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Alahmed S, Frost S, Fernandez R, Win K, Mutair AA, Harthi MA, Meedya S. Evaluating a woman-centred web-based breastfeeding educational intervention in Saudi Arabia: A before-and-after quasi-experimental study. Women Birth 2024; 37:101635. [PMID: 38964228 DOI: 10.1016/j.wombi.2024.101635] [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: 09/26/2023] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Although digital educational resources are used worldwide to educate new parents, the impact of digital resources tailored specifically to women's needs on breastfeeding practices is not well explored. AIM The study aimed to evaluate the effectiveness of using a women-centred Web-Based Breastfeeding Educational Resource (WEBBER) in increasing the rate of exclusive breastfeeding at one month after birth. METHODS A quasi-experimental study with before and after intervention was conducted in one metropolitan hospital in Saudi Arabia. Participants were primiparous women (n=290) aged 18 or above who intended to breastfeed. The intervention involved introducing the WEBBER to pregnant women and reinforcing its uses as a routine breastfeeding educational resource. Women's characteristics and infant feeding data were collected at one month after birth via an online survey. FINDINGS The rate of exclusive breastfeeding at one month postpartum among the women who received the WEBBER intervention was nearly three times higher compared to the women prior to the introduction of the intervention (66 % vs. 26 %, p-value <.001). Furthermore, other predictors of exclusive breastfeeding at one month were the mother being unemployed, the baby not receiving infant formula in the hospital, and the mother having postnatal intention to continue breastfeeding for 6 months or more. DISCUSSION AND CONCLUSION Using WEBBER as a routine breastfeeding educational resource increased the rate of exclusive breastfeeding one month after birth. Embedding woman-centred digital resources into routine breastfeeding education is an effective intervention for women in Saudi Arabia.
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Affiliation(s)
- Salma Alahmed
- School of Nursing, University of Wollongong, Australia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Steve Frost
- School of Nursing, University of Wollongong, Australia
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Australia
| | - Khin Win
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Australia
| | - Abbas Al Mutair
- School of Nursing, University of Wollongong, Australia; Research Center, Almoosa Specialist Hospital, Saudi Arabia; College of Nursing, Princess Nourah Bent Abdulrahman University, Riyadh, Saudi Arabia
| | - Muna Al Harthi
- Breastfeeding Committee, Maternity and Children Hospital, Dammam, Eastern Province, Saudi Arabia
| | - Shahla Meedya
- School of Nursing, University of Wollongong, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia
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Simões CF, Lopes LPN, Lara LDS, Cortês AL. Health literacy for elderly patients with high blood pressure: A scoping review. Res Social Adm Pharm 2024; 20:846-859. [PMID: 38890034 DOI: 10.1016/j.sapharm.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/30/2023] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Hypertension is the chronic disease that most affects the elderly population worldwide and is the main modifiable risk factor for cardiovascular diseases. In hypertensive elderly patients, health literacy emerges as a key component for achieving better clinical outcomes. OBJECTIVE This study aims to describe the health literacy strategies used for elderly patients with arterial hypertension. METHODS A review of the scientific literature was conducted in accordance with recommendations from the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Three databases were used to identify relevant studies which were then assessed for eligibility, extracted, and categorized. RESULTS A total of 6442 articles were identified in the databases, out of which 1486 were duplicates and were removed. Based on titles and abstracts, 4887 articles were excluded, and 59 were eliminated through full-text analysis for not meeting the eligibility criteria. Ten studies were included in this scoping review. The identified strategies included face-to-face group educational sessions, face-to-face individual educational sessions, use of written educational materials, educational sessions through electronic devices and/or computers, individual counseling, physical exercise, and personal health diary. The most addressed topics were the nature of hypertension, nutrition, and physical exercise. The study environments highlighted the importance of involving a multidisciplinary team in health literacy strategies for elderly individuals whith hypertension. CONCLUSIONS Interventions with mixed measures were commonly used by the authors and encouraged disease self-management. Access to information and the promotion of critical thinking allowed patients to have better disease control. However, studies linking health literacy and elderly individuals with arterial hypertension are still scarce, indicating the need for further research.
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Affiliation(s)
| | | | - Lucienne da Silva Lara
- Instituto de Ciências Biomédicas e Centro de Pesquisa em Medicina de Precisão, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Aline Leal Cortês
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Bell CM, Thamboo AV, Monteiro E, Yip J. Prescribing Practices and Barriers of Biologics for Chronic Rhinosinusitis Amongst Otolaryngologists. Laryngoscope 2024; 134:3493-3498. [PMID: 38411268 DOI: 10.1002/lary.31370] [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: 12/18/2023] [Revised: 01/25/2024] [Accepted: 02/15/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE(S) Biologics for chronic rhinosinusitis with nasal polyposis (CRSwNP) are an evolving therapeutic option, but there are limited data on physician experiences in prescribing them. The goal of this study was to gain a better understanding of these experiences including prescribing practices, patient factors which guide prescriber decision, and physician and patient-reported issues which might limit cost-effectiveness of these therapies. METHODS A survey was distributed to attending otolaryngologists using the Canadian Society of Otolaryngology (CSOHNS) email distribution and eSurvey program. Responses were tabulated for the entire cohort and compared between rhinologists and non-rhinologists where appropriate. Frequencies and proportions were expressed as a percentage of total respondents. Fisher's exact test was used for statistical analysis between groups. RESULTS Seventy-nine total survey responses were recorded representing a response rate of 43%. Significantly more rhinologists reported prescribing biologic medications on their own (100% vs. 50%; p < 0.001) and a higher proportion (1 to 10% vs. <1%) of their patients were on biologics compared with non-rhinologists (p = 0.023). Rhinologists were more likely to consider poor response to medical therapies, need for rescue steroids, and comorbid type 2 conditions in their decision to pursue biologics than non-rhinologists, but they also experienced poorer assistance from patient support programs and less availability to medications. CONCLUSION Rhinologists are more comfortable with prescribing and managing biologics for CRSwNP compared with non-rhinologist colleagues. Clinicians prescribing biologic medications for CRSwNP should be familiar with guidelines, indications, and potential adverse events. LEVEL OF EVIDENCE N/A Laryngoscope, 134:3493-3498, 2024.
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Affiliation(s)
- Christopher M Bell
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andrew V Thamboo
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan Yip
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Conti DM, Vibeke B, Kirsten B, Leif B, Adam C, Stephanie D, Mina G, Monika G, Philippe G, Eckard H, Hellings PW, Milos J, Kopp MV, Marcus M, Marcia P, Dermot R, Scadding GK, Eike W, Ulrich W, Susanne L. EUFOREUM Berlin 2023: Optimizing care for type 2 inflammatory diseases from clinic to AI: A pediatric focus. Pediatr Allergy Immunol 2024; 35:e14183. [PMID: 38949196 DOI: 10.1111/pai.14183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 07/02/2024]
Abstract
The European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi-annual forum EUFOREUM in Berlin in November 2023. The aim of EUFOREUM 2023 was to highlight pediatric action plans for prevention and optimizing care for type 2 inflammatory conditions starting in childhood, with a focus on early-stage diagnosis, ensuring neither under- nor overdiagnosis, optimal care, and suggestions for improvement of care. EUFOREA is an international not-for-profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic respiratory diseases through the implementation of optimal patient care via educational, research, and advocacy activities. The inclusive and multidisciplinary approach of EUFOREA was reflected in the keynote lectures and faculty of the virtual EUFOREUM 2023 (www.euforea.eu/euforeum) coming from the pediatric, allergology, pulmonology, ENT, dermatology, primary health care fields and patients around the central theme of type 2 inflammation. As most type 2 inflammatory conditions may start in childhood or adolescence, and most children have type 2 inflammation when suffering from a respiratory or skin disease, the moment has come to raise the bar of ambitions of care, including prevention, remission and disease modification at an early stage. The current report provides a comprehensive overview of key statements by the faculty of the EUFOREUM 2023 and the ambitions of EUFOREA allowing all stakeholders in the respiratory field to be updated and ready to join forces in Europe and beyond.
