1
|
Jiang J, Zheng Z. Medical Information Protection in Internet Hospital Apps in China: Scale Development and Content Analysis. JMIR Mhealth Uhealth 2024; 12:e55061. [PMID: 38904994 PMCID: PMC11226934 DOI: 10.2196/55061] [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: 12/01/2023] [Revised: 03/23/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Hospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical services and enhanced accessibility. However, increasing concerns about personal information (PI) and strict legal compliance requirements necessitate privacy assessments for these platforms. Guided by the theory of contextual integrity, this study investigates the regulatory compliance of privacy policies for internet hospital apps in the mainland of China. OBJECTIVE In this paper, we aim to evaluate the regulatory compliance of privacy policies of internet hospital apps in the mainland of China and offer recommendations for improvement. METHODS We obtained 59 internet hospital apps on November 7, 2023, and reviewed 52 privacy policies available between November 8 and 23, 2023. We developed a 3-level indicator scale based on the information processing activities, as stipulated in relevant regulations. The scale comprised 7 level-1 indicators, 26 level-2 indicators, and 70 level-3 indicators. RESULTS The mean compliance score of the 52 assessed apps was 73/100 (SD 22.4%), revealing a varied spectrum of compliance. Sensitive PI protection compliance (mean 73.9%, SD 24.2%) lagged behind general PI protection (mean 90.4%, SD 14.7%), with only 12 apps requiring separate consent for processing sensitive PI (mean 73.9%, SD 24.2%). Although most apps (n=41, 79%) committed to supervising subcontractors, only a quarter (n=13, 25%) required users' explicit consent for subcontracting activities. Concerning PI storage security (mean 71.2%, SD 29.3%) and incident management (mean 71.8%, SD 36.6%), half of the assessed apps (n=27, 52%) committed to bear corresponding legal responsibility, whereas fewer than half (n=24, 46%) specified the security level obtained. Most privacy policies stated the PI retention period (n=40, 77%) and instances of PI deletion or anonymization (n=41, 79%), but fewer (n=20, 38.5%) committed to prompt third-party PI deletion. Most apps delineated various individual rights, but only a fraction addressed the rights to obtain copies (n=22, 42%) or to refuse advertisement based on automated decision-making (n=13, 25%). Significant deficiencies remained in regular compliance audits (mean 11.5%, SD 37.8%), impact assessments (mean 13.5%, SD 15.2%), and PI officer disclosure (mean 48.1%, SD 49.3%). CONCLUSIONS Our analysis revealed both strengths and significant shortcomings in the compliance of internet hospital apps' privacy policies with relevant regulations. As China continues to implement internet hospital apps, it should ensure the informed consent of users for PI processing activities, enhance compliance levels of relevant privacy policies, and fortify PI protection enforcement across the information processing stages.
Collapse
Affiliation(s)
- Jiayi Jiang
- Law School, Central South University, Changsha, China
| | - Zexing Zheng
- Law School, Central South University, Changsha, China
| |
Collapse
|
2
|
Arbour C, Lapierre A, Hjeij D, Bilodeau K. Do All Patients Benefit From the Soothing Properties of a Conversational Nursing Intervention to Reduce Symptom Burden During Outpatient Chemotherapy?: A Multimethod Secondary Analysis. Cancer Nurs 2024:00002820-990000000-00259. [PMID: 38865610 DOI: 10.1097/ncc.0000000000001376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
BACKGROUND Soothing conversation (SC) is particularly promising for symptom management during outpatient chemotherapy. However, we know little about the profile of patients who are most likely to benefit from this intervention. OBJECTIVE To gain a better understanding of the profile of patients most likely to benefit from SC to reduce symptom burden during outpatient chemotherapy. METHODS We performed a multimethod secondary analysis of 2 data sets: the first gathered during a quantitative pilot trial investigating the impact of SC on patients' symptom fluctuations during chemotherapy perfusion (n = 24); the second derived from qualitative interviews about nurses' experiences with SC in this context (n = 6). RESULTS Secondary quantitative analysis suggests that symptom control with SC is more effective in older patients, reporting lower education, widowed status, work incapacity, advanced cancer, and undergoing chemotherapy perfusion for less than 1 hour. According to nurses' interviews, SC could best benefit patients (1) prone to anxiety and fear, (2) with unalleviated pain, (3) who are unaccompanied during treatment, and contrary to what was shown with quantitative data, (4) undergoing longer perfusion duration. CONCLUSION Although this study provides valuable insights, much work remains to be done to fully understand the factors that predispose patients to respond positively to SC during outpatient chemotherapy. IMPLICATIONS FOR PRACTICE This study extends previous research on the effectiveness of SC for symptom management during outpatient chemotherapy by comparing nurses' experience with the intervention to patients' results. Results could be used to inform the assignment and delivery of supportive communication-based interventions during chemotherapy protocols.
Collapse
Affiliation(s)
- Caroline Arbour
- Author Affiliations: Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal (Drs Arbour and Lapierre and Mrs Hjeij); Faculty of Nursing, Université de Montréal (Drs Arbour, Lapierre, and Bilodeau); Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal (Dr Bilodeau), Quebec, Canada
| | | | | | | |
Collapse
|
3
|
Wen Q, Yang B, Wang X, Xia L, Song L. Characteristics analysis of Internet pharmacy consultation services for children in southwest China during the post-epidemic era: A cross-sectional study. Int J Med Inform 2024; 186:105424. [PMID: 38547627 DOI: 10.1016/j.ijmedinf.2024.105424] [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: 10/09/2023] [Revised: 03/13/2024] [Accepted: 03/20/2024] [Indexed: 04/22/2024]
Abstract
AIM This study aims to examine the features of online pediatric pharmacy consultations in Southwest China, an area with limited medical resources during the post-epidemic era and to explore the factors affecting the dialogue volume in online consultations. METHODS A cross-sectional study was conducted in southwest China from April 2022 to March 2023. The study encompassed a cohort of 2,526 children, ranging from 0 to 18 years old. The collected data encompassed patient gender, age, weight, department, drugs involved in consultation services, types of questions consulted, consultation start time, and the dialogue volume in online consultations. Descriptive statistics and an ordered multicategorical logistic regression analysis were performed. SPSS 26.0 software was used for data analysis. RESULTS Among the total Internet pharmacy consultation services offered, the infant group constituted the largest portion (n = 1021). Children with internal medicine concerns have greater online consultation needs (n = 455). The peak usage of Internet pharmacy consultation occurred in the fall at 11:00 a.m. (n = 73). Factors influencing the dialogue volume in online consultations include the non-availability of Chinese medications [P = 0.033, OR = 0.81, 95 % CI (0.67-0.98)], consultation initiation during the spring [P = 0.002, OR = 1.52, 95 % CI(1.17-1.97)] or afternoon [P = 0.012, OR = 1.36, 95 % CI (1.07-1.72)] and weight<15 kg group [P = 0.038, OR = 2.19, 95 % CI (1.04-4.58)]. CONCLUSION Our findings provide important information for peers to carry out their work. In the post-epidemic era, emphasis should be placed on addressing concerns related to children's internal medicine and otolaryngology. Optimizing healthcare resource allocation should take into account the time-seasonal variability of children's consultation behaviors. Furthermore, it is recommended to focus on weight<15 kg children in inquiries, absorb sufficient knowledge about Chinese medicines, and schedule more pharmacists to participate in consultation services during the spring or in every afternoon. These findings help the authorities of online platforms and the National Health Commission to rationalize the allocation of healthcare resources, optimize the quality of service delivery, and develop new policies.
Collapse
Affiliation(s)
- Qiang Wen
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China
| | - Bin Yang
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China
| | - Xiuling Wang
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China
| | - Linli Xia
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China.
| | - Lin Song
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Chongqing, China; Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China.
| |
Collapse
|
4
|
Wang X, Wang J, Du X, Yu L, Zhou Y, Zhou S, Wang Y, Ding Y. Telemedicine during the COVID-19 epidemic improves outcomes in children with tuberous sclerosis complex: A 1206 visits retrospective cohort study. CNS Neurosci Ther 2024; 30:e14549. [PMID: 38031962 PMCID: PMC11163188 DOI: 10.1111/cns.14549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 11/02/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
AIMS To evaluate the benefits of telemedicine in children with tuberous sclerosis complex during the COVID-19 pandemic. METHODS A retrospective cohort study was conducted, comparing telemedicine and in-person visits within the timeframe spanning from June 1, 2021, to June 1, 2022. Disparities in demographics, emergency visits, hospitalizations, adverse effects (AEs) associated with sirolimus, and the incidence of drug-refractory epilepsy (DRE) between telehealth and in-person care were assessed. Additionally, distinctions between audio and video telehealth, as well as varying frequencies of telehealth encounters, were investigated and reported as odds ratios (ORs). RESULTS A total of 378 patients with 1206 visits were included, of which 137 were telemedicine patients and 241 were in-person patients. The median age was 5.0 years (IQR 2.8-10.0 years). There were 197 males (52.12%), 691 in-person visits (57.30%), and 515 telemedicine visits (42.70%). Children under 12 years old, those farther away from the center, mothers with more than 12 years of education, and children treated with sirolimus were more likely to visit via telemedicine. Telehealth was associated with significantly fewer emergency visits, hospitalizations, AEs of sirolimus, and DRE. With 10 or more visits, the incidence of emergency visits, hospitalization, and DRE was significantly reduced. CONCLUSION Telemedicine visits are almost as close in number as in-person visits. Younger patients, patients in remote areas, and mothers with higher education levels are more willing to complete telemedicine visits. Telemedicine visits were associated with a significantly lower number of emergency visits, hospitalizations, and AEs of sirolimus. Patients with more than 10 visits per year seemed to have better clinical outcomes.
Collapse
Affiliation(s)
- Xia Wang
- Department of NeonatologyXinhua Hospital Affiliated to Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Ji Wang
- Department of Neurology, National Children Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Xiaonan Du
- Department of Neurology, National Children Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Lifei Yu
- Department of Neurology, National Children Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yuanfeng Zhou
- Department of Neurology, National Children Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Shuizhen Zhou
- Department of Neurology, National Children Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yi Wang
- Department of Neurology, National Children Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yifeng Ding
- Department of Neurology, National Children Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| |
Collapse
|
5
|
Yin X, Pan J, Xu F. Effects of Wuxi CDC WeChat official account article features on user engagement in health promotion. BMC Public Health 2024; 24:756. [PMID: 38468225 PMCID: PMC10929147 DOI: 10.1186/s12889-024-18277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE To identify the characteristics of subscribers to assess users' needs and analyze the features of articles published on Wuxi CDC WeChat official account (WOA) to evaluate the effectiveness of health education dissemination and guide future communication strategies. METHODS Collect data from the WeChat official account (WOA) of the Wuxi Center for Disease Control and Prevention (CDC) to identify factors affecting the effectiveness of health education dissemination as measured by shares and 100% reading completion rate between January 1, 2022, and December 31, 2022. Multivariate logistic regression analysis was utilized to identify influencing features of articles associated with health education dissemination. RESULTS By the end of 2022, our account had accumulated 891,170 subscribers, of which, 523,576 were females (58.75%), 349,856 were males (39.3%), mainly located in third-tier cities (82.59%). Age distribution peaked in the 26-35 and 36-45 age groups (43.63% and 30.6%, respectively). A total of 170 articles were included in the analysis. Multivariate logistic regression analysis revealed that articles with a lower word count (OR = 0.999, 95% CI = 0.998 ~ 1), lower picture count (OR = 0.892, 95% CI = 0.828 ~ 0.962), dominated headlines (OR = 2.454, 95% CI = 1.234 ~ 4.879) and thematically focused on Nutrition and food-borne diseases (OR = 5.728, 95% CI = 1.778 ~ 18.458) demonstrated higher engagement, as measured by shares and 100% completion rates. CONCLUSIONS Our findings suggest that future content should prioritize conciseness, optimize images, and align with subscriber interests, particularly in nutrition and food hygiene. Additionally, maintaining informative yet engaging content formats remains crucial for maximizing reach and impact.
