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Daemen MMJ, De Bruijn-Heijligers BAAG, Van Der Heijden C, Boots LMM, Oosterloo M, De Vugt ME, Duits AA. Navigating Life With Parkinson's Disease: A Focus Group Study on Coping Strategies and Considerations for Self-Management Support. J Adv Nurs 2024. [PMID: 39225125 DOI: 10.1111/jan.16414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/12/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
AIM To investigate the experiences of people with Parkinson's disease in coping with and adapting to their disease and to identify considerations for a tailored self-management support program. DESIGN A descriptive phenomenological focus group study. METHODS Five semi-structured focus groups were conducted between April 2023 and June 2023 in the Netherlands, with 12 people with Parkinson's disease. Two researchers independently performed an inductive content analysis. RESULTS Three principal categories emerged: (1) Rational realisation versus emotional experience: the coping strategy transition. This category includes three main coping strategies: denial or avoidance coping, acknowledging with less active coping and proactive and task-oriented coping. (2) Factors that influence coping, including mindset and skills, social circles and communication and access to support and care. (3) Considerations for successful self-management of Parkinson's disease, highlighting key areas such as psycho-emotional guidance, nutrition and lifestyle, peer support and maintaining autonomy and sense of identity. CONCLUSION Coping and adaptation strategies are individual and dynamic processes, with multiple key or turning points during the transition between strategies. Tailored self-management support can enhance coping abilities during these transitions, fostering adaptation to a life with Parkinson's disease. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE A patient-focused version of an existing blended self-management support program for family caregivers will be developed, which will be delivered by healthcare professionals. IMPACT This study can help healthcare professionals tailor support for people with Parkinson's disease, emphasising their role in facilitating coping and adaptation. Enhancing self-management can improve self-efficacy, quality of life and potentially reduce healthcare utilisation in people with Parkinson's disease. REPORTING METHOD Findings are reported according to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION Patients and Parkinson's disease experts participated in the preparation and implications of the findings. All participants could contribute to the self-management support program, either through video interviews or content feedback.
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Affiliation(s)
- Maud M J Daemen
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
| | | | - Colin Van Der Heijden
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lizzy M M Boots
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Mayke Oosterloo
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marjolein E De Vugt
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Annelien A Duits
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
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Di Maio S, Villinger K, Knoll N, Scholz U, Stadler G, Gawrilow C, Berli C. Compendium of dyadic intervention techniques (DITs) to change health behaviours: a systematic review. Health Psychol Rev 2024; 18:538-573. [PMID: 38437798 DOI: 10.1080/17437199.2024.2307534] [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: 03/15/2023] [Accepted: 01/15/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Dyadic interventions for health behaviour change involving the romantic partner are promising. However, it often remains unclear how exactly the partner is involved in dyadic interventions. We propose a novel compendium of dyadic intervention techniques (DITs) that facilitates systematic description of dyadic interventions in terms of who performs what for whom during intervention delivery and subsequent implementation. OBJECTIVE We aimed to systematically characterise dyadic interventions along their degree of partner involvement and to provide a comprehensive list of DITs used in dyadic interventions with romantic partners. METHODS We systematically reviewed dyadic health behaviour change interventions with controlled designs. We included 165 studies describing 122 distinct dyadic interventions with romantic partners. Interventions were classified along their degree of partner involvement, 160 DITs were extracted, and their frequencies of use counted. RESULTS The majority of interventions (n = 90, 74%) explicitly instructed partners to interact. Half of the DITs were performed jointly by the couple and also targeted the couple. Mostly, couples were instructed to jointly practice communication skills and to jointly perform problem solving for the couple. DISCUSSION The present review contributes to the development of a shared and systematic way of describing dyadic interventions to facilitate cumulation of evidence.
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Affiliation(s)
- Sally Di Maio
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | | | - Nina Knoll
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Urte Scholz
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Gertraud Stadler
- Institute of Gender in Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Caterina Gawrilow
- Department of Psychology, University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), partner site Tübingen, Germany
| | - Corina Berli
- Institute of Psychology, University of Bern, Bern, Switzerland
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Sextl-Plötz T, Steinhoff M, Baumeister H, Cuijpers P, Ebert DD, Zarski AC. A systematic review of predictors and moderators of treatment outcomes in internet- and mobile-based interventions for depression. Internet Interv 2024; 37:100760. [PMID: 39139716 PMCID: PMC11320424 DOI: 10.1016/j.invent.2024.100760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/08/2024] [Accepted: 07/19/2024] [Indexed: 08/15/2024] Open
Abstract
This systematic review aimed to synthesize evidence on predictors and moderators of treatment outcomes in internet- and mobile-based interventions (IMIs) for depression, informing personalized care. A systematic search across PubMed, PsycInfo, and Cochrane yielded 33,002 results. Two reviewers independently performed screening, data extraction, risk of bias assessment, and methodological quality evaluation. Fifty-eight single studies (m = 466 analyses) focusing on baseline-predictors (59.7 %, m = 278), process-predictors (16.5 %, m = 77), and moderators (21.9 %, m = 102), and six individual patient data meta-analyses (m = 93) were included. Only 24.0 % (m = 112/466) of analyses in single studies and 15.1 % (m = 14/93) in individual patient data meta-analyses were significant. Evidence from single studies was rated as insufficient for all variable categories with only 2 out of 40 categories showing >50 % significant results. Baseline depression severity had the strongest predictive value with higher scores linked to better outcomes followed by variables indicative for the course-of-change. Other frequently analyzed and potentially relevant variables with significant results were adherence, age, educational level, ethnicity, relationship status, treatment history, and behavioral variables. More high quality quantitative studies with sufficient power are essential to validate and expand findings, identifying predictors and moderators specifically relevant in IMIs to explain differential treatment effects.
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Affiliation(s)
- Theresa Sextl-Plötz
- Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Germany
- Department of Clinical Psychology, Division of eHealth in Clinical Psychology, Philipps University of Marburg, Marburg, Germany
| | - Maria Steinhoff
- Department of Clinical Psychology and Psychotherapy, University of Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, University of Ulm, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute and World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Netherlands
- Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
| | - David D. Ebert
- Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Germany
| | - Anna-Carlotta Zarski
- Department of Clinical Psychology, Division of eHealth in Clinical Psychology, Philipps University of Marburg, Marburg, Germany
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Hudson P, Francis J, Cohen J, Kapp S, De Abreu Lourenco R, Beatty L, Gray K, Jefford M, Juraskova I, Northouse L, de Vleminck A, Chang S, Yates P, Athan S, Baptista S, Klaic M, Philip J. Improving the Well-Being of People With Advanced Cancer and Their Family Caregivers: Protocol for an Effectiveness-Implementation Trial of a Dyadic Digital Health Intervention (FOCUSau). JMIR Res Protoc 2024; 13:e55252. [PMID: 39137414 DOI: 10.2196/55252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/19/2024] [Accepted: 05/21/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Advanced cancer significantly impacts patients' and family caregivers' quality of life. When patients and caregivers are supported concurrently as a dyad, the well-being of each person is optimized. Family, Outlook, Communication, Uncertainty, Symptom management (FOCUS) is a dyadic, psychoeducational intervention developed in the United States, shown to improve the well-being and quality of life of patients with advanced cancer and their primary caregivers. Originally, a nurse-delivered in-person intervention, FOCUS has been adapted into a self-administered web-based intervention for European delivery. OBJECTIVE The aims of this study are to (1) adapt FOCUS to the Australian context (FOCUSau); (2) evaluate the effectiveness of FOCUSau in improving the emotional well-being and self-efficacy of patients with advanced cancer and their primary caregiver relative to usual care control group; (3) compare health care use between the intervention and control groups; and (4) assess the acceptability, feasibility, and scalability of FOCUSau in order to inform future maintainable implementation of the intervention within the Australian health care system. METHODS FOCUS will be adapted prior to trial commencement, using an iterative stakeholder feedback process to create FOCUSau. To examine the efficacy and cost-effectiveness of FOCUSau and assess its acceptability, feasibility, and scalability, we will undertake a hybrid type 1 implementation study consisting of a phase 3 (clinical effectiveness) trial along with an observational implementation study. Participants will include patients with cancer who are older than 18 years, able to access the internet, and able to identify a primary support person or caregiver who can also be approached for participation. The sample size consists of 173 dyads in each arm (ie, 346 dyads in total). Patient-caregiver dyad data will be collected at 3 time points-baseline (T0) completed prerandomization; first follow-up (T1; N=346) at 12 weeks post baseline; and second follow-up (T2) at 24 weeks post baseline. RESULTS The study was funded in March 2022. Recruitment commenced in July 2024. CONCLUSIONS If shown to be effective, this intervention will improve the well-being of patients with advanced cancer and their family caregivers, regardless of their location or current level of health care support. TRIAL REGISTRATION ClinicalTrials.gov NCT06082128; https://clinicaltrials.gov/study/NCT06082128. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55252.
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Affiliation(s)
- Peter Hudson
- Centre for Palliative Care, c/o St Vincent's Hospital and The University of Melbourne, Melbourne, Australia
- End of Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jill Francis
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
- Centre for Implementation Research, Ottawa Hospital Research, Ottawa, ON, Canada
| | - Joachim Cohen
- End of Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Suzanne Kapp
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, Australia
| | - Lisa Beatty
- College of Education, Psychology and Social Work, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
| | - Kathleen Gray
- Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Australia
| | - Michael Jefford
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ilona Juraskova
- Faculty of Science, School of Psychology, University of Sydney, Sydney, Australia
| | - Laurel Northouse
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Aline de Vleminck
- End of Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sungwon Chang
- Faculty of Health, Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), University of Technology Sydney, Sydney, Australia
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Queensland, Australia
| | - Sophy Athan
- Cancer Consumer Advisory Committee, Victorian Comprehensive Cancer Centre Alliance, Melbourne, Australia
| | - Shaira Baptista
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Marlena Klaic
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Jennifer Philip
- St. Vincent's Hospital and the Victorian Comprehensive Cancer Centre, The University of Melbourne, Melbourne, Australia
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Welsh ET, McIntosh JE, Vuong A, Cloud ZCG, Hartley E, Boyd JH. Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review. J Med Internet Res 2024; 26:e49431. [PMID: 38959030 PMCID: PMC11255536 DOI: 10.2196/49431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/13/2023] [Accepted: 05/04/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together. OBJECTIVE As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families. METHODS A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented. RESULTS Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself. CONCLUSIONS In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.