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Affiliation(s)
- Diego M Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
- Escuela de Doctorado UAM, Centro de Estudios de Posgrado, Universidad Autónoma de Madrid, Madrid, Spain
| | - Backer Vibeke
- Department of Otorhinolaryngology, Head & Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Beyer Kirsten
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bjermer Leif
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
| | - Chaker Adam
- Department of Otorhinolaryngology and Center for Allergy and Environment (ZAUM), TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dramburg Stephanie
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gaga Mina
- 1st Respiratory Medicine Department, Hygeia Hospital, Marousi, Greece
- WHO Europe, Standing Committee SCRC
| | - Gappa Monika
- Department of Pediatrics, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
| | - Gevaert Philippe
- Laboratory of Upper Airways Research, Department of Otorhinolaryngology, University of Ghent, Ghent, Belgium
| | - Hamelmann Eckard
- Children's Center Bethel, University Hospital Bielefeld, University Bielefeld, Bielefeld, Germany
| | - Peter W Hellings
- Laboratory of Upper Airways Research, Department of Otorhinolaryngology, University of Ghent, Ghent, Belgium
- KU Leuven Department of Microbiology and Immunology, Allergy and Clinical Immunology Research Unit, Leuven, Belgium
- Clinical Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jesenak Milos
- Department of Pulmonology and Phthisiology, Department of Pediatrics, Department of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| | - Matthias V Kopp
- Division of Paediatric Pneumology and Allergology, University Children's Hospital, University Medical Center Schleswig-Holstein Campus Luebeck, Luebeck, Germany
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Maurer Marcus
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Podesta Marcia
- EFA - European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Ryan Dermot
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- International Primary Care Respiratory Group, Edinburgh, UK
| | - Glenis K Scadding
- Department of Allergy & Rhinology, Royal National ENT Hospital, London, UK
- Division of Immunity and Infection, University College, London, UK
| | - Wüstenberg Eike
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine (and University Hospital) Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Wahn Ulrich
- Emeritus Department of Pediatric Pneumology and Immunology, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Lau Susanne
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
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Grewal N, Idhrees M, Velayudhan B, Klautz RJM, Grewal S. Practical Considerations of Remote Care in Thoracic Aortopathy in India. J Clin Med 2024; 13:3327. [PMID: 38893041 PMCID: PMC11172736 DOI: 10.3390/jcm13113327] [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: 04/25/2024] [Revised: 05/26/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Thoracic aortopathy includes conditions like aortic aneurysms and dissections, posing significant management challenges. In India, care delivery is complicated by geographic vastness, financial constraints, and healthcare resource disparities. Telemedicine and digital health technologies offer promising solutions. Methods: A comprehensive review of literature and clinical experiences was conducted to explore the implementation of remote care strategies for thoracic aortopathy in India. The review included studies from 2000 to 2023 and insights from cardiothoracic specialists. Results: Remote care benefits include improved access to specialized expertise, enhanced patient engagement, and optimized resource utilization. Telemedicine enables consultations without travel, and remote monitoring facilitates early intervention. However, challenges like technology integration, digital literacy, patient engagement, privacy concerns, and regulatory compliance need addressing. Discussion: Telemedicine offers significant advantages but requires overcoming challenges to ensure effective, secure care. Careful planning for technology integration, patient education, robust privacy measures, and supportive regulatory policies are essential. Addressing these issues can bridge the healthcare access gap and improve outcomes in India's diverse landscape.
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Affiliation(s)
- Nimrat Grewal
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, 1105AZ Amsterdam, The Netherlands;
- Department of Cardiothoracic Surgery, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Department of Anatomy and Embryology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Mohammed Idhrees
- Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes for Medical Science (SIMS Hospital), Chennai 600083, India; (M.I.); (B.V.)
| | - Bashi Velayudhan
- Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes for Medical Science (SIMS Hospital), Chennai 600083, India; (M.I.); (B.V.)
| | - Robert J. M. Klautz
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, 1105AZ Amsterdam, The Netherlands;
- Department of Cardiothoracic Surgery, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Simran Grewal
- Department of Orthopaedic Surgery, Amsterdam University Medical Center, 1105 Amsterdam, The Netherlands;
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Ushida T, Tano S, Imai K, Matsuo S, Kajiyama H, Kotani T. Postpartum and interpregnancy care of women with a history of hypertensive disorders of pregnancy. Hypertens Res 2024; 47:1457-1469. [PMID: 38467793 DOI: 10.1038/s41440-024-01641-7] [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: 10/24/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
Hypertensive disorders of pregnancy (HDP) are common complications associated with maternal and neonatal morbidity and mortality worldwide. Insights gained from long-term cohort studies have revealed that women with a history of HDP are predisposed to recurrent HDP in subsequent pregnancies and face heightened risks for cardiovascular and metabolic diseases later in life. Pregnancy is a unique condition that overloads maternal cardiac and metabolic functions, and is recognized as a "maternal stress test" for future cardiovascular and metabolic diseases. Pregnancy and postpartum period provide a valuable opportunity for identifying women with underlying and unrecognized cardiovascular and metabolic risk factors. Establishing an effective postpartum healthcare program for women who have experienced HDP is crucial in reducing the future risk of health complications. Postpartum care consists of supportive care for both mothers and children, including not only the assessment of physical and psychological well-being but also long-term postpartum preventive health management. Interpregnancy care is a continuum from postpartum care and includes supportive care to prepare for future pregnancies. Various initiatives across nations have been initiated to establish follow-up programs for women with a history of HDP; however, sufficient evidence of the impact of such programs is not available. Substantial challenges persist in establishing an efficient postpartum follow-up program, including educational strategies, selection of effective lifestyle interventions, and collaboration among various healthcare providers. This review outlines the postpartum and interpregnancy care of women who have experienced HDP as well as the current status and challenges of related healthcare initiatives in Japan.
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Affiliation(s)
- Takafumi Ushida
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
- Division of Reproduction and Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Division of Reproduction and Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Kenji Imai
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Division of Reproduction and Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Seiko Matsuo
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Division of Reproduction and Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Division of Reproduction and Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Al-Qerem W, Jarab A, Eberhardt J, Alasmari F, Alkaee SM, Alsabaa ZH. Development and Validation of the Jordanian Diabetic Health Literacy Questionnaire: Enhancing Diabetes Management in Arabic-Speaking Populations. Healthcare (Basel) 2024; 12:801. [PMID: 38610223 PMCID: PMC11011997 DOI: 10.3390/healthcare12070801] [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: 03/13/2024] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Amidst the global rise in type 2 diabetes mellitus (T2DM), effective management of the disease has become increasingly important. Health literacy, particularly in non-English speaking populations, plays a crucial role in this management. To address the lack of suitable tools for Arabic-speaking diabetic patients, this study developed and validated the Jordanian Diabetic Health Literacy Questionnaire (JDHLQ). (2) Methods: A sample of 400 diabetic patients from Jordan, with a balance in gender, age, and educational background, was recruited from an endocrinology outpatient clinic. The JDHLQ, consisting of informative and communicative sections, underwent rigorous validation. Utilizing principal component analysis and Rasch analysis, the JDHL's reliability and validity were evaluated. (3) Results: The results showed moderate proficiency in understanding and communicating diabetes-related information and confirmed the reliability and validity of the JDHLQ. (4) Conclusions: These findings emphasize the importance of culturally appropriate health literacy tools in enhancing patient understanding, engagement, and overall management of T2DM in Arabic-speaking communities.