Collapse
Affiliation(s)
- Xinyi Yin
- Department of Health Promotion, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, 214023, Wuxi, China.
| | - Junxia Pan
- Department of Health Promotion, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, 214023, Wuxi, China
| | - Fanfan Xu
- Department of Health Promotion, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, 214023, Wuxi, China.
| |
Collapse
|
6
|
Li L, Fu L, Li H, Liu T, Sun J. Emerging trends and patterns in healthcare-seeking behavior: A systematic review. Medicine (Baltimore) 2024; 103:e37272. [PMID: 38394511 PMCID: PMC11309724 DOI: 10.1097/md.0000000000037272] [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: 07/26/2023] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES The study of healthcare-seeking behavior is essential for optimizing resource allocation and improving healthcare services. Its complexity and diversity have made it a prominent research area. Understanding factors influencing healthcare-seeking decisions allows targeted interventions and policy development to address barriers and ensure equitable access to quality healthcare for diverse populations. Such research plays a vital role in enhancing healthcare outcomes and overall population health. METHODS The study utilized a systematic quantitative literature review approach, employing the Web of Science (WOS) Core Collection and PubMed databases as data sources. Additionally, bibliometric tools such as CiteSpace and VOSviewer were employed for analysis and visualization of the literature. RESULTS A comprehensive statistical analysis and visualization were performed on the annual publication volume, publication countries, journals, keywords, and keyword co-occurrence patterns up until 2023. Through this analysis, a framework was established, identifying the determinants and fundamental elements of healthcare-seeking behavior. These findings contribute to the advancement of research in this field and inform future studies and interventions aimed at improving healthcare-seeking behavior. CONCLUSIONS Based on the aforementioned literature review and framework, several conclusions were drawn. The determinants that facilitate healthcare-seeking behavior include improving health education awareness, enhancing healthcare resources, reducing costs, and ensuring system soundness. Additionally, providing social environment support was found to be crucial. Furthermore, the fundamental elements of healthcare-seeking behavior were identified as healthcare demand, healthcare choices, and the process of diagnosis and treatment. These findings provide valuable insights for developing interventions and policies to promote optimal healthcare-seeking behavior.
Collapse
Affiliation(s)
- Limin Li
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Li Fu
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Hui Li
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Tong Liu
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Jiangjie Sun
- School of Health Care Management, Anhui Medical University, Hefei, China
- School of Management, Hefei University of Technology, Hefei, China
| |
Collapse
|
7
|
Wu X, Kuang Y, Guo Y, Wu J, Xiao L. Internet hospital response to the COVID-19 pandemic in a tertiary hospital in China: Perspectives based on a mixed-methods. Digit Health 2024; 10:20552076241228418. [PMID: 38303968 PMCID: PMC10832419 DOI: 10.1177/20552076241228418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
Objective This study aimed to summarize the characteristics of the Internet hospital services of the Seventh Affiliated Hospital of Sun Yat-sen University (SAHSYSU), describe diagnosis and treatment patterns in each department, determine SAHSYSU Internet hospital's role in pandemic control, and explore development strategies in non-pandemic situations. Methods Mixed-methods was used in this study. Qualitative organizational behavior analysis was conducted on hospital meeting records and semi-structured interview records to determine the research analysis indicators. We quantitatively analyzed online consultation record data of SAHSYSU Internet hospital from January to December 2020, and conduct classification analysis on departmental case studies using K-means clustering algorithm. Results 29,944 patient data items were retrieved. Internet hospital services synchronized with COVID-19 pandemic development in China and Guangdong province. The service volume peaked during the period of January to March, which coincided with the height of the pandemic. Out of the total visits, 58.90% were conducted during office hours while 41.10% were conducted during non-office hours. The majority of the patients came from Guangdong (19.67%) and Hubei (9.09%) provinces. The cluster analysis identified three clusters, each with different change rates and magnitudes of change for various departments. Conclusion Internet hospitals complemented conventional medical services, providing crucial medical care during the COVID-19 pandemic. Internet hospitals are the future trend of medical services and should be improved based on each department's treatment characteristics.
Collapse
Affiliation(s)
- Xiaolong Wu
- Business School, Sun Yat-sen University, Shenzhen, China
| | - Yulin Kuang
- Business School, Sun Yat-sen University, Shenzhen, China
| | - Yonglin Guo
- School of Government, Sun Yat-sen University, Guangzhou, China
| | - Ji Wu
- School of Business, Sun Yat-sen University, Guangzhou, China
| | - Li Xiao
- Office of the SYSU CPC Committee, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
8
|
Zhang Y, Zhang Y, Huang J, Dong L. Application of Internet hospitals for first-visit patients with COVID-19 during the pandemic in China. Eur J Public Health 2023; 33:789-795. [PMID: 37550253 PMCID: PMC10567245 DOI: 10.1093/eurpub/ckad138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND There has been controversy over whether to carry out online medical inquiries and electronic prescription for first-visit patients. While Internet hospitals have become crucial to ensure providing online diagnosis and prescription needs for first-visit COVID-positive patients. OBJECTIVE We describe the results and advantages of online medical treatment during the coronavirus disease 2019 (COVID-19) outbreak and analyse the results and advantages of online medical treatment. METHODS Data were collected from the patients who received online medical inquiry services through the COVID-19 Special Section of our Internet hospital. The user demographic characteristics, user behaviour, clinical symptoms and medical records were collected. Baseline data of offline outpatient patients were also collected. RESULTS A total of 16 173 online medical inquiries were included. The daily online outpatient service volume reached a peak of 2446 person-times. The median age was 29.92 years (SD 15.59), ranging from 20-39 years (n = 8870, 54.84%). A total of 89.20% (n = 14 426/16 173) patients had epidemic-related symptoms. Moreover, 23.35% of the people were diagnosed as COVID-19-positive through antigen or nucleic acid testing. Furthermore, 86.61% (14 008/16 173) of the patients visited our hospital for the first time or had no offline physical outpatient service record within the past 3 months. The demand for medical inquiries was mainly for drug dispensing, followed by medication guidance and disease diagnosis. And 2.07% (334/16 173) of the patients needed to go to the offline hospital for further treatment. CONCLUSION The service model of the COVID-19 Special Section based on Internet hospitals provided the public with the necessary medical support during the COVID-19 outbreak. It provides a reference for future pandemics or public health emergencies.
Collapse
Affiliation(s)
- Ye Zhang
- Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Ye Zhang
- Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, China
| | - Jie Huang
- Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Liang Dong
- Department of Information, Affiliated Hospital of Jiaxing University, Jiaxing, China
| |
Collapse
|
9
|
Liu L, Shi L. Chinese Patients' Virtual Consultation Use of Different Sponsorship Types of Telemedicine Platforms: A Cross-Sectional Study in Zhejiang Province, China. Telemed J E Health 2023; 29:1573-1584. [PMID: 36888545 DOI: 10.1089/tmj.2022.0358] [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: 03/09/2023] Open
Abstract
Background: Virtual consultation has been one of the most prevalent direct-to-consumer telemedicine services in China. However, little is known about patients' virtual consultation use of different sponsorship types of telemedicine platforms. This study aimed to examine Chinese patients' virtual consultation use and identify the factors that affect consultation use of different sponsorship types of platforms. Methods: We conducted a cross-sectional survey on 1,653 participants in tier 1, tier 2, and tier 3 hospitals in 3 cities with different income levels, in Zhejiang Province, in May and June 2019. Multinomial logistic regression analysis was used to identify the factors that affect patients' virtual consultation use of different sponsorship types of platforms. Results: The most frequently used consultation platform was digital health company-sponsored platforms (36.60%), hospital-sponsored platforms (34.57%), doctors' personal social media (11.09%), other company-sponsored platforms (9.24%), and medical e-commerce company-sponsored platforms (8.50%). The patients' virtual consultation use of different sponsorship types of platforms was determined by education levels, monthly income levels, perceived health status, internet use, and city income levels. Conclusions: Chinese patients' virtual consultation service use varied by platform sponsorship type. Digital health company-sponsored platforms owned advantages over other platform types in high-end consumers with higher education levels, higher income levels, living in high-income cities, and active in internet use. This study implied that different sponsorship types of direct-to-consumer telemedicine platforms in China differ from each other in online health care resource allocation, business model, and competitive advantage.
Collapse
Affiliation(s)
- Liyun Liu
- Department of Management, School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lizheng Shi
- Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| |
Collapse
|
10
|
Sang L, Song L. The Current Status of the Use of Internet Hospitals for Outpatients With Pain: Retrospective Study. J Med Internet Res 2023; 25:e44759. [PMID: 37695652 PMCID: PMC10520772 DOI: 10.2196/44759] [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: 12/01/2022] [Revised: 08/07/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND The national "Internet +" policies and the emergence of internet hospitals have created a new direction for the management of pain outside of the hospital. Nevertheless, there are no consolidated studies conducted by pain physicians on the current state of internet hospital-based online medical services used by patients with pain outside of a hospital setting. OBJECTIVE In this retrospective study, we aimed to examine the status of the use of internet hospitals by patients who experience pain. Moreover, we identified the factors that influenced patients' decisions to make an online visit through the internet hospital. METHODS Detailed information was collected online and offline from outpatients with pain at the information technology center of West China Hospital of Sichuan University from February 2020 to April 2022. Binary logistic regression analysis was conducted to identify the determinants that influenced patients' decisions to make an online visit to the internet hospital. RESULTS Over a 2-year period, 85,266 pain-related clinic visits were recorded. Ultimately, 39,260 patients were enrolled for the analysis, with 12.9% (5088/39,260) having online visits. Both online and offline clinics had a greater number of visits by women than men. The average age of patients attending the online clinic was 46.85 (SD 16.56) years, whereas the average age of patients attending the offline clinic was 51.48 (SD 16.12) years. The majority of online clinic visitors (3059/5088, 60.1%) were employed, and one of the most common occupations was farming (721/5088, 14.2%). In addition, 51.8% (2635/5088) of patients who participated in the online clinics lived outside the hospital vicinity. Young (odds ratio [OR] 1.35, 95% CI 1.01-1.81; P=.045) and middle-aged (OR 1.98, 95% CI 1.81-2.16; P<.001) patients, employed patients (OR 1.11, 95% CI 1.04-1.18; P=.002), nonlocal patients (OR 1.57, 95% CI 1.48-1.67; P<.001), and the ordinary staff (OR 1.19, 95%CI 1.01-1.39; P=.03) were more likely to have the intention to choose online visits through the internet hospitals. CONCLUSIONS Internet hospitals are flourishing as a more efficient and promising method of pain management and follow-up for patients with pain outside the hospital. People with pain who are young, working, and not in the vicinity of hospitals are more likely to visit internet hospitals.
