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Basile I, Consolo L, Colombo S, Rusconi D, Rampichini F, Lusignani M. Technology to Support Older Adults in Home Palliative Care: A Scoping Review. Am J Hosp Palliat Care 2024; 41:673-690. [PMID: 37473720 PMCID: PMC11032634 DOI: 10.1177/10499091231189502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Today, many older adults use health technologies, approach their final days with laptops, smartphones, and tablets. Telepalliative care is a service that remotely delivers palliative care through videoconferencing, telephonic communication, or remote symptom monitoring. The service meets the needs of patients who want to die at home and reducing unnecessary hospitalizations. The objective of this study is to map the literature on the use of technology by the terminally ill older adult population being cared for at home, to identify which technology systems are in use, to determine how technology can change communication between palliative care professionals and patients, and to explore the strengths or weaknesses patients perceive regarding the use of technology. METHODS We conducted a scoping review following the methodology of Arksey and O'Malley. A literature search was conducted in the MEDLINE, Embase, Web of Science, SCOPUS, PsycINFO, CINAHL, Ilisi and Google Scholar databases. RESULTS Fourteen eligible papers identified various tools available in clinical practice and found that most older adults are comfortable and satisfied using them. Despite being physically distanced from clinicians, patients felt cared for even though eye contact was lacking. Being unfamiliar with technology emerged as a barrier to telepalliative care in addition to difficulties caused by screen size and internet connection problems. CONCLUSIONS Older adults in palliative care at home perceive technology as a means of receiving efficient care. However, future research is needed to investigate what they look for in a technological tool and to develop more suitable technologies for them. CLINICAL TRIAL REGISTRATION The protocol of this study has been published in the Open Science Framework (OSF) preregistrations at https://osf.io/acv7q to enhance replicability and transparency and reduce any publication or reporting bias.
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Affiliation(s)
- Ilaria Basile
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, IRCCS, National Cancer Institute Milan, Milan, Italy
| | - Letteria Consolo
- Bachelor School of Nursing, IRCCS, National Cancer Institute, Milan Italy
| | - Stella Colombo
- Intensive Care Unit, IRCCS, National Cancer Institute, Milan, Italy
| | - Daniele Rusconi
- Urology Unit, IRCCS, National Cancer Institute, Milan, Italy
| | - Flavia Rampichini
- Central Medical and Surgical Pole Library, University of Milan, Milan, Italy
| | - Maura Lusignani
- Associate Professor, Department of Biomedical Sciences for Health, Milan, Italy
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Blatt MI, Rupp J, Lipton M, Barrett TW, Boyd JS, Ward MJ. Effect of Departmental and Physician-Selected Interventions on Point-of-Care Ultrasound Documentation Completion. Cureus 2024; 16:e61675. [PMID: 38966489 PMCID: PMC11223751 DOI: 10.7759/cureus.61675] [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: 06/04/2024] [Indexed: 07/06/2024] Open
Abstract
Background Point-of-care ultrasound (POCUS) has been disruptive to many experienced emergency physicians as it requires competence in a new physical skill, real-time image interpretation, and navigation of novel software for submission to the electronic health record (EHR). Incomplete documentation of a performed POCUS study used for clinical decision-making represents a potential medicolegal liability, may expose the patient to repetitive or potentially unnecessary imaging, and is a missed opportunity for reimbursement. Identifying effective facilitators of ED POCUS documentation completion requires additional investigation. Methods In the first part of this mixed-methods study, eligible attending physicians were stratified into levels of use ("high"/"low"/"never") based on recent POCUS documentation performance. Semi-structured interviews were conducted with high and low utilizers to explore their perceptions of the POCUS submission workflow and their receptivity to various proposed interventions. Qualitative data were analyzed using a thematic analysis that explored perceived usefulness and usability. The second part of the study consisted of two intervention phases. First, physicians achieving minimum POCUS documentation numbers were rewarded with additional shift scheduling flexibility. In the second phase, the intervention that garnered the most interview support, daily documentation reminder emails, was implemented. The primary outcome was the individual POCUS documentation rates calculated as all studies submitted divided by all studies performed (submitted plus unsubmitted) per month. Provider-level monthly data was aggregated into a departmental rate. Results Interviews were conducted with 12 physicians, six from the highest and six from the lowest documentation quartiles. Both groups supported the same two proposed interventions: reminder emails ranked first, then monetary rewards ranked second. High utilizers emphasized the clinical utility of POCUS, whereas low utilizers expressed concerns over "double billing" and exposure to medicolegal liability with uncertain scan interpretations. For low utilizers, a documentation decision could be dependent on the performing resident physician's displayed confidence. Both groups voiced frustration with the need to use a separate program, Qpath (Telexy Healthcare, Inc, Maple Ridge, British Columbia, Canada), for POCUS documentation. During intervention phase one, the aggregate departmental documentation rate increased from 44.6% to 60.1% with the introduction of the schedule request incentive. This improvement was seen across all documentation quartiles. The departmental rate remained stable and did not improve further following the addition of the daily documentation reminder emails in intervention phase two. When reminder emails ceased yet the day-off request incentive continued, the departmental rate did not drop. Conclusions The implementation of a non-financial shift scheduling incentive correlated with the largest increase in departmental POCUS documentation rate. Interviewees incorrectly predicted that email reminders would be the most influential intervention highlighting a mismatch between physician perception and effective drivers of behavior change. Further investigation may focus on determining the size and longevity of the isolated impact of a schedule request incentive, as one might expect diminishing marginal utility.
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Affiliation(s)
- Marc I Blatt
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Jordan Rupp
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Matthew Lipton
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Tyler W Barrett
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Jeremy S Boyd
- Department of Emergency Medicine, VA Tennessee Valley Healthcare System, Nashville, USA
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Michael J Ward
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA
- Geriatric Research, Education, and Clinical Center, VA Tennessee Valley Healthcare System, Nashville, USA
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O'Brien N, Fernandez Crespo R, O'Driscoll F, Prendergast M, Chana D, Darzi A, Ghafur S. Usability and Feasibility Evaluation of a Web-Based and Offline Cybersecurity Resource for Health Care Organizations (The Essentials of Cybersecurity in Health Care Organizations Framework Resource): Mixed Methods Study. JMIR Form Res 2024; 8:e50968. [PMID: 38603777 PMCID: PMC11046383 DOI: 10.2196/50968] [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: 08/04/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Cybersecurity is a growing challenge for health systems worldwide as the rapid adoption of digital technologies has led to increased cyber vulnerabilities with implications for patients and health providers. It is critical to develop workforce awareness and training as part of a safety culture and continuous improvement within health care organizations. However, there are limited open-access, health care-specific resources to help organizations at different levels of maturity develop their cybersecurity practices. OBJECTIVE This study aims to assess the usability and feasibility of the Essentials of Cybersecurity in Health Care Organizations (ECHO) framework resource and evaluate the strengths, weaknesses, opportunities, and threats associated with implementing the resource at the organizational level. METHODS A mixed methods, cross-sectional study of the acceptability and usability of the ECHO framework resource was undertaken. The research model was developed based on the technology acceptance model. Members of the Imperial College Leading Health Systems Network and other health care organizations identified through the research teams' networks were invited to participate. Study data were collected through web-based surveys 1 month and 3 months from the date the ECHO framework resource was received by the participants. Quantitative data were analyzed using R software (version 4.2.1). Descriptive statistics were calculated using the mean and 95% CIs. To determine significant differences between the distribution of answers by comparing results from the 2 survey time points, 2-tailed t tests were used. Qualitative data were analyzed using Microsoft Excel. Thematic analysis used deductive and inductive approaches to capture themes and concepts. RESULTS A total of 16 health care organizations participated in the study. The ECHO framework resource was well accepted and useful for health care organizations, improving their understanding of cybersecurity as a priority area, reducing threats, and enabling organizational planning. Although not all participants were able to implement the resource as part of information computing technology (ICT) cybersecurity activities, those who did were positive about the process of change. Learnings from the implementation process included the usefulness of the resource for raising awareness and ease of use based on familiarity with other standards, guidelines, and tools. Participants noted that several sections of the framework were difficult to operationalize due to costs or budget constraints, human resource limitations, leadership support, stakeholder engagement, and limited time. CONCLUSIONS The research identified the acceptability and usability of the ECHO framework resource as a health-focused cybersecurity resource for health care organizations. As cybersecurity in health care organizations is everyone's responsibility, there is potential for the framework resource to be used by staff with varied job roles. Future research needs to explore how it can be updated for ICT staff and implemented in practice and how educational materials on different aspects of the framework could be developed.