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Affiliation(s)
- Ellen T Welsh
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Jennifer E McIntosh
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - An Vuong
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Zoe C G Cloud
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Eliza Hartley
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - James H Boyd
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Suffoletto B, Lee CM, Mason M. A text message intervention aimed at nurturing peer outreach to help meet drinking limit goals: A remote pilot randomized trial in non-collegiate young adults. Addict Behav 2024; 154:108020. [PMID: 38552400 DOI: 10.1016/j.addbeh.2024.108020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Scalable interventions attempting to nurture peer outreach to help young adults meet drinking limit goals remain under-developed. To address this gap, we developed ASPIRE, a text message intervention focused on coaching individuals to engage with close peers to assist them in meeting drinking limit goals. METHOD Non-collegiate young adults who had reported one or more heavy drinking days in the preceding month and were at least contemplating change were recruited through social media. Participants were randomly assigned to one of three 6-week text message interventions: Control, Goal Support, or ASPIRE. All groups completed baseline assessments and received weekly text message assessments on Thursdays and Sundays. Control and ASPIRE groups were prompted to complete web-based outcome assessments at 6- and 12-weeks. RESULTS We enrolled 92 young adults from 31 US states (65% female; 73% White). All groups had high text response rates but intervention usability was sub-optimal. Follow-up rates were 87% at 6-weeks and 79% at 12-weeks. Compared to Control, ASPIRE participants reported significantly more peer support and less peer pressure to drink. ASPIRE exhibited higher goal confidence compared to the Goal Support group. Using multiple imputation, there were no significant differences in drinking outcomes between groups. CONCLUSIONS Preliminary findings from this pilot study suggest that a text message intervention focused on nurturing peer outreach to help meet drinking limit goals holds promise in altering peer support and pressure as well as boosting drinking limit goal confidence. Design improvements are needed to reduce alcohol consumption.
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Affiliation(s)
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington
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Cho E, Akard TF. Perspectives From Adolescent and Young Adult Cancer Survivors for a Planned Nurse-Patient Dyadic Storytelling Intervention. J Holist Nurs 2024; 42:49-63. [PMID: 37475533 DOI: 10.1177/08980101231189392] [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]
Abstract
Purpose: This qualitative study aimed to explore the perspectives of adolescents and young adults (AYA) on a planned nurse-patient dyadic storytelling intervention. Background: Cancer is a highly distressful event for AYA. AYA with cancer experience multidimensional suffering while dealing with their developmental transition from adolescence to young adulthood. Their unique needs require appropriate, well-tailored psychosocial support. Nurses can provide such support through storytelling approaches. METHOD AYA cancer survivors participated in cross-sectional qualitative interviews to provide feedback on the nurse-patient storytelling intervention model. ANALYSIS Qualitative content analysis was used to interpret and categorize the data. FINDINGS Barriers and facilitators of the intervention emerged. Themes related to barriers included (a) the disadvantages of an online program, (b) the limitations of the in-person program, (c) interacting with nurses, (d) sharing personal stories with others, and (e) the timing of the program. Themes regarding facilitators included (a) benefits to AYA with cancer, (b) benefits to nurses, (c) benefits of online/in-person programs, and (d) willingness to participate. Conclusions: AYA with cancer may benefit from the nurse-patient dyadic storytelling intervention. Developing innovative methods to optimize and customize interventions based on preferences is essential. Future research should involve nurse feedback and tailored approaches for AYA with cancer.
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Affiliation(s)
- Eunji Cho
- Connell School of Nursing, Boston College, Boston, MA, USA
| | - Terrah Foster Akard
- School of Nursing, Vanderbilt University, Nashville, TN, USA
- School of Medicine, Vanderbilt University, Nashville, TN, USA
- Graduate School, Vanderbilt University, Nashville, TN, USA
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Schulte C, Harrer M, Sachser C, Weiss J, Zarski AC. Internet- and mobile-based psychological interventions for post-traumatic stress symptoms in youth: a systematic review and meta-analysis. NPJ Digit Med 2024; 7:50. [PMID: 38424186 PMCID: PMC10904807 DOI: 10.1038/s41746-024-01042-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
Psychological interventions can help reduce posttraumatic stress symptoms (PTSS) in youth, but many do not seek help. Internet- and mobile-based interventions (IMIs) show promise in expanding treatment options. However, the overall evidence on IMIs in reducing PTSS among youth remains unclear. This systematic review and meta-analysis investigated the efficacy of IMIs in PTSS reduction for youth exposed to traumatic events. A comprehensive literature search was conducted in January 2023 including non-randomized and randomized-controlled trials (RCT) investigating the effects of IMIs on PTSS in youth aged ≤25 years. Six studies were identified with five providing data for the meta-analysis. The majority of studies included youth with different types of trauma irrespective of PTSS severity at baseline (k = 5). We found a small within-group effect in reducing PTSS from baseline to post-treatment (g = -0.39, 95% CrI: -0.67 to -0.11, k = 5; n = 558; 9 comparisons). No effect emerged when comparing the effect of IMIs to control conditions (g = 0.04; 95%-CrI: -0.52 to 0.6, k = 3; n = 768; k = 3; 4 comparisons). Heterogeneity was low between and within studies. All studies showed at least some concerns in terms of risk of bias. Current evidence does not conclusively support the overall efficacy of IMIs in addressing youth PTSS. This review revealed a scarcity of studies investigating IMIs for youth exposed to traumatic events, with most being feasibility studies rather than adequately powered RCTs and lacking a trauma focus. This underscores the demand for more high-quality research.
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Affiliation(s)
- Christina Schulte
- Professorship Psychology and Digital Mental Health Care, Department Health and Sport Sciences, School of Medicine and Health, Technical University of Munich, Munich, Germany.
| | - Mathias Harrer
- Professorship Psychology and Digital Mental Health Care, Department Health and Sport Sciences, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Ulm, Ulm, Germany
| | - Jasmina Weiss
- Professorship Psychology and Digital Mental Health Care, Department Health and Sport Sciences, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Anna-Carlotta Zarski
- Department of Clinical Psychology, Division of eHealth in Clinical Psychology, Philipps University of Marburg, Marburg, Germany
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Low NJH, Leow DGW, Klainin-Yobas P. Effectiveness of Technology-Based Psychosocial Interventions on Psychological Outcomes Among Adult Cancer Patients and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2024; 40:151533. [PMID: 37977974 DOI: 10.1016/j.soncn.2023.151533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Technology-based psychosocial interventions (TBPIs) have increasingly gained intention. However, the effectiveness of TBPIs on psychological outcomes remains inconclusive. This review aimed to evaluate the effectiveness of TBPIs on health-related quality of life (HRQOL), coping, self-efficacy, and depression among adult cancer patients and caregivers. DATA SOURCES Randomised controlled trials (RCTs) evaluating the effectiveness of TBPIs targeting adult cancer patients, caregivers, or patient-caregiver dyads were included. English articles dated from 2012 to 2022 were retrieved from eight electronic databases, three clinical trial registries, and six grey literature databases. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias assessment tool and GRADE were used to appraise the methodological quality of included studies. Meta-analyses and subgroup analyses were undertaken with statistical pooling of standardized mean differences based on the random-effects model. CONCLUSION Totally, 37 RCTs were included in the review, with 35 trials for meta-analysis. Results demonstrated improvements in HRQOL, self-efficacy, and depression among cancer patients and caregivers with varying pooled effect sizes. Subgroup analyses suggested that dyadic TBPIs were more effective in improving HRQOL among cancer patients and caregivers, compared with those solely targeted at cancer patients or caregivers. IMPLICATION FOR NURSING PRACTICE Findings value-added to the existing evidence base on TBPIs. An interactive patient-caregiver dyadic program integrating TBPIs into routine oncology care is recommended to improve health outcomes for cancer patients and caregivers. Well-designed future RCTs are required to further evaluate the effectiveness of dyadic TBPIs, with emphasis on coping and self-efficacy outcomes among cancer patients and caregivers.
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Affiliation(s)
| | - Darryl Ge Wei Leow
- Staff Nurse, Woodlands Health Campus, Yishun Community Hospital, Singapore
| | - Piyanee Klainin-Yobas
- Associate Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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May M, Milrad SF, Perdomo DM, Czaja SJ, Jutagir DR, Hall DL, Klimas N, Antoni MH. Videoconference-delivered group Cognitive Behavioral Stress Management for ME/CFS patients who present with severe PEM: A randomized controlled trial. FATIGUE : BIOMEDICINE, HEALTH & BEHAVIOR 2024; 12:101-122. [PMID: 38736736 PMCID: PMC11086677 DOI: 10.1080/21641846.2024.2306801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/15/2024] [Indexed: 05/14/2024]
Abstract
Background In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), post-exertional malaise (PEM) is associated with greater distress and symptoms. Cognitive Behavioral Stress Management (CBSM) has demonstrated beneficial effects for ME/CFS and may mitigate stress-related triggers of PEM. We tested a virtual CBSM intervention to increase access, and we report on its effects on stress and symptoms in ME/CFS patients with severe PEM. Methods Data were from a randomized controlled trial (NCT01650636) comparing 10-week videoconference-delivered group CBSM (V-CBSM, n=75) to a 10-week Health Information active control (V-HI, n=75) in Fukuda criteria ME/CFS patients (71 classified as highPEM, 79 lowPEM). Linear regression explored PEM-by-Treatment interactions on overall symptom frequency and intensity, perceived stress, and fatigue-specific interference and intensity, at 5-month follow-up. Logistic regression tested V-CBSM effects on 5-month PEM status. Analyses controlled for age, gender, race/ethnicity, mode of symptom onset, and time since diagnosis. Results The sample was middle-aged (47.96±10.89 years), mostly women (87%) and non-Hispanic White (65%), with no group differences on these variables or baseline PEM. For highPEM patients, V-CBSM (versus V-HI) demonstrated medium to large effects on follow-up symptom frequency, symptom intensity, fatigue interference, and fatigue intensity (p's < .05) and trending to significant reductions in perceived stress (p =.07). Differences were not evident for lowPEM patients. Treatment predicted follow-up PEM status at a trend (p = .058), with patients receiving V-CBSM demonstrating half the risk of highPEM classification versus V-HI. Conclusions V-CBSM demonstrates benefits for ME/CFS patients presenting with severe PEM and may reduce the expression of PEM over time.
