their medications, allergies, immunizations, and their medical, social, and family health history. Thus, patients can actively participate in the management of their health care by ensuring that their health care providers have an updated and accurate overview of the patients' medical records. However, the uptake of PEHRs remains low, especially in terms of patients entering and managing their personal and medical data in their PEHR. OBJECTIVE This scoping review aimed to explore the barriers and facilitators that patients face when deciding to review, enter, update, or modify their personal and medical data in their PEHR. This review also explores the extent to which patient-generated and -managed data affect the quality and safety of care, patient engagement, patient satisfaction, and patients' health and health care services. METHODS We searched the MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, and Google Scholar web-based databases, as well as reference lists of all primary and review articles using a predefined search query. RESULTS Of the 182 eligible papers, 37 (20%) provided sufficient information about patients' data management activities. The results showed that patients tend to use their PEHRs passively rather than actively. Patients refrain from generating and managing their medical data in a PEHR, especially when these data are complex and sensitive. The reasons for patients' passive data management behavior were related to their concerns about the validity, applicability, and confidentiality of patient-generated data. Our synthesis also showed that patient-generated and -managed health data ensures that the medical record is complete and up to date and is positively associated with patient engagement and patient satisfaction. CONCLUSIONS The findings of this study suggest recommendations for implementing design features within the PEHR and the construal of a dedicated policy to inform both clinical staff and patients about the added value of patient-generated data. Moreover, clinicians should be involved as important ambassadors in informing, reminding, and encouraging patients to manage the data in their PEHR.
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Affiliation(s)
| | - Guus G Schoonman
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands.,Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| | - Barbara Maat
- Department of Pharmacy, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| | - Mirela Habibović
- Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
| | - Steffen Pauws
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands.,Department of Remote Patient Management & Connected Care, Philips Research, Eindhoven, Netherlands
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14
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Do electronic and economic empowerment protect women from intimate partner violence (IPV) in India? BMC Womens Health 2022; 22:510. [PMID: 36494662 PMCID: PMC9733227 DOI: 10.1186/s12905-022-02110-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a major public health problem. Electronic empowerment has several positive impacts on health. No study has examined whether electronic empowerment prevents intimate partner violence. Economic empowerment has positive and negative effects on IPV victimization. The current study was conducted to investigate whether economic and electronic empowerment of women act as protective factors against IPV in India. METHODS A national representative sample of 66,013 ever-married women from 36 member states and union territories of India has been used from the National Family Health Survey 2015 to 2016. Emotional, physical and sexual violence against women by husbands were target variables. We used bivariate and multivariate analyses. RESULTS The prevalence of emotional violence was 13%, physical violence was 28% and sexual violence was 7%. IPV against women was as follows: The prevalence was higher among women living in rural areas, belonging to Hindu religion and those belonging to Scheduled Castes. Higher education and higher socio-economic status were found to be protective factors against IPV. The prevalence of IPV was higher among the working women, among those having knowledge of business loans for women and the recipients of such business loans. Exposure to media was found to reduce IPV. The women who used mobile phones and SMS facility experienced less violence. CONCLUSION Economic independence of women was found to be a risk factor for IPV in India, whereas electronic empowerment was a protective factor. In the Indian context, policymakers should make use of mobile phones and support SMS use in the IPV awareness programs. Women empowerment, combined with gender equity, can reduce the prevalence of violence against women.
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15
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Rodríguez Parrado IY, Achury Saldaña DM. Digital Health Literacy in Patients With Heart Failure in Times of Pandemic. Comput Inform Nurs 2022; 40:754-762. [PMID: 35234702 PMCID: PMC9707854 DOI: 10.1097/cin.0000000000000883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study sought to determine the effect of a digital health literacy program regarding knowledge and skills in the use of digital resources related to self-care and health empowerment for patients with heart failure. A cross-sectional pilot study was conducted before and after the program in patients (n = 28) with heart failure at a tertiary care center. Both a knowledge test and the Health Empowerment Scale were used with a Cronbach's α of 0.89. The information was processed using the statistical software Restudio, which allowed us to make a descriptive and inferential analysis. Seventy-five percent of the participants were men with an average age of 68 years, 60.7% had elementary schooling, 71.4% had preserved ejection fraction, and 57.6% had a family member as a caregiver. A statistically significant change ( P < .005) was found in the level of empowerment and the knowledge and skills in the use of digital resources applied in health. The results showed that the digital health literacy program is a cost-effective intervention that nursing professionals must integrate into continuity of care, not only in pandemic times but also in a permanent and standardized manner. An empowered patient with knowledge and skills in the use of digital resources is a patient with the ability to decide, satisfy needs, and solve problems, with critical thinking and control over their health.
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16
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Delgado GV, Carvalho RBD, Choo CW, Leite RS, Castro JMD. Empowerment through Mobile Apps: A Mixed Methods Case Study of an Application for Pregnant Women. JOURNAL OF HEALTH MANAGEMENT 2022. [DOI: 10.1177/09720634221121363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article analyses the manner in which mobile health applications contribute to the empowerment of patients. The theoretical background included m-health, user empowerment and value co-creation. Quantitative and qualitative methods were used to investigate the representative case study of the Kangaroo application, a free app designed by a health-tech start-up and a reference Brazilian hospital which seeks to make Brazilian women empowered for a healthy pregnancy. The data collection effort comprised application log analysis of 6 months of records of almost one-hundred thousand users, a mobile-based survey with approximately 400 women, and 16 in-depth interviews. The results demonstrated that the app’s social features impacted more than personal features. This research’s results suggested that the perception of patient empowerment is not greater for the active users of the application, so the patient is not related to ‘doing’, but rather to ‘being able to do’. The participation of specialised professionals, who moderate and interact with the app community, is valued by the users and mentioned as a differential among other health information sources available on the Web. This study was approved by the Brazilian Research Ethics Committee.
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Affiliation(s)
- Gustavo Varela Delgado
- Pontifical Catholic University of Minas Gerais – PUCMinas, Belo Horizonte, State of Minas Gerais, Brazil
| | - Rodrigo Baroni de Carvalho
- Pontifical Catholic University of Minas Gerais – PUCMinas, Belo Horizonte, State of Minas Gerais, Brazil
| | - Chun Wei Choo
- Faculty of Information, University of Toronto, Toronto, Ontario, Canada
| | - Ramon Silva Leite
- Pontifical Catholic University of Minas Gerais – PUCMinas, Belo Horizonte, State of Minas Gerais, Brazil
| | - José Márcio de Castro
- Pontifical Catholic University of Minas Gerais – PUCMinas, Belo Horizonte, State of Minas Gerais, Brazil
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17
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Sulis E, Amantea IA, Aldinucci M, Boella G, Marinello R, Grosso M, Platter P, Ambrosini S. An ambient assisted living architecture for hospital at home coupled with a process-oriented perspective. JOURNAL OF AMBIENT INTELLIGENCE AND HUMANIZED COMPUTING 2022:1-19. [PMID: 36160943 PMCID: PMC9490692 DOI: 10.1007/s12652-022-04388-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/30/2022] [Indexed: 06/16/2023]
Abstract
The growing number of next-generation applications offers a relevant opportunity for healthcare services, generating an urgent need for architectures for systems integration. Moreover, the huge amount of stored information related to events can be explored by adopting a process-oriented perspective. This paper discusses an Ambient Assisted Living healthcare architecture to manage hospital home-care services. The proposed solution relies on adopting an event manager to integrate sources ranging from personal devices to web-based applications. Data are processed on a federated cloud platform offering computing infrastructure and storage resources to improve scientific research. In a second step, a business process analysis of telehealth and telemedicine applications is considered. An initial study explored the business process flow to capture the main sequences of tasks, activities, events. This step paves the way for the integration of process mining techniques to compliance monitoring in an AAL architecture framework.
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Affiliation(s)
- Emilio Sulis
- Computer Science Department, University of Turin, Corso Svizzera 185, 10149 Turin, Italy
| | - Ilaria Angela Amantea
- Computer Science Department, University of Turin, Corso Svizzera 185, 10149 Turin, Italy
| | - Marco Aldinucci
- Computer Science Department, University of Turin, Corso Svizzera 185, 10149 Turin, Italy
| | - Guido Boella
- Computer Science Department, University of Turin, Corso Svizzera 185, 10149 Turin, Italy
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Cao C, Li D, Xu Q, Shao X. Motivational Influences Affecting Middle-Aged and Elderly Users' Participation Intention in Health-Related Social Media. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11240. [PMID: 36141521 PMCID: PMC9517440 DOI: 10.3390/ijerph191811240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
Social media provide users with multi-directional dialogue for creating and sharing health information that can effectively promote the self-management of health. In regard to the 'greying' trend in social media, most researchers have studied the health-related social media (HRSM) acceptance status and use behavior of middle-aged and elderly people, and have explored the role of HRSM in this group. However, the continuous participation of users is the key to the successful operation of HRSM, and is an essential prerequisite for the subsequent HRSM behavior habits of middle-aged and elderly people. Therefore, we aimed to explore what motivations drive the first use of HRSM among middle-aged and older adults, and the impact of their perception of HRSM, after personal use, on their intention to use it continually. In the study, we used the partial least squares structural equation model (PLS-SEM) to analyze data collected from online questionnaires. The results showed that a self-protection motivation and a social motivation promoted the initial participation of middle-aged and elderly individuals. In addition, these people experienced deeper levels of perceived usefulness and perceived entertainment after their initial participation. The results also revealed that these two perceptions could positively influence middle-aged and elderly individuals' intention to continue with their participation. Our findings should help service platforms to better understand the needs of middle-aged and elderly users. This would help researchers and practitioners to gain a more complete understanding of the motivation of middle-aged and elderly people for participating in HRSM, and the related impacts this may have.