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Affiliation(s)
- Niki O'Brien
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | | | - Fiona O'Driscoll
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Mabel Prendergast
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Deeph Chana
- Institute for Security Science and Technology, Imperial College London, London, United Kingdom
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Saira Ghafur
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Lee HH, Melbye EL. Nursing home caregivers' acceptance of, and experiences with, a new digital intervention for oral healthcare: A qualitative feasibility study. Gerodontology 2024; 41:68-82. [PMID: 37294037 DOI: 10.1111/ger.12695] [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] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The objectives of the present study were to qualitatively investigate nursing home caregivers' acceptance of, and experiences with, a new digital intervention for oral healthcare after a period of real-life testing in three nursing homes located in Rogaland county, Norway. BACKGROUND Nursing home caregivers report numerous barriers when it comes to provision of adequate oral care for care-dependent older adults. Among the reported barriers are lack of knowledge and skills, care-resistant behaviours, lack of adequate routines and documentation systems for oral health, a high workload, and unclear responsibilities. To overcome these barriers, a digital tool named SmartJournal was developed to assist caregivers in preserving nursing home residents' oral health. MATERIALS AND METHODS Semistructured interviews were performed with selected caregivers (n = 12) taking part in SmartJournal testing. A theory-driven thematic analysis based on technology acceptance model was conducted. RESULTS SmartJournal was generally described as a userfriendly and useful tool. The initial reaction of the participants was mixed; some were positive, some had concerns, but many seemed to have a neutral stance to the intervention. Both barriers and facilitating factors for SmartJournal usage were revealed. Interestingly, the usage gradually changed from norm-based to routine-based behaviour during the test period. Although the tool was well-accepted, as demonstrated with study participants' willingness to use it in the future, they had several suggestions for improvements to further adapt it to a nursing home setting. CONCLUSION Results from the present study provide valuable information on questions about SmartJournal acceptance and intervention delivery, thereby preparing the ground for a larger scale evaluation study assessing measurable effects of SmartJournal usage in nursing homes.
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Calderon Y, Sandigan G, Tan-Lim CSC, De Mesa RYH, Fabian NMC, Rey MP, Sanchez JT, Dans LF, Galingana CLT, Bernal-Sundiang N, Casile RU, Aquino MRN, Poblete KE, Lopez JFE, Zabala H, Dans AL. Feasibility, acceptability and impact of a clinical decision support tool among primary care providers in an urban, rural and remote site in the Philippines. BMJ Open Qual 2024; 13:e002526. [PMID: 38423587 PMCID: PMC10910488 DOI: 10.1136/bmjoq-2023-002526] [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: 07/30/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Strengthening primary care helps address health inequities that continue to persist in the Philippines. The Philippine Primary Care Studies pilot-tested interventions to improve the primary care system. One intervention was the provision of a free subscription to an electronic decision support application called UpToDate (UTD) for primary care providers (PCPs), including doctors, nurses, midwives and community health workers (CHWs). This study aimed to (1) assess the feasibility of using UTD as information source for PCPs in urban, rural and remote settings, (2) determine the acceptability of UTD as an information source for PCPs and (3) examine the impact of UTD access on PCP clinical decision-making. METHODS Four focus group discussions (FGDs) and two key informant interviews (KII) were conducted to gather insights from 30 PCPs. Thematic analysis through coding in NVivo V.12 was done using the technology acceptance model (TAM) as a guiding framework. RESULTS All PCPs had positive feedback regarding UTD use because of its comprehensiveness, accessibility, mobility and general design. The participants relayed UTD's benefit for point-of-contact use, capacity-building and continuing professional development. PCPs across the three sites, including CHWs with no formal medical education, were able to provide evidence-based medical advice to patients through UTD. However, external factors in these settings impeded the full integration of UTD in the PCPs' workflow, including poor internet access, unstable sources of electricity, lack of compatible mobile devices and the need for translation to the local language. CONCLUSION UTD was a feasible and acceptable clinical decision support tool for the PCPs. Factors affecting the feasibility of using UTD include technological and environmental factors (ie, internet access and the lack of translation to the local language), as well as the organisational structure of the primary care facility which determines the roles of the PCPs. Despite the difference in roles and responsibilities of the PCPs, UTD positively impacted decision-making and patient education for all PCPs through its use as a point-of-contact tool and a tool for capacity-building.
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Affiliation(s)
- Ysabela Calderon
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Gillian Sandigan
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Carol Stephanie C Tan-Lim
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | - Regine Ynez H De Mesa
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Noleen Marie C Fabian
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Mia P Rey
- Department of Accounting and Finance, Cesar E.A. Virata School of Business, University of the Philippines Diliman, Quezon City, Philippines
| | - Josephine T Sanchez
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Leonila F Dans
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | - Cara Lois T Galingana
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Nannette Bernal-Sundiang
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Ray U Casile
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Maria Rhodora N Aquino
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Karl Engelene Poblete
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Johanna Faye E Lopez
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Herbert Zabala
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
| | - Antonio L Dans
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines
- National Institutes of Health, University of the Philippines Manila, Manila, Metro Manila, Philippines
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Sharma Y, Cheung L, Patterson KK, Iaboni A. Factors influencing the clinical adoption of quantitative gait analysis technology with a focus on clinical efficacy and clinician perspectives: A scoping review. Gait Posture 2024; 108:228-242. [PMID: 38134709 DOI: 10.1016/j.gaitpost.2023.12.003] [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: 08/18/2023] [Revised: 11/14/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Quantitative gait analysis (QGA) has the potential to support clinician decision-making. However, it is not yet widely accepted in practice. Evidence for clinical efficacy (i.e., efficacy and effectiveness), as well as a users' perspective on using the technology in clinical practice (e.g., ease of use and usefulness) can help impact their widespread adoption. OBJECTIVE To synthesize the literature on the clinical efficacy and clinician perspectives on the use of gait analysis technologies in the clinical care of adult populations. METHODS This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. We included peer-reviewed and gray literature (i.e., conference abstracts). A search was conducted in MEDLINE (Ovid), CENTRAL (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and SPORTDiscus (EBSCO). Included full-text studies were critically appraised using the JBI critical appraisal tools. RESULTS A total of 15 full-text studies and two conference abstracts were included in this review. Results suggest that QGA technologies can influence decision-making with some evidence to suggest their role in improving patient outcomes. The main barrier to ease of use was a clinician's lack of data expertise, and main facilitator was receiving support from staff. Barriers to usefulness included challenges finding suitable reference data and data accuracy, while facilitators were enhancing patient care and supporting clinical decision-making. SIGNIFICANCE This review is the first step to understanding how QGA technologies can optimize clinical practice. Many gaps in the literature exist and reveal opportunities to improve the clinical adoption of gait analysis technologies. Further research is needed in two main areas: 1) examining the clinical efficacy of gait analysis technologies and 2) gathering clinician perspectives using a theoretical model like the Technology Acceptance Model to guide study design. Results will inform research aimed at evaluating, developing, or implementing these technologies. FUNDING This work was supported by the Walter and Maria Schroeder Institute for Brain Innovation and Recovery and AGE-WELL Graduate Student Award in Technology and Aging [2021,2022].
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Affiliation(s)
- Yashoda Sharma
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada
| | - Lovisa Cheung
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada
| | - Kara K Patterson
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada
| | - Andrea Iaboni
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, M5T 1R8 Toronto, ON, Canada.