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Affiliation(s)
| | | | | | | | | | | | - Nancy Klimas
- Nova Southeastern University, Miami VA Medical Center
Geriatric Research Education and Clinical Center
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Bogart LM, Phaladze N, Kgotlaetsile K, Goggin KJ, Mosepele M. Qualitative Evaluation of Treatment Partners for People With HIV in Botswana: Current Healthcare Provider Practices and Recommendations for Improvement. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024:2752535X231225809. [PMID: 38171536 PMCID: PMC11219526 DOI: 10.1177/2752535x231225809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Botswana has an adult HIV prevalence of 20.8% and annual incidence of 0.2%. We aimed to evaluate current practices and advance recommendations for treatment partners (informal adherence supporters) for people with HIV in Botswana. In January-February 2020, we conducted seven focus groups with 36 healthcare providers at seven HIV clinics in Gaborone, Botswana. Providers perceived treatment partners to be critical for quality patient care. They shared that in the new era of universal antiretroviral therapy (ART) initiation immediately after diagnosis ("test-and-treat"), providers no longer require patients to select treatment partners at ART initiation. Providers suggested a renewed emphasis on treatment partners. They believed that standard guidance for providers around treatment partner selection would ensure that providers cover similar topics across patients and endorsed implementation of workshops to educate treatment partners on how to support patients. However, streamlined ART initiation policies require innovative strategies, including eHealth interventions, to engage treatment partners.
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Affiliation(s)
- Laura M. Bogart
- RAND Corporation, Santa Monica, CA, USA
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | | | - Kathy J. Goggin
- Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
- University of Missouri - Kansas City Schools of Medicine and Pharmacy, Kansas City, MO, USA
| | - Mosepele Mosepele
- University of Botswana, Gaborone, Botswana
- Botswana Harvard Health Partnership, Gaborone, Botswana
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Benoit JR, Hartling L, Scott SD. Bridging evidence-to-care gaps with mHealth: Designing a symptom checker for parents accessing knowledge translation resources on acute children's illnesses in a smartphone application. PEC INNOVATION 2023; 2:100152. [PMID: 37214490 PMCID: PMC10194162 DOI: 10.1016/j.pecinn.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/06/2023] [Accepted: 03/28/2023] [Indexed: 05/24/2023]
Abstract
Background Smartphone applications offer a novel platform for delivering health information to parents. This study created and evaluated an app-based symptom checker that recommends educational tools to parents based on their child's symptoms. Methods Symptoms extracted from 23 knowledge translation (KT) tools for 10 children's illnesses comprised a set of plain-language symptoms. The symptom checker works by producing confusion matrices evaluating a child's reported symptoms against possible illnesses, comparing precision scores to examine how well each illness matched reported symptoms, and ordering possible illnesses by performance score. Performance was evaluated by extracting symptoms from 8 clinical vignettes, and examining correct first-try matches. Results We created a final list of 54 plain-language symptoms. Visualizations of the symptom set creation process and logic mapping are presented, as well as images of the working symptom checker. The symptom checker matched 100% (8/8) of tested clinical vignettes to the appropriate illness resource. Discussion Symptom checkers are a potentially useful tool to integrate into apps that parents use for their children's health. The design of these systems has the potential to change parents' relationship with technology, affecting both their adoption and acceptance of symptom checkers. Our design choices contribute to addressing current barriers to the adoption of symptom checkers, reducing functional, critical, and interactive literacy requirements for parents.
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Affiliation(s)
- James R.A. Benoit
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Lisa Hartling
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Shannon D. Scott
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
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Van Goethem V, Dierickx S, Matthys O, Northouse L, Lund L, Jordan C, Turola E, van der Wel M, Scott D, Harding R, Deliens L, Lapeire L, Hudson P, De Vleminck A, Cohen J. A self-management psychoeducational eHealth program to support and empower people with advanced cancer and their family caregivers: Development using the scrum methodology. Internet Interv 2023; 33:100659. [PMID: 37593143 PMCID: PMC10428037 DOI: 10.1016/j.invent.2023.100659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023] Open
Abstract
Background eHealth programs could be a flexible and scalable resource to support and empower people with advanced cancer and their family caregivers. A face-to-face intervention that has demonstrated effectiveness is the "FOCUS" program, developed and tested in the USA. Recently the FOCUS program was translated and adapted to the European context as part of an international study in six European countries, resulting in the "FOCUS+" program. FOCUS+ served as the basis for development of the web-based iFOCUS program. Objective We aim to (1) describe the development process of the iFOCUS program, (2) outline the challenges we encountered and how they were overcome, and (3) present findings regarding the acceptability and usability of iFOCUS. Methods We used the four phased agile Scrum methodology to develop iFOCUS and applied set timeframes of rapid program development and evaluation (sprints). Five teams were involved in the development i.e. a core development group, a web development team, an international consortium, audio-visual experts, and potential end-users. Results Development followed seven steps, integrated across the four phases of Scrum: (1) concept design, (2) development of mock-ups, (3) Feedback from the international consortium, (4) technical development of iFOCUS, (5) creating versions for the six participating countries, (6) preliminary testing of iFOCUS and (7) implementing the final version in a randomized controlled trial. User testing included 42 participants (twenty patient-family caregiver dyads and two bereaved family caregivers) who reviewed the iFOCUS program. Users found the iFOCUS program to be acceptable and usable. Feedback mainly focused on text size and fonts. Minor changes to the content, tailoring, and program flow were required. During development we encountered program specific and general challenges. Using the Scrum methodology facilitated iterative development to address these issues. For some challenges, such as tailoring, we had to make pragmatic choices due to time and resource limitations. Conclusions/discussion The development of a tailored, self-managed psychoeducational eHealth program for people with advanced cancer and their family caregivers is an intense process and requires pragmatic choices. By keeping the emphasis on the target population during development, no specific remarks pertaining to advanced cancer were identified. Some challenges we encountered are common to eHealth development, others were related to program specific requirements. Using the Scrum methodology allows teams to efficiently collaborate during program development and increases the flexibility of the development process. Interpersonal contact between research staff and potential end-users is recommended during and after the development of eHealth programs.
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Affiliation(s)
- Vincent Van Goethem
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Sigrid Dierickx
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Orphé Matthys
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | | | - Line Lund
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Palliative Care Research Unit, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Catherine Jordan
- University College Dublin, National University of Ireland, Dublin, Ireland
| | - Elena Turola
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - David Scott
- The School of Nursing and Midwifery, Queen's University of Belfast, Belfast, United Kingdom
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
| | - Luc Deliens
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Lore Lapeire
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University Hospital, Department of Medical Oncology, C. Heymanslaan 10, 9000 Ghent, Belgium
| | | | - Peter Hudson
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- St Vincent's Hospital and the Univeristy of Melbourne, Centre of Palliative Care, Melbourne, Australia
| | - Aline De Vleminck
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Joachim Cohen
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
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Tan JYA, Ong GYQ, Cheng LJ, Pikkarainen M, He HG. Effectiveness of mHealth-based psychosocial interventions for breast cancer patients and their caregivers: A systematic review and meta-analysis. J Telemed Telecare 2023:1357633X231187432. [PMID: 37650270 DOI: 10.1177/1357633x231187432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Breast cancer causes significant distress in patient-caregiver dyads. While psychosocial and/or mHealth-based interventions have shown efficacy in improving their psychosocial well-being, no reviews have synthesised the effectiveness of such interventions delivered specifically to the breast cancer patient-caregiver dyad. OBJECTIVE To synthesise available evidence examining the effectiveness of mHealth-based psychosocial interventions among breast cancer patient-caregiver dyads in improving their psychosocial well-being (primary outcomes: dyadic adjustment, depression and anxiety; secondary outcomes: stress, symptom distress, social well-being and relationship quality), compared to active or non-active controls. DESIGN A systematic review and meta-analysis. METHODS Randomised controlled trials and quasi-experimental studies were comprehensively searched from seven electronic databases (PubMed, CENTRAL, CINAHL, Embase, PsycINFO, Scopus, Web of Science), ongoing trial registries (ClinicalTrials.gov, WHO ICTRP) and grey literature (ProQuest Dissertations and Theses Global) from inception of databases till 23 December 2022. Studies involving breast cancer patient-caregiver dyads participating in mHealth-based psychosocial interventions, compared to active or non-active controls, were included. Exclusion criteria were terminally ill patients and/or participants with psychiatric disorders or cognitive impairment and interventions collecting symptomatic data, promoting breast cancer screening or involving only physical activities. Screening, data extraction and quality appraisal of studies were conducted independently by two reviewers. Cochrane Risk of Bias Tool version 1 and JBI Critical Appraisal Checklist were used to appraise the randomised controlled trials and quasi-experimental studies, respectively. Meta-analyses using Review Manager 5.4.1 synthesised the effects of outcomes of interest. Sensitivity and subgroup analyses were conducted. The GRADE approach appraised the overall evidence quality. RESULTS Twelve trials involving 1204 breast cancer patient-caregiver dyads were included. Meta-analyses found statistically significant increase in caregiver anxiety (standardised mean difference (SMD) = 0.43, 95% confidence interval (CI) [0.09, 0.77], Z = 2.47, p = 0.01), involving 479 caregivers in 5 studies, and stress (SMD = 0.25, 95% CI [0.05, 0.45], Z = 2.44, p = 0.01), involving 387 caregivers in 4 studies post-intervention, favouring control groups. The intervention effects on the remaining outcomes were statistically insignificant. Beneficial effects of such interventions remain uncertain. The overall quality of evidence was very low for all primary outcomes. CONCLUSIONS Results of the effectiveness of mHealth-based psychosocial interventions on the psychosocial well-being of breast cancer patient-caregiver dyads are inconclusive. The high heterogeneity shown in the meta-analyses and very-low overall quality of evidence imply the need for cautious interpretation of findings. Higher-quality studies are needed to assess the effects of psychosocial interventions on dyadic outcomes and determine optimal intervention regimes.