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Affiliation(s)
- Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
| | - Anan Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi 112612, United Arab Emirates;
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi 112612, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Judith Eberhardt
- Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Borough Road, Middlesbrough TS1 3BX, UK;
| | - Fawaz Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Safa M. Alkaee
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
| | - Zein H. Alsabaa
- Department of Pharmacy, Faculty of Pharmacy, Petra University, Amman 11196, Jordan;
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Färber A, Schwabe C, Stalder PH, Dolata M, Schwabe G. Physicians' and Patients' Expectations From Digital Agents for Consultations: Interview Study Among Physicians and Patients. JMIR Hum Factors 2024; 11:e49647. [PMID: 38498022 PMCID: PMC10985611 DOI: 10.2196/49647] [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: 06/04/2023] [Revised: 12/09/2023] [Accepted: 01/15/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Physicians are currently overwhelmed by administrative tasks and spend very little time in consultations with patients, which hampers health literacy, shared decision-making, and treatment adherence. OBJECTIVE This study aims to examine whether digital agents constructed using fast-evolving generative artificial intelligence, such as ChatGPT, have the potential to improve consultations, adherence to treatment, and health literacy. We interviewed patients and physicians to obtain their opinions about 3 digital agents-a silent digital expert, a communicative digital expert, and a digital companion (DC). METHODS We conducted in-depth interviews with 25 patients and 22 physicians from a purposeful sample, with the patients having a wide age range and coming from different educational backgrounds and the physicians having different medical specialties. Transcripts of the interviews were deductively coded using MAXQDA (VERBI Software GmbH) and then summarized according to code and interview before being clustered for interpretation. RESULTS Statements from patients and physicians were categorized according to three consultation phases: (1) silent and communicative digital experts that are part of the consultation, (2) digital experts that hand over to a DC, and (3) DCs that support patients in the period between consultations. Overall, patients and physicians were open to these forms of digital support but had reservations about all 3 agents. CONCLUSIONS Ultimately, we derived 9 requirements for designing digital agents to support consultations, treatment adherence, and health literacy based on the literature and our qualitative findings.
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Affiliation(s)
- Andri Färber
- ZHAW School of Management and Law, Zurich University of Applied Sciences, Winterthur, Switzerland
- Department of Informatics, University of Zurich, Zurich, Switzerland
| | | | - Philipp H Stalder
- ZHAW School of Management and Law, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Mateusz Dolata
- Department of Informatics, University of Zurich, Zurich, Switzerland
| | - Gerhard Schwabe
- Department of Informatics, University of Zurich, Zurich, Switzerland
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Bradley MS, Hetzel-Riggin MD, Knight JC, Murillo A, Zyczynski H, Shelton CR. Online Search Strategies and Results From a Crowdsourced Survey on Asymptomatic Bacteriuria. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024:02273501-990000000-00191. [PMID: 38498773 DOI: 10.1097/spv.0000000000001500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
IMPORTANCE Despite the prevalence of asymptomatic bacteriuria (ASB), what proportion of the population is aware of this condition and the quality of internet resources are currently unknown. OBJECTIVE This study aimed to use an online crowdsourcing platform to explore general knowledge and internet search strategies, along with the quality of information, on ASB. STUDY DESIGN An online survey was administered through a crowdsourcing platform to women 50 years or older via Qualtrics, which is a sophisticated online survey tool. Participants completed a survey on ASB, and participants were asked how they would search the internet for information both on urinary test results and on ASB. Outcomes included survey responses, and qualitative data were coded and analyzed thematically. χ2 Testing and regression modeling were used to look for variables associated with concern for ASB. RESULTS There were a total of 518 participants who passed attention check qualifications, and only 45 respondents (8.7%) had heard of ASB. Many were concerned about progress to a worsening infection (n = 387 [77.6%]). When controlling for confounders, education beyond a college degree was not associated with a lower concern for ASB when compared with those with a high school education or less (adjusted odds ratio, 0.63; 95% confidence interval, 0.25-1.55; P = 0.31). Medical providers were the target audience for a majority of the websites, and many of the patient-facing results were of poor quality. CONCLUSIONS Our national survey of women demonstrated a prevalent knowledge deficit surrounding ASB. We must seek to create high-quality, readily available, patient-facing information to increase awareness of ASB, allay concerns, and increase antibiotic stewardship.
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Affiliation(s)
- Megan S Bradley
- From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, University of Pittsburgh Medical Center
| | | | | | - Ashley Murillo
- From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, University of Pittsburgh Medical Center
| | - Halina Zyczynski
- From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, University of Pittsburgh Medical Center
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Alqallaf A. The Impact of Integrated Patient Education on Short-Term Revisit Rates in Healthcare Settings: A Quality Improvement Project. Cureus 2024; 16:e56512. [PMID: 38646365 PMCID: PMC11026867 DOI: 10.7759/cureus.56512] [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] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Patient education plays a critical role in healthcare, influencing outcomes and resource utilization. However, effectively integrating patient education into clinical practice remains challenging due to time constraints and inconsistencies in information delivery. Enhancements in Electronic Health Records (EHR) offer potential solutions by facilitating customized, quality education delivery. This study investigates the impact of an EHR-enhanced patient education intervention on short-term revisit rates to healthcare facilities. METHODS A quasi-experimental, pre-test/post-test design without a control group was employed at the International Medical Center in Riffa, Bahrain. The intervention consisted of modifications to the EHR system to support patient education, along with staff training on effective education delivery. Patient revisit rates within seven days post-consultation were compared before and after the intervention using chi-square tests and logistic regression, adjusting for potential confounders. RESULTS A total of 1,239 patients participated in the study, which was divided into two groups: 754 patients in the pre-intervention group and 485 patients in the post-intervention group. A significant change was observed in the patient revisit rates: in the pre-intervention group, 53.32% of patients (402 out of 754) returned within seven days, compared to 41.44% of patients (201 out of 485) in the post-intervention group, with a p-value < 0.01. CONCLUSION Enhancements to EHR systems, combined with comprehensive staff education on patient education, can lead to significant reductions in short-term patient revisits. This underscores the importance of integrating technological and educational interventions in healthcare settings to improve patient outcomes and efficiency.
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Grega ML, Shalz JT, Rosenfeld RM, Bidwell JH, Bonnet JP, Bowman D, Brown ML, Dwivedi ME, Ezinwa NM, Kelly JH, Mechley AR, Miller LA, Misquitta RK, Parkinson MD, Patel D, Patel PM, Studer KR, Karlsen MC. American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care. Am J Lifestyle Med 2024; 18:269-293. [PMID: 38559790 PMCID: PMC10979727 DOI: 10.1177/15598276231202970] [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] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE Identify areas of consensus on integrating lifestyle medicine (LM) into primary care to achieve optimal outcomes. METHODS Experts in both LM and primary care followed an a priori protocol for developing consensus statements. Using an iterative, online process, panel members expressed levels of agreement with statements, resulting in classification as consensus, near consensus, or no consensus. RESULTS The panel identified 124 candidate statements addressing: (1) Integration into Primary Care, (2) Delivery Models, (3) Provider Education, (4) Evidence-base for LM, (5) Vital Signs, (6) Treatment, (7) Resource Referral and Reimbursement, (8) Patient, Family, and Community Involvement; Shared Decision-Making, (9) Social Determinants of Health and Health Equity, and (10) Barriers to LM. After three iterations of an online Delphi survey, statement revisions, and removal of duplicative statements, 65 statements met criteria for consensus, 24 for near consensus, and 35 for no consensus. Consensus was reached on key topics that included LM being recognized as an essential component of primary care in patients of all ages, including LM as a foundational element of health professional education. CONCLUSION The practice of LM in primary care can be strengthened by applying these statements to improve quality of care, inform policy, and identify areas for future research.