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Luo M, Yue Y, Du N, Xiao Y, Chen C, Huan Z. Needs for mobile and internet-based psychological intervention in patients with self-injury and suicide-related behaviors: a qualitative systematic review. BMC Psychiatry 2024; 24:26. [PMID: 38178028 PMCID: PMC10768375 DOI: 10.1186/s12888-023-05477-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/24/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND In recent years, mobile psychological interventions have proven effective in reducing self-injury and suicide-related behaviors. Therefore, it is essential to continually enhance the user experience and address patients' needs to facilitate the development of mobile mental health interventions. Identifying patients with mobile mental health needs can be challenging for mental health professionals. To address this, we conducted a systematic review of qualitative research to synthesize the needs of patients engaged in self-injury and suicide-related behaviors for mobile and internet-based psychological interventions. METHODS This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement (ENTREQ). We explored 11 databases and synthesized the results using thematic analysis. RESULTS Sixteen qualitative and mixed-method studies were included. The study found that the needs of patients with self-injury and suicide-related behaviors for mobile psychological intervention included therapy, technology, culture, privacy, communication, emotional support, personalization, and self-management. Consistent with the Technology Acceptance Model (TAM), the needs of patients with self-injury and suicide-related behaviors are influenced by the perceived ease of use and perceived usefulness of the mobile intervention. However, the findings also highlight the importance and unmet needs of peer support, communication, self-management, and empowerment in using mobile psychological interventions for patients with self-injury and suicide-related behaviors. CONCLUSIONS Studies in this area have shown that the needs of patients with self-harm and suicide-related behaviors cover multiple stages, including basic therapeutic and technical needs and advanced emotional needs. This complexity makes it challenging to address the needs of patients engaged in self-injury and suicide-related behaviors through digital interventions. In the future, mental health professionals should be encouraged to participate in multidisciplinary collaborations to expand the use of digital interventions, enhancing remote self-management for patients and providing new strategies for the ongoing care of psychiatric patients. We registered the review protocol on PROSPERO (CRD42022324958).
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Affiliation(s)
- Meiqi Luo
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuchuan Yue
- The Fourth People's Hospital of Chengdu, Hospital Office, Sichuan Province, Chengdu, China.
| | - Na Du
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, 610036, China.
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China.
| | - Yu Xiao
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, 610036, China
- Clinical Psychology Department, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Chunyan Chen
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zongsu Huan
- College of Nursing, Zunyi Medical University, Zunyi, China
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Garnett A, Yurkiv H, Booth R, Connelly D, Donelle L. Web-Based Presence for Social Connectedness in Long-Term Care: Protocol for a Qualitative Multimethods Study. JMIR Res Protoc 2023; 12:e50137. [PMID: 37889518 PMCID: PMC10638636 DOI: 10.2196/50137] [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: 06/23/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and resultant restrictions on social gatherings significantly impacted many peoples' sense of social connectedness, defined as an individual's subjective sense of having close relationships with others. Older adults living in long-term care homes (LTCHs) experienced extreme restrictions on social gatherings, which negatively impacted their physical and mental health as well as the health and well-being of their family caregivers. Their experiences highlighted the need to reconceptualize social connectedness. In particular, the pandemic highlighted the need to explore novel ways to attain fulfilling relationships with others in the absence of physical gatherings such as through the use of a hybridized system of web-based and in-person presence. OBJECTIVE Given the potential benefits and challenges of web-based presence technology within LTCHs, the proposed research objectives are to (1) explore experiences regarding the use of web-based presence technology (WPT) in support of social connectedness between older adults in LTCHs and their family members, and (2) identify the contextual factors that must be addressed for successful WPT implementation within LTCHs. METHODS This study will take place in south western Ontario, Canada, and be guided by a qualitative multimethod research design conducted in three stages: (1) qualitive description with in-depth qualitative interviews guided by the Technology Acceptance Model (TAM) and analyzed using content analysis; (2) qualitative description and document analysis methodologies, informed by content and thematic analysis methods; and (3) explicit between-methods triangulation of study findings from stages 1 and 2, interpretation of findings and development of a guiding framework for technology implementation within LTCHs. Using a purposeful, maximum variation sampling approach, stage 1 will involve recruiting approximately 45 participants comprising a range of older adults, family members (30 participants) and staff (15 participants) within several LTCH settings. In stage 2, theoretical sampling will be used to recruit key LTCH stakeholders (directors, administrators, and IT support). In stage 3, the findings from stages 1 and 2 will be triangulated and interpreted to develop a working framework for WPT usage within LTCHs. RESULTS Data collection will begin in fall 2023. The findings emerging from this study will provide insights and understanding about how the factors, barriers, and facilitators to embedding and spreading WPT in LTCHs may benefit or negatively impact older adults in LTCHs, family caregivers, and staff and administrators of LTCHs. CONCLUSIONS The results of this research study will provide a greater understanding of potential approaches that could be used to successfully integrate WPTs in LTCHs. Additionally, benefits as well as challenges for older adults in LTCHs, family caregivers, and staff and administrators of LTCHs will be identified. These findings will help increase knowledge and understanding of how WPT may be used to support social connectedness between older adults in LTCHs and their family members. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50137.
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Affiliation(s)
- Anna Garnett
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Halyna Yurkiv
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Richard Booth
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Denise Connelly
- School of Physical Therapy, University of Western Ontario, London, ON, Canada
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
- University of South Carolina, Columbia, SC, United States
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Lu J, Deng Q, Chen Y, Liu W. Impact of perceived ease of use, organizational support mechanism, and industry competitive pressure on physicians' use of liver cancer screening technology in medical alliances. Front Public Health 2023; 11:1174334. [PMID: 37601185 PMCID: PMC10434768 DOI: 10.3389/fpubh.2023.1174334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Liver cancer is one of the malignant tumors worldwide, while the prevention and control situation is grim at present, and the diffusion of its early screening technology still faces some challenges. This study aims to investigate the influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on hepatic early screening technologies use by physicians, so as to promote the wider use of corresponding technologies. Methods Under the theoretical guidance of technology-organization-environment framework and mindsponge theory, this study took hepatic contrast-enhanced ultrasound as an example, and conducted a cross-sectional questionnaire by randomly selecting physicians from Fujian and Jiangxi provinces in China with a high and low incidence of liver cancer, respectively. Structural equation modeling was used to determine the correlation among perceived ease of use, organizational support mechanism, and industry competitive pressure, as well as their impact on the physicians' behavior toward contrast-enhanced ultrasound use. Results The hypothesis model fits well with the data (χ2/df = 1.863, GFI = 0.937, AGFI = 0.908, RMSEA = 0.054, NFI = 0.959, IFI = 0.980, CFI = 0.980). Under technology-organization-environment framework, the perceived ease of use (β = 0.171, p < 0.05), organizational support mechanism (β = 0.423, p < 0.01), industry competitive pressure (β = 0.159, p < 0.05) significantly influenced physicians' use of hepatic contrast-enhanced ultrasound. Besides, perceived ease of use and organizational support mechanism (β = 0.216, p < 0.01), perceived ease of use and industry competitive pressure (β = 0.671, p < 0.01), organizational support mechanism and industry competitive pressure (β = 0.330, p < 0.01) were all associated significantly. Conclusion From the lens of information processing (mindsponge theory) and technology-organization-environment framework, this study clarified the social and psychological influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on physicians' use of hepatic contrast-enhanced ultrasound. The results will directly propose recommendations for expanding hepatic contrast-enhanced ultrasound utilization and indirectly promoting other appropriate and effective health technologies diffusion within the integrated health system.