Collapse
Affiliation(s)
- Ling Sang
- Department of Pain Management, West China Hospital, Sichuan University, Chengdu, China
| | - Li Song
- Department of Pain Management, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
11
|
Deng W, Yang T, Deng J, Liu R, Sun X, Li G, Wen X. Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study. J Med Internet Res 2023; 25:e46621. [PMID: 37523226 PMCID: PMC10425818 DOI: 10.2196/46621] [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: 02/18/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. OBJECTIVE This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. METHODS A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. RESULTS On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. CONCLUSIONS This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.
Collapse
Affiliation(s)
- Wenhao Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Tianan Yang
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Jianwei Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Ran Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xueqin Sun
- Department of Medical Insurance Management, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Gang Li
- TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinmei Wen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
12
|
Lu J, Wang X, Zeng X, Zhong W, Han W. Application of telemedicine system on the management of general patient in quarantine. Sci Rep 2023; 13:12215. [PMID: 37500673 PMCID: PMC10374524 DOI: 10.1038/s41598-023-37926-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
To limit the epidemic of COVID-19, most countries and regions have adopted the policy of quarantine, providing an opportunity for the development of telemedicine. This study aims to develop a telemedicine system within a quarantined district and validate its effectiveness and safety in managing a variety of diseases within the population. Appling the private network and specialized set, telemedicine system and service process were constructed in the quarantine district. Based on the patients' conditions, the staffs supplied kinds of medical service for the patients in the quarantine district. The basic characteristics and results of patients in the quarantine area who used telemedicine system during January to September 2022 were statistically analyzed. Within this period, 2410 cases were included in this study, among which, 1803 patients directly saw a doctor by the Internet hospital in the Internet hospital of telemedicine system, 607 patients used telemedicine system, 166 patients achieved referral to a specific hospital via telemedicine system, and 162 cases made further consultation, with no infection cases in the quarantine zone and no death cases. The six most occurred diseases were respiratory disease (20.6%), ophthalmology and otorhinolaryngology (12.9%), cardiovascular diseases (12.7%), digestive system disease (12.5%), dermatological diseases (10.6%), and metabolic and endocrine diseases (7.6%). The top three referred cases were obstetric diseases (19.3%), others (12.0%) and respiratory disease (10.2%). There were statistically significant differences between the diseases of the cases using telemedicine system with and without referral (P < 0.001). It is feasible, effective and efficient to construct and use telemedicine system in quarantine area. It is an approach to manage many patients by indirectly contact. With the solution of follow-up related problems and the application of novel technologies, telemedicine may usher in greater development.
Collapse
Affiliation(s)
- Jiafa Lu
- Emergency Department of Shenzhen University General Hospital, Shenzhen, China
| | - Xin Wang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xiaolin Zeng
- Department of Cardiology, Shenzhen University General Hospital, Shenzhen, China
| | - Wanjing Zhong
- Emergency Department of Shenzhen University General Hospital, Shenzhen, China
| | - Wei Han
- Emergency Department of Shenzhen University General Hospital, Shenzhen, China.
| |
Collapse
|
13
|
Pan Z, Ma T, Zeng Q, Xu T, Ran Q, Li T, Lu D. People's knowledge, attitudes, practice, and healthcare education demand regarding OSA: a cross-sectional study among Chinese general populations. Front Public Health 2023; 11:1128334. [PMID: 37521967 PMCID: PMC10372425 DOI: 10.3389/fpubh.2023.1128334] [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: 12/20/2022] [Accepted: 04/03/2023] [Indexed: 08/01/2023] Open
Abstract
Background Population knowledge and attitudes toward obstructive sleep apnea (OSA) syndrome are critical to public health initiatives to overcome the disease. Healthcare education is an appropriate approach to expediting the process to build active medical practice models in the public. Objective This study aimed to assess the level of knowledge, attitude, and practice (KAP) regarding OSA and healthcare education demand among the Chinese general population. Methods A cross-sectional survey was performed online via Wenjuanxing in China between 8 February and 8 March 2022, using a 34-item questionnaire designed and reviewed by multidisciplinary experts. Results This study enrolled 1507 respondents, aged 18 to 68, with a city-to-countryside ratio of approximately 2:1. Four-fifths of respondents reported that they had children (n = 1237), and mothers accounted for 57.7%. If they or their children had symptoms of OSA, nearly nine in 10 respondents would undertake positive medical practices, especially parents. A total of 89.4% of the respondents reported a desire to receive healthcare education through the new multimedia approach, and most were concerned about the etiology of OSA. Conclusion The current study indicated that even the higher educated and urban populations in China had insufficient knowledge about positive attitudes toward and practices regarding OSA, indicating an urgent demand for healthcare education. A special emphasis should be placed on appropriating population demand for healthcare education and promoting the benefits of active medical practice models in sleep medicine.
Collapse
Affiliation(s)
- Zhongjing Pan
- Department of Otorhinolaryngology, Head, and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tianpei Ma
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qinghan Zeng
- Department of Otorhinolaryngology, Head, and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Xu
- Department of Otorhinolaryngology, Head, and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qiong Ran
- Department of Outpatient Nursing, Dazhou Central Hospital, Dazhou, China
| | - Tianming Li
- Department of Otorhinolaryngology, Head, and Neck Surgery, Santai People's Hospital, Mianyang, China
| | - Dan Lu
- Department of Otorhinolaryngology, Head, and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
14
|
Chen X, Wu X, Zhang Q, Jing R, Cheng W, Tian J, Jin C. The construction and operational models of internet hospitals in China: a hospital-based survey study. BMC Health Serv Res 2023; 23:669. [PMID: 37344831 DOI: 10.1186/s12913-023-09675-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND China has empowered and continues to empower internet hospitals, which saw an increase in their development due to the pandemic, to fight against COVID-19. The construction and operational models of internet hospitals can be categorized as self-constructed and self-managed models, self-constructed and enterprise-run models, hospital and enterprise joint-owned models, and hosted by a third-party platform. Despite the growing importance of internet hospitals, there have been few systematic summaries of their construction and operational models. The primary purpose of the study was to understand the construction and operational models of internet hospitals in China. METHODS Data was collected from 39 internet hospitals and 356 medical staff between September 2020 and April 2021, via internet hospital and hospital staff surveys. T-tests were used to compare the continuous variables, while Chi-square tests were employed to compare the proportions of categorical variables. The self-perception of the internet hospitals' services was assessed using a 5-point Likert scale on 16 aspects and a root cause analysis was conducted to identify the root causes and influencing factors of current deficiencies experienced by internet hospitals. RESULTS Among the 39 internet hospitals, 22 (56.4%) were self-constructed and self-managed. Compared to other models of Internet hospitals, self-constructed and self-managed hospitals had lower percentages of professionals providing online services (P = 0.006), numbers of doctors outside of the entity (P = 0.006), numbers of online nurses (P = 0.004), and the ratio of online nurses to offline doctors (P < 0.001). Of the 16 aspects evaluated with regards to the medical staff's self-perception of the internet hospital services, the highest scores were given for fee transparency, fee rationality, travel cost capital, patience and responsibility, and consultation behaviors. The root causes included five aspects: human, channels, prices, services, and time. CONCLUSIONS While the self-constructed and self-managed model was found to be the most prevalent form of internet hospital in China, the different models of internet hospitals can have an impact on both the quantity and quality of online healthcare services. This study contributes to the existing literature on internet hospitals' construction and operational models, offering additional policy implications for telemedicine management.
Collapse
Affiliation(s)
- Xuejiao Chen
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China
| | - Xinxia Wu
- Peking University Third Hospital, Beijing, China
| | - Qihang Zhang
- London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Ran Jing
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China
| | - Weibin Cheng
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China.
- School of Data Science, City University of Hong Kong, Hong Kong S.A.R, China.
| | - Junzhang Tian
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China
| | | |
Collapse
|
15
|
Zemni I, Gara A, Nasraoui H, Kacem M, Maatouk A, Trimeche O, Abroug H, Fredj MB, Bennasrallah C, Dhouib W, Bouanene I, Belguith AS. The effectiveness of a health education intervention to reduce anxiety in quarantined COVID-19 patients: a randomized controlled trial. BMC Public Health 2023; 23:1188. [PMID: 37340300 DOI: 10.1186/s12889-023-16104-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/11/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is regarded as a serious public health concern that boosts levels of stress and anxiety which could be explained by several reasons, including social isolation. In this regard, we aimed to assess the impact of health education on the anxiety level of COVID-19 patients during the isolation period. METHODS This is a randomized controlled trial conducted between February 2021 and June 2021. Patients tested positive for Covid-19 with mild to moderate forms were randomized to Education (n = 267) or control (n = 269). The education group received a phone health education session on day 1 (D1) following the diagnosis. The three components of the health education intervention were an explanation of the coronavirus disease, what to do in the event of complications, and the recommended preventive measures. The two groups received a telephone evaluation of their Hospital Anxiety and Depression scores on D1 and day seven D7 following the positive diagnosis. The primary outcome was the rate of anxiety reduction in each group on D7 based on a HAD-A score ≥ 8. Secondary outcomes were the rate of anxiety reduction on D7 based on a HAD-A score ≥ 11, the percentage of people complying with isolation and the scores of adherences to preventive measures during the isolation in each group. RESULTS Hundred and ninety-six patients in the intervention group and 206 patients in the control group completed the study. The sociodemographic, clinical, and initial anxiety level features of the intervention and control groups were comparable at baseline (p ≥ 0.05). On D7, the education group's anxiety level (HAD-A ≥ 8) decreased from 26 to 16.3% (p = 0.013) while in the control group it increased from 19.4 to 22.8% (p = 0.37). Thus, the percentage change in anxiety between D1 and D7 (delta D7 - D1) was - 9.7% in the Education group and + 3.4% in the Control group. Using the HAD-A ≥ 11 thresholds, the percentage of anxiety decreased from 15.3 to 11.2% (p = 0.26) between D1 and D7, while it increased in the control group from 9.7 to 15.7% (p = 0.045). Thus, the education group's change in anxiety (delta D7 - D1) was - 4.1%, while the control group's change was + 6%. CONCLUSION During an outbreak, providing health education to quarantined patients may be beneficial to reduce the psychological impact of the disease. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT05715593, retrospectively registered on 8/02/2023 https://clinicaltrials.gov/ct2/results?term=NCT05715593&Search=Search .