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Affiliation(s)
- Meagan L. Grega
- St. Luke's University Health Network, Easton, PA, USA; Kellyn Foundation, Tatamy, PA, USA (MLG)
| | - Jennifer T. Shalz
- Lifestyle Medicine Department, St. Luke’s Health System, Boise ID, USA (JTS)
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Science University, Brooklyn, NY, USA (RMR)
| | - Josie H. Bidwell
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, MI, USA (JHB)
| | - Jonathan P. Bonnet
- Palo Alto VA Health Care, Palo Alto, CA, USA; Department of Medicine and Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA (JPB)
| | - David Bowman
- Department of Pediatrics, Howard University College of Medicine, Washington, DC, USA; Lifestyle Med Revolution, LLC, Upper Marlboro, MD, USA (DB)
| | - Melanie L. Brown
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA (MLB)
| | - Mollie E. Dwivedi
- Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation, Washington University Living Well Center, St. Louis, MO, USA (MED)
| | | | - John H. Kelly
- Loma Linda University, Loma Linda, CA, USA; Lifestyle Health Education Inc., Rocky Mount, VA, USA (JHK)
| | - Amy R. Mechley
- University of Cincinnati College of Medicine, Cincinnati, OH, USA (ARM)
| | - Lawrence A. Miller
- Department of Psychiatry & Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA (LAM)
| | - Rajiv K. Misquitta
- Department of Lifestyle Medicine, The Permanente Medical Group, Sacramento, CA, USA (RKM)
| | | | - Dipak Patel
- Community Health Center, Inc., Meriden, CT, USA; Connecticut Lifestyle Medicine, CT, USA (DP)Community Health Center, Inc., Middletown, CT, USA (DP)
| | - Padmaja M. Patel
- Lifestyle Medicine Center, Midland Health, Midland, TX, USA (PMP)
| | - Karen R. Studer
- Preventive Medicine, Loma Linda University Health, Loma Linda, CA, USA (KRS)
| | - Micaela C. Karlsen
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO, USA; Departments of Applied Nutrition and Global Public Health, University of New England, Biddeford, ME, USA (MCK)
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Avoke D, Elshafeey A, Weinstein R, Kim CH, Martin SS. Digital Health in Diabetes and Cardiovascular Disease. Endocr Res 2024; 49:124-136. [PMID: 38605594 DOI: 10.1080/07435800.2024.2341146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Digital health technologies are rapidly evolving and transforming the care of diabetes and cardiovascular disease (CVD). PURPOSE OF THE REVIEW In this review, we discuss emerging approaches incorporating digital health technologies to improve patient outcomes through a more continuous, accessible, proactive, and patient-centered approach. We discuss various mechanisms of potential benefit ranging from early detection to enhanced physiologic monitoring over time to helping shape important management decisions and engaging patients in their care. Furthermore, we discuss the potential for better individualization of management, which is particularly important in diseases with heterogeneous and complex manifestations, such as diabetes and cardiovascular disease. This narrative review explores ways to leverage digital health technology to better extend the reach of clinicians beyond the physical hospital and clinic spaces to address disparities in the diagnosis, treatment, and prevention of diabetes and cardiovascular disease. CONCLUSION We are at the early stages of the shift to digital medicine, which holds substantial promise not only to improve patient outcomes but also to lower the costs of care. The review concludes by recognizing the challenges and limitations that need to be addressed for optimal implementation and impact. We present recommendations on how to navigate these challenges as well as goals and opportunities in utilizing digital health technology in the management of diabetes and prevention of adverse cardiovascular outcomes.
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Affiliation(s)
- Dorothy Avoke
- Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Robert Weinstein
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chang H Kim
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seth S Martin
- Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Kaplan A, Boivin M, Bouchard J, Kim J, Hayes S, Licskai C. The emerging role of digital health in the management of asthma. Ther Adv Chronic Dis 2023; 14:20406223231209329. [PMID: 38028951 PMCID: PMC10657529 DOI: 10.1177/20406223231209329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
The most common reasons seen for lack of asthma control include misconceptions about disease control, low controller treatment adherence, poor inhaler technique, and the resulting underuse of controllers and overuse of short-acting beta2 agonists (SABAs). Narrowing these care gaps may be achieved through well-designed patient education that considers the patient's motivation, beliefs, and capabilities regarding their asthma and its management and empowers the patient to become an active participant in treatment decisions. Digital health technologies (DHTs) and digital therapeutic (DT) devices provide new opportunities to monitor treatment behaviors, improve communication between healthcare providers and patients, and generate data that inform educational interactions. DHT and DT have been proven effective in enhancing patient self-management in other chronic conditions, particularly diabetes. Accelerated integration of DHT and DT into the management of asthma patients is facilitated by the use of digital inhalers that employ sensor technology ("smart" inhalers). These devices efficiently provide real-time feedback on controller adherence, SABA use, and inhaler technique that have the strong potential to optimize asthma control.
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Affiliation(s)
- Alan Kaplan
- Department of Family and Community Medicine, University of Toronto, 14872 Yonge Street, Aurora, Toronto, ON L4G 1N2, Canada
- Family Physician Airways Group of Canada, Markham, ON, Canada
| | | | | | - James Kim
- Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Christopher Licskai
- Division of Respirology, Department of Medicine, Western University, London, ON, Canada
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14
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Sollie M, Hansen M, Thomsen JB. Health Technology Readiness amongst Patients with Suspected Breast Cancer Using the READHY-tool - a Cross-sectional Study. J Med Syst 2023; 47:118. [PMID: 37971517 PMCID: PMC10654165 DOI: 10.1007/s10916-023-02016-0] [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: 09/22/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
Information technologies are increasingly used when informing patients about their disease, treatment and prognosis. These digital platforms have many advantages compared to traditional education interventions. However, there are concerns that some patients may have difficulty with this mode of information delivery. Newly diagnosed breast cancer patients are dependent on understanding their treatment options to make informed treatment decisions. Yet, there is a lack of published material on breast cancer patients and their relationship with technology. We aimed to assess health technology readiness profiles amongst women with a suspected breast cancer diagnosis. Secondly, we wanted to investigate the potential differences between these profiles according to sociodemographic factors and the patients´ current use of technology. This cross-sectional study used the Readiness and Enablement Index for Health Technology (READHY) questionnaire. We included all patients (n = 92) referred to our department with suspected breast cancer. Cluster analysis revealed three distinct profiles: medium (n = 54), high (n = 18), and low (n = 20) health technology readiness. The third profile showed difficulties in health literacy, eHealth literacy, and health insights, along with higher emotional stress. Our study found that most patients had medium to high health technology readiness, but we also identified a group with lower health technology readiness. Based on our results, healthcare personnel dealing with women with suspected breast cancer should be aware of patients struggling with health technology. Age and technology familiarity may indicate vulnerable patients. Future studies should explore optimal methods for information delivery to these distinct profiles and evaluate the long-term impacts.
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Affiliation(s)
- Martin Sollie
- Research Unit for Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark.
- OPEN, Open Patient Data Explorative Network, Odense University Hospital, Region of Southern, Odense, Denmark.
- Department of Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark.
| | - Marianne Hansen
- Department of Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark
| | - Jørn Bo Thomsen
- Research Unit for Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark
- Department of Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark
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Wang X, Su A, Liu F, Gong Y, Wei T, Gong R, Zhu J, Li Z, Lei J. Trends, Influence Factors, and Doctor-Patient Perspectives of Web-Based Visits for Thyroid Surgery Clinical Care: Cross-Sectional Study. J Med Internet Res 2023; 25:e47912. [PMID: 37796623 PMCID: PMC10664019 DOI: 10.2196/47912] [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: 04/05/2023] [Revised: 07/16/2023] [Accepted: 10/04/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND In recent years, the new generation of telecommunication technologies has profoundly changed the traditional medical industry. To alleviate the medical difficulties faced by patients with thyroid diseases, hospitals have opened web-based visits and actively combined online-to-offline outpatient services. OBJECTIVE This study aims to explore differences between office and web-based outpatient services from doctors' and patients' perspectives, illustrate the effect of the COVID-19 pandemic on outpatient services, and provide clues for improving the online-to-offline mode of care for patients with thyroid diseases. METHODS We collected the complete web-based and office outpatient records of the Thyroid Surgery Center of West China Hospital. A total of 300,884 completed patient encounters occurred (201,840 office visits and 99,044 web-based visits) from January 1, 2019, to May 31, 2022. We performed logistic regression to evaluate the association between the chosen visit type and patients' sociodemographic characteristics. RESULTS The number of web-based visits rapidly increased since March 2020 and reached 45.1% (4752/10,531) of all encounters in December 2021. The COVID-19 pandemic dramatically accelerated the development of web-based visits. Web-based visits were preferred by patients 18-45 years old (odds ratio [OR] 2.043, 95% CI 1.635-2.552, P<.001), patients with relatively high-paying jobs (technical staff: OR 1.278, 95% CI 1.088-1.479, P=.003; office clerk: OR 1.25, 95% CI 1.07-1.461, P=.005; national public servant: OR:1.248, 95% CI 1.042-1.494, P=.02), and patients living in Sichuan Province (excluding Chengdu; OR 1.167, 95% CI 1.107-1.23, P<.001). The medicine cost (P<.001) and examination cost (P<.001) of office visits were significantly higher than those of web-based visits. CONCLUSIONS Web-based outpatient visits have increased rapidly in recent years, and the COVID-19 pandemic has boosted their development. The preference for web-based visits was influenced by the socioeconomic and demographic characteristics of both patients and doctors.
