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Lostelius PV, Gustavsson C, Adolfsson ET, Söderlund A, Revenäs Å, Zakrisson AB, Mattebo M. Identification of health-related problems in youth: a mixed methods feasibility study evaluating the Youth Health Report System. BMC Med Inform Decis Mak 2024; 24:64. [PMID: 38443898 PMCID: PMC10913260 DOI: 10.1186/s12911-024-02465-8] [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: 06/14/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Because poor health in youth risk affecting their entry in adulthood, improved methods for their early identification are needed. Health and welfare technology is widely accepted by youth populations, presenting a potential method for identifying their health problems. However, healthcare technology must be evidence-based. Specifically, feasibility studies contribute valuable information prior to more complex effects-based research. The current study assessed the process, resource, management, and scientific feasibility of the Youth Health Report System prototype, developed within a youth health clinic context in advance of an intervention study. METHODS This mixed-methods feasibility study was conducted in a clinical setting. The process, resource, management, and scientific feasibility of the Youth Health Report System were investigated, as recommended in the literature. Participants were youth aged 16-23 years old, attending a youth health clinic, and healthcare professionals from three clinics. The youth participants used their smart phones to respond to Youth Health Report System health questions and healthcare professionals used their computer to access the results and for registration system entries. Qualitative data were collected from interviews with healthcare professionals, which were described with thematic analysis. Youth participants' quantitative Youth Health Report System data were analyzed for descriptive statistics. RESULTS Feasibility analysis of qualitative data from interviews with 11 healthcare professionals resulted in three themes: We expected it could be hard; Information and routines helped but time was an issue; and The electronic case report form was valuable in the health assessment. Qualitative data were collected from the Youth Health Report System. A total of 54 youth participants completed the evaluation questionnaire, and healthcare professionals retrieved information from, and made post-appointment system entries. Quantitative results revealed few missing items and acceptable data variability. An assessment template of merged qualitative and quantitative data guided a consensus discussion among the researchers, resulting in acceptable feasibility. CONCLUSIONS The process-, resource-, management-, and scientific feasibility aspects were acceptable, with some modifications, strengthening the potential for a successful Youth Health Report System intervention study.
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Affiliation(s)
- Petra V Lostelius
- Centre for Innovation, Research and Education, Region Västmanland, Västmanland Hospital Västerås, Västerås, Sweden.
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden.
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden.
| | - Catharina Gustavsson
- Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Thors Adolfsson
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Åsa Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
- Orthopedic Clinic, Västerås Hospital Region Västmanland, Västerås, Sweden
| | - Ann-Britt Zakrisson
- University Health Care Research Center, Faculty of Medicine, and Health, Örebro University, Örebro, Sweden
| | - Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Yan R, Fan B, Luo S, Wang K, Xie G, Wang Y, Wang J. Comparison of the Novel Digital Multi-dimension Botong Score with the Brief Pain Inventory for Evaluating Cancer-Related Pain: A Randomized Crossover Trial. Pain Ther 2023; 12:1375-1384. [PMID: 37603204 PMCID: PMC10616054 DOI: 10.1007/s40122-023-00550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023] Open
Abstract
INTRODUCTION Pain is a common symptom in patients with cancer, and comprehensive assessments of pain are crucial for decision-making of treatment regimens. This study aimed to compare the practicality of the novel digital multi-dimension Botong score (BTS) and the brief pain inventory (BPI) for evaluating cancer-related pain. METHODS This randomized crossover trial enrolled patients with cancer-related pain at the Affiliated Cancer Hospital of Shandong First Medical University between July and December 2022. The participants were randomized 1:1 to BTS evaluation followed by BPI or vice versa. The consistency of BTS and BPI was analyzed, including pain score and the impact of pain on emotions and sleep. The convenience, patient preference, and the filling time of the two tools were compared. The accuracy of BTS in detecting breakthrough pain and neuropathic pain was analyzed. RESULTS A total of 308 patients with cancer-related pain were screened and 233 were finally included in the analysis. The Pearson correlation coefficients of pain score for BTS and BPI (4 relevant questions) were 0.583 for the worst pain score within 24 h, 0.394 for the mildest pain score within 24 h, 0.551 for the average pain score within 24 h, and 0.511 for the current pain score, respectively (all P < 0.01), indicating a positive correlation between the BTS and BPI pain scores. BTS was superior to BPI for filling time, convenience, and patient preference (191.03 vs. 256.76, 7.70 vs. 6.78, 7.58 vs. 6.70; all P < 0.01). The accuracy of BTS in detecting breakthrough pain and neuropathic pain was 98.28% and 97.42%, respectively. CONCLUSION Pain scores evaluated by BTS have a positive correlation with those evaluated by BPI. BTS reduces the filling time, is more convenient to use, and is more favored by patients. In addition, BTS could help identify breakthrough pain and neuropathic pain. CLINICAL TRIAL REGISTRATION Chictr.org.cn, identifier: ChiCTR220062624.
