Adoption of an Internet-based patient education programme in psychiatric hospitals

Sensor technology to monitor health, well-being and movement among healthcare personnel at workplace: a systematic scoping review protocol

INTRODUCTION

The well-being and health of healthcare personnel is becoming increasingly important in the delivery of high-quality healthcare. The recent developments in technology have provided new opportunities for the objective detection of a wide variety of real-world properties and movement. However, technologies that are used to monitor health, well-being and movement among healthcare personnel have not been fully synthesised. The overall aim of this scoping review is to examine what type of sensor technology is available to monitor the health, well-being and movement of healthcare personnel in healthcare settings. More specifically, we want to explore what types of sensor technology applications, for what purposes and how they have been used to monitor health, well-being and movement among healthcare personnel in different workplace settings.

METHODS AND ANALYSIS

This scoping review protocol will follow Arksey and O'Malley's methodology, complemented by the approach of the Joanna Briggs Institute to scoping reviews and guidance for conducting systematic scoping reviews. Peer-reviewed literature will be identified using a search strategy developed by a librarian, and a wide range of electronic datasets of medical, computer and information systems disciplines will be used. Eligibility of the articles will be determined using a two-stage screening process consisting of (1) a title and abstract scan, and (2) a full-text review. Extracted data will be thematically analysed and validated by an expert of sensor technology and a group of nurses as stakeholders. Descriptive statistics will be calculated when necessary.

ETHICS AND DISSEMINATION

The results obtained from the review will inform what technology has been used, how it has been used in healthcare settings and what types of technology might still be needed for future innovations. Findings of the scoping review will be published in a peer-reviewed journal.

REGISTRATION

This review was submitted in Open Science Framework on 12 December 2020.

Theories Informing eHealth Implementation: Systematic Review and Typology Classification

Background

Theory-guided approaches to implementation science have informed translation efforts and the acceptance of eHealth (digital health) interventions in clinical care. However, there is scarce evidence on which theories are best suited to addressing the inherent complexity of eHealth implementation.

Objective

The objectives of this systematic review are to identify theories that inform and explain eHealth implementation and to classify these theories using the typology by Sovacool and Hess for theories of sociotechnical change.

Methods

An electronic search was conducted in the PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Sociological Source Ultimate, Web of Science, ABI/INFORM, EBSCO, and ProQuest databases in June 2019. Studies were included if they were published between 2009 and June 2019; were written in English; reported on empirical research, regardless of study or publication type; reported on one or more theories in the context of eHealth implementation; and were published in a peer-reviewed journal. A total of 2 reviewers independently assessed the titles, abstracts, and full texts. Theories identified were classified using a typology for theories of sociotechnical change, which was considered a useful tool for ordering and analyzing the diverse theoretical approaches as a basis for future theory building.

Results

Of the 13,101 potentially relevant titles, 119 studies were included. The review identified 36 theories used to explain implementation approaches in eHealth. The most commonly used approaches were the Technology Acceptance Model (TAM) (n=33) and the Unified Theory of Acceptance and Use of Technology (UTAUT) (n=32). These theories were primarily concerned with individual and interpersonal elements of eHealth acceptance. Less common were theories that reflect the various disorderly social processes and structural dimensions of implementation, such as the normalization process theory (n=17) and the structuration theory (n=6).

Conclusions

Theories currently informing the implementation of eHealth interventions predominantly focus on predicting or explaining end-user acceptance. Theoretical perspectives that capture the dense and intricate relationships and structures required to enact sustainable change are less well represented in the eHealth literature. Given the growing acknowledgment of the inherent complexity of eHealth implementation, future research should develop and test models that recognize and reflect the multidimensional, dynamic, and relational nature of this process.

Habits and Attitudes of Video Gaming and Information Technology Use in People with Schizophrenia: Cross-Sectional Survey

Background

Information technology and video gaming have potential advantages in the treatment of schizophrenia. However, information regarding the habits and attitudes related to internet use and video gaming in people with schizophrenia is limited.

Objective

The aim of this study was to explore the habits and attitudes regarding video gaming and information technology usage and their associated factors in people with schizophrenia in Hong Kong.

Methods

In this cross-sectional survey, service users with schizophrenia were recruited from 6 halfway hostels and 7 integrated centers for mental wellness in Hong Kong. A 79-item self-report questionnaire was utilized to explore the habits of internet use and video gaming in these people with schizophrenia. The attitude toward video gaming was assessed using the Gaming Attitudes, Motivations, and Experiences Scales. Of the 148 individuals in a convenience sample who were invited to participate in this study, 110 willingly participated (a response rate of 74.3%). The data were analyzed using descriptive statistics, a two-tailed independent t test, Pearson correlation, and principal analysis with 3 methods of rotation (varimax, equimax, and promax).