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Affiliation(s)
- Cong Cao
- School of Management, Zhejiang University of Technology, Hangzhou 310023, China
| | - Dan Li
- School of Management, Zhejiang University of Technology, Hangzhou 310023, China
| | - Qianwen Xu
- School of Management, Zhejiang University of Technology, Hangzhou 310023, China
| | - Xiuyan Shao
- School of Economics and Management, Southeast University, Nanjing 211189, China
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Zhou Z, Jin X, Hsu C, Tang Z. User empowerment and
well‐being
with
mHealth
apps during pandemics: A
mix‐methods
investigation in China. J Assoc Inf Sci Technol 2022. [DOI: 10.1002/asi.24695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Zhongyun Zhou
- School of Economics and Management Tongji University Shanghai China
| | - Xiao‐Ling Jin
- Management School Shanghai University Shanghai China
| | - Carol Hsu
- Discipline of Business Information Systems University of Sydney Sydney New South Wales Australia
| | - Zhenya Tang
- Monfort College of Business University of Northern Colorado Greeley Colorado USA
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20
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Towards a Didactic Concept for Heterogeneous Target Groups in Digital Learning Environments—First Course Implementation. J Pers Med 2022; 12:jpm12050696. [PMID: 35629119 PMCID: PMC9147950 DOI: 10.3390/jpm12050696] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
Abstract
In the context of the ongoing digitization of interdisciplinary subjects, the need for digital literacy is increasing in all areas of everyday life. Furthermore, communication between science and society is facing new challenges, not least since the COVID-19 pandemic. In order to deal with these challenges and to provide target-oriented online teaching, new educational concepts for the transfer of knowledge to society are necessary. In the transfer project “Zukunftslabor Gesundheit” (ZLG), a didactic concept for the creation of E-Learning classes was developed. A key factor for the didactic concept is addressing heterogeneous target groups to reach the broadest possible spectrum of participants. The concept has already been used for the creation of the first ZLG E-Learning courses. This article outlines the central elements of the developed didactic concept and addresses the creation of the ZLG courses. The courses created so far appeal to different target groups and convey diverse types of knowledge at different levels of difficulty.
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Affinito L, Fontanella A, Montano N, Brucato A. How physicians can empower patients with digital tools. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01370-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
While there is broad consensus that the use of digital tools would significantly improve patient empowerment, to date, an improvement in health outcomes has been elusive.
Objective
The objective of this study was to assess how to improve the ability of physicians to empower patients with digital tools.
Methods
We conducted a web-based survey using SurveyMonkey over nearly 6 months. A questionnaire was sent with an email, explaining the aims of the survey and providing a link to complete the web-based questionnaire, to the heads of each of the 37 medical national societies adhering to the EFIM (European Federation of Internal Medicine), inviting them to disseminate the questionnaire among their members.
Results
Two hundred and eighteen responses were received. They suggest that the main success factors in increasing and improving patient empowerment with digital tools and realizing health goals are clinical evidence, followed by patient/physician involvement in the design, tools designed around the real needs of the patient, and reimbursement. Most of the respondents who have already prescribed digital tools for patient empowerment are just enough satisfied with the results achieved by their patients. Interestingly, 18% of the respondents had spent more than 30 min on the visit of patient to doctor. However, the majority devoted only 5–9 min to illustrating the suggested digital tools.
Conclusions
According to the respondents, clinical evidence, motivation, physician and patient’s involvement in design, and reimbursement, as well as organizations’ appropriate business models and support, are the main determinants of the diffusion and effective adoption of digital tools for successful patient empowerment in internal medicine.
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22
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Gellerstedt M, Melin J, Johansson V, Angenete E. Are patients willing to take a more active role? Questionnaires to measure patients' willingness to be empowered. PATIENT EDUCATION AND COUNSELING 2022; 105:741-749. [PMID: 34312033 DOI: 10.1016/j.pec.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/26/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE One crucial prerequisite for increased patient empowerment is the willingness among patients to take a more active role. The aim of this study was to develop questionnaires for measuring a patient's willingness to be empowered in general and by using e-health. METHODS The study was based on a random sample from an online panel. The 800 responders were Swedish citizens and reflected the internet-using population in Sweden regarding age, gender, income, and education. The measurement properties were evaluated according to the Rasch Measurement Theory. RESULTS The analyses showed two questionnaires with adequate fit to the basic measurement model and with high reliability (PSI 0.84 and 0.89, respectively). CONCLUSION We conclude that this study generated two questionnaires with an intuitive order of items illustrating an understandable progression of willingness to be empowered in general as well as for e-health. PRACTICE IMPLICATIONS The suggested questionnaires are valuable tools supporting the effort to tailor empowerment strategies to meet the patient's willingness. Questionnaires will also be valuable for evaluating strategies for supporting willingness, studying factors related to willingness and potential inequalities due to e.g. varying digital literacy, and for enabling identification of patient stereotypes using cluster analyses.
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Affiliation(s)
- Martin Gellerstedt
- School of Health Sciences, University of Skövde, Skövde, Sweden; University West, School of Business, Economics and IT, SE-461 86 Trollhättan, Sweden.
| | - Jeanette Melin
- The Department of Measurement Sciences and Technology, Research Institutes of Sweden (RISE), Gothenburg, Sweden; Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
| | - Victoria Johansson
- University West, School of Business, Economics and IT, SE-461 86 Trollhättan, Sweden
| | - Eva Angenete
- Department of Surgery, SSORG - Scandinavian Surgical Outcomes Research Group, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital/Östra, Department of Surgery, Gothenburg, Sweden
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Oestergaard CU, Spindler H, Dinesen B. Video and social rehabilitation of persons with mental illness helps to structure everyday life: a qualitative study. Mhealth 2022; 8:4. [PMID: 35178435 PMCID: PMC8800196 DOI: 10.21037/mhealth-21-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/11/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Living with a mental disorder has a significant impact on everyday life. In 2018, one out of every six adults, equivalent to 17.3% of the adult population of the European Union, had symptoms of mental disorders. This paper focus on social rehabilitation of patients with mental illness who have been discharged from hospital and who use video communication technologies in their rehabilitation in collaboration with their social worker. The aim of this study has been to explore the experiences of persons with mental illnesses who participated in a long-term video-based tele-social rehabilitation program, the Video Assist. METHODS The overall research strategy is the case study method. Data collection techniques are based on triangulation. Document analysis has been performed. Participant observation in homes of persons with mental using video with social workers (168 hours). Semi structured qualitative interviews with persons with mental illness (n=13) has been conducted lasting between 30 and 60 minutes. Data were analyzed using NVivo 10.0. RESULTS Experiences of persons with mental illness participating in the tele-social rehabilitation program are in themes: user friendly video technology, video created a new means of communication between citizen and social worker, feeling of surveillance by having the technology in the home, development of new coping strategies in everyday life and need for psychosocial support and training via the video technology. CONCLUSIONS Persons with mental illness who are in a recovery process find that participating in a tele-social-rehabilitation program gives them a sense of mobility, security, surveillance but the ability to develop new coping strategies in their everyday lives. Future research is needed on long-term effects of tele-social rehabilitation for persons with mental illness.
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Affiliation(s)
- Claus Ugilt Oestergaard
- Laboratory of Welfare Technologies - Telehealth & Telerehabilitation, Sports Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Helle Spindler
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Birthe Dinesen
- Laboratory of Welfare Technologies - Telehealth & Telerehabilitation, Sports Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Elbeltagy R, Waly EH, Bakry HM. Teleaudiology practice in COVID-19 pandemic in Egypt and Saudi Arabia. J Otol 2021; 17:78-83. [PMID: 34976033 PMCID: PMC8704730 DOI: 10.1016/j.joto.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the audiologists’ attitudes and practice towards teleaudiology, as well as to assess the audiological services provided in Egypt and Saudi Arabia during the COVID-19 pandemic. Methods A cross sectional study was conducted among 112 audiologists who were recruited through convenience sampling . Multinomial logistic regression was used to test the association between practice of tele audiology as a dependent variable and some independent variables. Results 25.4% of the studied sample were practicing tele audiology. Participants’ age and attitude toward telemedicine were the independent predictors of tele audiology practice at p value ≤ 0.05. Conclusion The tele audiology practice is essential. Therefore, raising the knowledge of audiologist about the great value of practicing tele audiology is very important, infrastructure, equipment, and technology especially telecommunication should be improved and facilitated for both audiologist and patients.