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Affiliation(s)
| | | | | | - Wenbin Liu
- School of Health Management, Fujian Medical University, Fuzhou, China
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10
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Abuabara A, de Castro JP, Locks MEN, Pezzin APT, Mattos NHR, de Araújo CM, Kuchler EC, Baratto-Filho F. Evaluation of Endo 10 mobile application as diagnostic tool in endodontics. J Clin Exp Dent 2023; 15:e612-e620. [PMID: 37674608 PMCID: PMC10478192 DOI: 10.4317/jced.60342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/22/2023] [Indexed: 09/08/2023] Open
Abstract
Background Endodontic diagnosis can be compared to a puzzle, requiring the interpretation of a series of clinical and imaging data. Mobile health, especially mobile application (apps), can assist professionals in endodontic diagnosis. This work aims to evaluate an app - Endo 10 app, designed to assist pulpal and periapical diagnosis based on the patient's signs and symptoms and radiographic data. Material and Methods A total of 41 dental students and dentists with different levels of expertise (10 multi-specialty clinic professors, 17 residents in endodontics and 14 dental students) were included. The System Usability Scale (SUS) was used to evaluate usability and the Davis' technology acceptance model was used to evaluate usefulness of Endo 10 app. The Mann-Whitney test was performed to compare SUS scores between professors and undergraduate dental students and to compare questions 6 and 7 of the utility test and verify whether participants who understood that the technology was useful also better understood the concepts of endodontic diagnosis. The agreement between professor's diagnosis with the app and professor without the app, and between professor and residents in endodontics with the app were evaluated. Results The SUS score at the 50th percentile was 77.5, graded as acceptable. No significant difference was observed in the SUS scores when analyzing professors and dental students separately (p = 0.442). Usefulness test showed positive responses ranging between 72% - 100%. No statistically significant difference was observed between questions 6 and 7 of the utility test (p = 0.206), indicating that the group of participants who understood that the technology was useful in endodontic diagnosis was associated with the agreement that the application helped to better understand the concepts related. The diagnosis agreement between professor in the common diagnosis process and professor with app was 100% (31) of cases. The concordance between professor and residents in endodontics with the app was 71% (22) of cases. The differences were associated with resident's misinterpreting the patient's data. Conclusions The Endo 10 app reached the usability and usefulness requirements. It proved accurate in diagnosing pulpal and periapical pathologies. Key words:Dental education, endodontics, diagnosis, smartphone, dental informatics.
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Affiliation(s)
- Allan Abuabara
- University of the Region of Joinville (Univille), Joinville, Santa Catarina, Brazil
| | | | | | | | | | | | | | - Flares Baratto-Filho
- University of the Region of Joinville (Univille), Joinville, Santa Catarina, Brazil
- Tuiuti University of Paraná (UTP), Curitiba, Paraná, Brazil
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11
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Challenges of E-Learning: Behavioral Intention of Academicians to Use E-Learning during COVID-19 Crisis. J Pers Med 2023; 13:jpm13030555. [PMID: 36983736 PMCID: PMC10056789 DOI: 10.3390/jpm13030555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/23/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
The COVID-19 crisis demanded that all educational activities should be performed virtually to follow social distancing guidelines. Therefore, there was a need to perform a research study to assess the effects of external factors on the perceived usefulness, ease of use of e-learning, and the further effect of these perceptions on attitude and intent to use e-learning by using the technology acceptance model (TAM) among academicians at higher education institutions in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted, and data were collected from 263 academicians across Saudi Arabia through an online survey questionnaire using a non-probability purposive sampling technique and analyzed and tested using the SPSS and Smart PLS software. Results: This study found that self-efficacy was positively associated with perceived usefulness at β = 0.143 and p < 0.05, but it had no association with perceived ease of use at β = 0.057 at p > 0.05. System accessibility had a significant and positive relationship with perceived usefulness and perceived ease of use at β = 0.283, β = 0.247, and p < 0.01, respectively. Self-efficacy had a positive effect on perceived usefulness, whereas the subjective norm had no relationship with perceived usefulness and perceived ease of use at β = −0.065 and β = −0.012 at p > 0.05, respectively. Perceived ease of use and perceived usefulness were positively related to attitude towards use, which has a significant influence on intention to use e-learning. Conclusion: Perceived ease of application is the most significant factor (β = 0.556) in developing the attitude among academicians to practice e-learning, followed by perceived usefulness (β = 0.262). Moreover, it can be concluded that system accessibility has a stronger influence on developing perception among academicians about the expediency and ease of application of e-learning than self-efficacy.
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12
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Towards Inclusive Diagnostics for Neglected Tropical Diseases: User Experience of a New Digital Diagnostic Device in Low-Income Settings. Trop Med Infect Dis 2023; 8:tropicalmed8030176. [PMID: 36977176 PMCID: PMC10056790 DOI: 10.3390/tropicalmed8030176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023] Open
Abstract
Designing new and inclusive diagnostic tools to detect Neglected Tropical Diseases (NTDs) to achieve rational disease control requires a co-design process where end-users’ input is important. Failure to involve all potential end-users in new diagnostics for NTDs can result in low use and adoption failure, leading to persistent infection hot spots and ineffective disease control. There are different categories of potential end-users of new diagnostic tools for NTD control, and it is unclear if there are differences between the user efficiency, effectiveness, perception, and acceptability across these end-user categories. This study evaluated the usability, user perception, contextual factors affecting the user’s experience, and acceptability of a new digital optical diagnostic device for NTDs across three types of potential end users. A total of 21 participants were tested. Laboratory scientists, technicians, and Community Health Extension Workers (CHEWs) in training achieved similar scores on the usability and user perception questionnaires with no statistically significant difference between end-user categories. All participants also have high scores for the user perception domains which strongly correlate with the acceptability of the AiDx NTDx Assist device. This study indicates that, by providing digital diagnostic tools in combination with minimal training and support, CHEWs undergoing training and, by extension, CHEWs post-training, can be involved in the diagnoses of NTDs, potentially enhancing a community’s capabilities to diagnose, treat, and control NTDs.
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13
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Chien SC, Chen CY, Chien CH, Iqbal U, Yang HC, Hsueh HC, Weng SF, Jian WS. Investigating nurses' acceptance of patients' bring your own device implementation in a clinical setting: A pilot study. Asia Pac J Oncol Nurs 2023; 10:100195. [PMID: 36915387 PMCID: PMC10006526 DOI: 10.1016/j.apjon.2023.100195] [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: 12/12/2022] [Accepted: 01/19/2023] [Indexed: 02/07/2023] Open
Abstract
Objective The popularity of the "bring your own device (BYOD)" concept has grown in recent years, and its application has extended to the healthcare field. This study was aimed at examining nurses' acceptance of a BYOD-supported system after a 9-month implementation period. Methods We used the technology acceptance model to develop and validate a structured questionnaire as a research tool. All nurses (n = 18) responsible for the BYOD-supported wards during the study period were included in our study. A 5-point Likert scale was used to assess the degree of disagreement and agreement. Statistical analysis was performed in SPSS version 24.0. Results The questionnaire was determined to be reliable and well constructed, on the basis of the item-level content validity index and Cronbach α values above 0.95 and 0.87, respectively. The mean constant values for all items were above 3.95, thus suggesting that nurses had a positive attitude toward the BYOD-supported system, driven by the characteristics of the tasks involved. Conclusions We successfully developed a BYOD-supported system. Our study results suggested that nursing staff satisfaction with BYOD-supported systems could be effectively increased by providing practical functionalities and reducing clinical burden. Hospitals could benefit from the insights generated by this study when implementing similar systems.
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Affiliation(s)
- Shuo-Chen Chien
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Artificial Intelligence Research and Development Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chun-You Chen
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Artificial Intelligence Research and Development Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hui Chien
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Office of Public Affairs, Taipei Medical University, Taipei, Taiwan
| | - Usman Iqbal
- Health ICT, Department of Health, Tasmania, Australia
- Global Health and Health Security Department, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Hsuan-Chia Yang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information and Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Huei-Chia Hsueh
- Department of Artificial Intelligence in Medicine, Professional Master Program, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuen-Fu Weng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Shan Jian
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
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14
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Vincent D, Peixoto C, Quinn KL, Kyeremanteng K, Lalumiere G, Kurahashi AM, Gilbert N, Isenberg SR. Virtual home-based palliative care during COVID-19: A qualitative exploration of the patient, caregiver, and healthcare provider experience. Palliat Med 2022; 36:1374-1388. [PMID: 36071621 PMCID: PMC9596681 DOI: 10.1177/02692163221116251] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Due to the COVID-19 pandemic, many community palliative healthcare providers shifted from providing care in a patient's home to providing almost exclusively virtual palliative care, or a combination of in-person and virtual care. Research on virtual palliative care is thus needed to provide evidence-based recommendations aiming to enhance the delivery of palliative care during and beyond the pandemic. AIM To explore the experiences and perceptions of community palliative care providers, patients and caregivers who delivered or received virtual palliative care as a component of home-based palliative care during the COVID-19 pandemic. DESIGN Qualitative study using phone and video-based semi-structured interviews. Data were analyzed using thematic analysis. SETTING/PARTICIPANTS A total of 37 participants, including community palliative care patients/caregivers (n = 19) and healthcare providers (n = 18) recruited from sites in Ottawa and Toronto, Ontario, Canada. RESULTS Overall, participants preferred in-person palliative care compared to virtual care, but suggested virtual care could be a useful supplement to in-person care. The findings are presented in three main themes: (1) Impact of COVID-19 pandemic on community palliative care services; (2) Factors influencing transition from exclusively virtual model of care back to a blended model of care; and (3) Recommended uses and implementation of virtual palliative care. CONCLUSIONS Incorporating virtual palliative care into healthcare provider practice models (blended care models) may be the ideal model of care and standard practice moving forward beyond the COVID-19 pandemic, which has important implications toward organization and delivery of community palliative care services and funding of healthcare providers.