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Affiliation(s)
- Jia Yu Amelia Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Germaine Yi Qing Ong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Minna Pikkarainen
- Department of Occupational Therapy, Prosthetics and Orthoptics, Faculty of Health Sciences & Department of Product Design, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
- Martti Ahtisaari Institute, University of Oulu, Oulu, Finland
| | - Hong-Gu He
- National University Health System, Singapore, Singapore
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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van der Kamp MR, Hengeveld VS, Brusse-Keizer MGJ, Thio BJ, Tabak M. eHealth Technologies for Monitoring Pediatric Asthma at Home: Scoping Review. J Med Internet Res 2023; 25:e45896. [PMID: 37477966 PMCID: PMC10403763 DOI: 10.2196/45896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND eHealth monitoring technologies offer opportunities to more objectively assess symptoms when they appear in daily life. Asthma is the most common chronic disease in childhood with an episodic course, requiring close follow-up of pediatric asthma control to identify disease deterioration, prevent exacerbations, and enhance quality of life. eHealth technologies in pediatric asthma care show promising results regarding feasibility, acceptability, and asthma-related health outcomes. However, broad systematic evaluations of eHealth technologies in pediatric asthma are lacking. OBJECTIVE The objective of this scoping review was to identify the types and applications of eHealth technologies for monitoring and treatment in pediatric asthma and explore which monitoring domains show the most relevance or potential for future research. METHODS A scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic and comprehensive search was performed on English papers that investigated the development, validation, or application of eHealth technologies for home monitoring or treatment of pediatric asthma in the following databases: PubMed, Cochrane Library, IEEE, Scopus, CINAHL, PsycINFO, and ACM Digital Library. Two authors independently assessed eligibility and extracted data. Data were presented by a descriptive analysis of characteristics and a narrative report for each eHealth domain. RESULTS The review included 370 manuscripts. The following 10 monitoring domains were identified: air quality, airway inflammation markers, lung function, physical activity, sleep, audiovisual, other physiological measurements, questionnaires, medication monitoring, and digital environment (ie, digital platforms, applications, websites, and software tools to monitor or support monitoring). Rising numbers of studies were seen, and the numbers accelerated in the last few years throughout most domains, especially medication monitoring and digital environment. Limited studies (35/370, 9.5%) of multiparameter monitoring strategies, using three or more domains, were found. The number of monitoring validation studies remained stable, while development and intervention studies increased. Intervention outcomes seemed to indicate the noninferiority and potential superiority of eHealth monitoring in pediatric asthma. CONCLUSIONS This systematic scoping review provides a unique overview of eHealth pediatric asthma monitoring studies, and it revealed that eHealth research takes place throughout different monitoring domains using different approaches. The outcomes of the review showed the potency for efficacy of most monitoring domains (especially the domains of medication monitoring, lung function, and digital environment). Future studies could focus on modifying potentially relevant hospital-based diagnostics for the home setting to investigate potential beneficial effects and focus on combining home-monitoring domains to facilitate multiparameter decision-making and personalized clinical decision support.
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Affiliation(s)
- Mattiènne R van der Kamp
- Pediatric Department, Medisch Spectrum Twente, Enschede, Netherlands
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Vera S Hengeveld
- Pediatric Department, Medisch Spectrum Twente, Enschede, Netherlands
| | - Marjolein G J Brusse-Keizer
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands
- Health Technology and Services Research, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Boony J Thio
- Pediatric Department, Medisch Spectrum Twente, Enschede, Netherlands
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands
| | - Monique Tabak
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
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Trivedi R, Hirayama SK, Risbud R, Suresh M, Humber MB, Butler K, Razze A, Timko C, Nelson K, Zulman DM, Asch SM, Humphreys K, Piette JD. Adapting a Telephone-Based, Dyadic Self-management Program to Be Delivered Over the Web: Methodology and Usability Testing. JMIR Form Res 2023; 7:e43903. [PMID: 37327057 PMCID: PMC10337331 DOI: 10.2196/43903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has amplified the need for web-based behavioral interventions to support individuals who are diagnosed with chronic conditions and their informal caregivers. However, most interventions focus on patient outcomes. Dyadic technology-enabled interventions that simultaneously improve outcomes for patients and caregivers are needed. OBJECTIVE This study aimed to describe the methodology used to adapt a telephone-based, facilitated, and dyadic self-management program called Self-care Using Collaborative Coping Enhancement in Diseases (SUCCEED) into a self-guided, web-based version (web-SUCCEED) and to conduct usability testing for web-SUCCEED. METHODS We developed web-SUCCEED in 6 steps: ideation-determine the intervention content areas; prototyping-develop the wireframes, illustrating the look and feel of the website; prototype refinement via feedback from focus groups; finalizing the module content; programming web-SUCCEED; and usability testing. A diverse team of stakeholders including content experts, web designers, patients, and caregivers provided input at various stages of development. Costs, including full-time equivalent employee, were summarized. RESULTS At the ideation stage, we determined the content of web-SUCCEED based on feedback from the program's original pilot study. At the prototyping stage, the principal investigator and web designers iteratively developed prototypes that included inclusive design elements (eg, large font size). Feedback about these prototypes was elicited through 2 focus groups of veterans with chronic conditions (n=13). Rapid thematic analysis identified two themes: (1) web-based interventions can be useful for many but should include ways to connect with other users and (2) prototypes were sufficient to elicit feedback about the esthetics, but a live website allowing for continual feedback and updating would be better. Focus group feedback was incorporated into building a functional website. In parallel, the content experts worked in small groups to adapt SUCCEED's content, so that it could be delivered in a didactic, self-guided format. Usability testing was completed by veterans (8/16, 50%) and caregivers (8/16, 50%). Veterans and caregivers gave web-SUCCEED high usability scores, noting that it was easy to understand, easy to use, and not overly burdensome. Notable negative feedback included "slightly agreeing" that the site was confusing and awkward. All veterans (8/8, 100%) agreed that they would choose this type of program in the future to access an intervention that aims to improve their health. Developing and maintaining the software and hosting together cost approximately US $100,000, excluding salary and fringe benefits for project personnel (steps 1-3: US $25,000; steps 4-6: US $75,000). CONCLUSIONS Adapting an existing, facilitated self-management support program for delivery via the web is feasible, and such programs can remotely deliver content. Input from a multidisciplinary team of experts and stakeholders can ensure the program's success. Those interested in adapting programs should have a realistic estimate of the budget and staffing requirements.
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Affiliation(s)
- Ranak Trivedi
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | | | - Rashmi Risbud
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Madhuvanthi Suresh
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Marika Blair Humber
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Kevin Butler
- Learning Systems International Metcor, Washington, DC, United States
| | - Alex Razze
- Learning Systems International Metcor, Washington, DC, United States
| | - Christine Timko
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Karin Nelson
- Veteran Affairs Puget Sound Health Care System, Seattle, WA, United States
| | - Donna M Zulman
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Steven M Asch
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - Keith Humphreys
- Center for Innovation to Implementation, Veteran Affairs Palo Alto Health Care System, Menlo Park, CA, United States
| | - John D Piette
- Veteran Affairs Ann Arbor Health Care System, Ann Arbor, MI, United States
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Semonella M, Bertuzzi V, Dekel R, Andersson G, Pietrabissa G, Vilchinsky N. Applying dyadic digital psychological interventions for reducing caregiver burden in the illness context: a systematic review and a meta-analysis protocol. BMJ Open 2023; 13:e070279. [PMID: 37164463 PMCID: PMC10173984 DOI: 10.1136/bmjopen-2022-070279] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
INTRODUCTION Providing informal care to one's romantic partner who is ill may become a highly distressing and demanding task. Based on the innovative dyadic coping model, several support interventions have been developed to alleviate informal caregivers' burden, including both caregivers' and care receivers' needs. Considering the unique challenges characterising the caregiving phenomenon, such as geographical barriers and time restrictions, digital solutions should be considered. However, there is a lack of research examining the effectiveness of dyadic digital solutions. Thus, this review aims to examine the existing literature on the efficacy of dyadic digital psychological interventions designed for caregivers and their care-receivers couples within the illness context. METHODS AND ANALYSIS Randomised controlled trials targeting caregivers' burden among dyads of informal caregivers and care receivers will be identified via an electronic search of the following databases: PubMed, Embase, the Cochrane Library, Cinhal, Scopus, PsycINFO, MEDLINE and supplemented by hand searching of previous systematic reviews. The search will be undertaken following the PICO (population, intervention, comparison and outcome) elements. If possible, a meta-analysis will be conducted to examine: (1) the effectiveness of dyadic digital psychological interventions for reducing caregivers' burden (primary outcome) among caregivers who are in a romantic relationship with the care receivers; (2) the effectiveness of dyadic digital psychological interventions on secondary outcomes such as anxiety, depression, stress, quality of life, well-being and self-efficacy among caregivers and care receivers; and (3) moderating effects of clinical and methodological factors on caregivers' burden. Prior to inclusion in the review, retrieved papers will be critically appraised by two independent reviewers. The Cochrane Risk of Bias tool will assess the risk of bias for randomised controlled trials. ETHICS AND DISSEMINATION Ethical approval is not required as no primary data will be collected. Findings will be disseminated through peer-reviewed publications, presentations at academic conferences and lay summaries for various stakeholders. PROSPERO REGISTRATION NUMBER CRD42022299125.
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Affiliation(s)
| | - Vanessa Bertuzzi
- Department of Psychology, Universita Cattolica del Sacro Cuore, Milano, Italy
| | - Rachel Dekel
- School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Linkoping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Giada Pietrabissa
- Department of Psychology, Universita Cattolica del Sacro Cuore, Milano, Italy
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Oggebbio (VCO), Italy
| | - Noa Vilchinsky
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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18
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Lyles CR, Nguyen OK, Khoong EC, Aguilera A, Sarkar U. Multilevel Determinants of Digital Health Equity: A Literature Synthesis to Advance the Field. Annu Rev Public Health 2023; 44:383-405. [PMID: 36525960 PMCID: PMC10329412 DOI: 10.1146/annurev-publhealth-071521-023913] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Current digital health approaches have not engaged diverse end users or reduced health or health care inequities, despite their promise to deliver more tailored and personalized support to individuals at the right time and the right place. To achieve digital health equity, we must refocus our attention on the current state of digital health uptake and use across the policy, system, community, individual, and intervention levels. We focus here on (a) outlining a multilevel framework underlying digital health equity; (b) summarizingfive types of interventions/programs (with example studies) that hold promise for advancing digital health equity; and (c) recommending future steps for improving policy, practice, and research in this space.