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Affiliation(s)
- Xinyi Wang
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Anping Su
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Feng Liu
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanping Gong
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tao Wei
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rixiang Gong
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jingqiang Zhu
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhihui Li
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jianyong Lei
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Parkinson MD, Stout R, Dysinger W. Lifestyle Medicine: Prevention, Treatment, and Reversal of Disease. Med Clin North Am 2023; 107:1109-1120. [PMID: 37806726 DOI: 10.1016/j.mcna.2023.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Lifestyle medicine (LM) expands the scope of preventive medicine by focusing on the promotion of healthy lifestyles while preventing, treating, and reversing the vast majority of chronic diseases caused by behaviors and environmental factors. LM focuses on six pillars-a plant-predominant eating pattern; physical movement; restorative sleep; management of stress; avoidance of risky substances; and positive social connections. Advances in LM competencies, education, certification, resources, and practice models are accelerating with a particular need and focus on underserved and most seriously impacted patients and communities. A comprehensive and integrated strategy addressing "whole person health" is emerging as a compelling framework for providers and health systems which combines a foundational commitment to prevention with a systematic approach to the actual and root causes of premature disease, disability, and death.
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Affiliation(s)
- Michael D Parkinson
- P3 Health, LLC (Prevention, Performance, Productivity), 5864 Aylesboro Avenue, Pittsburgh, PA 15217, USA.
| | - Ron Stout
- Ardmore Institute of Health, PO Box 1269, Ardmore, OK 73402, USA
| | - Wayne Dysinger
- Lifestyle Medical, 4368 Central Avenue, Riverside, CA 92506, USA
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17
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Livingston DS, Krishnan V. Nurses' Perceptions of Intensive Care Unit Orientation Patient Education Pamphlet. ATS Sch 2023; 4:332-343. [PMID: 37795124 PMCID: PMC10547037 DOI: 10.34197/ats-scholar.2022-0142oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/16/2023] [Indexed: 10/06/2023] Open
Abstract
Background Critical illness is a stressful time for patients and their support networks. Although patient-directed educational material to improve the understanding of critical illness exists, both patients and staff members are often unaware of these resources or how to find them. Objectives We aimed to evaluate the impact of the implementation of the American Thoracic Society's (ATS) "Managing the Intensive Care Unity (ICU) Experience: A Proactive Guide for Patients and Families", an ICU orientation pamphlet, on nurses' perceptions of the availability and effectiveness of patient and family educational resources. Methods In a safety-net urban institution, we surveyed medical ICU (MICU) nurses in February 2021 regarding their perceptions of the availability of patient and family educational materials and the time and quality of communication with families of critically ill patients. We then introduced the MICU nurses to the ATS ICU orientation pamphlet to complement patient and family education. Quick response (QR) codes were created, linking to the online versions of the ICU pamphlet, and made available in waiting rooms. Printed copies of the pamphlet were provided to families in the ICU introductory packet upon patient MICU admission. We informed nurses regarding the pamphlet content, website, and QR codes. A postintervention survey was administered 11 months after the initial survey. Changes between pre and postintervention responses were analyzed for significant differences. Debriefing sessions with the MICU nurses were conducted, and subsequent discussions identified opportunities to improve the available educational resources. Results At baseline, 28 of 67 (42%) MICU nurses responded to the survey. Although all nurses provided verbal education to patients and families, only 18% reported knowing about and using additional resources to supplement this education. The postintervention survey was completed by 39% of nurses; 39% of them reported using additional materials to supplement patient and family education. Reported awareness of the ATS ICU pamphlet increased from 4% before implementation to 23% after implementation (P = 0.04). MICU nurses offered suggestions to improve the pamphlet, which thematically fell into three categories: 1) opportunities to alter the ICU pamphlet, 2) opportunities to provide the pamphlet in varied formats, and 3) opportunities to add additional education topics. Conclusions Informing nurses about the ICU pamphlet improved the acceptance and use of the materials, but it was still not accepted by many nurses. Barriers to ICU nurses using patient education resources should be explored to facilitate quality materials reaching patients and complementing patient communication. QR codes may have offered a way to disseminate educational materials to patients and families in a manner not previously considered. The process of evaluating the ICU pamphlet for our institution led to a broader discussion of additional needs for patient and family educational materials for our patient population. We encourage institutions to evaluate the sufficiency of their patient and family educational materials for similar local benefits.
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Affiliation(s)
- Daniel S. Livingston
- Division of Pulmonary and Critical Care Medicine and
- Division of Physician Informatics, Community Physician Network, Kokomo, Indiana
| | - Vidya Krishnan
- Division of Pulmonary, Critical Care and Sleep Medicine, Case Western Reserve University/The MetroHealth System, Cleveland, Ohio
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Noch EK, Pham D, Kitago T, Wuennemann M, Wortman-Jutt S, Falo MC. Qualitative feasibility study of the mobile app Destroke for clinical stroke monitoring based on the NIH stroke scale. Heliyon 2023; 9:e18393. [PMID: 37560705 PMCID: PMC10407036 DOI: 10.1016/j.heliyon.2023.e18393] [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: 02/21/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Stroke is a leading cause of severe disability in the United States, but there is no effective method for patients to accurately detect the signs of stroke at home. We developed a mobile app, Destroke, that allows remote performance of a modified NIH stroke scale (NIHSS) by patients. AIMS To assess the feasibility of a mobile app for stroke monitoring and education by patients with a history of stroke. MATERIALS AND METHODS We enrolled 25 patients with a history of stroke in a prospective open-label study to evaluate the feasibility of the Destroke app in patients with stroke. Nineteen patients completed all study assessments, with a median time from stroke onset to enrollment of 5.6 years (range 0.1-12 years). We designed a modified NIHSS that assessed 12 out of 16 tasks on the NIHSS. Patients completed this test eight times over a 28-day period. We conducted pre-study surveys that assessed demographic information, stroke and cardiovascular history, baseline NIHSS, and experience using mobile technologies, and mid- and post-study surveys that assessed patient satisfaction on app usage and confidence in stroke detection. RESULTS Ten men and nine women participated in this study (median age of 64 (33-76)), representing ten US states and Washington D.C. Median baseline NIHSS was 0 (0-4). 15 patients reported using health apps. On a 5-point Likert scale, patients rated the app as 4.2 on being able to understand and use the app and 4.3 on using the app when instructed by their doctor. For eight patients with poor confidence in detecting the signs of a stroke before the study, six showed higher confidence after the study. CONCLUSIONS The use of an at-home stroke monitoring app is feasible by patients with a history of stroke and improves confidence in detecting the signs of stroke.
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Affiliation(s)
- Evan K. Noch
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
- Destroke, Inc., USA
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Rosenlund M, Kinnunen UM, Saranto K. The Use of Digital Health Services Among Patients and Citizens Living at Home: Scoping Review. J Med Internet Res 2023; 25:e44711. [PMID: 36972122 PMCID: PMC10131924 DOI: 10.2196/44711] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/31/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The development of digital health services reflects not only the technical development of services but also a change in attitude and the way of thinking. It has become a cornerstone for engaging and activating patients and citizens in health management while living at home. Digital health services are also aimed at enhancing the efficiency and quality of services, while simultaneously providing services more cost-effectively. In 2020, the COVID-19 pandemic accelerated worldwide the development and use of digital services in response to requirements for social distancing and other regulations. OBJECTIVE The aim of this review is to identify and summarize how digital health services are being used among patients and citizens while living at home. METHODS The Joanna Briggs Institute (JBI) methodology for scoping reviews was used as guidance. A search conducted in 3 databases (CINAHL, PubMed, Scopus) resulted in 419 papers. The reporting was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR), and the analysis of the included papers was performed using a framework consisting of 5 clusters describing the use of digital health services. After screening and excluding papers that did not match the inclusion criteria, 88 (21%) papers from 2010 to 2022 were included in the final analysis. RESULTS Results indicated that digital health services are used in different situations and among different kinds of populations. In most studies, digital health services were used in the form of video visits or consultations. The telephone was also used regularly for consultations. Other services, such as remote monitoring and transmitting of recorded information and the use the of internet or portals for searching information, were observed as well. Alerts, emergency systems, and reminders were observed to offer possibilities of use, for example, among older people. The digital health services also showed to have potential for use in patient education. CONCLUSIONS The development of digital services reflects a shift toward the provision of care regardless of time and place. It also reflects a shift toward emphasis on patient-centered care, meaning activating and engaging patients in their own care as they use digital services for various health-related purposes. Despite the development of digital services, many challenges (eg, adequate infrastructure) still prevail worldwide.