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Affiliation(s)
- Daniel Vincent
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada
| | | | - Kieran L Quinn
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, ON, Canada
| | | | - Genevieve Lalumiere
- Regional Palliative Consultation Team, Elizabeth Bruyère Hospital, Ottawa, ON, Canada
| | - Allison M Kurahashi
- Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, ON, Canada
| | - Nathalie Gilbert
- Home and Community Care Support Services Champlain, Ottawa, ON, Canada
| | - Sarina R Isenberg
- Bruyère Research Institute, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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15
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Ho YX, Morse RS, Lambden K, Mushi BP, Ngoma M, Mahuna H, Ngoma T, Miesfeldt S. How a Digital Case Management Platform Affects Community-Based Palliative Care of Sub-Saharan African Cancer Patients: Clinician-Users' Perspectives. Appl Clin Inform 2022; 13:1092-1099. [PMID: 36384234 PMCID: PMC9668489 DOI: 10.1055/s-0042-1758223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Symptom control among cancer patients is a Tanzanian public health priority impacted by limited access to palliative care (PC) specialists and resources. Mobile Palliative Care Link (mPCL), a mobile/web application, aims to extend specialist access via shared care with local health workers (LHWs) with the African Palliative care Outcome Scale (POS) adapted for regular, automated symptom assessment as a core feature. OBJECTIVE The aim of the study is to assess clinicians' attitudes, beliefs, and perceptions regarding mPCL usability and utility with their patients within a government-supported, urban Tanzanian cancer hospital setting. METHODS We used a mixed methods approach including surveys, qualitative interviews, and system usage data to assess clinicians' experience with mPCL in a field study where discharged, untreatable cancer patients were randomized to mPCL or phone-contact POS collection. RESULTS All six specialists and 10 LHWs expressed overall satisfaction with mPCL among 49 intervention arm patients. They perceived mPCL as a way to stay connected with patients and support remote symptom control. Timely access to POS responses and medical records were identified as key benefits. Some differences in perceptions of mPCL use and utility were seen between clinician groups; however, both expressed strong interest in continuing app use, recommending it to colleagues, and extending use throughout Tanzania. Primary use was for clinical status communication and care coordination. Pain and other symptom progression were the most frequently reported reasons for provider-patient interactions accounting for 34% (n = 44) and 12% (n = 15) of reasons, respectively. Usage barriers included time required to create a new clinical record, perceived need for response to non-urgent reminders or alerts, and training. necessary for competent use. System-level implementation barriers included variable patient access to smartphones and SIM cards and unreliable Internet access. CONCLUSION This work demonstrates broad clinician desire for digital health tools to support remote community-based PC among cancer patients, particularly pain management.
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Affiliation(s)
- Yun Xian Ho
- Dimagi, Inc., Cambridge, Massachusetts, United States
| | - Robert S. Morse
- DaVinci Usability, Inc., Lexington, Massachusetts, United States
| | - Kaley Lambden
- Dimagi, Inc., Cambridge, Massachusetts, United States
| | - Beatrice P. Mushi
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mamsau Ngoma
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Habiba Mahuna
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Twalib Ngoma
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
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16
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Namasivayam P, Bui DT, Low C, Barnett T, Bridgman H, Marsh P, Lee S. The use of telehealth in the provision of after-hours palliative care services in rural and remote Australia: A scoping review. PLoS One 2022; 17:e0274861. [PMID: 36156089 PMCID: PMC9512207 DOI: 10.1371/journal.pone.0274861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Accessing quality palliative care, especially at the end of life is vital in reducing physical and emotional distress and optimising quality of life. For people living in rural and remote Australia, telehealth services can be effective in providing access to after-hours palliative care. Objective To review and map the available evidence on the use of telehealth in providing after-hours palliative care services in rural and remote Australia. Method Scoping review using Arksey and O’Malley methodological framework. Findings are reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Scopus, Web of Science, CINAHL Complete, Embase via Ovid, Emcare via Ovid, and Medline via Ovid databases were searched. Peer-reviewed studies and grey literature published in English from 2000 to May 2021 were included. Results Twelve studies were included in the review. Four main themes were identified: 1) Stakeholder perceptions of service; 2) benefits to services and users; 3) service challenges; and 4) recommendations for service improvement. Conclusion Telehealth can connect patients and families with healthcare professionals and enable patients to continue receiving care at home. However, challenges relating to patients, service, staff skills, and experience need to be overcome to ensure the success and sustainability of this service. Improved communication and care coordination, better access to patient records, and ongoing healthcare professional education are required. Implications Protocols, comprehensive policy documents and standardized operating procedures to guide healthcare professionals to provide after-hours palliative care is needed. Ongoing education and training for staff is crucial in managing patients’ symptoms. Existing service gaps need to be explored and alternative models of after-hours palliative care need to be tested.
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Affiliation(s)
| | - Dung T. Bui
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Christine Low
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Tony Barnett
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Pauline Marsh
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Simone Lee
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
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17
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Zhai Y, Yu Z, Zhang Q, Zhang Y. Barriers and facilitators to implementing a nursing clinical decision support system in a tertiary hospital setting: A qualitative study using the FITT framework. Int J Med Inform 2022; 166:104841. [PMID: 36027798 DOI: 10.1016/j.ijmedinf.2022.104841] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/23/2022] [Accepted: 08/04/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Clinical decision support systems (CDSSs) have been increasingly introduced to health care settings; however, their adoption is far from ideal. Guided by the FITT framework, this study aims to explore barriers and facilitators to the implementation of a CDSS from the perspective of nurses. METHODS A qualitative study with 200 h of participatory observation and 21 semi structured interviews was conducted from February to August 2021 in four medical-surgical wards in a 2000-bed tertiary hospital in Shanghai, China. The field notes were typed and the audio-recorded interviews were transcribed to texts verbatim and were coded with a four-step approach. We used the FITT framework to interpret our findings based on the technology, individual and task attributes and the fit between them. RESULTS A total of twelve categories were identified, which were integrated into two themes: barriers and facilitators to system implementation. All categories but one can be mapped to the three attributes of the FITT framework: technology, individual and task. We assumed that management has a vital role to play in the following areas: addressing user resistance, improving system usability, setting standards on practice and, finally, building connectivity between nurses and the technical staff to improve the fit between the technology, individual and task attribute and thus promote system implementation. CONCLUSION Barriers and facilitators to CDSS implementation include system-related, user-related and organizational factors which can largely be fit io the FITT framework. There is potential to extend the FITT framework to represent management intervention on inter-disciplinary collaboration. Future empirical studies on facilitating strategies from the management to improve user experience and willingness of CDSS adoption are needed.