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Affiliation(s)
- Courtney R Lyles
- Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA;
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
- School of Public Health, University of California-Berkeley, Berkeley, California, USA
| | - Oanh Kieu Nguyen
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
- Department of Medicine, Division of Hospital Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, USA
| | - Elaine C Khoong
- Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA;
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
| | - Adrian Aguilera
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
- School of Social Welfare, University of California-Berkeley, Berkeley, California, USA
- Department of Psychiatry, University of California-San Francisco, San Francisco, California, USA
| | - Urmimala Sarkar
- Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California-San Francisco, San Francisco, California, USA;
- Center for Vulnerable Populations, University of California-San Francisco, San Francisco, California, USA
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Hassan AYI, Cucculelli M, Lamura G. Caregivers' willingness to pay for digital support services: Comparative survey. Health Policy 2023; 130:104751. [PMID: 36857837 DOI: 10.1016/j.healthpol.2023.104751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 01/24/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Considering the substantial information needs experienced by informal caregivers, the increased availability of digital support services for caregivers as well as the potential they offer, further understanding of caregivers' willingness to pay for digital support services is needed. OBJECTIVE The aim of this study is to identify associations between informal caregiver's characteristics and their willingness to pay for digital support services in two countries: Italy and Sweden. METHODS A sample of 378 respondents participated in a cross-sectional survey. Respondents were recruited by the Italian National Institute of Health and Science on Ageing and the Swedish Family Care Competence Centre. A two-part regression model was used. In the first part, logistic regression analysis was applied to investigate the association between willingness to pay and sets of independent variables (caregiver's demographics, caregiver's socioeconomic resources and caregiving context). In the second part, a generalized linear model (log-link and gamma distribution) was applied to determine the adjusted mean willingness to pay. RESULTS More than half of the participants from both countries of our study were willing to pay out of pocket for digital support services. A recommendation by a healthcare professional was the top factor that may motivate caregivers' willingness to pay an additional amount for a paid version of a digital support service. In both countries, the majority of the respondents believe that the government should allocate more funds for digital support services and for improving digital infrastructures. Caregiver' s gender, care recipient relationship to the caregiver, care duration, the total household income and the amount spent per month on professional caregiving services are all associated with willingness to pay. For every additional 10 Euro increase in the amount spent per month on professional caregiving services, the odds of willingness to pay an additional Euro for a digital support service increased by 0.60 % in the Italian sample (p= 0.002, 95% CI: 1.002, 1.009) and 0.31% in the Swedish sample (p=0.015, 95% CI: 1.006, 1.057). CONCLUSIONS Factors such as demographics, socioeconomic resources and the caregiving context may play a role in caregivers' willingness to pay for digital support services. The digital and social divide may negatively affect caregivers' willingness to pay for digital support services. Policy makers and insurance providers should consider innovative policies to fund digital support services that have been shown to be effective at supporting and improving caregivers' health outcomes via subsidies or other incentives. Future research that evaluates the cost-effectiveness of digital support services is needed in a context of a growing number of informal caregivers and ever scarcer resources.
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Affiliation(s)
- Alhassan Yosri Ibrahim Hassan
- INRCA IRCCS - National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy; Department of Economics and Social Sciences, Faculty of Economics "Giorgio Fuà", Marche Polytechnic University, Ancona, Italy.
| | - Marco Cucculelli
- Department of Economics and Social Sciences, Faculty of Economics "Giorgio Fuà", Marche Polytechnic University, Ancona, Italy
| | - Giovanni Lamura
- INRCA IRCCS - National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy
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Edwards KM, Dalla RL, Mauer VA, Roselius K, Camp EE, Marshall J, Ybarra M. Formative research to develop an app to prevent dating and sexual violence and alcohol use among high school youth. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1273-1287. [PMID: 36350588 DOI: 10.1002/jcop.22958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to conduct formative research to inform the development of an app, that would simultaneously engage youth and adults, to prevent dating and sexual violence (DSV) and alcohol use (AU). Participants (N = 56) were high school students, parents/guardians, and professionals (e.g., school personnel) from across the United States who participated in online focus groups. Overall, participants had positive perceptions of the utility, helpfulness, and effectiveness of an app to prevent DSV and AU among high school students. Participants provided in depth information about both the content (e.g., local rates of DSV and AU) and features (e.g., skills-based, inclusion of incentives, help button) that the app should include. These preliminary data suggest that future research to develop and pilot an app for both youth and adults to prevent DSV and AU among high school students is warranted.
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Affiliation(s)
- Katie M Edwards
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Rochelle L Dalla
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Victoria A Mauer
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Kaitlin Roselius
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Emily E Camp
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Jania Marshall
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Michele Ybarra
- Center of Innovative Public Health Research, Santa Ana, California, USA
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Web-Based Psychosocial Interventions for Disaster-Related Distress: What Has Been Trialed in the Past, and What Can We Learn From This? Disaster Med Public Health Prep 2023; 17:e299. [PMID: 36785535 DOI: 10.1017/dmp.2022.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To summarize reports describing implementation and evaluation of Web-based psychosocial interventions for disaster-related distress with suggestions for future intervention and research, and to determine whether a systematic literature review on the topic is warranted. METHODS Systematic searches of Embase, PsycINFO, and MEDLINE were conducted. Duplicate entries were removed. Two rounds of inclusion/exclusion were conducted (abstract and full-text review). Relevant data were systematically charted by 2 reviewers. RESULTS The initial search identified 112 reports. Six reports, describing and evaluating 5 interventions, were included in a data analysis. Four of the 5 interventions were asynchronous and self-guided modular programs, with interactive components. The fifth was a short-term, online supportive group intervention. Studies utilized a variety of evaluation methods, and only 1 of 14 outcome measures used across the studies was utilized in more than 1 project. CONCLUSIONS Several Web-based psychosocial interventions have been developed to target disaster-related distress, but few programs have been formally evaluated. A systematic review of the topic would not be recommended at this time due to heterogeneity in reported studies. Further research on factors impacting participation, generalizability, and methods of program delivery with consistent outcome measures is needed.
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22
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Schulman-Green D, Linsky S, Blatt L, Jeuland J, Kapo J, Jeon S. Improving Breast Cancer Family Caregivers' Palliative Care Literacy: A Pilot Randomized Trial. JOURNAL OF FAMILY NURSING 2023; 29:99-114. [PMID: 35670155 DOI: 10.1177/10748407221099541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Self- and family management (SFM) refers to patients' and family caregivers' activities to co-manage illness. Two barriers to SFM are low palliative care literacy and lack of goals of care communication, which potentially result in SFM activities that are unsupportive of patients' goals. Managing Cancer Care: A Caregiver's Guide (MCC-CG) aims to improve palliative care literacy and communication within a SFM training program. In this pilot randomized trial, we enrolled breast cancer family caregivers and collected data at 0, 1, and 3 months on palliative care literacy, SFM engagement, communication, transitions management, uncertainty, caregiver burden, and caregiver competence/personal gain. Participants (n = 35) had a mean age of 54 (range: 18-81) and were 66% white and 34% racial/ethnic minorities. Intervention participants improved their palliative care literacy and SFM engagement, reduced uncertainty and caregiver burden, increased competence/personal gain, and had more goals of care conversations over time. MCC-CG has preliminary efficacy, warranting further study.
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Kitzmüller G, Wiklund Gustin L, Kalhovde AM. Filling the Void: The Role of Adult Siblings Caring for a Brother or Sister With Severe Mental Illness. Glob Qual Nurs Res 2023; 10:23333936231162230. [PMID: 37020709 PMCID: PMC10068502 DOI: 10.1177/23333936231162230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
Little is known about the role of adult siblings’ caregiver role within the context of mental illness. Therefore, our purpose was to explore how siblings narrate their experiences of being the main caregivers of a brother or sister with severe mental illness and how they cooperate with their ill sibling and their family of origin. We used a narrative hermeneutic approach and performed a secondary analysis of two interviews of siblings derived from a study of peoples’ experiences of hearing voices. The findings illuminate the participants’ multifaceted roles and how differently siblings might deal with the multiple challenges of caring for an ill sibling. The mediating role between their ill sibling and their family of origin to reestablish the broken family bonds was a significant aspect. Nurses’ awareness of the important and multidimensional role of caregiving siblings can improve the provision of family support and promote involvement of siblings in the treatment of an ill family member.
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Affiliation(s)
- Gabriele Kitzmüller
- UiT, the Arctic University of Norway,
Narvik, Norway
- Gabriele Kitzmüller, UiT, the Arctic
University of Norway, Lodve Langesgt., Narvik, 8505, Norway.
| | - Lena Wiklund Gustin
- UiT, the Arctic University of Norway,
Narvik, Norway
- Mälardalen University, Västerås,
Sweden
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24
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Brenk-Franz K, Leonhardt LJ, Strauß B. Attachment and patient activation as predictors of the interest and use of telemedical health applications –results of an observational study in primary health care. BMC PRIMARY CARE 2022; 23:96. [PMID: 35488203 PMCID: PMC9052500 DOI: 10.1186/s12875-022-01711-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/20/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Telemedicine applications are becoming more accepted and offer great potential to support physicians and patients. However, there is an increasing need for research, especially in personal predictors that determine the interest and use of telemedicine and e-health applications. This study aims to identify if attachment and patient activation are potential predictors of the interest in and the use of e-health applications in primary care patients.
Methods
We used data from the cross-sectional observational Weimar TelMed study on 192 patients treated by general practitioners from a practice of family medicine in Thuringia, the middle of Germany. The adult attachment was measured using the ECR-RD12 and patient activation with the PAM-13D. Multiple regression analysis by the General Linear Model was used to evaluate the association between attachment, patient activation, and interest in and use of e-health applications.
Results
Patient activation was associated with a higher interest in e-health care. The attachment dimension avoidance was a potential predictor of interest in e-health and e-health-care use.
Conclusion
Adult attachment is an essential predictor of different ways of healthcare use. While avoidant patients evade contact with general practitioners, self-determined access via e-health seems to improve the health care of these patients. A personalized view might be a basis for the evaluation of individual approaches in Primary Care.