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Affiliation(s)
- Reem Elbeltagy
- Ear-Nose-Throat department, Faculty of Medicine, Zagazig University.,Health Communication sciences department. College of Health and rehabilitation sciences, Princess Nourah bint Abdulrahman University
| | - Eman H Waly
- Environmental and Occupational medicine department, Faculty of Medicine, Zagazig University
| | - Huny M Bakry
- Environmental and Occupational medicine department, Faculty of Medicine, Zagazig University
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Nwolise CH, Carey N, Shawe J. Preconception and Diabetes Information (PADI) App for Women with Pregestational Diabetes: a Feasibility and Acceptability Study. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2021; 5:446-473. [PMID: 35415455 PMCID: PMC8982818 DOI: 10.1007/s41666-021-00104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 03/07/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
Diabetes mellitus increases the risk of adverse maternal and fetal outcomes. Preconception care is vital to minimise complications; however, preconception care service provision is hindered by inadequate knowledge, resources and care fragmentation. Mobile health technology, particularly smartphone apps, could improve preconception care and pregnancy outcomes for women with diabetes. The aim of this study is to co-create a preconception and diabetes information app with healthcare professionals and women with diabetes and explore the feasibility, acceptability and preliminary effects of the app. A mixed-methods study design employing questionnaires and semi-structured interviews was used to assess preliminary outcome estimates (preconception care knowledge, attitudes and behaviours), and user acceptability. Data analysis included thematic analysis, descriptive statistics and non-parametric tests. Improvements were recorded in knowledge and attitudes to preconception care and patient activation measure following the 3-month app usage. Participants found the app acceptable (satisfaction rating was 72%), useful and informative. The app's usability and usefulness facilitated usage while manual data input and competing priorities were barriers which participants felt could be overcome via personalisation, automation and use of daily reminders. This is the first study to explore the acceptability and feasibility of a preconception and diabetes information app for women with diabetes. Triangulated data suggest that the app has potential to improve preconception care knowledge, attitudes and behaviours. However, in order for women with DM to realise the full potential of the app intervention, particularly improved maternal and fetal outcomes, further development and evaluation is required.
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Affiliation(s)
- Chidiebere H Nwolise
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, L1/16 Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF UK
| | - Nicola Carey
- School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
| | - Jill Shawe
- School of Nursing & Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
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Rauwerdink A, Kasteleyn MJ, Chavannes NH, Schijven MP. Successes of and Lessons From the First Joint eHealth Program of the Dutch University Hospitals: Evaluation Study. J Med Internet Res 2021. [PMID: 34842536 DOI: 10.1016/j.ceh.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A total of 8 Dutch university hospitals are at the forefront of contributing meaningfully to a future-proof health care system. To stimulate nationwide collaboration and knowledge-sharing on the topic of evidence-based eHealth, the Dutch university hospitals joined forces from 2016 to 2019 with the first Citrien Fund (CF) program eHealth; 29 eHealth projects with various subjects and themes were selected, supported, and evaluated. To determine the accomplishment of the 10 deliverables for the CF program eHealth and to contribute to the theory and practice of formative evaluation of eHealth in general, a comprehensive evaluation was deemed essential. OBJECTIVE The first aim of this study is to evaluate whether the 10 deliverables of the CF program eHealth were accomplished. The second aim is to evaluate the progress of the 29 eHealth projects to determine the barriers to and facilitators of the development of the CF program eHealth projects. METHODS To achieve the first aim of this study, an evaluation study was carried out using an adapted version of the Commonwealth Scientific and Industrial Research Organization framework. A mixed methods study, consisting of a 2-part questionnaire and semistructured interviews, was conducted to analyze the second aim of the study. RESULTS The 10 deliverables of the CF program eHealth were successfully achieved. The program yielded 22 tangible eHealth solutions, and significant knowledge on the development and use of eHealth solutions. We have learned that the patient is enthusiastic about accessing and downloading their own medical data but the physicians are more cautious. It was not always possible to implement the Dutch set of standards for interoperability, owing to a lack of information technology (IT) capacities. In addition, more attention needed to be paid to patients with low eHealth skills, and education in such cases is important. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the success of the 29 projects. The in-depth interviews illustrated that a novel eHealth solution should fulfill a need, that partners already having the knowledge and means to accelerate development should be involved, that clear communication with IT developers and other stakeholders is crucial, and that having a dedicated project leader with sufficient time is of utmost importance for the success of a project. CONCLUSIONS The 8 Dutch university hospitals were able to collaborate successfully and stimulate through a bottom-up approach, nationwide eHealth development and knowledge-sharing. In total, 22 tangible eHealth solutions were developed, and significant eHealth knowledge about their development and use was shared. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the successful progress of the projects and should therefore be closely monitored when developing novel eHealth solutions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.ceh.2020.12.002.
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Affiliation(s)
- Anneloek Rauwerdink
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
- Citrien Fund program eHealth, Amsterdam, Netherlands
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27
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Rauwerdink A, Kasteleyn MJ, Chavannes NH, Schijven MP. Successes of and Lessons From the First Joint eHealth Program of the Dutch University Hospitals: Evaluation Study. J Med Internet Res 2021; 23:e25170. [PMID: 34842536 PMCID: PMC8663485 DOI: 10.2196/25170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/23/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A total of 8 Dutch university hospitals are at the forefront of contributing meaningfully to a future-proof health care system. To stimulate nationwide collaboration and knowledge-sharing on the topic of evidence-based eHealth, the Dutch university hospitals joined forces from 2016 to 2019 with the first Citrien Fund (CF) program eHealth; 29 eHealth projects with various subjects and themes were selected, supported, and evaluated. To determine the accomplishment of the 10 deliverables for the CF program eHealth and to contribute to the theory and practice of formative evaluation of eHealth in general, a comprehensive evaluation was deemed essential. OBJECTIVE The first aim of this study is to evaluate whether the 10 deliverables of the CF program eHealth were accomplished. The second aim is to evaluate the progress of the 29 eHealth projects to determine the barriers to and facilitators of the development of the CF program eHealth projects. METHODS To achieve the first aim of this study, an evaluation study was carried out using an adapted version of the Commonwealth Scientific and Industrial Research Organization framework. A mixed methods study, consisting of a 2-part questionnaire and semistructured interviews, was conducted to analyze the second aim of the study. RESULTS The 10 deliverables of the CF program eHealth were successfully achieved. The program yielded 22 tangible eHealth solutions, and significant knowledge on the development and use of eHealth solutions. We have learned that the patient is enthusiastic about accessing and downloading their own medical data but the physicians are more cautious. It was not always possible to implement the Dutch set of standards for interoperability, owing to a lack of information technology (IT) capacities. In addition, more attention needed to be paid to patients with low eHealth skills, and education in such cases is important. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the success of the 29 projects. The in-depth interviews illustrated that a novel eHealth solution should fulfill a need, that partners already having the knowledge and means to accelerate development should be involved, that clear communication with IT developers and other stakeholders is crucial, and that having a dedicated project leader with sufficient time is of utmost importance for the success of a project. CONCLUSIONS The 8 Dutch university hospitals were able to collaborate successfully and stimulate through a bottom-up approach, nationwide eHealth development and knowledge-sharing. In total, 22 tangible eHealth solutions were developed, and significant eHealth knowledge about their development and use was shared. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the successful progress of the projects and should therefore be closely monitored when developing novel eHealth solutions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.ceh.2020.12.002.
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Affiliation(s)
- Anneloek Rauwerdink
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
- Citrien Fund program eHealth, Amsterdam, Netherlands
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Mobile 5P-Medicine Approach for Cardiovascular Patients. SENSORS 2021; 21:s21216986. [PMID: 34770292 PMCID: PMC8587644 DOI: 10.3390/s21216986] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 12/13/2022]
Abstract
Medicine is heading towards personalized care based on individual situations and conditions. With smartphones and increasingly miniaturized wearable devices, the sensors available on these devices can perform long-term continuous monitoring of several user health-related parameters, making them a powerful tool for a new medicine approach for these patients. Our proposed system, described in this article, aims to develop innovative solutions based on artificial intelligence techniques to empower patients with cardiovascular disease. These solutions will realize a novel 5P (Predictive, Preventive, Participatory, Personalized, and Precision) medicine approach by providing patients with personalized plans for treatment and increasing their ability for self-monitoring. Such capabilities will be derived by learning algorithms from physiological data and behavioral information, collected using wearables and smart devices worn by patients with health conditions. Further, developing an innovative system of smart algorithms will also focus on providing monitoring techniques, predicting extreme events, generating alarms with varying health parameters, and offering opportunities to maintain active engagement of patients in the healthcare process by promoting the adoption of healthy behaviors and well-being outcomes. The multiple features of this future system will increase the quality of life for cardiovascular diseases patients and provide seamless contact with a healthcare professional.