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Affiliation(s)
- Yue Zhai
- School of Nursing, Fudan University, Shanghai 200032, China; Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhenghong Yu
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Qi Zhang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - YuXia Zhang
- School of Nursing, Fudan University, Shanghai 200032, China; Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
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18
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Yang TY, Huang CH, An C, Weng LC. Construction and evaluation of a 360 degrees panoramic video on the physical examination of nursing students. Nurse Educ Pract 2022; 63:103372. [DOI: 10.1016/j.nepr.2022.103372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 12/01/2022]
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Dias SB, Oikonomidis Y, Diniz JA, Baptista F, Carnide F, Bensenousi A, Botana JM, Tsatsou D, Stefanidis K, Gymnopoulos L, Dimitropoulos K, Daras P, Argiriou A, Rouskas K, Wilson-Barnes S, Hart K, Merry N, Russell D, Konstantinova J, Lalama E, Pfeiffer A, Kokkinopoulou A, Hassapidou M, Pagkalos I, Patra E, Buys R, Cornelissen V, Batista A, Cobello S, Milli E, Vagnozzi C, Bryant S, Maas S, Bacelar P, Gravina S, Vlaskalin J, Brkic B, Telo G, Mantovani E, Gkotsopoulou O, Iakovakis D, Hadjidimitriou S, Charisis V, Hadjileontiadis LJ. Users' Perspective on the AI-Based Smartphone PROTEIN App for Personalized Nutrition and Healthy Living: A Modified Technology Acceptance Model (mTAM) Approach. Front Nutr 2022; 9:898031. [PMID: 35879982 PMCID: PMC9307489 DOI: 10.3389/fnut.2022.898031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
The ubiquitous nature of smartphone ownership, its broad application and usage, along with its interactive delivery of timely feedback are appealing for health-related behavior change interventions via mobile apps. However, users' perspectives about such apps are vital in better bridging the gap between their design intention and effective practical usage. In this vein, a modified technology acceptance model (mTAM) is proposed here, to explain the relationship between users' perspectives when using an AI-based smartphone app for personalized nutrition and healthy living, namely, PROTEIN, and the mTAM constructs toward behavior change in their nutrition and physical activity habits. In particular, online survey data from 85 users of the PROTEIN app within a period of 2 months were subjected to confirmatory factor analysis (CFA) and regression analysis (RA) to reveal the relationship of the mTAM constructs, i.e., perceived usefulness (PU), perceived ease of use (PEoU), perceived novelty (PN), perceived personalization (PP), usage attitude (UA), and usage intention (UI) with the users' behavior change (BC), as expressed via the acceptance/rejection of six related hypotheses (H1-H6), respectively. The resulted CFA-related parameters, i.e., factor loading (FL) with the related p-value, average variance extracted (AVE), and composite reliability (CR), along with the RA results, have shown that all hypotheses H1-H6 can be accepted (p < 0.001). In particular, it was found that, in all cases, FL > 0.5, CR > 0.7, AVE > 0.5, indicating that the items/constructs within the mTAM framework have good convergent validity. Moreover, the adjusted coefficient of determination (R 2) was found within the range of 0.224-0.732, justifying the positive effect of PU, PEoU, PN, and PP on the UA, that in turn positively affects the UI, leading to the BC. Additionally, using a hierarchical RA, a significant change in the prediction of BC from UA when the UI is used as a mediating variable was identified. The explored mTAM framework provides the means for explaining the role of each construct in the functionality of the PROTEIN app as a supportive tool for the users to improve their healthy living by adopting behavior change in their dietary and physical activity habits. The findings herein offer insights and references for formulating new strategies and policies to improve the collaboration among app designers, developers, behavior scientists, nutritionists, physical activity/exercise physiology experts, and marketing experts for app design/development toward behavior change.
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Affiliation(s)
- Sofia Balula Dias
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | | | - José Alves Diniz
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | - Filomena Carnide
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Lisbon, Portugal
| | | | | | | | | | | | | | - Petros Daras
- Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Anagnostis Argiriou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Konstantinos Rouskas
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Saskia Wilson-Barnes
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Kathryn Hart
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Neil Merry
- OCADO Technology, London, United Kingdom
| | | | | | - Elena Lalama
- Department of Endocrinology, Diabetes and Nutrition and German Institute of Human Nutrition, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition and German Institute of Human Nutrition, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Kokkinopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Elena Patra
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Roselien Buys
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Véronique Cornelissen
- Department of Rehabilitation Sciences and Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ana Batista
- Sport Lisboa Benfica Futebol, Lisbon, Portugal
| | | | - Elena Milli
- Polo Europeo della Conoscenza, Verona, Italy
| | | | - Sheree Bryant
- European Association for the Study of Obesity (EASO), Middlesex, United Kingdom
| | - Simon Maas
- AgriFood Capital BV, Hertogenbosch, Netherlands
| | | | | | - Jovana Vlaskalin
- BioSense Institute, Research and Development Institute for Information Technology in Biosystems, Novi Sad, Serbia
| | - Boris Brkic
- BioSense Institute, Research and Development Institute for Information Technology in Biosystems, Novi Sad, Serbia
| | | | - Eugenio Mantovani
- Research Group on Law, Science, Technology and Society, Faculty of Law & Criminology, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Olga Gkotsopoulou
- Research Group on Law, Science, Technology and Society, Faculty of Law & Criminology, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Dimitrios Iakovakis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stelios Hadjidimitriou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Charisis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leontios J. Hadjileontiadis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
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Chan ZY, Lim CF, Leow JL, Chium FY, Lim SW, Tong CHM, Zhou JJX, Tsi MMY, Tan RYC, Chew LST. Using the technology acceptance model to examine acceptance of telemedicine by cancer patients in an ambulatory care setting. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221104578] [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: Telemedicine has demonstrated benefits for cancer patients including the potential to improve care coordination and patient outcomes. Since June 2020, teleconsultations have been implemented in the National Cancer Centre Singapore. Objectives: This study aims to assess cancer patients acceptance of telemedicine as a complement to traditional in-person care and identify factors affecting their acceptance. Methods: An online self-administered questionnaire was designed using a modified technology acceptance model (TAM) previously validated to predict acceptance of telemedicine by patients and factors affecting acceptance. Descriptive statistics were used to summarise data on demographic factors and TAM construct scores. Univariate and multivariate logistic regression were used to determine how demographics factors and TAM constructs influenced acceptance. Results: Respondents ( n = 278; mean age 59 years) were mostly female (67.6%), Chinese (86.3%) and received parenteral chemotherapy (72.6%). Technology access and confidence were generally moderate to high, while past telemedicine use was low (18%). Overall, more than half (59.7%) expressed acceptance. The odds of acceptance were significantly higher if respondents agreed that their healthcare access would improve by using telemedicine (OR 4.17, 95% CI 1.71–10.16) or they would have the necessary resources for using telemedicine (OR 4.54, 95% CI 2.30–8.97). Conclusion: Acceptance of telemedicine was high amongst respondents. Facilitating conditions such as having necessary resources and perceived improved access were identified as main predictors of high acceptance. Telemedicine services should work to improve these aspects, leverage on advantages and address disadvantages brought up by patients.
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Affiliation(s)
- Zhi Yao Chan
- Department of Pharmacy, National University Hospital, National University Health System, Singapore
| | - Chen Fang Lim
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Jo Lene Leow
- Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - Feng Yong Chium
- Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - Su Wen Lim
- Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | | | - Jessie Jie Xi Zhou
- Ambulatory Support Services – Telemedicine, National Cancer Centre Singapore, Singapore
| | - Moses Min Yuan Tsi
- Ambulatory Support Services – Telemedicine, National Cancer Centre Singapore, Singapore
| | - Ryan Ying Cong Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
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21
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Exploring Usability and Patient Attitude towards a Smart Hospital Service with the Technology Acceptance Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106059. [PMID: 35627595 PMCID: PMC9141123 DOI: 10.3390/ijerph19106059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 01/18/2023]
Abstract
The demand for health care has increased with the development of global technology and the rise of public health awareness, and smart service systems have also been introduced to medical care to relieve the pressure on hospital staff. However, the survey found that patients’ willingness to use smart services at the time of consultation has not improved. The main research purpose of this study was to understand the willingness of patients from various groups to use smart medical service systems and to explore the influencing factors on patients’ use of smart service systems in hospitals through the technology acceptance model. This study distributed questionnaires in the outpatient area of National Taiwan University Hospital Yunlin Branch, and a total of 202 valid questionnaires were obtained. After related research and regression analysis, it was found that patients paid more attention to the benefits and convenience brought by smart services. If patients believed that smart services were trustworthy and beneficial to themselves, their usage intention and attitude would be positive. The results of this study are summarized by the following four points: (1) Designed according to the cultural conditions of different regions; (2) think about design from the patient’s perspective; (3) strengthen the explanation and promotion of smart services; and (4) add humanized care and design. This study could be used as a reference for hospitals to improve their service quality and systems in the future.