Collapse
Affiliation(s)
- Imen Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia.
| | - Amel Gara
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Hadhba Nasraoui
- Department of Emergency Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
| | - Meriem Kacem
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Amani Maatouk
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Oumeyma Trimeche
- Department of Endocrinology, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hela Abroug
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Cyrine Bennasrallah
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| | - Ines Bouanene
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Asma Sriha Belguith
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
| |
Collapse
|
16
|
Calpbinici P, Uzunkaya Öztoprak P. The Effect of Fear of COVID-19 on Women's Attitudes toward Cancer Screening and Healthy Lifestyle Behaviors: A Cross-Sectional Study. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2023; 21:45. [PMID: 37214638 PMCID: PMC10186287 DOI: 10.1007/s40944-023-00719-3] [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: 01/23/2023] [Revised: 04/04/2023] [Accepted: 04/30/2023] [Indexed: 05/24/2023]
Abstract
Purpose The study was conducted to evaluate the effect of fear of COVID-19 on women's attitudes toward cancer screening and healthy lifestyle behaviors. Method The study is of descriptive and cross-sectional type. The sample of the study consisted of 221 women living in Turkey. Research data were collected using Introductory Information Form, Attitude Scale for Cancer Screening, The Fear of COVID-19 Scale and Healthy Lifestyle Behaviors Scale II (HLBS-II). Results It was found out that 92.3% of the women did not have cancer screening during the pandemic period, 33.0% of the women who did not have it because they were afraid of the contamination, 33.0% thought they were healthy, 13.1% did not have screening tests because they thought that screening tests were not easy and accessible during the pandemic period. While no significant relationship was found between women's attitudes toward cancer screenings and fear of COVID-19 (P > 0.05), a positive significant relationship was found between women's attitudes toward cancer screenings and spiritual growth, health responsibility and interpersonal relations scores, which are sub-dimensions of the HLBS-II scale (P > 0.05). In addition, it was found out that women's fear of COVID-19 affected interpersonal relations and stress management (P < 0.05). Conclusion In our study, it was concluded that most of the women did not have cancer screening during the pandemic, and that the fear of COVID-19 affected such healthy lifestyle behaviors as interpersonal relations and stress management.
Collapse
Affiliation(s)
- Pelin Calpbinici
- Department of Obstetrics and Gynecology Nursing, Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir Hacı Bektaş Veli University, Nevşehir, Turkey
| | - Pınar Uzunkaya Öztoprak
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| |
Collapse
|
17
|
Li D, Hu Y, Liu S, Li G, Lu C, Yuan S, Zhang Z. The effect of using internet hospitals on the physician-patient relationship: Patient perspective. Int J Med Inform 2023; 174:105058. [PMID: 37002986 DOI: 10.1016/j.ijmedinf.2023.105058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Internet hospitals are rapidly developing in China. Despite many studies regarding internet hospitals, there has been little further research that evaluates the impact of using internet hospitals on the physician-patient relationship during outpatient visits. METHODS We developed a questionnaire based on the patient-doctor relationship questionnaire (PDRQ-9) to survey the physician-patient relationship. A sample of 505 patients who sought medical services from offline physical or internet hospitals was selected by convenience sampling. Multiple linear regression analysis was performed to determine whether the use of internet hospitals during outpatient visits was associated with the physician-patient relationship. RESULTS Internet hospital users gave significantly lower scores than nonusers in total physician-patient relationship scores (P =.01) and in the 5 items of "My physician helps me" (P <.001), "I trust my physician" (P =.001), "My physician understands me" (P =.002), "My physician and I agree on the nature of my medical symptoms" (P =.01), and "I can talk to (communicate with) my physician freely" (P =.005). Multiple linear regression results showed that the use of internet hospitals during outpatient visits influenced the physician-patient relationship. And after controlling for other patient characteristics, the use of internet hospitals decreased the physician-patient relationship scores by 11.9%. CONCLUSIONS Our findings suggest that the current use of internet hospitals could not significantly enhance the physician-patient relationship during outpatient visits. Therefore, we should work on improving physicians' online communication skills and strengthening the level of trust between physicians and their patients. Policymakers should also pay close attention to the gap of the physician-patient relationship between internet hospitals and offline physical hospitals.
Collapse
Affiliation(s)
- Dehe Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Yinhuan Hu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Sha Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Gang Li
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Chuntao Lu
- Jingmen No. 2 People's Hospital, Jingmen, Hubei, China.
| | - Shaochun Yuan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Zemiao Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| |
Collapse
|
18
|
Huang F, Liu H. The impact of the COVID-19 pandemic and related policy responses on non-COVID-19 healthcare utilization in China. HEALTH ECONOMICS 2023; 32:620-638. [PMID: 36397307 DOI: 10.1002/hec.4636] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/20/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
We investigate the impact of the COVID-19 pandemic and related policy responses on non-COVID-19 healthcare utilization (i.e., different types of outpatient care) up to October 2020 in China. Using an administrative database from a large prefecture-level city, we find that both direct exposure to the COVID-19 pandemic and the strict containment policy responses led to reductions in outpatient care utilization. The largest decline during the lockdown was observed in preventive care visits, which nevertheless recovered to pre-pandemic levels 2 months after the lockdown. The disruptions in prenatal care visits could not be offset by the recovery later on. Chronic care and emergency department visits had not returned to pre-pandemic levels as of October 2020, which may be driven by extended days' supply of prescription medication, increased use of telemedicine, and improved health-protective behaviors. In the reopening period, there were increases in visits for mental and sleep disorders, especially among children, and for medical abortion. Among health facilities at all levels, primary care facilities saw the least reductions in total outpatient visits. Our results emphasize the need for strategies to ensure access to urgent or essential care services when managing the current epidemiologic transition and future crises.
Collapse
Affiliation(s)
- Feng Huang
- School of Economics, Shanghai University of Finance and Economics, Shanghai, China
| | - Hong Liu
- School of Labor and Human Resources, Renmin University of China, Beijing, China
| |
Collapse
|
19
|
Cheng ZJ, Zhan Z, Xue M, Zheng P, Lyu J, Ma J, Zhang XD, Luo W, Huang H, Zhang Y, Wang H, Zhong N, Sun B. Public Health Measures and the Control of COVID-19 in China. Clin Rev Allergy Immunol 2023; 64:1-16. [PMID: 34536214 PMCID: PMC8449219 DOI: 10.1007/s12016-021-08900-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 01/26/2023]
Abstract
In December 2019, the COVID-19 pandemic quickly spread throughout China and beyond, posing enormous global challenges. With prompt, vigorous, and coordinated control measures, mainland China contained the spread of the epidemic within two months and halted the epidemic in three months. Aggressive containment strategy, hierarchical management, rational reallocation of resources, efficient contact tracing, and voluntary cooperation of Chinese citizens contributed to the rapid and efficient control of the epidemic, thus promoting the rapid recovery of the Chinese economy. This review summarizes China's prevention and control strategies and other public health measures, which may provide a reference for the epidemic control in other countries.
Collapse
Affiliation(s)
- Zhangkai Jason Cheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhiqing Zhan
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China ,Guangzhou Medical University, Guangzhou, China
| | - Mingshan Xue
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Peiyan Zheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiali Lyu
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jing Ma
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Wenting Luo
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huimin Huang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yong Zhang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongman Wang
- The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Nanshan Zhong
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
20
|
Navarro Martínez O, Igual García J, Salcedo VT. Nurses' view of benefits, enablers and constraints to the use of digital health tools with patients: A cross-sectional study. Digit Health 2023; 9:20552076231197339. [PMID: 37675060 PMCID: PMC10478564 DOI: 10.1177/20552076231197339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Digital literacy helps patients to be more informed in order to make decisions about their health. Patient empowerment in the digital realm is a duty for all healthcare professionals, but nurses are the most numerous professionals in all healthcare systems worldwide. In addition, they have an important role in health education and patient follow-up. Therefore, the use of digital tools, by nurses to empower and help patients know more about their health, is crucial. Objective This study was conducted to identify nurses' views on the benefits as well as constraints nurses encounter when using digital resources to empower and educate their patients. We sought to identify enablers that could help nurses use technology with their patients as a means to reinforce the care and advice they offer them. Methods An online ad hoc questionnaire was answered by 848 currently employed Spanish nurses on the benefits of using digital media with their patients, as well as on the constraints and enablers during implementation. Results The majority of the nurses considered that reliable digital information would reduce unnecessary consultations. In addition, they think that at least 50% of their patients could benefit from consulting information online. Among the constraints, nurses mainly pointed out the older age and low educational level of their patients. Younger nurses are the most likely nurses to see patient age as a problem. As for enablers, nurses pointed out the training offered to patients as well as digital tools being user-friendly for patients. Conclusions It is crucial to work while following a lifelong learning strategy, with training from university education as well as training from healthcare institutions to reduce the digital gap that affects patients' digital empowerment.
Collapse
Affiliation(s)
| | - Jorge Igual García
- Higher Technical School of Telecommunication Engineering, Universitat Politècnica de València, Valencia, Spain
| | | |
Collapse
|
21
|
Maimaitiming M, Xie J, Zheng Z, Zhu Y. Effect of the Announcement of Human-to-Human Transmission on Telemedicine Services in China During COVID-19. Disaster Med Public Health Prep 2022; 17:e311. [PMID: 36503653 PMCID: PMC9947051 DOI: 10.1017/dmp.2022.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Telemedicine enables patients to communicate with physicians effectively, especially during the coronavirus disease (COVID-19) pandemic. However, few studies have explored the use of online health care platforms for a comprehensive range of specialties during the COVID-19 pandemic. This study aimed to investigate how telemedicine services were affected by the announcement of human-to-human transmission in China. METHODS Telemedicine data from haodf.com in China were collected. A difference-in-differences analysis compared the number of telemedicine use and the number of active online physicians for different specialties in 2020 with the numbers in 2019, before and after the announcement of human-to-human transmission. RESULTS Data from 2 473 734 telemedicine use during the same calendar time in 2020 and 2019 were collected. Telemedicine use in 2020 increased by 349.9% after the announcement of human-to-human transmission in China, and the number of active online physicians increased by 23.2%. The difference-in-differences analysis indicated that the announcement had statistically significant positive effects on the numbers of telemedicine use for almost all specialties, except cosmetic dermatology, pathology, occupational diseases, sports medicine, burn, medical imaging, and interventional medicine. CONCLUSION Telemedicine services increased significantly after the announcement of human-to-human transmission of COVID-19. Online activities of most specialties increased, except where providers had to conduct in-person testing and provide bedside therapies.