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Hörhammer I, Kujala S, Hilama P, Heponiemi T. Building Primary Health Care Personnel's Support for a Patient Portal While Alleviating eHealth-Related Stress: Survey Study. J Med Internet Res 2021; 23:e28976. [PMID: 34550087 PMCID: PMC8495577 DOI: 10.2196/28976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/18/2021] [Accepted: 07/05/2021] [Indexed: 01/27/2023] Open
Abstract
Background Health care personnel’s (HCP) engagement in patient portal implementation is necessary in embedding the use of the portal in everyday practices of a health care organization. While portal implementation may raise personnel’s positive expectations of the benefits in patient care, it is often also stressful for them due to increased workloads and disruptions in clinical workflows. An understanding of social and technical factors that build personnel’s support for patient portal implementation and alleviate their eHealth-related stress is therefore needed to realize the full potential of portals. Objective The aim of this study was to explore the influence of managerial implementation practices, information technology (IT) usability, and personnel’s eHealth competences on support for patient portal implementation and eHealth-related stress among primary HCP. Methods The data were collected through a survey of 919 members at 2 health organizations in Finland. Linear and logistic regression models were fitted to study the associations between the variables. Results Professionals’ eHealth competence (β=.15, P<.001), usability (β=.11, P<.001), and implementation practices (β=.07, P<.001) were positively associated with professionals’ support and negatively associated with professionals eHealth-related stress (β=−.07, P=.010; β=−.27, P<.001; and β=−.14, P<.001, respectively). Professionals’ support was associated with their promotion of the portal to the patients (odds ratio 1.22, 95% CI 1.07-1.40). Conclusions The adoption of appropriate implementation practices and the usability of the technology can build personnel’s support for a patient portal and alleviate their stress related to eHealth. Personnel’s support is manifested in their promotion of the portal to patients. Health care managers are encouraged to consider the usability of the technology and the good implementation practices, such as proper informing, engagement of the personnel in planning the services, and allocation of resources to improve eHealth competence, as prerequisites for meaningful and sustainable use of patient portals.
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Affiliation(s)
- Iiris Hörhammer
- Department of Industrial Engineering and Management, Aalto University, Espoo, Finland
| | - Sari Kujala
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Pirjo Hilama
- Social Health Care Joint Authority of South-Savo, Mikkeli, Finland
| | - Tarja Heponiemi
- Social and Health System Research Unit, National Institute for Health and Welfare, Helsinki, Finland
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Bombana M, Wittek M, Müller G, Heinzel-Gutenbrunner M, Wensing M. Women's Media Use and Preferences of Media-Based Interventions on Lifestyle-Related Risk Factors in Gynecological and Obstetric Care: A Cross-Sectional Multi-Center Study in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189840. [PMID: 34574762 PMCID: PMC8466324 DOI: 10.3390/ijerph18189840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate factors affecting (1) women’s media use regarding health-related behaviors during pregnancy and lactation, (2) women’s preferences for media format, and (3) the content of media-based interventions on lifestyle-related risk factors during pregnancy and lactation. A cross-sectional observational multi-center study of pregnant and lactating women and women of childbearing age was carried out in 14 randomly selected obstetric and gynecologic care settings in the 12 most populated cities in Baden-Wuerttemberg, South-West Germany. Data from 219 surveyed women showed that older women, pregnant women, and lactating women have a higher probability of using media during pregnancy and lactation, respectively. The majority of women preferred a combination of analog and digital media-based interventions in gynecological (46.9%) and obstetric (47.1%) care settings and at home (73.0%). Women would like to see information brochures and flyers on health-related behaviors during pregnancy and lactation for use in gynecological and obstetric care settings, and for media use at home, they would like to have books. The probability of preferring the favored media formats in gynecological and obstetric care settings and at home were associated with pregnancy status, relationship status, socioeconomic status (SES), ethnicity, and health insurance status. About 80% of the surveyed women preferred media content regarding recommendations for a healthy lifestyle and healthy behavior during pregnancy and lactation. All of the independent variables were associated with the probability of preferring a specific media content. The SES was found to play a major role in the probability of preferring a specific media content, followed by pregnancy status, ethnicity, and health insurance status. The results from our study provide a basis for tailored preventive interventions in gynecological and obstetric care settings and for use at home. The results imply that a woman can be reached before conception, during pregnancy, or during lactation with preventive measures tailored to their requirements; however, acceptance may vary across personal attributes, such as SES, ethnicity, and others.
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Affiliation(s)
- Manuela Bombana
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
- Department of Health Promotion, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany;
- Correspondence: ; Tel.: +49-711-2593-7945
| | - Maren Wittek
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
| | - Gerhard Müller
- Department of Health Promotion, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany;
| | | | - Michel Wensing
- Department of General Practice and Health Service Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.W.); (M.W.)
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Müller SD, Wehner DL, Konzag H, Vesterby M, Høybye MT. The paradox of project success despite lack of the "My Pathway" telehealth platform usage. Health Informatics J 2021; 27:1460458220976734. [PMID: 33438499 DOI: 10.1177/1460458220976734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The article investigates the paradoxical success of a Danish telehealth project introducing the "My Pathway" platform to reduce the length of patient stays while maintaining patient satisfaction. These goals were achieved in the project, which was considered successful despite the lack of actual platform usage. Based on a qualitative, longitudinal case study we investigate this paradox by showing how barriers and facilitators have influenced telehealth adoption and use in the post-implementation process, affecting the overall success of the project. The study makes two contributions. First, it describes dynamics of adoption barriers, that is, that barriers are interrelated and influence adoption to varying degrees over time. Adoption barriers resulted in the telehealth platform not being used and it consequently only influenced the actual project success and goal achievement indirectly. Second, it highlights information management as a critical facilitator in telehealth adoption and use. Information management facilitated achievement of project goals despite the lack of actual use of "My Pathway," which explains the paradoxical project success. Based on these interpretations, we point to information management as a critical facilitator of the success of telehealth initiatives and provide recommendations for research and practice.
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Stampe K, Kishik S, Müller SD. Mobile Health in Chronic Disease Management and Patient Empowerment: Exploratory Qualitative Investigation Into Patient-Physician Consultations. J Med Internet Res 2021; 23:e26991. [PMID: 34128817 PMCID: PMC8277350 DOI: 10.2196/26991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/03/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Chronic diseases often present severe consequences for those affected. The management and treatment of chronic diseases largely depend on patients’ lifestyle choices and how they cope with the disease in their everyday lives. Accordingly, the ability of patients to self-manage diseases is a highly relevant topic. In relation to self-management, studies refer to patient empowerment as strengthening patients’ voices and enabling them to assert control over their health and treatment. Mobile health (mHealth) provides cost-efficient means to support self-management and foster empowerment. Objective There is a scarcity of research investigating how mHealth affects patient empowerment during patient-physician consultations. The objective of this study is to address this knowledge gap by investigating how mHealth affects consultations and patient empowerment. Methods We relied on data from an ethnographic field study of 6 children and adolescents diagnosed with juvenile idiopathic arthritis. We analyzed 6 patient-physician consultations and drew on Michel Foucault’s concepts of power and power technology. Results Our results suggest that the use of mHealth constitutes practices that structure the consultations around deviations and noncompliant patient behavior. Our analysis shows how mHealth is used to discipline patients and correct their behavior. We argue that the use of mHealth during consultations may unintentionally lead to relevant aspects of patients’ lives related to the disease being ignored; thus, inadvertently, patients’ voices may be silenced. Conclusions Our results show that concrete uses of mHealth may conflict with extant literature on empowerment, which emphasizes the importance of strengthening the patients’ voices and enabling patients to take more control of their health and treatment. We contribute to the state-of-the-art knowledge by showing that the use of mHealth may have unintended consequences that do not lead to empowerment. Our analysis underscores the need for further research to investigate how mHealth impacts patient empowerment during consultations.