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Affiliation(s)
- Milla Rosenlund
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Ulla-Mari Kinnunen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
| | - Kaija Saranto
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
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Reiter A, Tov EY, Hochberg I. Do patients read emails from their physician containing tips on improving lifestyle habits? A pilot study. Int J Med Inform 2023; 170:104967. [PMID: 36587533 DOI: 10.1016/j.ijmedinf.2022.104967] [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: 03/23/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Healthcare providers and organizations occasionally use electronic messages to provide information to patients. There is insufficient data on whether patients actually read the emails they receive. In this study, we aimed to assess the cooperation of patients in reading multiple information pages sent over 6 months from their diabetologist via email. METHODS Adults with non-optimally controlled type 2 diabetes received via email, once every 2 weeks for 6 months, a message containing information and tips on how to improve diabetes control through lifestyle choices. The information was provided in a format that required the recipient to actively click on a "read more" tab in order to reveal the entire text. Each email contained a short questionnaire requesting a response. Analysis compared the effect of patient variables on co-operation with reading the emails and answering the questionnaires. MAIN FINDINGS 45 patients completed the study, 53.3% of them read 66-100% of the emails, 17.8% read 34-65% of the emails and only 26.7% read less than 33% of the emails. Women answered more questionnaires than men did. Answering a questionnaire on nutrition or medications correlated with reading the following email sent. CONCLUSIONS This study is the first to demonstrate that most patients do indeed read a significant portion of emails sent by their physician. Email could be an effective means of sharing information and improving patient engagement with treatment.
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Affiliation(s)
- Adam Reiter
- Maccabi Health Services, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Elad Yom Tov
- Microsoft Research, Herzelya, Israel; Faculty of Industrial Engineering and Management, Technion - Israel Institute of Technology, Israel
| | - Irit Hochberg
- Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
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Baroni MP, Jacob MFA, Rios WR, Fandim JV, Fernandes LG, Chaves PI, Fioratti I, Saragiotto BT. The state of the art in telerehabilitation for musculoskeletal conditions. Arch Physiother 2023; 13:1. [PMID: 36597130 PMCID: PMC9810517 DOI: 10.1186/s40945-022-00155-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/16/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Given the rapid advances in communication technology and the need that emerged from the COVID-19 pandemic, telehealth initiatives have been widely used worldwide. This masterclass aims to provide an overview of telerehabilitation for musculoskeletal conditions, synthesizing the different terminologies used to describe telehealth and telerehabilitation, its effectiveness and how to use it in clinical practice, barriers and facilitators for the implementation in health services, and discuss the need of a curriculum education for the near future. MAIN BODY Telerehabilitation refers to the use of information and communication technologies provided by any healthcare professionals for rehabilitation services. Telerehabilitation is a safe and effective option in the management of musculoskeletal conditions in different models of delivery. There are many technologies, with different costs and benefits, synchronous and asynchronous, that can be used for telerehabilitation: telephone, email, mobile health, messaging, web-based systems and videoconferences applications. To ensure a better practice of telerehabilitation, the clinician should certify safety and access, and appropriateness of environment, communication, technology, assessment, and therapeutic prescription. Despite the positive effect of telerehabilitation in musculoskeletal disorders, a suboptimal telerehabilitation implementation may have happened due to the COVID-19 pandemic, especially in countries where telehealth was not a reality, and clinicians lacked training and guidance. This emphasizes the need to identify the necessary curriculum content to guide future clinicians in their skills and knowledge for telerehabilitation. There are some challenges and barriers that must be carefully accounted for to contribute to a health service that is inclusive and relevant to health professionals and end users. CONCLUSIONS Telerehabilitation can promote patient engagement in health care and plays an important role in improving health outcomes in patients with musculoskeletal conditions. Digital health technologies can also offer new opportunities to educate patients and facilitate the process of behavior change to a healthy lifestyle. Currently, the main needs in telerehabilitation are the inclusion of it in health curriculums in higher education and the development of cost-effectiveness and implementation trials, especially in low- and middle-income countries where access, investments and digital health literacy are limited.
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Affiliation(s)
- Marina P. Baroni
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil
| | - Maria Fernanda A. Jacob
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil
| | - Wesley R. Rios
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil
| | - Junior V. Fandim
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil
| | - Lívia G. Fernandes
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil
| | - Pedro I. Chaves
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil
| | - Iuri Fioratti
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil
| | - Bruno T. Saragiotto
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, São Paulo 03071-000 Brazil ,Centre for Pain, Health and Lifestyle, São Paulo São Paulo, Brazil ,grid.117476.20000 0004 1936 7611Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, NSW 2000 Sydney, Australia
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Karavasileiadou S, Almegwely W, Alanazi A, Alyami H, Chatzimichailidou S. Self-management and self-efficacy of women with gestational diabetes mellitus: a systematic review. Glob Health Action 2022; 15:2087298. [PMID: 35867537 PMCID: PMC9310944 DOI: 10.1080/16549716.2022.2087298] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a temporary form of diabetes induced by pregnancy and is potentially harmful to both the mother and fetus The impact of GDM diagnosis on pregnant women needs to be taken into account. This is related to the capacity for self-management of GDM, for which quality evidence is still lacking. OBJECTIVE to identify several aspects of self-management and self- efficacy for women with GDM. METHOD Electronic databases were searched for studies related to the self-management, self-efficacy, and glycemic control of women with GDM, from January 2012 to January 2021. The extraction of study features was based on study location, reported research aims, study design, methodology, and the analytical approach, using Endnote Version X7.7.1. The Critical Appraisal Skills Program Qualitative Checklist (CASP) was used to assess quality, as recommended by the Cochrane Qualitative Research Methods Group. RESULTS Ten out of 70 studies were identified as meeting the established criteria and including a diverse population. The synthesis revealed seven major themes: preliminary psychological impact, communicating the diagnosis, knowledge of GDM, self-efficacy and self-management of GDM, risk perception, the burden of GDM, and gaining control. The benefits of a diagnosis were behavioral and were mostly crystalized if a particular level of self-management and self-efficacy was reached and women were able to have specific control over their diet and body weight. On the other hand, women reported that the diagnosis increased their responsibility, as they had to take extra precautions regarding their dietary regimen. CONCLUSION Self-management and self-efficacy for GDM management are possible, despite the psychological hurdles that most women confront. There is still potential for improvement in terms of developing a healthy lifestyle that not only manages GDM for the best pregnancy result, but also prevents diabetes after pregnancy.