Collapse
Affiliation(s)
| | - Jingui Xie
- School of Management, Technical University of Munich, Heilbronn, Germany
| | - Zhichao Zheng
- Lee Kong Chian School of Business, Singapore Management University, Singapore
| | - Yongjian Zhu
- School of Management, University of Science and Technology of China, Hefei, China
- Corresponding author: Yongjian Zhu,
| |
Collapse
|
22
|
Bu F, Sun H, Li L, Tang F, Zhang X, Yan J, Ye Z, Huang T. Artificial intelligence-based internet hospital pharmacy services in China: Perspective based on a case study. Front Pharmacol 2022; 13:1027808. [PMID: 36438784 PMCID: PMC9682042 DOI: 10.3389/fphar.2022.1027808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Background: Recently, internet hospitals have been emerging in China, saving patients time and money during the COVID-19 pandemic. In addition, pharmacy services that link doctors and patients are becoming essential in improving patient satisfaction. However, the existing internet hospital pharmacy service mode relies primarily on manual operations, making it cumbersome, inefficient, and high-risk. Objective: To establish an internet hospital pharmacy service mode based on artificial intelligence (AI) and provide new insights into pharmacy services in internet hospitals during the COVID-19 pandemic. Methods: An AI-based internet hospital pharmacy service mode was established. Initially, prescription rules were formulated and embedded into the internet hospital system to review the prescriptions using AI. Then, the “medicine pick-up code,” which is a Quick Response (QR) code that represents a specific offline self-pick-up order, was created. Patients or volunteers could pick up medications at an offline hospital or drugstore by scanning the QR code through the window and wait for the dispensing machine or pharmacist to dispense the drugs. Moreover, the medication consultation function was also operational. Results: The established internet pharmacy service mode had four major functional segments: online drug catalog search, prescription preview by AI, drug dispensing and distribution, and AI-based medication consultation response. The qualified rate of AI preview was 83.65%. Among the 16.35% inappropriate prescriptions, 49% were accepted and modified by physicians proactively and 51.00% were passed after pharmacists intervened. The “offline self-pick-up” mode was preferred by 86% of the patients for collecting their medication in the internet hospital, which made the QR code to be fully applied. A total of 426 medication consultants were served, and 48.83% of them consulted outside working hours. The most frequently asked questions during consultations were about the internet hospital dispensing process, followed by disease diagnosis, and patient education. Therefore, an AI-based medication consultation was proposed to respond immediately when pharmacists were unavailable. Conclusion: The established AI-based internet hospital pharmacy service mode could provide references for pharmacy departments during the COVID-19 pandemic. The significance of this study lies in ensuring safe/rational use of medicines and raising pharmacists’ working efficiency.
Collapse
Affiliation(s)
- Fengjiao Bu
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Hong Sun
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Ling Li
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Fengmin Tang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xiuwen Zhang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jingchao Yan
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Zhengqiang Ye
- Information Center, Eye & ENT Hospital, Fudan University, Shanghai, China
- *Correspondence: Taomin Huang, ; Zhengqiang Ye,
| | - Taomin Huang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
- *Correspondence: Taomin Huang, ; Zhengqiang Ye,
| |
Collapse
|
23
|
Galo NR, Roriz Junior MP, Tóffano Pereira RP. A fuzzy approach to support decision-making in the triage process for suspected COVID-19 patients in Brazil. Appl Soft Comput 2022; 129:109626. [PMID: 36157968 PMCID: PMC9487152 DOI: 10.1016/j.asoc.2022.109626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022]
Abstract
Triage is a fundamental process in hospitals and emergency care units, as it allows for the classification and prioritization of patient care based on the severity of their clinical conditions. In Brazil, the triage of suspected COVID-19 cases is performed using a specific protocol, which involves manual steps, requiring the completion of four different forms, by four health care professionals. Aiming to investigate the possibility of improving the triage processes in Brazil, this article proposes the use of computational techniques for decision-making based on fuzzy inference systems. We argue that fuzzy set theory is appropriate to the problem because it allows the use of natural language to express the patient’s symptoms, making it easier for health care professionals. After modelling the problem in a fuzzy system we applied a pilot test. The model includes symptoms that health professionals currently use to analyse COVID-19 cases. The results suggest that the model presents convergence with the sample data, highlighting its potential application in supporting triage for the classification of the severity of COVID-19 cases. Among the benefits of the proposed model, we emphasize contributions as the reduction of the time and number of professionals required for triage as well as the reduction of exposure of health care professionals and other patients suspected of carrying the virus. In this context, this research provides an opportunity to obtain social contributions regarding the services in public hospitals improvement.
Collapse
Affiliation(s)
- Nadya Regina Galo
- Federal University of Goiás, Faculty of Sciences and Technology, Mucuri Street s/n, Setor Conde dos Arcos, Aparecida de Goiânia, Goiás, Brazil
| | - Marcos Paulino Roriz Junior
- Federal University of Goiás, Faculty of Sciences and Technology, Mucuri Street s/n, Setor Conde dos Arcos, Aparecida de Goiânia, Goiás, Brazil
| | - Rodrigo Pinheiro Tóffano Pereira
- Federal University of Goiás, Faculty of Sciences and Technology, Mucuri Street s/n, Setor Conde dos Arcos, Aparecida de Goiânia, Goiás, Brazil
| |
Collapse
|
24
|
Xiong HY, Zhang G, Wang L, Li Z, Shen Q, Li Y, Zhu H, Du Y, Sun L, Zhao B, Zhao L, Fu H, Li X, Gao X, Hao S, Ding J, Chen Z, Xu Z, Liu X, Tao Y, Zhang A, Li Q, Wang M. Psychological research of the children with chronic kidney disease and their guardians during the COVID-19 pandemic. Front Public Health 2022; 10:922678. [PMID: 36324445 PMCID: PMC9621117 DOI: 10.3389/fpubh.2022.922678] [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: 04/18/2022] [Accepted: 09/27/2022] [Indexed: 01/22/2023] Open
Abstract
Background There is great mental stress due to the coronavirus disease 2019 (COVID-19) pandemic. However, there are no detailed psychological studies of the children with chronic kidney disease (CKD) and their guardians during the COVID-19 pandemic. Objective This study explores the psychological pressure on children with CKD and their guardians. Methods An online survey was conducted at 20 of the largest pediatric nephropathy departments in China, including the Rutter Parent Questionnaire, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Overall, 885 children (589 children with CKD associated with 296 children of the control group) completed the survey together with their guardians. Results There was no statistical difference between CKD children and control children regarding their Rutter behavior scores and abnormal behaviors. Nevertheless, the abnormal behavior of children might aggravate the anxiety and depression of guardians in both CKD and control groups (p < 0.05). We confirmed that the anxiety and depression of guardians in the CKD group were both significantly higher than those in the control group (p < 0.05). The guardians in the CKD group with lower annual income were more likely to experience anxiety (p < 0.05). Furthermore, the guardians whose children were older than 11 years old might be more anxious than those who were 6-11 years old. Besides, the guardians in the CKD group who watched the news for 30-60 min daily were less likely to have depression than those who watched < 10 min (p < 0.05). The subgroup results showed that the gender, the time of watching the news, the annual income of guardians, and children's age might be the most critical factors influencing guardians' psychological burden. Conclusion The guardians in the CKD group have more severe anxiety and depression during the pandemic. The children's abnormal behavior, adolescents' pressure, low household income, and the panic about the pandemic may be the main reasons for the anxiety and depression of guardians.
Collapse
Affiliation(s)
- Hua-Ying Xiong
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Gaofu Zhang
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Wang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhijuan Li
- Department of Nephrology, Xi'an Children's Hospital, Xi'an, China
| | - Qian Shen
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Yuhong Li
- Department of Nephrology, Guiyang Children's Hospital, Guiyang, China
| | - Hongtao Zhu
- Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Yue Du
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liangzhong Sun
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bo Zhao
- Department of Nephrology, Kunming Children's Hospital, Kunming, China
| | - Lijun Zhao
- Department of Nephrology, Shanxi Children's Hospital, Taiyuan, China
| | - Haidong Fu
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Li
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaojie Gao
- Department of Nephrology, Shenzhen Children's Hospital, Shenzhen, China
| | - Sheng Hao
- Department of Nephrology and Rheumatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Juanjuan Ding
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zongwen Chen
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - Zhiquan Xu
- Department of Nephrology, Rheumatology, and Immunology, Hainan Women and Children's Medical Center, Haikou, China
| | - Xiaorong Liu
- Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yuhong Tao
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Aihua Zhang
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qiu Li
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Mo Wang
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Mo Wang
| |
Collapse
|
25
|
Liu X, Xu Z, Yu X, Oda T. Using Telemedicine during the COVID-19 Pandemic: How Service Quality Affects Patients' Consultation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12384. [PMID: 36231685 PMCID: PMC9565113 DOI: 10.3390/ijerph191912384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 epidemic put pressure on the traditional healthcare system and offline consultation methods. Telemedicine platforms provide a more convenient and safer channel for online health communication. Based on the signaling theory, our study explores the impacts of three dimensions of physicians' service quality (need fulfillment, security, and responsiveness) on online patient consultation on telemedicine platforms. A negative binomial model was used to test cross-sectional data of 2982 physicians obtained from Haodf.com. The results show the following: (1) the need fulfillment dimension variables positively affect online patient consultation; (2) the security dimension variables positively affect online patient consultation; (3) the responsiveness dimension variables positively affect online patient consultation. Our results contribute to the theoretical aspect of signaling theory and service quality in the context of telemedicine platforms and have several practical implications for telemedicine platform physicians and platform operators.