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Affiliation(s)
- Kathrine Stampe
- Department of Management, School of Business and Social Sciences, Aarhus University, Aarhus V, Denmark
| | - Sharon Kishik
- Department of Management, School of Business and Social Sciences, Aarhus University, Aarhus V, Denmark
| | - Sune Dueholm Müller
- Department of Management, School of Business and Social Sciences, Aarhus University, Aarhus V, Denmark
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Lazarou I, Stavropoulos TG, Mpaltadoros L, Nikolopoulos S, Koumanakos G, Tsolaki M, Kompatsiaris IY. Human Factors and Requirements of People with Cognitive Impairment, Their Caregivers, and Healthcare Professionals for mHealth Apps Including Reminders, Games, and Geolocation Tracking: A Survey-Questionnaire Study. J Alzheimers Dis Rep 2021; 5:497-513. [PMID: 34368634 PMCID: PMC8293665 DOI: 10.3233/adr-201001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Mobile Health (mHealth) apps can delay the cognitive decline of people with dementia (PwD), by providing both objective assessment and cognitive enhancement. Objective: This patient involvement survey aims to explore human factors, needs and requirements of PwD, their caregivers, and Healthcare Professionals (HCPs) with respect to supportive and interactive mHealth apps, such as brain games, medication reminders, and geolocation trackers through a constructive questionnaire. Methods: Following the principles of user-centered design to involve end-users in design we constructed a questionnaire, containing both open-ended and closed-ended questions as well as multiple choice and Likert scale, in order to investigate the specific requirements and preferences for mHealth apps. We recruited 48 participants including people with cognitive impairment (n = 15), caregivers (n = 16), and HCPs (n = 17) and administered the questionnaire. Results: All participants are likely to use mHealth apps, with the primary desired features being the improvement of memory and cognition, assistance on medication treatment, and perceived ease to use. HCPs, caregivers, and PwD consider brain games as an important technology-based, non-pharmaceutical intervention. Both caregivers and patients are willing to use a medication reminder app frequently. Finally, caregivers are worried about the patient wandering. Therefore, global positioning system tracking would be particularly important to them. On the other hand, patients are concerned about their privacy, but are still willing to use a geolocation app for cases of emergency. Conclusion: This research contributes to mHealth app design and potential adoption. All three groups agree that mHealth services could facilitate care and ameliorate behavioral and cognitive disturbances of patients.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Greece.,Medical School, Neuroscience Department, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Thanos G Stavropoulos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Greece
| | - Lampros Mpaltadoros
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Greece
| | - Spiros Nikolopoulos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Greece
| | | | - Magda Tsolaki
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD-Alzheimer Hellas), Thessaloniki, Greece.,Medical School, Neuroscience Department, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
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Darker CD, Moore E, Flynn E, O'Neill M, Doherty L, McMahon J, McLoughlin O, Rouine E, Ivers JH, Allwright S, McGrath D, Seery A, McAndrew M, Barrett E, Tanner M, Bennett AE, Brennan S, Mullin M, Barry JM. Development and proposed evaluation of an eHealth learning tool for undergraduate university students in Ireland. Health Promot Int 2021; 37:6289848. [PMID: 34056643 DOI: 10.1093/heapro/daab071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Undergraduate university students are at a critical stage of development in terms of their academic, social, psychological and behavioural health. Patterns established during these formative years can last a lifetime. eHealth tools have the potential to be engaging, convenient and accessible to a wide range of students by providing health information and enhancing the uptake of positive health behaviours. The 'Healthy Trinity Online Tool' (H-TOT) was developed in collaboration with students and a transdisciplinary team with decades of experience between them in terms of research, clinical responsibility and service delivery. Developmental steps undertaken included: a literature review to formulate the topic content choices; a survey of students to check the relevance and suitability of topics identified; and, the tacit experience of the development team. This co-design model led to the development of content encompassing academic life, healthy eating, physical activity, mood, financial matters, alcohol, tobacco, drugs and relaxation. Qualitative focus groups were subsequently conducted for in-depth exploration of the usage and functionality of H-TOT. The theoretical underpinnings include the locus of control and social cognitive theory. Evidence-based behavioural change techniques are embedded throughout. During early pre-piloting of H-TOT, the team identified and solved content functionality problems. The tone of the content was also revised to ensure it was non-judgemental. To make the H-TOT as interactive as possible, video scenarios were included and all content was audio-recorded to allow playback for students with visual or learning difficulties. Evaluation plans for the pilot year of H-TOT are outlined.
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Affiliation(s)
- Catherine D Darker
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Emma Moore
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Ellen Flynn
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Mary O'Neill
- School of Medicine, Trinity Centre for Health Sciences, St James's Healthcare Campus, Old Stone Building, Dublin, D08 W9RT, Ireland
| | - Lena Doherty
- Faculty of Health Sciences, The University of Dublin, Trinity College, College Street, Dublin, D02 PN40, Ireland
| | - Jean McMahon
- Library Services, Tallaght University Hospital, Tallaght, Dublin, D24 NR04, Ireland
| | - Orla McLoughlin
- Student Counselling Service, 7-9 Leinster Street South, Dublin, D02 K104, Ireland
| | - Eimear Rouine
- Office of Chief Operating Officer, The University of Dublin, Trinity College, West Theatre, Dublin, D02 PN40, Ireland
| | - Jo-Hanna Ivers
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Shane Allwright
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - David McGrath
- College Health Service, The University of Dublin, Trinity College, College Street, House 47, Dublin, D02 PN40, Ireland
| | - Aidan Seery
- Senior Tutor Office, The University of Dublin, Trinity College, College Street, House 27, Dublin, D02 PN40, Ireland
| | - Martin McAndrew
- Senior Tutor Office, The University of Dublin, Trinity College, College Street, House 27, Dublin, D02 PN40, Ireland
| | - Emer Barrett
- Discipline of Physiotherapy, Trinity Centre for Health Sciences, St James's Healthcare Campus, Dublin, D08 W9RT, Ireland
| | - Michelle Tanner
- Trinity College Sports Centre, The University of Dublin, Trinity College, 43 Pearse Street, Dublin, D02 WO85, Ireland
| | - Annemarie E Bennett
- Unit of Nutrition and Dietetics, Discipline of Clinical Medicine, Trinity Centre for Health Sciences, St James's Healthcare Campus, Dublin, D08 W9RT, Ireland
| | - Sabina Brennan
- ADAPT Centre, O'Reilly Institute, The University of Dublin, Trinity College, College Street, Dublin, D02 PN40, Ireland
| | - Martina Mullin
- College Health Service, The University of Dublin, Trinity College, College Street, House 47, Dublin, D02 PN40, Ireland
| | - Joe M Barry
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
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Parmar B, Beukes E, Rajasingam S. The impact of COVID-19 on provision of UK audiology services & on attitudes towards delivery of telehealth services. Int J Audiol 2021; 61:228-238. [PMID: 34010078 DOI: 10.1080/14992027.2021.1921292] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To (i) identify the impact of COVID-19 on provision of UK audiology services across sectors (ii) compare teleaudiology service provision between private and public sectors before and after the introduction of restrictions and (iii) identify barriers to teleaudiology delivery amongst UK hearing care professionals in both sectors. DESIGN A mixed-methods cross-sectional survey study design. Responses to the structured questionnaire were analysed using descriptive and non-parametric statistics. STUDY SAMPLE UK based hearing care professionals (HCP) (n = 323) completed the survey (218 public sector; 89 private sector). RESULTS Changes in working patterns varied greatly between different sectors, with 61% of national employed and 26% of independent HCPs being furloughed, compared with 1% in the public sector. Use of telehealth was under-utilised across all sectors and groups in UK hearing healthcare, despite 92% of public and 75% of private HCPs reporting feeling comfortable conducting remote consultations. CONCLUSION This study highlights a variation in teleaudiology adoption and key barriers across sector in the UK. A collaborative approach between hearing device manufacturers, research centres, HCPs and professional bodies is required for the creation of targeted guidance and training materials according to sector, to support clinicians in effective teleaudiology provision.
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Affiliation(s)
- Bhavisha Parmar
- UCL Ear Institute, University College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Eldre Beukes
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom of Great Britain and Northern Ireland
| | - Saima Rajasingam
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom of Great Britain and Northern Ireland
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Villalba-Mora E, Ferre X, Pérez-Rodríguez R, Moral C, Valdés-Aragonés M, Sánchez-Sánchez A, Rodríguez-Mañas L. Home Monitoring System for Comprehensive Geriatric Assessment in Patient's Dwelling: System Design and UX Evaluation. Front Digit Health 2021; 3:659940. [PMID: 34713133 PMCID: PMC8521833 DOI: 10.3389/fdgth.2021.659940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/29/2021] [Indexed: 12/04/2022] Open
Abstract
Population aging threatens the sustainability of welfare systems since it is not accompanied by an extended healthy and independent period in the last years of life. The Comprehensive Geriatric Assessment (CGA) has been shown to be efficient in maintaining the healthy period at the end of the life. Frailty monitoring is typically carried out for an average period of 6 months in clinical settings, while more regular monitoring could prevent the transition to disability. We present the design process of a system for frailty home monitoring based on an adapted CGA and the rationale behind its User eXperience (UX) design. The resulting home monitoring system consists of two devices based on ultrasound sensors, a weight scale, and a mobile application for managing the devices, administering CGA-related questionnaires, and providing alerts. Older users may encounter barriers in their usage of technology. For this reason, usability and acceptability are critical for health monitoring systems addressed to geriatric patients. In the design of our system, we have followed a user-centered process, involving geriatricians and older frail patients by means of co-creation methods. In the iterative process of design and usability testing, we have identified the most effective way of conducting the home-based CGA, not just by replicating the dialogue between the physician and the patient, but by adapting the design to the possibilities and limitations of mobile health for this segment of users. The usability evaluation, carried out with 14 older adults, has proved the feasibility of users older than 70 effectively using our monitoring system, additionally showing an intention over 80% for using the system. It has also provided some insights and recommendations for the design of mobile health systems for older users.