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Affiliation(s)
- Savvato Karavasileiadou
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Wafa Almegwely
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Anwar Alanazi
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hanan Alyami
- Medical - Surgical Nursing Department, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sofia Chatzimichailidou
- Department of Pathology, Hippokration General Teaching Hospital, Municipality of Thessaloniki, Greece
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23
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Heerdegen ACS, Cellini CM, Wirtz VJ, Rockers PC. Digital Health Technologies Applied by the Pharmaceutical Industry to Improve Access to Noncommunicable Disease Care in Low- and Middle-Income Countries. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:e2200072. [PMID: 36316151 PMCID: PMC9622287 DOI: 10.9745/ghsp-d-22-00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is limited research on how digital health technologies (DHTs) are used to promote access to care for patients with noncommunicable diseases (NCDs), particularly in low- and middle-income countries (LMICs). We describe the use of DHTs in pharmaceutical industry-led access programs aimed at improving access to NCD care in LMICs. METHODS The Access Observatory is the largest publicly available repository containing detailed information about pharmaceutical industry-led access programs targeting NCDs. The repository includes 101 access program reports submitted by 19 pharmaceutical companies. From each report, we extracted data relating to geographic location, disease area, beneficiary population, use of DHTs, partnerships, strategies, and activities. Data were analyzed descriptively using SAS Statistical Software and categorized according to the World Health Organization Digital Health Classification Framework. RESULTS A total of 43 access programs (42.6%) included DHTs. The majority of programs using DHTs were clustered across sub-Saharan Africa (72.1%) and targeted cancer (60.5%) followed by metabolic disorders (39.5%). The applied DHTs mostly related to program strategies on health service strengthening (74.4%) and community awareness (41.9%) and were largely directed toward health providers, followed by data services and clients. Only a few DHTs were used for health system management. To promote access, most DHTs focused on improving data collection, management, and use (51.1%); building health provider capacity through training (37.2%); and providing targeted patient information (34.8%). CONCLUSION The range of DHTs applied by the pharmaceutical industry offers opportunities for more effective access to NCD care. Transparent reporting on DHT use and its contributions to access programs' achievements may reduce duplicative and redundant efforts and provide learnings for private and public stakeholders that may contribute to greater access to NCD care in LMICs.
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Affiliation(s)
| | | | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Peter C Rockers
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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24
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Posyandu Application in Indonesia: From Health Informatics Data Quality Bridging Bottom-Up and Top-Down Policy Implementation. INFORMATICS 2022. [DOI: 10.3390/informatics9040074] [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] Open
Abstract
The community’s mother and child health (MCH) and nutrition problems can be overcome through evidence-based health policy. Posyandu is an implementation of community empowerment in health promotion strategies. The iPosyandu application (app) is one of the health informatics tools, in which data quality should be considered before any Posyandu health interventions are made. This study aims to describe and assess differences in data quality based on the dimensions (completeness, accuracy, and consistency) of the secondary data collected from the app in Purwakarta Regency in 2019–2021. Obstacles and suggestions for improving its implementation were explored. This research applies a mixed-method explanatory approach. Data completeness was identified as the number of reported visits of children under five per year. Data accuracy was analyzed using WHO Z-score anthropometry and implausible Z-score values. Data consistency was measured using Cronbach’s alpha coefficient, followed by qualitative research with focus group discussions, in-depth interviews, and field observation notes. The quantitative study results found that some of the data were of good quality. The qualitative research identified the obstacles experienced using the iPosyandu app, one of them being that there were no regulations governing the use of iPosyandu to bridge the needs of the government, and provided suggestions from the field to improve its implementation.
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25
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The Effect of a Patient Education Multimodal Digital Platform on Knowledge Acquisition, Self-efficacy, and Patient Satisfaction. Comput Inform Nurs 2022; 41:356-364. [PMID: 36071664 DOI: 10.1097/cin.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examined the impact of digital training instrument based on multimodal learning approach on surgical ward hospitalized patient education-related variables. The study was conducted as a multisite study in a large medical center as a two-arm, controlled trial with randomized cluster sampling. All patients meeting the inclusion criteria were offered the opportunity to participate. The control group (n = 40) received nurse explanation on home self-injection of enoxaparin sodium, whereas the intervention group (n = 40) received a tablet for multimodal learning specifically developed for this study. All participants completed before-and-after questionnaires evaluating knowledge acquisition, change in self-efficacy, and patient satisfaction. Results showed that the intervention group gained significantly more knowledge than the control group (P < .01). There was no significant difference in the level of self-efficacy change between the groups, and it was found that the control group patients were more satisfied with the training process (P = .01). This study shows that the use of a digital application for the benefit of patients' self-injection learning is effective in achieving educational goals such as knowledge acquisition and therefore can be a helpful resource for caregivers. Yet, these applications are not a substitute for attention provided by professionals, which is highly valued by patients.
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Olatunde OE, Richards D, Dobbs PD, Nahar VK, Sharma M, Davis RE. Psychological Help-Seeking Among College Students: Applying the Multi-Theory Model of Health Behavior Change in Assessing Telehealth Use for Psychological Help-Seeking. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221116561] [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] Open
Abstract
Background Due to the deleterious effects on psychological health and wellbeing spurred by the pandemic, utilization of telehealth-based care increased over the past few years. The rapid transition from in-person to telehealth-based health service delivery has yet to be fully understood. The aim of the current study was to examine telehealth use for psychological help-seeking among college students using the Multi-theory Model of health behavior change (MTM) as a theoretical framework. Methods A cross-sectional and survey-based study was conducted among students at a large US university (N = 356). Valid and reliable scales were used to measure domains of psychological distress and MTM constructs. Participants were grouped based on past 12-month utilization of telehealth for any mental, emotional, or substance use problems. Results Roughly 67% of the sample reported that they needed help dealing with psychological distress, and 56.1%,43.3%, and 38.7% screened positive for anxiety, depression, and suicidal ideation, respectively. Depression, anxiety, and suicidal ideation were positively associated with past 12-month telehealth-based help-seeking. Past 12-month telehealth users reported greater advantages, confidence, and emotion direction toward telehealth-based psychological help-seeking than their counterparts. Participants also perceived higher exhibition of behavioral skills and greater social support to aid help-seeking than their counterparts. Advantages and disadvantages as well as behavioral confidence predicted intentions for telehealth-based help-seeking after controlling for anxiety, depression, suicidal ideation, perceived stigma, and perceived need for help among both groups. Conclusion The MTM theoretical framework is a valuable framework for predicting telehealth-based psychological help-seeking among college students. Such framework can be used to design and implement mental health programing.
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Affiliation(s)
- Oluwatoyin E. Olatunde
- Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (OO, DR, RED); Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (PDD); Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA (VKN); Department of Dermatology, University of Mississippi Medical Center, Jackson
| | - Dallion Richards
- Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (OO, DR, RED); Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (PDD); Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA (VKN); Department of Dermatology, University of Mississippi Medical Center, Jackson
| | - Page D. Dobbs
- Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (OO, DR, RED); Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (PDD); Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA (VKN); Department of Dermatology, University of Mississippi Medical Center, Jackson
| | - Vinayak K. Nahar
- Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (OO, DR, RED); Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (PDD); Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA (VKN); Department of Dermatology, University of Mississippi Medical Center, Jackson
| | - Manoj Sharma
- Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (OO, DR, RED); Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (PDD); Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA (VKN); Department of Dermatology, University of Mississippi Medical Center, Jackson
| | - Robert E. Davis
- Substance Use and Mental Health Laboratory, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (OO, DR, RED); Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA (PDD); Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA (VKN); Department of Dermatology, University of Mississippi Medical Center, Jackson
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27
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Adesina N, Dogan H, Green S, Tsofliou F. Effectiveness and Usability of Digital Tools to Support Dietary Self-Management of Gestational Diabetes Mellitus: A Systematic Review. Nutrients 2021; 14:10. [PMID: 35010884 PMCID: PMC8746603 DOI: 10.3390/nu14010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022] Open
Abstract
Advice on dietary intake is an essential first line intervention for the management of gestational diabetes mellitus (GDM). Digital tools such as web-based and smartphone apps have been suggested to provide a novel way of providing information on diet for optimal glucose regulation in women with GDM. This systematic review explores the effectiveness and usability of digital tools designed to support dietary self-management of GDM. A systematic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Scopus using key search terms identified 1476 papers reporting research studies, of which 16 met the specified inclusion criteria. The quality of the included studies was assessed using the ErasmusAGE Quality Score or the Mixed Methods Appraisal Tool (MMAT) version 2018. The findings show that the adoption of digital tools may be an effective approach to support self-management relating to healthy diet, health behaviour, and adherence to therapy in women with GDM as a usable intervention. However, there is a lack of evidence concerning the effectiveness of tools to support the dietary management of GDM. Consideration for ethnic specific dietary advice and evidence-based frameworks in the development of effective digital tools for dietary management of GDM should be considered as these aspects have been limited in the studies reviewed.