Collapse
Affiliation(s)
- Xiaochen Liu
- Graduate School of Technology Management, Ritsumeikan University, Ibaraki 567-8570, Japan
| | - Zhen Xu
- School of Communication, East China University of Political Science and Law, Shanghai 201620, China
| | - Xintao Yu
- School of Economics and Management, Liaoning University of Technology, Jinzhou 121001, China
| | - Tetsuaki Oda
- Graduate School of Technology Management, Ritsumeikan University, Ibaraki 567-8570, Japan
| |
Collapse
|
26
|
Zhu Y, Liu Y, Jiang H. Geriatric Health Care During the COVID-19 Pandemic: Managing the Health Crisis. Clin Interv Aging 2022; 17:1365-1378. [PMID: 36158515 PMCID: PMC9491878 DOI: 10.2147/cia.s376519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/20/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 pandemic significantly threatens the health and well-being of older adults. Aging-related changes, including multimorbidity, weakened immunity and frailty, may make older people more susceptible to severe infection and place them at higher risk of morbidity and mortality from COVID-19. Various quarantine measures have been implemented to control the spread of COVID-19. Nevertheless, such social distancing has disrupted routine health care practices, such as accessibility of medical services and long-term continuous care services. The medical management of older adults with multimorbidity is significantly afflicted by COVID-19. Older persons with frailty or multiple chronic disease may poorly adapt to the altered health care system, having detrimental consequences on their physical and mental health. COVID-19 pandemic has posed great challenges to the health of older adults. We highlighted the difficulties and obstacles of older adults during this unprecedented time. Also, we provided potential strategies and recommendations for actions to mitigate the COVID-19 pandemic threats. Certain strategies like community primary health care, medication delivery and home care support are adopted by many health facilities and caregivers, whereas other services such as internet hospital and virtual medical care are promoted to be accessible in many regions. However, guidelines and policies based on high-quality data are still needed for better health promotion of older groups with increasing resilience during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Yingqian Zhu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
| | - Yue Liu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
| | - Hua Jiang
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China.,Department of General Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, People's Republic of China
| |
Collapse
|
27
|
Dai MF, Li SY, Zhang JF, Wang BY, Zhou L, Yu F, Xu H, Ge WH. Warfarin anticoagulation management during the COVID-19 pandemic: The role of internet clinic and machine learning. Front Pharmacol 2022; 13:933156. [PMID: 36225580 PMCID: PMC9549053 DOI: 10.3389/fphar.2022.933156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/30/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Patients who received warfarin require constant monitoring by hospital staff. However, social distancing and stay-at-home orders, which were universally adopted strategies to avoid the spread of COVID-19, led to unprecedented challenges. This study aimed to optimize warfarin treatment during the COVID-19 pandemic by determining the role of the Internet clinic and developing a machine learning (ML) model to predict anticoagulation quality. Methods: This retrospective study enrolled patients who received warfarin treatment in the hospital anticoagulation clinic (HAC) and “Internet + Anticoagulation clinic” (IAC) of the Nanjing Drum Tower Hospital between January 2020 and September 2021. The primary outcome was the anticoagulation quality of patients, which was evaluated by both the time in therapeutic range (TTR) and international normalized ratio (INR) variability. Anticoagulation quality and incidence of adverse events were compared between HAC and IAC. Furthermore, five ML algorithms were used to develop the anticoagulation quality prediction model, and the SHAP method was introduced to rank the feature importance. Results: Totally, 241 patients were included, comprising 145 patients in the HAC group and 96 patients in the IAC group. In the HAC group and IAC group, 73.1 and 69.8% (p = 0.576) of patients achieved good anticoagulation quality, with the average TTR being 79.9 ± 20.0% and 80.6 ± 21.1%, respectively. There was no significant difference in the incidence of adverse events between the two groups. Evaluating the five ML models using the test set, the accuracy of the XGBoost model was 0.767, and the area under the receiver operating characteristic curve was 0.808, which showed the best performance. The results of the SHAP method revealed that age, education, hypertension, aspirin, and amiodarone were the top five important features associated with poor anticoagulation quality. Conclusion: The IAC contributed to a novel management method for patients who received warfarin during the COVID-19 pandemic, as effective as HAC and with a low risk of virus transmission. The XGBoost model could accurately select patients at a high risk of poor anticoagulation quality, who could benefit from active intervention.
Collapse
Affiliation(s)
- Meng-Fei Dai
- Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Shu-Yue Li
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
- Department of Pharmacy, Shanxi Province Cancer Hospital, Taiyuan, China
| | | | - Bao-Yan Wang
- Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Lin Zhou
- Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Feng Yu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Hang Xu
- Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- *Correspondence: Hang Xu, ; Wei-Hong Ge,
| | - Wei-Hong Ge
- Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- *Correspondence: Hang Xu, ; Wei-Hong Ge,
| |
Collapse
|
28
|
Valls Martínez MDC, Grasso MS, Montero JM. Regional well-being inequalities arising from healthcare expenditure public policies in Spain. Front Public Health 2022; 10:953827. [PMID: 36211653 PMCID: PMC9533108 DOI: 10.3389/fpubh.2022.953827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Well-being inequalities arising from different healthcare expenditure public policies is currently a hot topic at a national scale, but especially so at a sub-national level because the inequalities in question are among citizens of the same country. Spain is an optimal study area to carry out research on this topic because it is considered to have one of the best health systems in the world, it is one of the top-ranking countries in terms of life expectancy rates (the indicators we use for well-being), and it has a decentralized public health system with significantly different regional healthcare expenditure public policies. Given that the factors involved in the complex direct, indirect, and second-order relationships between well-being and health spending are latent in nature, and that there are more hypotheses than certainties regarding these relationships, we propose a partial least squares structural equation modeling specification to test the research hypotheses and to estimate the corresponding impacts. These constructs are proxied by a set of 26 indicators, for which annual values at a regional scale were used for the period 2005-2018. From the estimation of this model, it can be concluded that mortality, expenditure and resources are the factors that have the greatest impact on well-being. In addition, a cluster analysis of the indicators for the constructs included in this research reveals the existence of three clearly differentiated groups of autonomous communities: the northern part of the country plus Extremadura (characterized by the lowest well-being and the highest mortality rates), Madrid (with the best results in well-being and mortality, the lowest public health expenditure per inhabitant and percentage of pharmaceutical spending, and the highest percentage in specialty care services and medical staff spending), and the rest of the country (south-eastern regions, with similar well-being values to those of the first group but with less health expenditure). Finally, a principal component analysis reveals that "healthiness" and "basic spending" are the optimal factors for mapping well-being and health spending in Spain.
Collapse
Affiliation(s)
- María del Carmen Valls Martínez
- European Research Center on Economics and Sustainable Development, Economics and Business Department, University of Almería, Almería, Spain
| | - Mayra Soledad Grasso
- European Research Center on Economics and Sustainable Development, Economics and Business Department, University of Almería, Almería, Spain
| | - José-María Montero
- Department of Political Economy and Public Finance, Economic and Business Statistics, and Economic Policy, University of Castilla-La Mancha, Toledo, Spain
| |
Collapse
|
29
|
Liu X, Xu Z, Yu X, Oda T. Why should I consult? The impact of social support on patient consultation in online healthcare communities. Front Psychol 2022; 13:993088. [PMID: 36204749 PMCID: PMC9530996 DOI: 10.3389/fpsyg.2022.993088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 epidemic put the traditional healthcare system and offline consultation method under strain. Patient consultations through online healthcare communities (OHCs) provide patients and physicians with a more convenient and secure route. Based on the social support theory, this study explores the impact of three dimensions of social support from physicians—information diagnosticity, source credibility, and emotional support—on patient consultations in OHCs and their moderating effect on patients’ compliments. We utilized Python Spiders to retrieve data from Haodf.com and gathered 2,982 physician reports. The model uses OLS regression with fixed effect estimations. The results show that these three dimensions of social support are positively impacted by consultation. Furthermore, patients’ compliments weaken the positive relationship between the three dimensions of physicians’ social support and patient consultations. This study contributes to the literature on social support theory in OHCs by exploring the physicians’ social support dimension and its impact on patient consultation. Moreover, this study makes practical contributions to physicians and platform administrators in OHCs.
Collapse
Affiliation(s)
- Xiaochen Liu
- Graduate School of Technology Management, Ritsumeikan University, Osaka, Japan
| | - Zhen Xu
- School of Communication, East China University of Political Science and Law, Shanghai, China
| | - Xintao Yu
- School of Economics and Management, Liaoning University of Technology, Jinzhou, China
- *Correspondence: Xintao Yu,
| | - Tetsuaki Oda
- Graduate School of Technology Management, Ritsumeikan University, Osaka, Japan
| |
Collapse
|
30
|
Ganjali R, Jajroudi M, Kheirdoust A, Darroudi A, Alnattah A. Telemedicine solutions for clinical care delivery during COVID-19 pandemic: A scoping review. Front Public Health 2022; 10:937207. [PMID: 35937265 PMCID: PMC9354887 DOI: 10.3389/fpubh.2022.937207] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/24/2022] [Indexed: 01/04/2023] Open
Abstract
Background: The unexpected emergence of coronavirus disease 2019 (COVID-19) has changed mindsets about the healthcare system and medical practice in many fields, forcing physicians to reconsider their approaches to healthcare provision. It is necessary to add new, unique, and efficient solutions to traditional methods to overcome this critical challenge. In this regard, telemedicine offers a solution to this problem. Remote medical activities could diminish unnecessary visits and provide prompt medical services in a timely manner. Objective This scoping review aimed to provide a map of the existing evidence on the use of telemedicine during the COVID-19 pandemic by focusing on delineation functions and technologies, analyzing settings, and identifying related outcomes. Methods This review was conducted following the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed and Scopus databases were systematically searched based on specific eligibility criteria. The English publications included in this study focused on telemedicine systems implemented during the COVID-19 pandemic to provide clinical care services. Two independent reviewers screened the articles based on predefined inclusion and exclusion criteria. The relevant features of telemedicine systems were summarized and presented into the following four domains and their subcategories, including functionality, technology, context, and outcomes. Results Out of a total of 1,602 retrieved papers, 66 studies met the inclusion criteria. The most common function implemented was counseling, and telemedicine was used for diagnosis in seven studies. In addition, in 12 studies, tele-monitoring of patients was performed by phone, designed platforms, social media, Bluetooth, and video calls. Telemedicine systems were predominantly implemented synchronously (50 studies). Moreover, 10 studies used both synchronous and asynchronous technologies. Although most studies were performed in outpatient clinics or centers, three studies implemented a system for hospitalized patients, and four studies applied telemedicine for emergency care. Telemedicine was effective in improving 87.5% of health resource utilization outcomes, 85% of patient outcomes, and 100% of provider outcomes. Conclusion The benefits of using telemedicine in medical care delivery systems in pandemic conditions have been well–documented, especially for outpatient care. It could potentially improve patient, provider, and healthcare outcomes. This review suggests that telemedicine could support outpatient and emergency care in pandemic situations. However, further studies using interventional methods are required to increase the generalizability of the findings.
Collapse
Affiliation(s)
- Raheleh Ganjali
- Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- *Correspondence: Raheleh Ganjali
| | - Mahdie Jajroudi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Kheirdoust
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Darroudi
- Department of Health Information Technology, Faculty of Paramedicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Ashraf Alnattah
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
31
|
Tesfa GA, Yehualashet DE, Ewune HA, Zemeskel AG, Kalayou MH, Seboka BT. eHealth Literacy and its Associated Factors Among Health Professionals During the COVID-19 Pandemic in Resource-Limited Settings: Cross-sectional Study. JMIR Form Res 2022; 6:e36206. [PMID: 35737897 PMCID: PMC9285670 DOI: 10.2196/36206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/26/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic has wreaked havoc on health care systems and governments worldwide. Although eHealth literacy is acknowledged as a critical component of public health, it was overlooked during the pandemic. To assist patients and their families, health professionals should be knowledgeable about online health information resources and capable of evaluating relevant online information. In a resource-constrained situation, the level of eHealth literacy among health professionals is not well documented. Objective The aim of this study was to assess the eHealth literacy level and its associated factors among health professionals working in Amhara regional state teaching hospitals, Ethiopia. Methods A self-administered questionnaire was used in an institutional-based cross-sectional study design. Descriptive statistics were calculated to describe eHealth literacy statements and key variables using SPSS v.24. Bivariable and multivariable logistic regression models were fit to identify factors related to eHealth literacy. Variables with P<.05 were declared to be statistically significant predictors. Results A total of 383 participants completed and returned the questionnaire with a response rate of 90.5%. Health professionals demonstrated a moderate level of eHealth literacy (mean 29.21). Most of the professionals were aware of the available health resources located on the internet, and know how to search and locate these resources. However, they lack the ability to distinguish high-quality health resources from low-quality resources. Factors that were significantly associated with eHealth literacy were computer access, computer knowledge, perceived ease of use, and perceived usefulness of eHealth information resources. Conclusions It is crucial to provide training and support to health care workers on how to find, interpret, and, most importantly, evaluate the quality of health information found on the internet to improve their eHealth literacy level. Further research is needed to explore the role of eHealth literacy in mitigating pandemics in developing countries.