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Affiliation(s)
- Elena Villalba-Mora
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Xavier Ferre
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Cristian Moral
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
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Stavropoulos TG, Lazarou I, Diaz A, Gove D, Georges J, Manyakov NV, Pich EM, Hinds C, Tsolaki M, Nikolopoulos S, Kompatsiaris I. Wearable Devices for Assessing Function in Alzheimer's Disease: A European Public Involvement Activity About the Features and Preferences of Patients and Caregivers. Front Aging Neurosci 2021; 13:643135. [PMID: 33912025 PMCID: PMC8072390 DOI: 10.3389/fnagi.2021.643135] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/10/2021] [Indexed: 01/18/2023] Open
Abstract
Background: Alzheimer's Disease (AD) impairs the ability to carry out daily activities, reduces independence and quality of life and increases caregiver burden. Our understanding of functional decline has traditionally relied on reports by family and caregivers, which are subjective and vulnerable to recall bias. The Internet of Things (IoT) and wearable sensor technologies promise to provide objective, affordable, and reliable means for monitoring and understanding function. However, human factors for its acceptance are relatively unexplored. Objective: The Public Involvement (PI) activity presented in this paper aims to capture the preferences, priorities and concerns of people with AD and their caregivers for using monitoring wearables. Their feedback will drive device selection for clinical research, starting with the study of the RADAR-AD project. Method: The PI activity involved the Patient Advisory Board (PAB) of the RADAR-AD project, comprised of people with dementia across Europe and their caregivers (11 and 10, respectively). A set of four devices that optimally represent various combinations of aspects and features from the variety of currently available wearables (e.g., weight, size, comfort, battery life, screen types, water-resistance, and metrics) was presented and experienced hands-on. Afterwards, sets of cards were used to rate and rank devices and features and freely discuss preferences. Results: Overall, the PAB was willing to accept and incorporate devices into their daily lives. For the presented devices, the aspects most important to them included comfort, convenience and affordability. For devices in general, the features they prioritized were appearance/style, battery life and water resistance, followed by price, having an emergency button and a screen with metrics. The metrics valuable to them included activity levels and heart rate, followed by respiration rate, sleep quality and distance. Some concerns were the potential complexity, forgetting to charge the device, the potential stigma and data privacy. Conclusions: The PI activity explored the preferences, priorities and concerns of the PAB, a group of people with dementia and caregivers across Europe, regarding devices for monitoring function and decline, after a hands-on experience and explanation. They highlighted some expected aspects, metrics and features (e.g., comfort and convenience), but also some less expected (e.g., screen with metrics).
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Affiliation(s)
- Thanos G Stavropoulos
- Center for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
| | - Ioulietta Lazarou
- Center for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece.,Medical School, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Ana Diaz
- Alzheimer Europe (AE), Luxembourg City, Luxembourg
| | - Dianne Gove
- Alzheimer Europe (AE), Luxembourg City, Luxembourg
| | - Jean Georges
- Alzheimer Europe (AE), Luxembourg City, Luxembourg
| | - Nikolay V Manyakov
- Clinical Insights and Experience, Janssen Research and Development, Beerse, Belgium
| | | | - Chris Hinds
- Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Magda Tsolaki
- Medical School, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD-Alzheimer Hellas), Thessaloniki, Greece
| | - Spiros Nikolopoulos
- Center for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Center for Research and Technology Hellas (CERTH-ITI), Information Technologies Institute, Thessaloniki, Greece
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Russ S, Sevdalis N, Ocloo J. A Smartphone App Designed to Empower Patients to Contribute Toward Safer Surgical Care: Qualitative Evaluation of Diverse Public and Patient Perceptions Using Focus Groups. JMIR Mhealth Uhealth 2021; 9:e24065. [PMID: 33830062 PMCID: PMC8063097 DOI: 10.2196/24065] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/15/2021] [Accepted: 01/31/2021] [Indexed: 12/28/2022] Open
Abstract
Background MySurgery is a smartphone app designed to empower patients and their caregivers to contribute toward safer surgical care by following practical advice to help reduce susceptibility to errors and complications. Objective The aim of this study is to evaluate service users’ perceptions of MySurgery, including its perceived acceptability, the potential barriers and facilitators to accessing and using its content, and ideas about how to facilitate its effective implementation. The secondary aim is to analyze how the intended use of the app might differ for diverse patients, including seldom-heard groups. Methods We implemented a diversity approach to recruit participants from a range of backgrounds with previous experience of surgery. We aimed to achieve representation from seldom-heard groups, including those from a Black, Asian, and minority ethnic (BAME) background; those with a disability; and those from the lesbian, gay, bisexual, transgender, queer (LGBT+) community. A total of 3 focus groups were conducted across a 2-month period, during which a semistructured protocol was followed to elicit a rich discussion around the app. The focus groups were audio recorded, and thematic analysis was carried out. Results In total, 22 individuals participated in the focus groups. A total of 50% (n=11) of the participants were from a BAME background, 59% (n=13) had a disability, and 36% (n=8) were from the LGBT+ community. There was a strong degree of support for the MySurgery app. The majority of participants agreed that it was acceptable and appropriate in terms of content and usability, and that it would help to educate patients about how to become involved in improving safety. The checklist-like format was popular. There was rich discussion around the accessibility and inclusivity of MySurgery. Specific user groups were identified who might face barriers in accessing the app or acting on its advice, such as those with visual impairments or learning difficulties and those who preferred to take a more passive role (eg, some individuals because of their cultural background or personality type). The app could be improved by signposting further specialty-specific information and incorporating a calendar and notes section. With regard to implementation, it was agreed that use of the app should be signposted before the preoperative appointment and that training and education should be provided for clinicians to increase awareness and buy-in. Communication about the app should clarify its scientific basis in plain English and should stress that its use is optional. Conclusions MySurgery was endorsed as a powerful tool for enhancing patient empowerment and facilitating the direct involvement of patients and their caregivers in maintaining patient safety. The diversity approach allowed for a better understanding of the needs of different population groups and highlighted opportunities for increasing accessibility and involvement in the app.
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Affiliation(s)
- Stephanie Russ
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Nick Sevdalis
- Centre for Implementation Science, King's College London, London, United Kingdom
| | - Josephine Ocloo
- Centre for Implementation Science, King's College London, London, United Kingdom
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Paulsen MM, Varsi C, Andersen LF. Process evaluation of the implementation of a decision support system to prevent and treat disease-related malnutrition in a hospital setting. BMC Health Serv Res 2021; 21:281. [PMID: 33766017 PMCID: PMC7995565 DOI: 10.1186/s12913-021-06236-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/26/2021] [Indexed: 12/15/2022] Open
Abstract
Background Malnutrition is present in 30% of hospitalized patients and has adverse outcomes for the patient and the healthcare system. The current practice for nutritional care is associated with many barriers. The MyFood decision support system was developed to prevent and treat malnutrition. Methods This paper reports on a process evaluation that was completed within an effectiveness trial. MyFood is a digital tool with an interface consisting of an app and a website. MyFood includes functions to record and evaluate dietary intake. It also provides reports to nurses, including tailored recommendations for nutritional treatment. We used an effectiveness-implementation hybrid design in a randomized controlled trial. The RE-AIM (Reach, Efficiency, Adoption, Implementation, Maintenance) framework was used to perform a process evaluation alongside the randomized controlled trial, using a combination of quantitative and qualitative methods. An implementation plan, including implementation strategies, was developed to plan and guide the study. Results Reach: In total, 88% of eligible patients consented to participate (n = 100). Adoption: Approximately 75% of the nurses signed up to use MyFood and 50% used the reports. Implementation: MyFood empowered the patients in their nutritional situation and acted as a motivation to eat to reach their nutritional target. The compliance of using MyFood was higher among the patients than the nurses. A barrier for use of MyFood among the nurses was different digital systems which were not integrated and the log-in procedure to the MyFood website. Despite limited use by some nurses, the majority of the nurses claimed that MyFood was useful, better than the current practice, and should be implemented in the healthcare system. Conclusions This study used a process evaluation to interpret the results of a randomized controlled trial more in-depth. The patients were highly compliant, however, the compliance was lower among the nurses. MyFood empowered the patients in their nutritional situation, the usability was considered as high, and the experiences and attitudes towards MyFood were primarily positive. Focus on strategies to improve the nurses’ compliance may in the future improve the MyFood system’s potential. Trial registration The trial was registered in ClinicalTrials.gov 26/01/2018 (NCT03412695). Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06236-3.
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Affiliation(s)
- Mari Mohn Paulsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, box 1110 Blindern, 0317, Oslo, Norway. .,National Advisory Unit on Disease-related Undernutrition, Division of Cancer Medicine, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway.
| | - Cecilie Varsi
- Center for Digital Health Research, Oslo University Hospital, Division of Medicine, Aker hospital, box 4959 Nydalen, 0424, Oslo, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, box 1110 Blindern, 0317, Oslo, Norway
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Ou CY, Yasmin M, Ussatayeva G, Lee MS, Dalal K. Maternal Delivery at Home: Issues in India. Adv Ther 2021; 38:386-398. [PMID: 33128202 PMCID: PMC7854433 DOI: 10.1007/s12325-020-01551-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/23/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Maternal delivery at home without skilled care at birth is a major public health issue. The current study aimed to assess the various contributing and eliminating factors of maternal delivery at home in India. The reasons for not delivering at healthcare facilities were also explored. METHODS The study used the National Family Health Surveys (NFHS)-4 (2015-2016) data from states and union territories of India for analysis. A national representative sample of 699,686 women of reproductive age group (15-49 years) was used. Cross-tabulation and multivariate logistic regression analyses were performed. RESULTS The prevalence of home delivery in India was 22%, among which 34% of women believed that institutional delivery was not a necessity. Financial constraints, lack of proper transportation facilities, non-accessibility of healthcare institutions and not getting permission from family members were the main reasons cited by the women for delivering at home. The proportion of home deliveries was much higher among women from more disadvantaged socioeconomic areas than women from less disadvantaged socioeconomic areas. Domestic violence and partner control were essential factors contributing to the prevalence of home delivery. However, the women who owned mobile phones and used a short message service (SMS) facility delivered at home less often. CONCLUSION Policymakers should focus more on the women living in disadvantaged socioeconomic areas and other marginalised populations with less education and low economic levels to provide them with optimum delivery care utilisation. Strengthening of public healthcare facilities and more effective use of skilled birth attendents and their networking are essential steps. Electronic and economic empowerment of women should be emphasised to bring about a significant reduction in the proportion of home deliveries in India.