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25
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Fox AL, Swink LA, Prabhu N, Fruhauf CA, Portz JD, Van Puymbroeck M, Sharp JL, Leach HJ, Schmid AA. Manual development for a multi-modal, dyadic intervention for persistent pain: A Qualitative Study. Br J Pain 2022; 16:481-489. [PMID: 36389010 PMCID: PMC9644100 DOI: 10.1177/20494637221090461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Background People who experience persistent pain often require help from a family member, partner, or friend. These caregivers frequently have pain but are often not included in interventions. Caregivers and care receivers who both experience pain are more likely to be socially isolated, and experience communication conflict and decreased quality of life. Interventions should target caregiving dyads to help them manage their pain together. However, there are few intervention manuals or research protocols developed to support the dyad. Objective The purpose of this qualitative study was to explore the needs of caregiving dyads, including input from dyads and medical and allied health experts to inform the development of an intervention manual for dyads with persistent pain. Method A total of 16 caregiving dyads experiencing persistent pain, one care receiver (caregiver could not participate), and 8 health experts, recruited from the community, participated in focus groups. Data were transcribed verbatim, uploaded into NVivo software, and analyzed using constant comparison qualitative methods. Results Findings identified the importance of a new intervention to focus on modifiable approaches to managing pain as a dyad, addressing the emotional and psychological effects of experiencing pain as a dyad, and careful consideration of logistics to implement an intervention with dyads in persistent pain. Conclusion These results highlight important considerations to meet the needs of caregiving dyads with pain. This study informed the development of the MY-Skills intervention, a novel program that merges self-management education with adaptive yoga to treat persistent pain in caregiving dyads.
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Affiliation(s)
| | - Laura A Swink
- Eastern Colorado VA Geriatric Research
Education and Clinical Center (GRECC), Aurora, CO, USA
- University of Colorado: Anschutz
Medical Campus, Aurora, CO, USA
| | - Neha Prabhu
- Growing Self Counseling and Coaching,
Denver, CO, USA
| | | | - Jennifer D Portz
- University of Colorado: Anschutz
Medical Campus, Aurora, CO, USA
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Shaffer KM, Mayberry LS, Salivar EG, Doss BD, Lewis AM, Canter K. Dyadic digital health interventions: Their rationale and implementation. PROCEDIA COMPUTER SCIENCE 2022; 206:183-194. [PMID: 36397858 PMCID: PMC9668031 DOI: 10.1016/j.procs.2022.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
While most psychosocial and behavioral digital health interventions have been designed to be consumed by an individual, intervening at the level of a dyad - two interdependent individuals - can more comprehensively address the needs of both individuals and their relationship. The clinical utility of the dyadic digital health intervention approach, as well as the practical implementation of this design, will be demonstrated via three examples: eSCCIP, FAMS, and OurRelationship.
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Affiliation(s)
- Kelly M. Shaffer
- Center for Behavioral Health and Technology, University of Virginia, Charlottesville, VA, USA
| | - Lindsay S. Mayberry
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
- Center for Health Behavior and Health Education, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily Georgia Salivar
- Department of Clinical and School Psychology, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Brian D. Doss
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Amanda M. Lewis
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
| | - Kimberly Canter
- Department of Pediatrics, Sidney Kimmel Medical College, Philadelphia, PA, USA
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Health, Wilmington, DE, USA
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27
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Pang X, Jin Y, Wang H. Effectiveness and moderators of cancer patient-caregiver dyad interventions in improving psychological distress: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2022; 9:100104. [PMID: 35990241 PMCID: PMC9382138 DOI: 10.1016/j.apjon.2022.100104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022] Open
Abstract
Objective As patients and family caregivers are increasingly viewed as a dyadic whole, growing studies have emerged that identify ways to improve the two parties’ emotional distress. However, the specific effectiveness, quality, and optimal intervention details of these studies are unclear. Our objective is to synthesize the effectiveness of existing dyadic interventions for improving the psychological distress of cancer patient-caregiver dyads and identify potential moderators that influence intervention effectiveness. Methods PubMed, Cochrane Library, Web of Science, CINHAL, Embase, and Clinical Trials were searched to identify all randomized controlled trials from inception until June 2021. Two reviewers performed the process independently. The Cochrane Risk of Bias tool was used for quality assessment. We calculated effect sizes (Hedges’ adjusted g) by standard mean difference. Potential moderators influencing the intervention effects were explored. Results We included 28 articles, of which 12 were available for meta-analysis. In total, 4784 participants were included, who were primarily middle-aged (M = 58 years old), with the highest proportion reporting a diagnosis of “mixed cancer” (30%). Patients’ anxiety (g = −0.31; 95% CI: −0.51 to −0.12; P = 0.001; I2 = 17%) and cancer-related distress (g = −0.32; 95% CI: −0.46 to −0.18; P < 0.0001; I2 = 0%) were statistically significantly improved from baseline to post-intervention. Interventionist, delivery type, duration, and frequency were potential moderators for psychosocial interventions on negative emotions. Conclusions Face-to-face, relatively shorter interventions led by psychologists in moderator analysis seem to have better performance. Cancer dyad-based interventions were efficacious in improving the emotional distress of both parties in the dyad, but the effect was more apparent in patients than in family caregivers. However, the long-term effects were modest for both groups.
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Affiliation(s)
- Xuenan Pang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yanfei Jin
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, China
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28
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Wooldridge JS, Rossi FS, Anderson C, Yarish NM, Pukhraj A, Trivedi RB. Systematic Review of Dyadic Interventions for Ambulatory Care Sensitive Conditions: Current Evidence and Key Gaps. Clin Gerontol 2022:1-29. [PMID: 35713392 DOI: 10.1080/07317115.2022.2086089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Identify non-pharmacological interventions to support patient/caregiver dyads with ACSCs; review the effects of dyadic interventions on health services outcomes; and review the effectiveness of dyadic interventions on patient and caregiver biopsychosocial outcomes. METHODS A systematic review of randomized controlled trials (RCTs). RESULTS Twenty-six manuscripts representing 20 unique RCTs (Mean N = 154 patients, 140 caregivers) were eligible. Eleven RCTs examined caregiving in patients with HF, seven with T2DM, one with COPD, and one with mixed ACSCs. Dyadic interventions for ACSCs were diverse in terms of length and content, with most including an educational component. Only 4/26 included studies had a low risk of bias. Interventions were most successful at improving quality of life, clinical health outcomes, health behaviors, and health services outcomes, with fewer improvements in patient mental health outcomes, psychosocial outcomes, relationship outcomes, and caregiver outcomes in general. The largest effect sizes were reported from trials focused on T2DM. CONCLUSIONS High-quality research with consistent measuring instruments is needed to understand which interventions are associated with improved patient and caregiver outcomes. CLINICAL IMPLICATIONS There may be clinically relevant benefits to including caregivers in interventions for patients with ACSCs, and clinicians should consider this when devising treatment plans.
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Affiliation(s)
- Jennalee S Wooldridge
- VA San Diego Health Care System
- Department of Psychiatry, University of California, San Diego, United States
| | - Fernanda S Rossi
- VA Palo Alto Healthcare System
- Department of Psychiatry Stanford University Stanford, California, United States
| | | | - Natalie M Yarish
- VA San Diego Health Care System
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, United States
| | - Ambri Pukhraj
- VA Palo Alto Healthcare System
- Department of Psychiatry Stanford University Stanford, California, United States
| | - Ranak B Trivedi
- VA Palo Alto Healthcare System
- Department of Psychiatry Stanford University Stanford, California, United States
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29
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Brunner M, Rietdijk R, Togher L. Training Resources Targeting Social Media Skills to Inform Rehabilitation for People Who Have an Acquired Brain Injury: Scoping Review. J Med Internet Res 2022; 24:e35595. [PMID: 35482369 PMCID: PMC9100544 DOI: 10.2196/35595] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In 2020 and 2021, people increasingly used the internet to connect socially and professionally. However, people with an acquired brain injury (ABI) experience challenges in using social media, and rehabilitation professionals have reported feeling underprepared to support them in its use. To date, no review of social media skills training to inform ABI rehabilitation has been conducted. OBJECTIVE This scoping review aimed to examine research on interventions addressing social media skills and safety, with a focus on people living with health conditions; free web-based resources for the general public on social media skills training; and currently available online support groups for people with ABI. METHODS An integrative scoping review was conducted, with a systematic search strategy applied in March and November 2020 across OvidSP (MEDLINE, AMED, PsycINFO, and Embase), Scopus, Web of Science, CINAHL, Google Scholar, Google, and Facebook. The data collected were critically appraised and synthesized to describe the key content and features of social media training resources. RESULTS This review identified 47 peer-reviewed academic articles, 48 social media training websites, and 120 online support groups for people with ABI. A key recommendation was interactive training with practical components addressing cybersafety, how to use platforms, and how to connect with others. However, no social media training resources that were relevant and accessible for people with ABI were identified. CONCLUSIONS Training resources to support people with ABI in safely using social media are limited. The key content to be addressed and the features to be incorporated into web-based social media training were determined, including the need for interactive training that is co-designed and safe and incorporates practical components that support people with ABI. These findings can be used to inform the development of web-based evidence-based support for people with ABI who may be vulnerable when participating in social media.
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Affiliation(s)
- Melissa Brunner
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, University of Sydney, Eora Nation, Camperdown, Australia
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30
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Bannon SM, Grunberg VA, Manglani HR, Lester EG, Ritchie C, Vranceanu AM. Together from the start: A transdiagnostic framework for early dyadic interventions for neurodegenerative diseases. J Am Geriatr Soc 2022; 70:1850-1862. [PMID: 35435998 DOI: 10.1111/jgs.17801] [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: 11/02/2021] [Revised: 02/27/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Neurodegenerative diseases (NDDs) are increasingly prevalent and radically alter the lives of individuals and their informal care partners (together called a dyad). As symptoms progress, dyads are at risk for elevated emotional distress and declines in relationship functioning and quality of life. Psychosocial interventions delivered to dyads early after diagnosis have successfully prevented chronic emotional distress across several chronic illnesses including cancer and acute brain injury. Dyads with NDD could benefit from such interventions, however, they are limited. Because NDDs have symptom profiles that are distinct from other chronic illnesses, they require a unique framework and interventions. Given the limited dyadic interventions and unified symptoms across NDDs, a transdiagnostic framework may help to enhance scalability and efficiency. To address this problem, we developed a transdiagnostic framework that cuts across NDD physical and emotional diagnoses to inform cost-effective and sustainable NDD dyadic interventions. METHODS To develop this framework, we conducted: (1) a narrative review on dyadic adjustment and existent dyadic interventions for those with NDDs, and (2) integrated findings to develop our NDD transdiagnostic framework for dyadic interventions early after diagnosis. RESULTS Findings revealed no existent dyadic interventions for NDDs delivered shortly after diagnosis. Among available interventions, all were delivered later in disease progression, thereby focusing on dyadic challenges at more advanced stages. In addition, although research emphasized the influence of individual, dyadic, and contextual factors on dyads' early adjustment to NDDs, no conceptual model has been developed. Informed by theory and current research, we introduce an NDD transdiagnostic framework for couples' early biopsychosocial adjustment. This framework includes NDD specific: contextual factors, illness-related factors, individual and dyadic stressors, adaptive coping strategies, and dyads' resources. CONCLUSIONS Our NDD transdiagnostic framework can be used to inform early dyadic psychosocial interventions that cut across all NDDs. This approach has important implications for implementation and scalability.