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Affiliation(s)
- Rong Yan
- Department of Nursing, Affiliated Cancer Hospital of Shandong First Medical University, Jinan, China
| | - Bifa Fan
- Department of Pain Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Suxia Luo
- Department of Medical Oncology, Henan Cancer Hospital, Zhengzhou, China
| | - Kun Wang
- Department of Pain Management, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Guanglun Xie
- Department of Pain Medicine, Henan Cancer Hospital, Zhengzhou, China
| | - Yong Wang
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China
| | - Jiejun Wang
- Department of Medical Oncology, Shanghai Changzheng Hospital, Shanghai, China.
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Waller D, Bailey S, Zolfaghari E, Ho J, Feuerlicht D, Ross K, Steinbeck K. Psychosocial assessment of adolescents and young adults in paediatric hospital settings: patient and staff perspectives on implementation of the e-HEEADSSS. BMC Health Serv Res 2023; 23:683. [PMID: 37349759 DOI: 10.1186/s12913-023-09621-2] [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: 02/17/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The main causes of morbidity and mortality for adolescents and young adults are preventable and stem from psychosocial and behavioural concerns. Psychosocial assessments can help clinicians to identify and respond holistically to risks and strengths that may impact upon a young person's physical and mental health. Despite broad support at a policy level, the implementation of routine psychosocial screening for young people remains varied in Australian health settings. The current study focused on the pilot implementation of a digital patient-completed psychosocial assessment (the e-HEEADSSS) at the Sydney Children's Hospital Network. The aim of this research was to evaluate patient and staff barriers and facilitators to local implementation. METHODS The research used a qualitative descriptive research design. Semi-structured interviews were conducted online with 8 young patients and 8 staff members who had completed or actioned an e-HEEADSSS assessment within the prior 5 weeks. Qualitative coding of interview transcripts was carried out in NVivo 12. The Consolidated Framework for Implementation Research guided the interview framework and qualitative analyses. RESULTS Results demonstrated strong support for the e-HEEADSSS from patients and staff. Key reported facilitators included strong design and functionality, reduced time requirements, greater convenience, improved disclosure, adaptability across settings, greater perceived privacy, improved fidelity, and reduced stigma for young people. The key barriers were related to concerns over available resources, the sustainability and continuity of staff training, perceived availability of clinical pathways for follow-up and referrals, and risks related to off-site completions. Clinicians need to adequately explain the e-HEEADSSS assessment to patients, educate them about it, and make sure that they receive timely feedback on the results. Greater reassurance and education regarding the rigour of confidentiality and data handling procedures is required for patients and staff. CONCLUSIONS Our findings indicate that continued work is required to support the integration and sustainability of digital psychosocial assessments for young people at the Sydney Children's Hospital Network. The e-HEEADSSS shows promise as an implementable intervention to achieve this goal. Further research is required to determine the scalability of this intervention across the broader health system.
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Affiliation(s)
- Daniel Waller
- Sydney Children's Hospitals Network, Sydney, Australia.