Results

Most participants (100/110, 90.9%) had access to the internet and half of them (54/110, 49.1%) used the internet daily mostly to watch videos (66/110, 60.0%) or read news or books, etc (42/110, 38.2%). One-third of the participants (36/110, 32.7%) used the internet to play web-based games, and most of them (88/110, 80.0%) had played a video game in the past year. The most favorable gaming platforms were cellular phones (43/88, 49%) followed by computers (19/88, 22%) and arcade cabinets (6/88, 7%). The most favorable game genre was action games (34/145, 23.4%). Those who had a bachelor’s degree or higher scored lower in social interaction than those with a lower education level (P=.03). Those who played video games daily scored higher in the category of story than those who did not play daily (t₈₆=2.03, P=.05). The most popular gaming category was autonomy and the least popular categories were violent catharsis and violent reward. Two motives, “social playing” and “evasive playing,” were formed to describe the characteristics of playing video games.

Conclusions

Our data showed a high internet utilization rate among people with schizophrenia in Hong Kong. Only a few of them used the internet to search for health-related information. Our study also exemplified the unique habits of gaming among the participants. Health care professionals could utilize video games to engage people with schizophrenia and promote coping with stress and provide social skills training to such people with schizophrenia. Identification of the gaming attitudes can contribute to the development of serious games for the schizophrenic population. Further investigation is vital for the promotion of mental health through web-based platforms.

A mixed-methods survey to explore views of staff and patients from mental health wards prior to introduction of a digital early warning system for physical deterioration

WHAT IS KNOWN ON THE SUBJECT?: The potential benefits of introducing technological innovation into all types of health services are recognized internationally. There are few studies exploring the use of technology in inpatient mental health settings, or the views of staff and patients regarding such developments. "Early warning systems" are increasingly used in inpatient mental health services to detect physical deterioration in patients and prompt staff to take appropriate action. We have identified no peer-reviewed publications concerning this development. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Using a questionnaire survey, this project gathered views from staff and patients on a planned change from a paper-based "early warning system" to one using handheld electronic devices (tablets). This study adds to the existing evidence by reporting specific staff and patient concerns about a technological development in an inpatient mental health setting. Some patients were concerned about confidentiality of data entered onto tablets. Whilst were either positive or neutral in attitude to the planned change some staff raised concerns that electronic devices could be used as weapons, and also that patients or visitors might misinterpret their use. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Views of staff and patients must be considered when introducing new technology into clinical practice, in order to make the change successful and sustainable. Inadequate or unclear information about the use and purpose of electronic devices may lead to misunderstandings as to their purpose and the security of their data, particularly in mental health settings. Further exploration across a range of services and countries would be useful in determining whether attitudes towards implementing similar technological change in mental health practice are commonly shared. ABSTRACT: Introduction Technological innovation offers opportunities to improve mental health care; however, little evidence exists regarding attitudes of inpatient staff and patients to such changes. We present a survey of staff and patients prior to introduction of a digital version of the National Early Warning Score (eNEWS) system for identifying physical deterioration. Aim To collate views of staff and inpatients related to prospective use of eNEWS, to inform the plan for implementation. Method Paper questionnaires were distributed to both groups in six wards prior to eNEWS implementation. Two discussion groups were then held. Results Eighty-two staff and 26 inpatients completed questionnaires. Some inpatients expressed concerns about data confidentiality. Most staff were neutral or positive about the planned change, but raised possible safety risks and the risk of electronic recording being misinterpreted by patients. The implementation plan was modified in response to this information, principally by improving communication processes with patients. Discussion This study adds to the existing evidence by reporting specific staff and patient concerns towards a form of information technology. Further evaluations would help determine the transferability of these findings. Implications for practice Listening to patient and staff views about planned technological innovation is essential for effective implementation.

INNOVATORS AND EARLY ADOPTERS IN THE DIFFUSION OF INNOVATIONS: A LITERATURE REVIEW

Despite accounting for a very small percentage of the population that adopts an innovation, the ‘innovators’ and ‘early adopters’ — representing the two earliest groups of individuals to acquire the new product or service — play a crucial role in the dissemination of the innovation to larger market segments. The objective of this paper is to understand the characteristics of these individuals that positively influence their decisions to adopt innovations. We argue that awareness of these traits will enable firms to attain speedier uptake of their offerings while aiding policymakers achieve quicker and wider proliferation of new technologies intended for societal benefit. We undertake a review of the literature studying the diffusion of innovations and show future directions that this framework should take to analyse the adoption lifecycle.

Nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders

BACKGROUND

Internet-based applications are potentially useful and effective interventions to reach and support adolescents with mental health problems. Adolescents' commitment to the use of a new Internet-based intervention is closely related to the support they receive from healthcare professionals. This study describes nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders.

METHOD

Qualitative descriptive study design including individual interviews with nine nurses at two psychiatric outpatient clinics. The Technology Acceptance Model (TAM) was used as the theoretical background of the study.

RESULTS

Nurses described several benefits of using the Internet-based support system in the care of adolescents with depressive disorders if the nurses integrate it into daily nursing practices. As perceived disadvantages the nurses thought that an adolescent's mental status might be a barrier to working with the support system. Perceived enablers could be organizational support, nurses' attitudes, and technology-related factors. Nurses' attitudes were identified as a barrier to supporting adolescents' use of the Internet-based support system.

CONCLUSION

The findings suggest that the implementation plan and support from the organization, including that from nurse managers, are crucial in the process of implementing a technology-based support system.