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Affiliation(s)
- Sarah M Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Victoria A Grunberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Heena R Manglani
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ethan G Lester
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Christine Ritchie
- Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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31
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Bannon SM, Cornelius T, Gates MV, Lester E, Mace RA, Popok P, Macklin EA, Rosand J, Vranceanu AM. Emotional distress in neuro-ICU survivor-caregiver dyads: The recovering together randomized clinical trial. Health Psychol 2022; 41:268-277. [PMID: 34498896 PMCID: PMC8904645 DOI: 10.1037/hea0001102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Emotional distress is common in both survivors and their informal caregivers following admission to a neuroscience intensive care unit (Neuro-ICU) and can negatively affect their individual recovery and quality of life. Neuro-ICU survivor-caregiver dyads can influence each other's emotional distress over time, but whether such influence emerges during dyadic treatment remains unknown. The present study involved secondary data analysis of Neuro-ICU dyads enrolled in a randomized clinical trial of a dyadic resiliency intervention, Recovering Together (RT), versus a health education attention placebo control to test dyadic similarities in emotional distress before and after treatment. METHOD Data were collected from 58 dyads following Neuro-ICU admission. Emotional distress (depression, anxiety, and posttraumatic stress) was assessed at baseline, 6 weeks (postintervention), and 12 weeks later. Nonindependence within survivor-caregiver dyads was examined (i.e., correlations between cross-sectional symptoms and changes in symptoms over time); mutual influence of emotional functioning over time (i.e., "partner effects") was examined using cross-lagged path analyses. RESULTS There were strong, positive cross-sectional correlations between survivor and caregiver distress at postintervention and follow-up and between changes in survivor and caregiver distress from baseline to postintervention and postintervention to follow-up. There were no partner effects. CONCLUSIONS Neuro-ICU survivors and their informal caregivers show similar changes in emotional distress after treatment. These findings highlight the potential benefits of intervening on both survivor and caregiver distress following Neuro-ICU admission. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Sarah M. Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital
| | - Talea Cornelius
- Department of Medicine, Columbia University Irving Medical Center
| | - Melissa V. Gates
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital
| | - Ethan Lester
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital
| | - Ryan A. Mace
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital
| | - Paula Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital
| | | | - Jonathan Rosand
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital
- Neuroscience Intensive Care Unit, Massachusetts General Hospital
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital
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Bouldin ED, Delgado R, Peacock K, Hale W, Roghani A, Trevino AY, Viny M, Wetter DW, Pugh MJ. Military Injuries-Understanding Posttraumatic Epilepsy, Health, and Quality-of-Life Effects of Caregiving: Protocol for a Longitudinal Mixed Methods Observational Study. JMIR Res Protoc 2022; 11:e30975. [PMID: 34989689 PMCID: PMC8771349 DOI: 10.2196/30975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Veterans with posttraumatic epilepsy (PTE), particularly those with comorbidities associated with epilepsy or traumatic brain injury (TBI), have poorer health status and higher symptom burden than their peers without PTE. One area that has been particularly poorly studied is that of the role of caregivers in the health of veterans with PTE and the impact caring for someone with PTE has on the caregivers themselves. OBJECTIVE In this study, we aim to address the following: describe and compare the health and quality of life of veterans and caregivers of veterans with and without PTE; evaluate the change in available supports and unmet needs for services among caregivers of post-9/11 veterans with PTE over a 2-year period and to compare support and unmet needs with those without PTE; and identify veteran and caregiver characteristics associated with the 2-year health trajectories of caregivers and veterans with PTE compared with veterans without PTE. METHODS We conducted a prospective cohort study of the health and quality of life among 4 groups of veterans and their caregivers: veterans with PTE, nontraumatic epilepsy, TBI only, and neither epilepsy nor TBI. We will recruit participants from previous related studies and collect information about both the veterans and their primary informal caregivers on health, quality of life, unmet needs for care, PTE and TBI symptoms and treatment, relationship, and caregiver experience. Data sources will include existing data supplemented with primary data, such as survey data collected at baseline, intermittent brief reporting using ecological momentary assessment, and qualitative interviews. We will make both cross-sectional and longitudinal comparisons, using veteran-caregiver dyads, along with qualitative findings to better understand risk and promotive factors for quality of life and health among veterans and caregivers, as well as the bidirectional impact of caregivers and care recipients on one another. RESULTS This study was approved by the institutional review boards of the University of Utah and Salt Lake City Veterans Affairs and is under review by the Human Research Protection Office of the United States Army Medical Research and Development Command. The Service Member, Veteran, and Caregiver Community Stakeholders Group has been formed and the study questionnaire will be finalized once the panel reviews it. We anticipate the start of recruitment and primary data collection by January 2022. CONCLUSIONS New national initiatives aim to incorporate the caregiver into the veteran's treatment plan; however, we know little about the impact of caregiving-both positive and negative-on the caregivers themselves and on the veterans for whom they provide care. We will identify specific needs in this understudied population, which will inform clinicians, patients, families, and policy makers about the specific impact and needs to equip caregivers in caring for veterans at home. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/30975.
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Affiliation(s)
- Erin D Bouldin
- Department of Health and Exercise Science, Appalchian State University, Boone, NC, United States
| | - Roxana Delgado
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Kimberly Peacock
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Willie Hale
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Ali Roghani
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Amira Y Trevino
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Mikayla Viny
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - David W Wetter
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Mary Jo Pugh
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
- Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States
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Boyt N, Ho AK, Morris-Bankole H, Sin J. Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis. Digit Health 2022; 8:20552076221129069. [PMID: 36276187 PMCID: PMC9585576 DOI: 10.1177/20552076221129069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This systematic review explored the effectiveness of internet-delivered interventions in improving psychological outcomes of informal caregivers for neurodegenerative-disorder (ND) patients. Methods We searched seven databases for English-language papers published from 1999 to May 2021. Study-eligibility required that interventions used a minimum 50% internet-facilitation, targeting unpaid, adult informal caregivers of community-based ND-patients. We included randomised controlled trials (RCTs) and pre-post evaluative studies reporting outcomes for at least one-time point post-intervention. Independent quality checks on abstract and full-text screening were completed. Data extraction encompassed interventions' features, approaches, theoretical bases and delivery-modes. The Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) framework assessed risk of bias. Alongside narrative synthesis, we calculated meta-analyses on post-intervention using outcome measures from at least two RCTs to assess effectiveness. Results Searches yielded 51 eligible studies with 3180 participants. In 48 studies, caregivers supported a dementia-diagnosed individual. Intervention-durations encompassed four weeks to 12 months, with usage-frequency either prescribed or participant-determined. The most frequently-used approach was education, followed by social support. We calculated meta-analyses using data from 16 RCTs. Internet-delivered interventions were superior in improving mastery (g = 1.17 [95% CI; 0.1 to 2.24], p = 0.03) and reducing anxiety (g = -1.29 [95% CI; -1.56 to -1.01], p < 0.01), compared to all controls. Findings were equivocal for caregivers' quality of life, burden and other outcomes. High heterogeneity reflected the multifarious combinations of approaches and delivery-modes, precluding assessment of the most efficacious intervention features. Analyses using burden and self-efficacy outcomes' follow-up data were also non-significant compared to all comparator-types. Although 32 studies met the ICROMS threshold scores, we rated most studies' evidence quality as 'very-low'. Conclusions This review demonstrated some evidence for the efficacy of internet-delivered interventions targeting informal ND-caregivers. However, more rigorous studies, with longer follow-ups across outcomes and involving NDs other than dementia, are imperative to enhance the knowledge-base.
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Affiliation(s)
- Neil Boyt
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Aileen K Ho
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Hannah Morris-Bankole
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Jacqueline Sin
- School of Health Sciences, University of London, Myddelton Street Building, Myddelton Street, London, EC1R 1UW, England
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34
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Miao M, Power E, Rietdijk R, Brunner M, Debono D, Togher L. A Web-Based Service Delivery Model for Communication Training After Brain Injury: Protocol for a Mixed Methods, Prospective, Hybrid Type 2 Implementation-Effectiveness Study. JMIR Res Protoc 2021; 10:e31995. [PMID: 34889770 PMCID: PMC8704121 DOI: 10.2196/31995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Acquired brain injuries (ABIs) commonly cause cognitive-communication disorders, which can have a pervasive psychosocial impact on a person's life. More than 135 million people worldwide currently live with ABI, and this large and growing burden is increasingly surpassing global rehabilitation service capacity. A web-based service delivery model may offer a scalable solution. The Social Brain Toolkit is an evidence-based suite of 3 web-based communication training interventions for people with ABI and their communication partners. Successful real-world delivery of web-based interventions such as the Social Brain Toolkit requires investigation of intervention implementation in addition to efficacy and effectiveness. OBJECTIVE The aim of this study is to investigate the implementation and effectiveness of the Social Brain Toolkit as a web-based service delivery model. METHODS This is a mixed methods, prospective, hybrid type 2 implementation-effectiveness study, theoretically underpinned by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of digital health implementation. We will document implementation strategies preemptively deployed to support the launch of the Social Brain Toolkit interventions, as well as implementation strategies identified by end users through formative evaluation of the Social Brain Toolkit. We will prospectively observe implementation outcomes, selected on the basis of the NASSS framework, through quantitative web analytics of intervention use, qualitative and quantitative pre- and postintervention survey data from all users within a specified sample frame, and qualitative interviews with a subset of users of each intervention. Qualitative implementation data will be deductively analyzed against the NASSS framework. Quantitative implementation data will be analyzed descriptively. We will obtain effectiveness outcomes through web-based knowledge tests, custom user questionnaires, and formal clinical tools. Quantitative effectiveness outcomes will be analyzed through descriptive statistics and the Reliable Change Index, with repeated analysis of variance (pretraining, posttraining, and follow-up), to determine whether there is any significant improvement within this participant sample. RESULTS Data collection commenced on July 2, 2021, and is expected to conclude on June 1, 2022, after a 6-month sample frame of analytics for each Social Brain Toolkit intervention. Data analysis will occur concurrently with data collection until mid-2022, with results expected for publication late 2022 and early 2023. CONCLUSIONS End-user evaluation of the Social Brain Toolkit's implementation can guide intervention development and implementation to reach and meet community needs in a feasible, scalable, sustainable, and acceptable manner. End user feedback will be directly incorporated and addressed wherever possible in the next version of the Social Brain Toolkit. Learnings from these findings will benefit the implementation of this and future web-based psychosocial interventions for people with ABI and other populations. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry ACTRN12621001170819; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001170819, Australia and New Zealand Clinical Trials Registry ACTRN12621001177842; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001177842, Australia and New Zealand Clinical Trials Registry ACTRN12621001180808; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001180808. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/31995.