Collapse
Affiliation(s)
- Getanew Aschalew Tesfa
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | | | - Helen Ali Ewune
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Addisu Getnet Zemeskel
- Department of Midwifery, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Mulugeta Hayelom Kalayou
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Wollo, Ethiopia
| | - Binyam Tariku Seboka
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| |
Collapse
|
32
|
Belciug S. Learning deep neural networks' architectures using differential evolution. Case study: Medical imaging processing. Comput Biol Med 2022; 146:105623. [PMID: 35751202 PMCID: PMC9112664 DOI: 10.1016/j.compbiomed.2022.105623] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/03/2022] [Accepted: 03/31/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has changed the way we practice medicine. Cancer patient and obstetric care landscapes have been distorted. Delaying cancer diagnosis or maternal-fetal monitoring increased the number of preventable deaths or pregnancy complications. One solution is using Artificial Intelligence to help the medical personnel establish the diagnosis in a faster and more accurate manner. Deep learning is the state-of-the-art solution for image classification. Researchers manually design the structure of fix deep learning neural networks structures and afterwards verify their performance. The goal of this paper is to propose a potential method for learning deep network architectures automatically. As the number of networks architectures increases exponentially with the number of convolutional layers in the network, we propose a differential evolution algorithm to traverse the search space. At first, we propose a way to encode the network structure as a candidate solution of fixed-length integer array, followed by the initialization of differential evolution method. A set of random individuals is generated, followed by mutation, recombination, and selection. At each generation the individuals with the poorest loss values are eliminated and replaced with more competitive individuals. The model has been tested on three cancer datasets containing MRI scans and histopathological images and two maternal-fetal screening ultrasound images. The novel proposed method has been compared and statistically benchmarked to four state-of-the-art deep learning networks: VGG16, ResNet50, Inception V3, and DenseNet169. The experimental results showed that the model is competitive to other state-of-the-art models, obtaining accuracies between 78.73% and 99.50% depending on the dataset it had been applied on.
Collapse
|
33
|
Ge F, Qian H, Lei J, Ni Y, Li Q, Wang S, Ding K. Experiences and Challenges of Emerging Online Health Services Combating COVID-19 in China: A Retrospective, Cross-sectional Study of Internet Hospitals. JMIR Med Inform 2022; 10:e37042. [PMID: 35500013 PMCID: PMC9162135 DOI: 10.2196/37042] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background Internet-based online virtual health services were originally an important way for the Chinese government to resolve unmet medical service needs due to inadequate medical institutions. Its initial development was not well received. Then, the unexpected COVID-19 pandemic produced a tremendous demand for telehealth in a short time, which stimulated the explosive development of internet hospitals. The Second Affiliated Hospital of Zhejiang University (SAHZU) has taken a leading role in the construction of internet hospitals in China. The pandemic triggered the hospital to develop unique research on health service capacity under strict quarantine policies and to predict long-term trends. Objective This study aims to provide policy enlightenment for the construction of internet-based health services to better fight against COVID-19 and to elucidate future directions through an in-depth analysis of 2 years of online health service data gleaned from SAHZU’s experiences and lessons learned. Methods We collected data from SAHZU Internet Hospital from November 1, 2019, to September 16, 2021. Data from over 900,000 users were analyzed with respect to demographic characteristics, demands placed on departments by user needs, new registrations, and consultation behaviors. Interrupted time series (ITS) analysis was adopted to evaluate the impact of this momentous emergency event and its long-term trends. With theme analysis and a defined 2D model, 3 investigations were conducted synchronously to determine users’ authentic demands on online hospitals. Results The general profile of internet hospital users is young or middle-aged women who live in Zhejiang and surrounding provinces. The ITS model indicated that, after the intervention (the strict quarantine policies) was implemented during the outbreak, the number of internet hospital users significantly increased (β_2=105.736, P<.001). Further, long-term waves of COVID-19 led to an increasing number of users following the outbreak (β_3=0.167, P<.001). In theme analysis, we summarized 8 major demands by users of the SAHZU internet hospital during the national shutdown period and afterwards. Online consultations and information services were persistent and universal demands, followed by concerns about medical safety and quality, time, and cost. Users’ medical behavior patterns changed from onsite to online as internet hospital demands increased. Conclusions The pandemic has spawned the explosive growth of telehealth; as a public tertiary internet hospital, the SAHZU internet hospital is partially and irreversibly integrated into the traditional medical system. As we shared the practical examples of 1 public internet hospital in China, we put forward suggestions about the future direction of telehealth. Vital experience in the construction of internet hospitals was provided in the normalization of COVID-19 prevention and control, which can be demonstrated as a model of internet hospital management practice for other medical institutions.
Collapse
Affiliation(s)
- Fangmin Ge
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Huan Qian
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Jianbo Lei
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, CN
| | - Yiqi Ni
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Qian Li
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Song Wang
- School of Management, Zhejiang University, Hangzhou, CN
| | - Kefeng Ding
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| |
Collapse
|
34
|
Sun Y, Gao D, Shen X, Li M, Nan J, Zhang W. Multi-Label Classification in Patient-Doctor Dialogues With the RoBERTa-WWM-ext + CNN (Robustly Optimized Bidirectional Encoder Representations From Transformers Pretraining Approach With Whole Word Masking Extended Combining a Convolutional Neural Network) Model: Named Entity Study. JMIR Med Inform 2022; 10:e35606. [PMID: 35451969 PMCID: PMC9073616 DOI: 10.2196/35606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background With the prevalence of online consultation, many patient-doctor dialogues have accumulated, which, in an authentic language environment, are of significant value to the research and development of intelligent question answering and automated triage in recent natural language processing studies. Objective The purpose of this study was to design a front-end task module for the network inquiry of intelligent medical services. Through the study of automatic labeling of real doctor-patient dialogue text on the internet, a method of identifying the negative and positive entities of dialogues with higher accuracy has been explored. Methods The data set used for this study was from the Spring Rain Doctor internet online consultation, which was downloaded from the official data set of Alibaba Tianchi Lab. We proposed a composite abutting joint model, which was able to automatically classify the types of clinical finding entities into the following 4 attributes: positive, negative, other, and empty. We adapted a downstream architecture in Chinese Robustly Optimized Bidirectional Encoder Representations from Transformers Pretraining Approach (RoBERTa) with whole word masking (WWM) extended (RoBERTa-WWM-ext) combining a text convolutional neural network (CNN). We used RoBERTa-WWM-ext to express sentence semantics as a text vector and then extracted the local features of the sentence through the CNN, which was our new fusion model. To verify its knowledge learning ability, we chose Enhanced Representation through Knowledge Integration (ERNIE), original Bidirectional Encoder Representations from Transformers (BERT), and Chinese BERT with WWM to perform the same task, and then compared the results. Precision, recall, and macro-F1 were used to evaluate the performance of the methods. Results We found that the ERNIE model, which was trained with a large Chinese corpus, had a total score (macro-F1) of 65.78290014, while BERT and BERT-WWM had scores of 53.18247117 and 69.2795315, respectively. Our composite abutting joint model (RoBERTa-WWM-ext + CNN) had a macro-F1 value of 70.55936311, showing that our model outperformed the other models in the task. Conclusions The accuracy of the original model can be greatly improved by giving priority to WWM and replacing the word-based mask with unit to classify and label medical entities. Better results can be obtained by effectively optimizing the downstream tasks of the model and the integration of multiple models later on. The study findings contribute to the translation of online consultation information into machine-readable information.
Collapse
Affiliation(s)
- Yuanyuan Sun
- Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.,Department of Internal Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Dongping Gao
- Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xifeng Shen
- Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Meiting Li
- Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jiale Nan
- Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Weining Zhang
- Institute of Medical Information, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| |
Collapse
|
35
|
Wu B, Luo P, Li M, Hu X. The Impact of Health Information Privacy Concerns on Engagement and Payment Behaviors in Online Health Communities. Front Psychol 2022; 13:861903. [PMID: 35465543 PMCID: PMC9024209 DOI: 10.3389/fpsyg.2022.861903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/08/2022] [Indexed: 12/15/2022] Open
Abstract
Online health communities (OHCs) have enjoyed increasing popularity in recent years, especially in the context of the COVID-19 pandemic. However, several concerns have been raised regarding the privacy of users’ personal information in OHCs. Considering that OHCs are a type of data-sharing or data-driven platform, it is crucial to determine whether users’ health information privacy concerns influence their behaviors in OHCs. Thus, by conducting a survey, this study explores the impact of users’ health information privacy concerns on their engagement and payment behavior (Paid) in OHCs. The empirical results show that users’ concerns about health information privacy reduce their Paid in OHCs by negatively influencing their OHC engagement. Further analysis reveals that if users have higher benefit appraisals (i.e., perceived informational and emotional support from OHCs) and lower threat appraisals (i.e., perceived severity and vulnerability of information disclosure from OHCs), the negative effect of health information privacy concerns on users’ OHC engagement will decrease.
Collapse
Affiliation(s)
- Banggang Wu
- Business School, Sichuan University, Chengdu, China
| | - Peng Luo
- Business School, Sichuan University, Chengdu, China
| | - Mengqiao Li
- School of Finance, Southwestern University of Finance and Economics, Chengdu, China
| | - Xiao Hu
- School of Finance, Southwestern University of Finance and Economics, Chengdu, China
- *Correspondence: Xiao Hu,
| |
Collapse
|
36
|
Quansah F, Hagan JE, Ankomah F, Srem-Sai M, Frimpong JB, Sambah F, Schack T. Relationship Between COVID-19 Related Knowledge and Anxiety Among University Students: Exploring the Moderating Roles of School Climate and Coping Strategies. Front Psychol 2022; 13:820288. [PMID: 35432145 PMCID: PMC9007403 DOI: 10.3389/fpsyg.2022.820288] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/17/2022] [Indexed: 12/12/2022] Open
Abstract
The emergence of the COVID-19 pandemic resulted in abrupt disruptions in teaching and learning activities in higher education, with students from diverse programs suffering varying levels of anxieties. The physical education field happens to be one of the most affected academic areas due to its experiential content as a medium of instruction. In this study, we investigated the roles of school climate and coping strategies in the relationship between COVID-19 related knowledge and anxiety. Through the census approach, a cross-sectional sample of 760 students was administered a questionnaire in two universities offering Physical Education in Ghana: the University of Education, Winneba, and University of Cape Coast. The outcome of the study found a positive and significant link between COVID-19 knowledge and anxiety. Further, school climate and coping strategies significantly moderated the relationship between students' COVID-19 knowledge and associated anxiety. The findings have implications for creating a conducive school environment that reduces the risk of COVID-19 infection and through students' adoption of active coping strategies in an attempt to reduce psychological distress associated with COVID-19 anxiety.