- The University of Sydney, Sydney, Australia.
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
| | | | | | - Jane Ho
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | | | - Kirsty Ross
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | - Katharine Steinbeck
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
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Wu X, Du J, Jiang H, Zhao M. Application of Digital Medicine in Addiction. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (SCIENCE) 2022; 27:144-152. [PMID: 34866856 PMCID: PMC8627382 DOI: 10.1007/s12204-021-2391-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/20/2021] [Indexed: 10/29/2022]
Affiliation(s)
- Xiaojun Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108 China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, 200031 China
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Rice LJ, Tsang TW, Carter E, Hand M, Davies J, Thomas S, Bedford E, Bear E, Carter C, Cannon L, Elliott EJ. Bigiswun Kid Project: a longitudinal study of adolescents living with high rates of prenatal alcohol exposure, fetal alcohol spectrum disorder and early life trauma in remote Australian Aboriginal communities. BMJ Open 2022; 12:e058111. [PMID: 35365538 PMCID: PMC8977804 DOI: 10.1136/bmjopen-2021-058111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/16/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The Lililwan Project was the first Australian population-based prevalence study of fetal alcohol spectrum disorder (FASD) using active case ascertainment. Conducted in 2010-2011, the study included 95% of all eligible children aged 7-9 years living in the very remote Aboriginal communities of the Fitzroy Valley, Western Australia. Women from Marninwarntikura Women's Resource Centre, a local Aboriginal-led organisation, are concerned that some participants from the study are struggling in adolescence so partnered with researchers from the University of Sydney to follow up the Lililwan cohort in 2020-2022 at age 17-19 years.The overarching aim of the Bigiswun Kid Project is to identify adolescents' needs and build knowledge to inform services to improve the health and well-being of adolescents in remote Aboriginal communities. The specific aims are to: (1) provide a voice to adolescents and their families to understand the health and well-being status of the Lililwan cohort at 17-19 years. (2) Examine relationships between exposures during pregnancy, birth characteristics, and health and neurodevelopment at 7-9 years, and positive/adverse adolescent outcomes at 17-19 years. This information will identify prenatal and early life factors that predict good health and well-being in adolescence. (3) Determine whether management plans provided in the Lililwan Project were followed, and identify past and present service gaps, support needs and barriers to service use. (4) Determine if key physical characteristics of FASD change between childhood and adolescence in this Aboriginal population. ETHICS AND DISSEMINATION Approved by the Kimberley Aboriginal Health Planning Forum and relevant ethics committees.
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Affiliation(s)
- Lauren J Rice
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Tracey W Tsang
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Emily Carter
- Marulu Team, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Marmingee Hand
- Marulu Team, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Jadnah Davies
- Marulu Team, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Sue Thomas
- Marulu Team, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Eric Bedford
- Marulu Team, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Emma Bear
- Marulu Team, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Cheyenne Carter
- Marulu Team, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Lisa Cannon
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
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Wong JJ, Hanes S, Iturralde E, Lanning MS, Naranjo D, Tanenbaum M, Hood KK. Do Youth Want Psychosocial Screenings in Diabetes Clinic? Profiles of Acceptability. J Pediatr Psychol 2021; 46:332-340. [PMID: 33316061 DOI: 10.1093/jpepsy/jsaa112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS Psychosocial screenings are recommended and increasingly common in pediatric subspecialty clinics, though little is known about their acceptability. This study seeks to uncover profiles of acceptability and assess demographic and clinical correlates among adolescents with diabetes. METHODS A sample of 124 adolescents (57.7% female) ages 12-21 years (M = 16.2 ± 2.3) completed screenings during routine diabetes appointments. K-means clustering of responses to acceptability items derived profiles; Analysis of Variance (ANOVA) and Chi-square tests assessed correlates. RESULTS Adolescents with the most common profile (72.6%) placed high importance on medical providers' awareness of their emotions and reported no difficulties/discomfort with the screener. These youth had moderate depressive symptoms, low diabetes distress, and low A1c. Those who fit a less common profile (18.5%) were uncomfortable with the screener and had the highest depressive symptoms and lowest A1c. Youth who fit a smaller profile (6.5%) endorsed technical difficulties and had high depressive symptoms and lowest diabetes distress. The smallest profile (2.4%, N = 3) had difficulty understanding and experienced discomfort with the screening and had the lowest depressive symptoms and the highest diabetes distress and A1c. These differences in depressive symptoms (F = 3.54, p = .017), A1c values (F = 4.03, p = .009), and diabetes distress (F = 3.27, p = .036) were significant though differences in age, gender, and diabetes duration were not. CONCLUSIONS Most youth responded favorably to in-clinic psychosocial screenings. Youth who were less satisfied were at increased risk for psychosocial and medical complications. Findings highlight areas of need, such as enhanced support with and an emphasized rationale for screenings, which may improve patient experience in subspecialty care.