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Affiliation(s)
- Melissa Miao
- University of Technology Sydney, Sydney, Australia
| | - Emma Power
- University of Technology Sydney, Sydney, Australia
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Miao M, Power E, Rietdijk R, Brunner M, Togher L. Implementation of online psychosocial interventions for people with neurological conditions and their caregivers: A systematic review protocol. Digit Health 2021; 7:20552076211035988. [PMID: 34567610 PMCID: PMC8456620 DOI: 10.1177/20552076211035988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background As the burden of neurological conditions increases globally, online psychosocial interventions offer a potentially scalable solution to enabling healthcare access. However, their successful development and implementation require research into electronic healthcare implementation specifically. Methods Using a search strategy combining the concepts of implementation, electronic healthcare, psychosocial interventions and neurological conditions, we will conduct comprehensive electronic searches for primary implementation evidence in MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, SpeechBITE and NeuroBITE databases. Included studies will be analysed according to the Non-adoption, Abandonment, Scale-Up, Spread, and Sustainability framework, appraised using the Mixed-Methods Appraisal Tool and evaluated for theoretical underpinning in implementation science, with hybrid studies of effectiveness-implementation research classified according to the type of hybrid design. Discussion This review will be the first to use a theoretical underpinning in the Non-adoption, Abandonment, Scale-Up, Spread, and Sustainability framework to evaluate strengths and gaps in existing implementation research into online psychosocial interventions for people with neurological conditions and/or their caregivers. The results may be useful to provide direction and recommendations for future clinical implementation and research into online psychosocial interventions for people with neurological conditions and/or their caregivers. Systematic review registration PROSPERO 2020: CRD42020186387.
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Affiliation(s)
- Melissa Miao
- Graduate School of Health, University of Technology Sydney, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Melissa Brunner
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Australia
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36
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Oudshoorn CEM, Frielink N, Nijs SLP, Embregts PJCM. Psychological eHealth interventions for people with intellectual disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:950-972. [PMID: 33704872 PMCID: PMC8359285 DOI: 10.1111/jar.12877] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of eHealth, which has accelerated in the wake of the COVID-19 pandemic, could contribute to the access to tailor-made psychological interventions for people with intellectual disabilities. METHOD A scoping review was conducted on peer-reviewed studies between 1996-2019. RESULTS Thirty-three studies reported on the use of psychological eHealth interventions focused on mental health problems and/or challenging behaviour. The vast majority of these studies reported on interventions that were delivered at the individual level. The context in which these interventions were delivered varied, primarily ranging from the home setting to residential settings, as well as day or activity centres and schools. The studies described various types of interventions: telehealth interventions, computerized cognitive behavioural therapy, and interventions focused on (social) learning principles targeting challenging behaviour. CONCLUSIONS eHealth provides new opportunities for both therapists and lay-therapists to deliver psychological interventions. Future studies should focus on the effectiveness of psychological eHealth interventions.
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Affiliation(s)
- Cathelijn E. M. Oudshoorn
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
- ASVZSliedrechtThe Netherlands
| | - Noud Frielink
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Sara L. P. Nijs
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Petri J. C. M. Embregts
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
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Shaffer KM, Kennedy E, Glazer JV, Clayton AH, Cohn W, Millard TA, Ritterband LM, Showalter S. Addressing sexual concerns of female breast cancer survivors and partners: a qualitative study of survivors, partners, and oncology providers about Internet intervention preferences. Support Care Cancer 2021; 29:7451-7460. [PMID: 34080054 DOI: 10.1007/s00520-021-06302-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Sexual side effects after breast cancer treatment are common and distressing to both survivors and their intimate partners, yet few receive interventions to address cancer-related sexual concerns. To direct intervention development, this qualitative study assessed the perceptions of female breast cancer survivors, intimate partners of breast cancer survivors, and breast cancer oncology providers about how an Internet intervention for couples may address breast cancer-related sexual concerns. METHODS Survivors (N = 20) responded to online open-ended surveys. Partners (N = 12) and providers (N = 8) completed individual semi-structured interviews. Data were inductively coded using thematic content analysis. RESULTS Three primary intervention content areas were identified by the key stakeholder groups: (1) information about and strategies to manage physical and psychological effects of cancer treatment on sexual health, (2) relationship and communication support, and (3) addressing bodily changes and self-image after treatment. Survivors and partners tended to express interest in some individualized intervention private from their partner, although they also emphasized the importance of opening communication about sexual concerns within the couple. Survivors and partners expressed interest in an intervention that addresses changing needs across the cancer trajectory, available from the time of diagnosis and through survivorship. CONCLUSION Internet intervention for couples to address cancer-related sexual concerns, particularly one that provides basic education about treatment side effects and that evolves with couples' changing needs across the cancer trajectory, was perceived as a valuable addition to breast cancer care by survivors, partners, and providers.
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Affiliation(s)
- Kelly M Shaffer
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA. .,Center for Behavioral Health and Technology, University of Virginia School of Medicine, PO Box 801075, Charlottesville, VA, 22908, USA. .,Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
| | - Erin Kennedy
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, PO Box 801075, Charlottesville, VA, 22908, USA
| | - Anita H Clayton
- Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Wendy Cohn
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Trish A Millard
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Medicine - Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Lee M Ritterband
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Center for Behavioral Health and Technology, University of Virginia School of Medicine, PO Box 801075, Charlottesville, VA, 22908, USA.,Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Shayna Showalter
- UVA Cancer Center, University of Virginia, Charlottesville, VA, USA.,Surgery - Surgical Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA
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Martorella G, Fredericks S, Sanders J, Wynne R. Breaking pandemic chain reactions: telehealth psychosocial support in cardiovascular disease during COVID-19. Eur J Cardiovasc Nurs 2021; 20:1-2. [PMID: 33570589 PMCID: PMC7799113 DOI: 10.1093/eurjcn/zvaa011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Geraldine Martorella
- College of Nursing, Florida State University, Tallahassee Memorial Healthcare Center for Research and Evidence-Based Practice, 98 Varsity Way, Tallahassee, FL 32304, USA
| | - Suzanne Fredericks
- Daphne Cockwell School of Nursing, Ryerson University, 350 Victoria St, Toronto, m5B 2K3, Canada
| | - Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust and Clinical Professor of Cardiovascular Nursing, William Harvey Research Institute, Charterhouse Square Barts and the London School of Medicine and Dentistry Queen Mary University of London, London EC1M 6BQ, UK
| | - Rochelle Wynne
- Western Sydney Nursing & Midwifery Research Centre, Research & Education Network WSLHD and Professor of Nursing, Western Sydney University, Locked Bag 1797 Penrith NSW 2751, Australia.,School of Nursing & Midwifery, Deakin University, Gheringhap Street, Geelong, VIC, 3220, Australia
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Read SH, Valverde I, Montealegre JR, Rutherford TJ, Anderson ML. Qualitative assessment of knowledge and attitudes towards cervical cancer screening among male Latino immigrants in Houston, Texas. BMC WOMENS HEALTH 2020; 20:141. [PMID: 32631299 PMCID: PMC7339392 DOI: 10.1186/s12905-020-01006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/28/2020] [Indexed: 11/25/2022]
Abstract
Background Male spouses and partners play an important role in determining a woman’s willingness to participate in cervical cancer screening. However, the attitudes and behaviors by which they influence a woman’s decision to undergo Pap testing remain poorly understood. Methods A series of semi-structured, qualitative interviews were conducted in Spanish with 19 recent Latino immigrants in Houston, Texas. The interview format was designed to establish each individual’s pattern of engagement with the United States healthcare system, assess baseline knowledge of cervical cancer screening and evaluate attitudes and patterns of communication with their female partners regarding health care. Interview questions were constructed using principles of the Theory of Reasoned Action. All interviews were conducted in Spanish. After translation, responses were coded and scored with the goal of identifying themes and key observations. Results Most subjects reported few, if any, interactions with the healthcare system since their arrival in the United States. Although most participants reported being aware that women should be seen by their doctors regularly, fewer than half could clearly indicate the purpose of a Pap test or could state with certainty the last time their female partner had undergone screening. Multiple subjects expressed a general distrust of the health care system and concern for its costs. Approximately half of subjects reported that they accompanied their female partner to the health care provider’s office and none of the participants reported that they were present in examination rooms at the time their partner underwent screening. Multiple participants endorsed that there may be some concerns within their community regarding women receiving frequent gynecologic care and distrust of the healthcare system. Almost all interviewed subjects stated that while they would allow their female partners to see male physicians, they also expressed the opinion that other men might be uncomfortable with this and that women would likely be more comfortable with female physicians. Conclusions Strategies to enhance knowledge of HPV and cancer screening and improve trust in the health care system among male spouses or partners should be explored with the goal of promoting cervical cancer screening among immigrant Latinx populations.
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Affiliation(s)
- Susan H Read
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Morsani College of Medicine, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC 2040A, Tampa, FL, 33612, USA.,H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
| | - Ivan Valverde
- Houston Independent School District, Houston, TX, USA
| | - Jane R Montealegre
- Department of Pediatrics and Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Thomas J Rutherford
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Morsani College of Medicine, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC 2040A, Tampa, FL, 33612, USA
| | - Matthew L Anderson
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Morsani College of Medicine, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC 2040A, Tampa, FL, 33612, USA. .,H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA.
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