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Affiliation(s)
- Chung-Ya Ou
- School of Public Administration, Nanfang College of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Masuma Yasmin
- Kolkata Hematology Education and Research Initiatives, Kolkata, India
| | - Gainel Ussatayeva
- Department of Epidemiology, Biostatistics and EBM, Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Ming-Shinn Lee
- Department of Education and Human Potentials Development, National Dong-Hwa University, Hualien, Taiwan
| | - Koustuv Dalal
- Department of Epidemiology, Biostatistics and EBM, Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan.
- Department of Public Health Science, School of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
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Complexity of Patient Data in Primary Care Practice. SYSTEMS MEDICINE 2021. [DOI: 10.1016/b978-0-12-801238-3.11590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Grussu P, Quatraro RM, Jorizzo GJ. Supporting perinatal women in the context of the COVID-19 emergency: can web-based antenatal education classes make it possible? J Reprod Infant Psychol 2020; 38:471-473. [PMID: 33073593 DOI: 10.1080/02646838.2020.1834261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Pietro Grussu
- Consultorio Familiare, Azienda ULSS 6 Euganea, Veneto Region, National Health Service , Italy
| | - Rosa Maria Quatraro
- Hospital Psychology Unit, Obstetrics and Gynaecology Section, Azienda ULSS 8 Berica, Veneto Region, National Health Service , Italy.,Maternità in difficoltà® , Padova and Vicenza, Italy
| | - Gianfranco J Jorizzo
- Prenatal Medicine, Azienda ULSS 6 Euganea, Veneto Region, National Health Service , Italy
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Russo GA, Oliveri S, Cincidda C, Guiddi P, Pravettoni G. Exploring public attitude toward biofeedback technologies: Knowledge, preferences and personality tendencies. J Public Health Res 2020; 9:1782. [PMID: 33209858 PMCID: PMC7662746 DOI: 10.4081/jphr.2020.1782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022] Open
Abstract
Background: Biofeedback is increasingly used in the clinical area and in daily health monitoring through wearable devices (e.g. smart watches). Nevertheless, it remains rather unknown. This study aimed to assess, in a sample of Italian citizens, the level of knowledge, attitudes, perceived efficacy and personality tendencies which could affect the uptake of biofeedback technologies. Design and Methods: Participants were recruited by advertising the survey on the social networks, from March to May 2019. 160 subjects filled in an ad hoc online questionnaire assessing socio-demographic variables, clinical status, physical activity, knowledge and attitude towards biofeedback, psychological tendencies toward health. Results: Data showed a good level of interest in biofeedback training in spite of poor knowledge about such technologies. Sport and chronic diseases were not correlated to a greater use of biofeedback. People informed about biofeedback technologies were more interested in undergoing biofeedback training and had higher scores in the Health Locus of Control. Finally, people who showed a positive perception of their own health (Health Esteem) did not rely on these technologies. Discussion: Despite the huge spread of biofeedback technologies, our results disconfirmed the expectation that people having an active lifestyle or a disease were more familiar with biofeedback systems. The attitude toward such technologies seems to depend on individual tendencies. Conclusions: This study suggests the importance to improve general public literacy on biofeedback technologies, tailor tools on their needs and characteristics, empower people’s sense of internal health control for promoting a valid use and a proper knowledge of biofeedback. Significance for public health Despite the huge application of biofeedback technologies in different areas, the technological progress and availability of biofeedback tools does not go hand-in-hand with the general public’s knowledge and attitude for such tools. This contribution focuses on the importance to improve general public literacy on these technologies, for disseminating correct messages on their usefulness for well-being, and highlight the importance to tailor technologies on people’s real needs.
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Affiliation(s)
- Gaetano A Russo
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan
| | - Serena Oliveri
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan
| | - Clizia Cincidda
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan.,Department of Oncology and Hemato-oncology, University of Milan, Italy
| | - Paolo Guiddi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan.,Department of Oncology and Hemato-oncology, University of Milan, Italy
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Karni L, Dalal K, Memedi M, Kalra D, Klein GO. Information and Communications Technology-Based Interventions Targeting Patient Empowerment: Framework Development. J Med Internet Res 2020; 22:e17459. [PMID: 32845245 PMCID: PMC7481871 DOI: 10.2196/17459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/04/2020] [Accepted: 06/03/2020] [Indexed: 01/22/2023] Open
Abstract
Background Empowerment of patients is often an explicit goal of various information and communications technology (ICT) (electronic, digital) interventions where the patients themselves use ICT tools via the internet. Although several models of empowerment exist, a comprehensive and pragmatic framework is lacking for the development of such interventions. Objective This study proposes a framework for digital interventions aiming to empower patients that includes a methodology that links objectives, strategies, and evaluation. Methods This study is based on a literature review and iterated expert discussions including a focus group to formulate the proposed model. Our model is based on a review of various models of empowerment and models of technology intervention. Results Our framework includes the core characteristics of the empowerment concept (control, psychological coping, self-efficacy, understanding, legitimacy, and support) as well as a set of empowerment consequences: expressed patient perceptions, behavior, clinical outcomes, and health systems effects. The framework for designing interventions includes strategies to achieve empowerment goals using different ICT services. Finally, the intervention model can be used to define project evaluations where the aim is to demonstrate empowerment. The study also included example indicators and associated measurement instruments. Conclusions This framework, which includes definitions, can be useful for the design and evaluation of digital interventions targeting patient empowerment and assist in the development of methods to measure results in this dimension. Further evaluation in the form of interventional studies will be needed to assess the generalizability of the model.
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Affiliation(s)
- Liran Karni
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
| | - Koustuv Dalal
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden.,School of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Mevludin Memedi
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
| | - Dipak Kalra
- European Institute for Innovation through Health Data, Gent, Belgium
| | - Gunnar Oskar Klein
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
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Ben-Sasson A, Ben-Sasson E, Jacobs K, Malinovitch R. The relationship between users’ technology approaches and experiences in a child development mobile application. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00457-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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46
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Frontini R, Sousa P, Dixe MA, Ferreira R, Figueiredo MC. Designing a mobile app to promote healthy behaviors and prevent obesity: analysis of adolescents' preferences. Inform Health Soc Care 2020; 45:327-341. [PMID: 32237933 DOI: 10.1080/17538157.2020.1725766] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To ensure that adolescents adhere to programmes promoting healthy behaviors, these programmes must be appealing and interesting. This study aims to characterize and assess the devices, operating system and type of mobile apps frequently used by adolescents; understand the features that mHealth apps should have to be appealing; comprehend the facilitators and barriers for adolescents to use mHealth apps. The sample comprised 165 adolescents (12-18 years) from the main population, recruited in 2018. Most participants used smartphones and the Android system. Food and physical activity suggestions were considered the most important features for an mHealth app. 62.6% had never tried an mHealth app. For those who had tried one, 26.0% stated it was to improve health status/lifestyle. Their favorite feature was physical exercise tips/plans (41.8%). Adolescents pointed out that the reasons that made them keep using the app were utility and interest (35.7%). Regarding possible barriers, 48.4% reported a lack of a senseof need/practical utility, and 18.8% considered notifications as their least favorite feature. Lack of interest was pointed out for 38.2% as the main reason for stopping use. Results provide practical information for the planning, design, and implementation of future mHealth apps for the promotion of healthy behaviors - an important implication for future research in this area.