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22
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Huo W, Zheng G, Yan J, Le S, Han L. Interacting with medical artificial intelligence: Integrating self-responsibility attribution, human–computer trust, and personality. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107253] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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23
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Garavand A, Aslani N, Nadri H, Abedini S, Dehghan S. Acceptance of telemedicine technology among physicians: A systematic review. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.100943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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24
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Salvador Vergès À, Cusí Sánchez MV, Bossio Grigera P, Fàbrega Agulló C, Gomes da Costa F, Serra Trullas A, García Abejas A. Determinants in Stakeholder Opinions About Telemedicine in Palliative Care: A Scoping Review. Telemed J E Health 2021; 28:932-941. [PMID: 34871034 DOI: 10.1089/tmj.2021.0441] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: The use of Telemedicine is growing, and its application in palliative medicine may facilitate patient care and be a solution to the growing pressures on hospital services in these pandemic times. Aim: The main objective of this review is to describe the current use of telemedicine in palliative care and assess stakeholders' views on the initiatives that have been implemented worldwide regarding digital service standards. Materials and Methods: Articles published between 2010 and 2020 were identified through PubMed, SCOPUS, Web of Science, and Google Scholar searches. We used Arksey and O'Malley's five-step framework to delimit and guide the initial search results. Results: The search identified 291 articles, of which 16 are included in this review. The selected studies were sufficiently detailed to allow their evaluation and answer our research questions. In addition, Telemedicine was used for patient and caregiver support and professional education. Conclusions: The use of Telemedicine for patient and caregiver support and professional education. Telemedicine empowers patients and increases their functional capacity. The imperative need to dictate implementation policies and ethical issues are some of the pending questions. In countries where a Telemedicine project has been initiated, it is valued as a good option for continuity of care, but all those involved would like face-to-face contact first, even if it is not mandatory.
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Affiliation(s)
- Àngels Salvador Vergès
- Iberian Society of Telemedicine and Telehealth, Madrid, Spain.,Digital Care Research Group, UVIC-UCC, Barcelona, Spain
| | | | - Paz Bossio Grigera
- Digital Health, School of Health, The National University of Jujuy, San Salvador de Jujuy, Argentina
| | - Carles Fàbrega Agulló
- Iberian Society of Telemedicine and Telehealth, Madrid, Spain.,Digital Health, School of Health, The National University of Jujuy, San Salvador de Jujuy, Argentina
| | - Fernando Gomes da Costa
- Iberian Society of Telemedicine and Telehealth, Madrid, Spain.,Portuguese Ministry of Health, Lisbon, Portugal
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Bhandari B, Schutte AE, Jayasuriya R, Vaidya A, Subedi M, Narasimhan P. Acceptability of a mHealth strategy for hypertension management in a low-income and middle-income country setting: a formative qualitative study among patients and healthcare providers. BMJ Open 2021; 11:e052986. [PMID: 34824118 PMCID: PMC8627401 DOI: 10.1136/bmjopen-2021-052986] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Understanding contextual needs and preferences is important for a successful design and effective outcome of a mHealth strategy. OBJECTIVES This formative study aimed to explore the perspectives of patients and providers on the acceptability of a mHealth (text message) strategy and elicit preferred features of a mHealth strategy for hypertension management. DESIGN A qualitative study was conducted using in-depth interviews and focus group discussions guided by the technology acceptance model. SETTING The study was conducted at primary healthcare facilities and at a tertiary level referral hospital in Kathmandu, Nepal. PARTICIPANTS A total of 61 participants, patients with hypertension (n=41), their family members (n=5), healthcare workers (n=11) and key informants (n=4) were included. We purposively recruited patients with hypertension aged 30-70 who attended the selected healthcare facilities to obtain maximum variation based on their age, sex and literacy. RESULTS The respondents perceived the mHealth strategy to be useful as it would reinforce medication compliance and behaviour change. Participants valued the trustworthiness of information from health authorities that could be delivered privately. Some implementation challenges were identified including a lack of technical manpower, resources for software development, gaps in recording a patient's essential information and digital illiteracy. Solutions proposed were having system-level preparedness for recording the patient's details, establishing a separate technical department in the hospital and involving a family member to assist illiterate/elderly patients. In addition, participants preferred text messages in the local language, containing comprehensive contextual content (disease, treatment, cultural foods and misconceptions) delivered at regular intervals (2-3 times/week) preferably in the morning or evening. CONCLUSIONS We found that a simple text messaging strategy was acceptable for hypertension management in this low/middle-income country setting. However, meticulous planning must address the needs of a diverse range of participants to ensure the mHealth strategy is acceptable to wider groups.
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Affiliation(s)
- Buna Bhandari
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Central Department of Public Health, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Cardiovascular Division, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Rohan Jayasuriya
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Abhinav Vaidya
- Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Madhusudan Subedi
- School of Public Health, Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Padmanesan Narasimhan
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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[Factors influencing the intention of caregivers to use digital technologies in outpatient care - A case study examining the introduction of a textile sensor mat]. ACTA ACUST UNITED AC 2021; 75:470-490. [PMID: 34658493 PMCID: PMC8513561 DOI: 10.1007/s41449-021-00277-4] [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] [Accepted: 09/23/2021] [Indexed: 11/20/2022]
Abstract
Durch die steigende Arbeitsbelastung in der Pflegebranche werden Arbeitsprozesse zunehmend digitalisiert. Die Folge eines unzureichenden Einbezugs von Pflegekräften in diesen Digitalisierungsprozess zeigt sich in schlecht integrierten technologischen Entwicklungen mit ausbleibender Technikakzeptanz. Um eine Basis für eine erfolgreiche Technikentwicklung in der ambulanten Pflege legen zu können, gilt es zunächst die Nutzungsabsicht ambulanter Pflegekräfte besser zu verstehen. Zur Untersuchung der Nutzungsabsicht wird in dieser Arbeit ein Modell entwickelt, das Einflussfaktoren auf die Nutzungsintention von digitalen Technologien in der ambulanten Pflege anhand einer Fallstudie zur Einführung einer textilen Sensormatte aufzeigt. Im entwickelten Modell wird erstmals neben der Technikakzeptanz auch die Pflegesituation als Einflussfaktor auf die Nutzungsintention betrachtet und untersucht. Neben der Herleitung der Faktoren des Modells und der Untersuchung der Stärke ihrer Einflüsse wird die praktische Relevanz für Technikentwickler*innen auch in anderen Pflegekontexten abgeleitet. Praktische Relevanz: Der demographische Wandel in der deutschen Bevölkerung führt zu großen Herausforderungen in unterschiedlichen Branchen. In der ohnehin bereits stark vom Fachkräftemangel betroffenen Pflegebranche macht sich dieser Wandel besonders in einer Zunahme pflegebedürftiger Menschen in der ambulanten Pflege und einer hohen Arbeitsbelastung der Beschäftigten bemerkbar. Zur Reduktion dieser Arbeitsbelastung werden daher vermehrt digitale Technologien verwendet, die den Arbeitsalltag von Pflegekräften hinsichtlich physischer und psychischer Faktoren erleichtern sollen. Das in dieser Studie entwickelte Modell beschreibt – auf Basis eines Fallbeispiels zur Einführung einer Sensormatte – förderliche und hinderliche Faktoren für die Technikeinführung in der ambulanten Pflege und trägt so zu einer gelingenden Digitalisierung in diesem Berufsbereich bei.