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Affiliation(s)
- Nurudeen Adesina
- Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Huseyin Dogan
- Department of Computing and Informatics, Faculty of Science and Technology, Bournemouth University, Poole BH12 5BB, UK;
| | - Sue Green
- Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
| | - Fotini Tsofliou
- Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK;
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
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Freeman KJ, Grega ML, Friedman SM, Patel PM, Stout RW, Campbell TM, Tollefson ML, Lianov LS, Pauly KR, Pollard KJ, Karlsen MC. Lifestyle Medicine Reimbursement: A Proposal for Policy Priorities Informed by a Cross-Sectional Survey of Lifestyle Medicine Practitioners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111632. [PMID: 34770148 PMCID: PMC8583485 DOI: 10.3390/ijerph182111632] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/29/2021] [Accepted: 10/31/2021] [Indexed: 12/18/2022]
Abstract
Lifestyle medicine (LM) is a rapidly emerging clinical discipline that focuses on intensive therapeutic lifestyle changes to treat chronic disease, often producing dramatic health benefits. In spite of these well-documented benefits of LM approaches to provide evidence-based care that follows current clinical guidelines, LM practitioners have found reimbursement challenging. The objectives of this paper are to present the results of a cross-sectional survey of LM practitioners regarding lifestyle medicine reimbursement and to propose policy priorities related to the ability of practitioners to implement and achieve reimbursement for these necessary services. Results from a closed, online survey in 2019 were analyzed, with a total of n = 857 included in this analysis. Results were descriptively analyzed. This manuscript articulates policy proposals informed by the survey results. The study sample was 58% female, with median age of 51. A minority of the sample (17%) reported that all their practice was LM, while 56% reported that some of their practice was LM. A total of 55% of practitioners reported not being able to receive reimbursement for LM practice. Of those survey respondents who provided an answer to the question of what would make the practice of LM easier (n = 471), the following suggestions were offered: reimbursement overall (18%), reimbursement for more time spent with patients (17%), more support from leadership (16%), policy measures to incentivize health (13%), education in LM for practitioners (11%), LM-specific billing codes and billing knowledge along with better electronic medical record (EMR) capabilities and streamlined reporting/paperwork (11%), and reimbursement for the extended care team (10%). Proposed policy changes focus on three areas of focus: (1) support for the care process using a LM approach, (2) reimbursement emphasizing outcomes of health, patient experience, and delivering person-centered care, and (3) incentivizing treatment that produces disease remission/reversal. Rectifying reimbursement barriers to lifestyle medicine practice will require a sustained effort from health systems and policy makers. The urgency of this transition towards lifestyle medicine interventions to effectively address the epidemic of chronic diseases in a way that can significantly improve outcomes is being hindered by current reimbursement policies and models.
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Affiliation(s)
- Kelly J. Freeman
- Department of Member Engagement & Administration, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA;
- Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA
- Correspondence:
| | - Meagan L. Grega
- Department of Lifestyle Medicine, Kellyn Foundation, Tatamy, PA 18015, USA;
| | - Susan M. Friedman
- School of Medicine and Dentistry, Department of Medicine, University of Rochester, Rochester, NY 14642, USA;
| | - Padmaja M. Patel
- American College of Lifestyle Medicine, Chesterfield, MO 63006, USA; (P.M.P.); (L.S.L.)
- Lifestyle Medicine Center, Midland Health, Midland, TX 79703, USA
| | - Ron W. Stout
- Ardmore Institute of Health, Ardmore, OK 73401, USA;
| | - Thomas M. Campbell
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Michelle L. Tollefson
- Department of Health Professions, Lifestyle Medicine Program, Metropolitan State University of Denver, Denver, CO 80204, USA;
| | - Liana S. Lianov
- American College of Lifestyle Medicine, Chesterfield, MO 63006, USA; (P.M.P.); (L.S.L.)
- Global Positive Health Institute, Sacramento, CA 95825, USA
| | - Kaitlyn R. Pauly
- Department of Member Engagement & Administration, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA;
| | - Kathryn J. Pollard
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA; (K.J.P.); (M.C.K.)
| | - Micaela C. Karlsen
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA; (K.J.P.); (M.C.K.)
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29
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Saab MM, Landers M, Egan S, Murphy D, Hegarty J. Nurses and Nursing Students' Attitudes and Beliefs Regarding the Use of Technology in Patient Care: A Mixed-Method Systematic Review. Comput Inform Nurs 2021; 39:704-713. [PMID: 34238834 DOI: 10.1097/cin.0000000000000791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Advancements in information technology and computer science have resulted in the development of computerized healthcare information systems. Information technology can optimize patient care through providing immediate electronic education. The purpose of this mixed-methods systematic review was to synthesize evidence from studies exploring nurses and nursing students' attitudes and beliefs regarding the use of technology in patient care. Electronic databases Academic Search Complete, CINAHL, MEDLINE, Education Full Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, and ERIC were searched. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. Convergent integrated synthesis was conducted. Eight studies were included. Technologies used in the reviewed studies include smartphones (n = 4) and Web-based information/educational resources (n = 4). Overall, nurses and nursing students' attitudes and beliefs regarding the use of smartphone applications were positive. When compared with other healthcare professionals, nurses were more likely to have access to Web-based resources and to appraise the importance of such resources in patient education. Nurses and nursing students are in a prime position to use technology in patient care and education. It is important therefore that nurses' positive attitudes toward technology be reinforced to increase the use and application of Web-based and smartphone technologies in clinical practice.
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Affiliation(s)
- Mohamad M Saab
- Author Affiliations: Catherine McAuley School of Nursing and Midwifery (Drs Saab, Landers, and Hegarty), School of Public Health (Ms Egan), and School of Computer Science and Information Technology (Mr Murphy), University College Cork, Ireland
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30
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George TP, DeCristofaro C, Kershner SH. Graduate Nursing Students' Awareness of Digital Resources for Patient Education. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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31
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Elkefi S, Yu Z, Asan O. Online Medical Record Nonuse Among Patients: Data Analysis Study of the 2019 Health Information National Trends Survey. J Med Internet Res 2021; 23:e24767. [PMID: 33616539 PMCID: PMC7939938 DOI: 10.2196/24767] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/19/2020] [Accepted: 12/12/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Online medical records are being used to organize processes in clinical and outpatient settings and to forge doctor-patient communication techniques that build mutual understanding and trust. OBJECTIVE We aimed to understand the reasons why patients tend to avoid using online medical records and to compare the perceptions that patients have of online medical records based on demographics and cancer diagnosis. METHODS We used data from the Health Information National Trends Survey Cycle 3, a nationally representative survey, and assessed outcomes using descriptive statistics and chi-square tests. The patients (N=4328) included in the analysis had experienced an outpatient visit within the previous 12 months and had answered the online behavior question regarding their use of online medical records. RESULTS Patients who were nonusers of online medical records consisted of 58.36% of the sample (2526/4328). The highest nonuser rates were for patients who were Hispanic (460/683, 67.35%), patients who were non-Hispanic Black (434/653, 66.46%), and patients who were older than 65 years (968/1520, 63.6%). Patients older than 65 years were less likely to use online medical records (odds ratio [OR] 1.51, 95% CI 1.24-1.84, P<.001). Patients who were White were more likely to use online medical records than patients who were Black (OR 1.71, 95% CI 1.43-2.05, P<.001) or Hispanic (OR 1.65, 95% CI 1.37-1.98, P<.001). Patients who were diagnosed with cancer were more likely to use online medical records compared to patients with no cancer (OR 1.31, 95% CI 1.11-1.55, 95% CI 1.11-1.55, P=.001). Among nonusers, older patients (≥65 years old) preferred speaking directly to their health care providers (OR 1.76, 95% CI 1.35-2.31, P<.001), were more concerned about privacy issues caused by online medical records (OR 1.79, 95% CI 1.22-2.66, P<.001), and felt uncomfortable using the online medical record systems (OR 10.55, 95% CI 6.06-19.89, P<.001) compared to those aged 18-34 years. Patients who were Black or Hispanic were more concerned about privacy issues (OR 1.42, 1.09-1.84, P=.007). CONCLUSIONS Studies should consider social factors such as gender, race/ethnicity, and age when monitoring trends in eHealth use to ensure that eHealth use does not induce greater health status and health care disparities between people with different backgrounds and demographic characteristics.
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Affiliation(s)
- Safa Elkefi
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Zhongyuan Yu
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
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