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Affiliation(s)
- R Frontini
- ciTechCare, Escola Superior de Saúde, Instituto Politécnico de Leiria , Leiria, Portugal
| | - P Sousa
- ciTechCare, Escola Superior de Saúde, Instituto Politécnico de Leiria , Leiria, Portugal
| | - M A Dixe
- ciTechCare, Escola Superior de Saúde, Instituto Politécnico de Leiria , Leiria, Portugal
| | - R Ferreira
- CIIS-UCP, UI-IPSantarém, Escola Superior de Saúde de Santarém, Instituto Politécnico de Santarém , Santarém, Portugal
| | - M C Figueiredo
- CIIS-UCP, UI-IPSantarém, Escola Superior de Saúde de Santarém, Instituto Politécnico de Santarém , Santarém, Portugal
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Russ S, Latif Z, Hazell AL, Ogunmuyiwa H, Tapper J, Wachuku-King S, Sevdalis N, Ocloo J. A Smartphone App Designed to Empower Patients to Contribute Toward Safer Surgical Care: Community-Based Evaluation Using a Participatory Approach. JMIR Mhealth Uhealth 2020; 8:e12859. [PMID: 31958067 PMCID: PMC6997920 DOI: 10.2196/12859] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 08/26/2019] [Accepted: 09/26/2019] [Indexed: 11/27/2022] Open
Abstract
Background MySurgery is a smartphone app designed to increase patient and carer involvement in behaviors that contribute toward safety in surgical care. Objective This study presents a pilot evaluation of MySurgery in which we evaluated surgical patients’ perceptions of the app in terms of its content, usability, and potential impacts on communication and safety. Methods A participatory action research (PAR) approach was used to formulate a research steering group consisting of 5 public representatives and 4 researchers with equal decision-making input. Surgical patients were recruited from the community using multiple approaches, including Web based (eg, social media, recruitment websites, and charitable or voluntary organizations) and face to face (via community centers). Participants referred to MySurgery before, during, and after their surgery and provided feedback via an embedded questionnaire and using reflective notes. Results A diverse mix of 42 patients took part with good representation from 2 “seldom heard” groups: those with a disability and those from a black, Asian, or minority ethnic group. Most were very supportive of MySurgery, particularly those with previous experience of surgery and those who felt comfortable to be involved in conversations and decisions around their care. The app showed particular potential to empower patients to become involved in their care conversations and safety-related behaviors. Perceptions did not differ according to age, ethnicity, or length of hospital stay. Suggestions for improving the app included how to make it more accessible to certain groups, for example, those with a disability. Conclusions MySurgery is a novel technology-driven approach for empowering patients to play a role in improving surgical safety that seems feasible for use within the United Kingdom’s National Health Service. Adopting a PAR approach and the use of a diversity strategy considerably enhanced the research process in terms of gaining diverse participant recruitment and patient and public involvement. Further testing with stakeholder groups will follow.
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Greysen SR, Magan Y, Rosenthal J, Jacolbia R, Auerbach AD, Harrison JD. Patient Recommendations to Improve the Implementation of and Engagement With Portals in Acute Care: Hospital-Based Qualitative Study. J Med Internet Res 2020; 22:e13337. [PMID: 31934868 PMCID: PMC6996719 DOI: 10.2196/13337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/09/2019] [Accepted: 08/19/2019] [Indexed: 11/24/2022] Open
Abstract
Background The inclusion of patient portals into electronic health records in the inpatient setting lags behind progress in the outpatient setting. Objective The aim of this study was to understand patient perceptions of using a portal during an episode of acute care and explore patient-perceived barriers and facilitators to portal use during hospitalization. Methods We utilized a mixed methods approach to explore patient experiences in using the portal during hospitalization. All patients received a tablet with a brief tutorial, pre- and postuse surveys, and completed in-person semistructured interviews. Qualitative data were coded using thematic analysis to iteratively develop 18 codes that were integrated into 3 themes framed as patient recommendations to hospitals to improve engagement with the portal during acute care. Themes from these qualitative data guided our approach to the analysis of quantitative data. Results We enrolled 97 participants: 53 (53/97, 55%) women, 44 (44/97, 45%) nonwhite with an average age of 48 years (19-81 years), and the average length of hospitalization was 6.4 days. A total of 47 participants (47/97, 48%) had an active portal account, 59 participants (59/97, 61%) owned a smartphone, and 79 participants (79/97, 81%) accessed the internet daily. In total, 3 overarching themes emerged from the qualitative analysis of interviews with these patients during their hospital stay: (1) hospitals should provide both access to a device and bring-your-own-device platform to access the portal; (2) hospitals should provide an orientation both on how to use the device and how to use the portal; and (3) hospitals should ensure portal content is up to date and easy to understand. Conclusions Patients independently and consistently identified basic needs for device and portal access, education, and usability. Hospitals should prioritize these areas to enable successful implementation of inpatient portals to promote greater patient engagement during acute care. Trial Registration ClinicalTrials.gov NCT00102401; https://clinicaltrials.gov/ct2/show/NCT01970852
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Affiliation(s)
- S Ryan Greysen
- Section of Hospital Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Yimdriuska Magan
- School of Medicine, University of California, Davis, Davis, CA, United States
| | - Jamie Rosenthal
- School of Medicine, Boston University, Boston, MA, United States
| | - Ronald Jacolbia
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew D Auerbach
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - James D Harrison
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, United States
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Sousa P, Martinho R, Reis CI, Dias SS, Gaspar PJS, Dixe MDA, Luis LS, Ferreira R. Controlled trial of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower): Effectiveness analysis. J Adv Nurs 2019; 76:1057-1068. [PMID: 31880009 DOI: 10.1111/jan.14301] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/15/2019] [Accepted: 12/17/2019] [Indexed: 01/13/2023]
Abstract
AIM To evaluate the effectiveness on lifestyle change of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower) and to analyse the predictors of the mHealth intervention effectiveness. DESIGN This study is designed as a non-randomized controlled trial with a two-arm structure. METHODS Adolescents of 12-16-year old were recruited from three school districts, with access to the Internet and smartphone/tablet devices. The intervention group was invited to engage in the mHealth intervention (TeenPower) for 6 months in addition to a school-based intervention. The control group only followed the school-based intervention. A repeated measures factorial ANOVA was used and the main effectiveness outcome was the lifestyle change measured by the adolescent lifestyle profile. RESULTS The outcomes of the mHealth intervention (TeenPower) show a significant effect on nutrition (ƞ2 p = 0.03, p = .03), positive life perspective (ƞ2 p = 0.04, p = .01), and global lifestyle (ƞ2 p = 0.02, p = .05), with a dropout rate of 62.1%. The analysis of the effectiveness predictors of the mHealth intervention suggested that older adolescents tended to show a significant increase in the rates of stress management (r = .40; p < .05). CONCLUSIONS Although the considerable dropout rate, the mHealth intervention presented significant impact on multiple lifestyle domains, providing support for the effectiveness of mHealth interventions for health promotion as an add-on to standard interdisciplinary interventions. IMPACT Adolescents must have the necessary and appropriate knowledge for the correct and responsible decision-making regarding their health and lifestyle. Innovative strategies (mHealth intervention) were used to promote healthy behaviours. This study evaluates the effectiveness of an mHealth intervention (TeenPower) specifically designed for adolescents. We found a significant impact in several lifestyle domains such as health responsibility, nutrition, positive life perspective, and global lifestyle.
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Affiliation(s)
- Pedro Sousa
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.,ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Ricardo Martinho
- School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal.,Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
| | - Catarina I Reis
- School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal
| | - Sara S Dias
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal.,EpiDoC Unit - CEDOC, NOVA Medical School - Universidade Nova de Lisboa (NMS-UNL), Lisboa, Portugal
| | - Pedro J S Gaspar
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Maria Dos Anjos Dixe
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Luis S Luis
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Regina Ferreira
- CIIS-UC, UI-IPSantarém, School of Health Sciences, Polytechnic Institute of Santarém, Santarém, Portugal.,UMIS-School of Health Sciences, Santarém, Portugal
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A national eHealth vision developed by University Medical Centres: A concept mapping study. Int J Med Inform 2019; 133:104032. [PMID: 31778886 DOI: 10.1016/j.ijmedinf.2019.104032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND EHealth solutions are envisaged to contribute significantly to a sustainable healthcare system. Between 2016 and 2018 the eight Dutch University Medical Centers (UMCs) received Dutch Government's funding to undertake research into the clinical impact, cost-effectiveness and ethical consideration of eHealth. The UMCs collaborated within the consortium 'Citrien fund (CF) program eHealth' and found that, in order to increase the value of eHealth in routine care, a national vision on eHealth developed by the UMCs was warranted. OBJECTIVE The objective of this paper was to elucidate the process of the 'Netherlands Federation of UMCs (NFU) eHealth vision' development by describing the results of the performed concept mapping study. METHODS A concept mapping approach was followed. Sixteen members of the steering committee of the CF program eHealth were selected as participants. First, each member selected relevant objectives from the eight individual UMC eHealth vision documents, which was to be incorporated into the overall 'NFU eHealth vision'. Second, objectives were rated for necessary to be included in the vision document and the need to achieve the objective within five years. Thereafter, the objectives were sorted into self-created thematic clusters. And finally, the concept map with the thematic clusters and corresponding objectives was discussed with the steering committee to determine the major themes of the 'NFU eHealth vision'. RESULTS 38 objectives were determined by the steering committee and grouped into the following 6 thematic clusters on the concept map: 'patient participation and empowerment'; 'infrastructure'; 'education and research'; 'multi-disciplinary care'; 'organisational restructuring'; and 'essential conditions for development of eHealth solutions'. After discussing the concept mapping results with the steering committee, the following five major themes were determined to be addressed in the vision document: 'patient and caregiver'; 'research and innovation'; 'education'; 'organisation of care'; and 'essential conditions for development of eHealth solutions'. CONCLUSION Concept mapping was successfully applied to conceptualise the different values and opinions of the eight Dutch UMCs in order to develop a national vision on eHealth. This vision document will give direction to the development, evaluation and implementation of eHealth in the eight Dutch UMCs and their adherent healthcare providers.
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