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Brown EG, Schleimer E, Bledsoe IO, Rowles W, Miller NA, Sanders SJ, Rankin KP, Ostrem JL, Tanner CM, Bove R. Enhancing clinical information display to improve patient encounters: human-centered design and evaluation of the Parkinson’s Disease-BRIDGE platform (Preprint). JMIR Hum Factors 2021; 9:e33967. [PMID: 35522472 PMCID: PMC9123539 DOI: 10.2196/33967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/11/2022] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background People with Parkinson disease (PD) have a variety of complex medical problems that require detailed review at each clinical encounter for appropriate management. Care of other complex conditions has benefited from digital health solutions that efficiently integrate disparate clinical information. Although various digital approaches have been developed for research and care in PD, no digital solution to personalize and improve communication in a clinical encounter is readily available. Objective We intend to improve the efficacy and efficiency of clinical encounters with people with PD through the development of a platform (PD-BRIDGE) with personalized clinical information from the electronic health record (EHR) and patient-reported outcome (PRO) data. Methods Using human-centered design (HCD) processes, we engaged clinician and patient stakeholders in developing PD-BRIDGE through three phases: an inspiration phase involving focus groups and discussions with people having PD, an ideation phase generating preliminary mock-ups for feedback, and an implementation phase testing the platform. To qualitatively evaluate the platform, movement disorders neurologists and people with PD were sent questionnaires asking about the technical validity, usability, and clinical relevance of PD-BRIDGE after their encounter. Results The HCD process led to a platform with 4 modules. Among these, 3 modules that pulled data from the EHR include a longitudinal module showing motor ratings over time, a display module showing the most recently collected clinical rating scales, and another display module showing relevant laboratory values and diagnoses; the fourth module displays motor symptom fluctuation based on an at-home diary. In the implementation phase, PD-BRIDGE was used in 17 clinical encounters for patients cared for by 1 of 11 movement disorders neurologists. Most patients felt that PD-BRIDGE facilitated communication with their clinician (n=14, 83%) and helped them understand their disease trajectory (n=11, 65%) and their clinician’s recommendations (n=11, 65%). Neurologists felt that PD-BRIDGE improved their ability to understand the patients’ disease course (n=13, 75% of encounters), supported clinical care recommendations (n=15, 87%), and helped them communicate with their patients (n=14, 81%). In terms of improvements, neurologists noted that data in PD-BRIDGE were not exhaustive in 62% (n=11) of the encounters. Conclusions Integrating clinically relevant information from EHR and PRO data into a visually efficient platform (PD-BRIDGE) can facilitate clinical encounters with people with PD. Developing new modules with more disparate information could improve these complex encounters even further.
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Affiliation(s)
- Ethan G Brown
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Erica Schleimer
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Ian O Bledsoe
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - William Rowles
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Nicolette A Miller
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Stephan J Sanders
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Katherine P Rankin
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Jill L Ostrem
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Caroline M Tanner
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
- Parkinson Disease Research, Education, and Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Riley Bove
- University of California San Francisco Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
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Participatory Design of an Electronic Cross-Facility Health Record (ECHR) System for Pediatric Palliative Care: A Think-Aloud Study. CHILDREN-BASEL 2021; 8:children8100839. [PMID: 34682105 PMCID: PMC8534759 DOI: 10.3390/children8100839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 01/15/2023]
Abstract
Background: Pediatric palliative care (PPC) patients experience years of multisectoral and professional care. An electronic cross-facility health record (ECHR) system can support the immediate exchange of information among PPC professionals. Based on a needs assessment, a prototype ECHR system was developed. Methods: To evaluate potential users’ perspective regarding the system, a qualitative observational study was conducted consisting of a concurrent think-aloud session and a semi-structured qualitative interview. Results: Twenty PPC professionals (nurses, physicians) from specialized outpatient PPC teams, a PPC unit, and medical offices rated the ECHR system as a helpful tool to improve the exchange and collection of information, communication between PPC professionals, and treatment planning. From the user’s point of view, the basic logic of the ECHR system should be further adapted to improve the interaction of data remirrored from patient records of outpatient and inpatient care with those entered via the system. The users wished for further functions (text search) and content (information on therapies). Some content, such as the treatment process, needs to be further adapted. Conclusion: The developed ECHR system needs to be more specific in some features by offering all available information; while for other features, be less specific to offer a quick overview. The ability to share information promptly and automatically was seen as a tremendous improvement to the quality of care for PPC patients.
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The Determinants of Telehealth Provision: Empirical Evidence from OECD Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168288. [PMID: 34444037 PMCID: PMC8392622 DOI: 10.3390/ijerph18168288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022]
Abstract
Health services provided through the telecommunications system aim to improve the population’s health and well-being. This research aims to explore what digital, economic, and health factors are associated with the provision of telehealth services, especially in ageing communities. Applying Organization for Economic Cooperation and Development (OECD) countries’ experiences, this research tries to construct a logistic regression model between adopting a telehealth system or not, a binary outcome variable, and a group of potentially explanatory variables. Estimation results showed that there were thresholds for telehealth provision: The demand for telehealth service usually began when the provision of telecommunication accessibility reached 50%, the proportion of elders exceeded 10%, or the proportion of health spending occupied more than 3–5% of the gross domestic product (GDP); the slope of each variable seemed to correspond with an increase in demand for such a provision. A growing number of individuals in OECD countries are now readily served by telehealth systems under the COVID-19 pandemic. These findings could be regarded as a model for other countries for implementing the necessary infrastructure early on when any of these parameters reaches its threshold. Moreover, telehealth applied in developing countries could be elevated for wider populations to access basic health services and for the remote delivery of health care. A rational decision could be made to appropriately use additional resources in telehealth provision. With accessible e-health services, the population’s health could be improved, which in turn would possibly increase productivity and social welfare.
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Busse TS, Jux C, Kernebeck S, Dreier LA, Meyer D, Zenz D, Zernikow B, Ehlers JP. Needs Assessment for the Development of an Electronic Cross-Facility Health Record (ECHR) for Pediatric Palliative Care: A Design Thinking Approach. CHILDREN-BASEL 2021; 8:children8070602. [PMID: 34356581 PMCID: PMC8304612 DOI: 10.3390/children8070602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 01/24/2023]
Abstract
Background: Pediatric palliative care (PPC) is characterized by years of multisectoral and multi-professional care. Sharing information between PPC professionals is, therefore, essential for quality care. The evidence shows that electronic cross-facility health records (ECHRs) provide useful support in this context. To our knowledge, no ECHRs have been developed through a user-centered approach for this specific setting in Germany. Methods: Guided by design thinking, first, qualitative interviews were conducted to assess the needs of PPC professionals. Second, the elicited needs were specified in focus groups (FGs). Based on the needs stated in the interviews, prototypes of the ECHR were developed and discussed in the FGs. The indicated needs were supplemented and specified in an iterative process. The prototypes were further adapted according to these results. The unified theory of acceptance and use of technology was the basic model in the evaluation of needs. Results: Across seven main categories, past and current medication, emergency view, and messaging functions were identified as the participants’ desired core components of an ECHR. Utilizing design thinking facilitated the explicit articulation of user needs. Conclusions: Developing an ECHR with the content identified would allow for real-time data during emergencies, tracking what other PPC professionals have done, and making the applied treatments visible to others. This would offer a broader picture of the complex conditions common to PPC.
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Affiliation(s)
- Theresa Sophie Busse
- Department of Didactics and Educational Research in Health Science, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (C.J.); (S.K.); (J.P.E.)
- Correspondence: ; Tel.: +49-2302-926-786-20
| | - Chantal Jux
- Department of Didactics and Educational Research in Health Science, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (C.J.); (S.K.); (J.P.E.)
| | - Sven Kernebeck
- Department of Didactics and Educational Research in Health Science, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (C.J.); (S.K.); (J.P.E.)
| | - Larissa Alice Dreier
- PedScience Research Institute, 45711 Datteln, Germany; (L.A.D.); (D.M.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany
| | - Dorothee Meyer
- PedScience Research Institute, 45711 Datteln, Germany; (L.A.D.); (D.M.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany
| | - Daniel Zenz
- Smart-Q Softwaresystems GmbH, 44801 Bochum, Germany;
| | - Boris Zernikow
- PedScience Research Institute, 45711 Datteln, Germany; (L.A.D.); (D.M.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany
- Pediatric Palliative Care Centre, Children’s and Adolescents’ Hospital, 45711 Datteln, Germany
| | - Jan Peter Ehlers
- Department of Didactics and Educational Research in Health Science, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (C.J.); (S.K.); (J.P.E.)
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