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Affiliation(s)
- Jessie J Wong
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Sarah Hanes
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Esti Iturralde
- Division of Research, Kaiser Permanente Northern California
| | - Monica S Lanning
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Diana Naranjo
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Molly Tanenbaum
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Korey K Hood
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
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Saw C, Smit A, Silva D, Bulsara MK, Nguyen ETTT. Service evaluation and retrospective audit of electronic HEEADSSS (e-HEEADSSS) screening device in paediatric inpatient service in Western Australia. Int J Adolesc Med Health 2020; 34:401-409. [PMID: 32960776 DOI: 10.1515/ijamh-2020-0120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/05/2020] [Indexed: 11/15/2022]
Abstract
Objectives The top causes of adolescents' mortality in Australia and worldwide are mostly preventable and many stem from psychosocial difficulties. The HEEADSSS screening is a widely accepted screening tool in assessing young people's psychosocial wellbeing. This retrospective audit was done to evaluate the service implementation of an electronic-HEEADSSS (e-HEEADSSS) screening system in a regional hospital's paediatric in-patient setting in Western Australia. The aim is to examine and compare the uptake rate of conventional HEEADSSS screening in 2018 and e-HEEADSSS screening in 2019, and to examine the relevant outcome and disclosure rate by the young person. Methods This retrospective audit (pre-post cross sectional study) is reported using the STROBE guideline. It was done over two different time frames: Pre e-HEEADSSS implementation (September-December 2018) and Post e-HEEADSSS implementation (September-December 2019). Inclusion criteria includes: All paediatric inpatients aged 12-16 years old. Exclusion criteria includes: Admission under other disciplines or clinically unstable/unsuitable patients. The uptake rate of conventional-HEEADSSS (2018) in comparison to e-HEEADSSS screening (2019) was examined. Other relevant data was extracted and analysed. Results The sample size pre-implementation was 26 while post-implementation was 24. The uptake rate increased from 12% (conventional-HEEADSSS) to 54% (e-HEEADSSS), a 450% increment with the e-HEEADSSS system implementation (Fisher Exact Test, p=0.005). More than half of young people who completed their e-HEEADSSS screening had concerns/flags which required management by the clinicians. 86% of patients in the e-HEEADSSS group with concerns/flags were acted appropriately by the treating clinicians prior to discharge. The overall disclosure rate of e-HEEADSSS was 93% with highest disclosure rate for 'Drugs' domain. Conclusions There is significant increase in uptake rate with high disclosure rate using e-HEEADSSS screening device when compared to conventional HEEADSSS screening in the paediatric in-patient setting. The e-HEEADSSS is a better screening tool for in-patient setting and should be implemented widely.
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Affiliation(s)
- Chia Saw
- Joondalup Health Campus, Joondalup,Western Australia, Australia.,Telethon Kids Institute, Nedlands, Australia
| | - Alide Smit
- Joondalup Health Campus, Joondalup,Western Australia, Australia
| | | | - Max K Bulsara
- UWA, University of Western Australia, Perth, Australia
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