Collapse
Affiliation(s)
- Frank Quansah
- Department of Educational Foundations, University of Education, Winneba, Ghana
| | - John E. Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Francis Ankomah
- Department of Education and Psychology, University of Cape Coast, Cape Coast, Ghana
- Department of Education, SDA College of Education, Asokore-Koforidua, Ghana
| | - Medina Srem-Sai
- Department of Health, Physical Education, Recreation and Sports, University of Education, Winneba, Ghana
| | - James B. Frimpong
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Francis Sambah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
37
|
Ganjali R, Eslami S, Samimi T, Sargolzaei M, Firouraghi N, MohammadEbrahimi S, Khoshrounejad F, Kheirdoust A. Clinical informatics solutions in COVID-19 pandemic: Scoping literature review. INFORMATICS IN MEDICINE UNLOCKED 2022; 30:100929. [PMID: 35350124 PMCID: PMC8949656 DOI: 10.1016/j.imu.2022.100929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/06/2022] [Accepted: 03/22/2022] [Indexed: 01/11/2023] Open
Abstract
Background The global outbreak of COVID-19 (coronavirus disease 2019) disease has highlighted the importance of disease monitoring, diagnosing, treating, and screening. Technology-based instruments could efficiently assist healthcare systems during pandemics by allowing rapid and widespread transfer of information, real-time tracking of data transfer, and virtualization of meetings and patient visits. Therefore, this study was conducted to investigate the applications of clinical informatics (CI) during the COVID-19 outbreak. Methods A comprehensive search was performed on Medline and Scopus databases in September 2020. Eligible studies were selected based on the inclusion and exclusion criteria. The extracted data from the studies reviewed were about study sample, study type, objectives, clinical informatics domain, applied method, sample size, outcomes, findings, and conclusion. The risk of bias was evaluated in the studies using appropriate instruments based on the type of each study. The selected studies were then subjected to thematic synthesis. Results In this review study, 72 out of 2716 retrieved articles met the inclusion criteria for full-text analysis. Most of the articles reviewed were done in China and the United States of America. The majority of the studies were conducted in the following CI domains: prediction models (60%), telehealth (36%), and mobile health (4%). Most of the studies in telehealth domain used synchronous methods, such as online and phone- or video-call consultations. Mobile applications were developed as self-triage, self-scheduling, and information delivery tools during the COVID-19 pandemic. The most common types of prediction models among the reviewed studies were neural network (49%), classification (42%), and linear models (4.5%). Conclusion The present study showed clinical informatics applications during COVID-19 and identified current gaps in this field. Health information technology and clinical informatics seem to be useful in assisting clinicians and managers to combat COVID-19. The most common domains in clinical informatics for research on the COVID-19 crisis were prediction models and telehealth. It is suggested that future researchers conduct scoping reviews to describe and analyze other levels of medical informatics, including bioinformatics, imaging informatics, and public health informatics.
Collapse
Affiliation(s)
- Raheleh Ganjali
- Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Eslami
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, University of Amsterdam, Amsterdam, the Netherlands
| | - Tahereh Samimi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Sargolzaei
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Firouraghi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shahab MohammadEbrahimi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnaz Khoshrounejad
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Kheirdoust
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
38
|
Hagan JE, Quansah F, Anin SK, Sorkpor RS, Abieraba RSK, Frimpong JB, Srem-Sai M, Schack T. COVID-19-Related Knowledge and Anxiety Response among Physical Education Teachers during Practical In-Person Lessons: Effects of Potential Moderators. Behav Sci (Basel) 2022; 12:bs12030083. [PMID: 35323402 PMCID: PMC8944953 DOI: 10.3390/bs12030083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/16/2022] [Accepted: 03/15/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic has resulted in heightened anxiety levels among teachers, especially regarding PE teachers who are required to engage students in practical in-person or contact teaching lessons. Previous research showed that these levels of anxiety among PE teachers appeared to be explained by the interplay between COVID-19 knowledge, workplace safety perception, and educational qualification. This study assessed the relationship between COVID-19-related knowledge and anxiety response among PE teachers during such practical lessons while moderating the effects of workplace safety perception and educational qualification within the relationship. The study conveniently recruited 160 PE teachers to solicit responses through both online and printed questionnaires. Using correlation and linear regression analyses, the study revealed a significant negative relationship between COVID-19-related knowledge and anxiety response among PE teachers. The educational qualification of PE teachers did not significantly moderate the association between COVID-19-related knowledge and anxiety response. Workplace safety perception significantly moderated the association between COVID-19-related knowledge and anxiety response among PE teachers. The findings remind educational authorities about the essence of creating a positive and safe working environment conducive to academic work. Achieving this goal requires the provision of adequate COVID-19 management logistics (e.g., personal protective equipment, hand sanitizers) by educational authorities for PE teachers to maintain safety practices and optimal learning conditions.
Collapse
Affiliation(s)
- John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana;
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany;
- Correspondence:
| | - Frank Quansah
- Department of Educational Foundations, University of Education, Winneba P.O. Box 25, Ghana;
| | - Stephen Kofi Anin
- Department of Industrial and Health Sciences, Faculty of Applied Sciences, Takoradi Technical University, P.O. Box 256, Takoradi WS-200-1123, Ghana;
- School of Public Health, Bielefeld University, P.O. Box 100131, 33501 Bielefeld, Germany
| | - Richmond Stephen Sorkpor
- Department of Health, Physical Education, Recreation and Sports, University of Education, Winneba P.O. Box 25, Ghana; (R.S.S.); (R.S.K.A.); (M.S.-S.)
| | - Richard Samuel Kwadwo Abieraba
- Department of Health, Physical Education, Recreation and Sports, University of Education, Winneba P.O. Box 25, Ghana; (R.S.S.); (R.S.K.A.); (M.S.-S.)
| | - James Boadu Frimpong
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana;
| | - Medina Srem-Sai
- Department of Health, Physical Education, Recreation and Sports, University of Education, Winneba P.O. Box 25, Ghana; (R.S.S.); (R.S.K.A.); (M.S.-S.)
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany;
| |
Collapse
|
39
|
Li W, Shen S, Yang J, Guo J, Tang Q. Determinants of Satisfaction With Hospital Online Appointment Service Among Older Adults During the COVID-19 Pandemic: A Cross-Sectional Study. Front Public Health 2022; 10:853489. [PMID: 35252106 PMCID: PMC8894200 DOI: 10.3389/fpubh.2022.853489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundHow did older adults who had to use online medical service during the COVID-19 pandemic bridge the “digital divide”? Taking Internet-based appointment service (IBAS) as an example, this study aimed to investigate the subjective feelings of older adults and evaluate their user-satisfaction.MethodsThis study was based on data from a questionnaire survey involving 325 outpatients 60 years old in shanghai during the COVID-19 pandemic. The satisfaction of IBAS was evaluated and compared from six domains including convenience, visiting time, correct identification of specialists, on-site assist service, COVID-19 prevention, and privacy protection. Logistic regression analysis was used to investigate the correlation between satisfaction and social factors.ResultsNo significant difference between older adults with or without previous experience using IBAS in terms of overall satisfaction. In the domain of operation difficulty (81.9 vs. 97.5%) and precise medicine (88.1 vs. 96.9%), such as correctly identifying the specialist, the satisfaction of previous user group was significantly higher than that of first-time user group. However, there was no significant difference in the remaining four domains between the two groups. Among the first time IBAS users, the satisfaction was higher than the walk-in registration they used before. Logistic regression revealed that some “intention to use IBAS”-associated social factors such as distance from the hospital, living status, and frequency of hospital visit, were related to the satisfaction of older adults.ConclusionsDriven by the external pandemic and internal intention, older adults would choose and manage network medical resources with their high satisfaction, which essentially demonstrates not only behavioral adjustment but also inner acceptance in older adults. Our findings support the need for promoting the driving force of older adults in using Internet-based medical service as well as transforming the design factors and behavior patterns.
Collapse
Affiliation(s)
- Wenjia Li
- College of Communication and Art Design, University of Shanghai for Science and Technology, Shanghai, China
| | - Shengwei Shen
- School of Medicine, Tongji University, Shanghai, China
| | - Jidong Yang
- School of Creativity and Art, Shanghai Tech University, Shanghai, China
| | - Jingyu Guo
- College of Communication and Art Design, University of Shanghai for Science and Technology, Shanghai, China
| | - Qinghe Tang
- Shanghai East Hospital, Tongji University, Shanghai, China
- *Correspondence: Qinghe Tang
| |
Collapse
|
40
|
Cao L, Chongsuvivatwong V, McNeil EB. Socio-demographic digital divide in mHealth app use among clients at outpatient departments in Inner Mongolia, China: a cross-sectional study (Preprint). JMIR Hum Factors 2022; 9:e36962. [PMID: 35587367 PMCID: PMC9164102 DOI: 10.2196/36962] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/20/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mobile health (mHealth) apps have become part of the infrastructure for access to health care in hospitals, especially during the COVID-19 pandemic. However, little is known about the effects of sociodemographic characteristics on the digital divide regarding the use of hospital-based mHealth apps and their benefits to patients and caregivers. Objective The aim of this study was to document the cascade of potential influences from digital access to digital use and then to mHealth use, as well as the potential influence of sociodemographic variables on elements of the cascade. Methods A cross-sectional survey was conducted from January to February 2021 among adult clients at outpatient departments in 12 tertiary hospitals of Inner Mongolia, China. Structural equation modeling was conducted after the construct comprising digital access, digital use, and mHealth use was validated. Results Of 2115 participants, the β coefficients (95% CI) of potential influence of digital access on digital use, and potential influence of digital use on mHealth use, were 0.28 (95% CI 0.22-0.34) and 0.51 (95% CI 0.38-0.64), respectively. Older adults were disadvantaged with regard to mHealth access and use (β=–0.38 and β=–0.41), as were less educated subgroups (β=–0.24 and β=–0.27), and these two factors had nonsignificant direct effects on mHealth use. Conclusions To overcome the mHealth use divide, it is important to improve digital access and digital use among older adults and less educated groups.
Collapse
Affiliation(s)
- Li Cao
- Information Technology Department, Inner Mongolia Medical University, Hohhot, China
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Edward B McNeil
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| |
Collapse
|
41
|
Niu N, Zhi X, Zhang L, Wang M, Zhao Y, Yang L, Wu B, Zhu P, Wang N, Zhang M, Wu B, Zhang Y, Meng A. Development and implementation of an “Internet+” management plan for cancer patients with wounds/stomas during the coronavirus disease 2019 pandemic. PRECISION MEDICAL SCIENCES 2022. [DOI: 10.1002/prm2.12055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Niu Niu
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Xiaoxu Zhi
- Nursing Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Liuliu Zhang
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Meixiang Wang
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Yun Zhao
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Lifang Yang
- Outpatient Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Bing Wu
- Nursing Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Ping Zhu
- Nursing Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Na Wang
- Outpatient Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Maomao Zhang
- Nursing Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Bainv Wu
- Nursing Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Yinan Zhang
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Aifeng Meng
- Nursing Department Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| |
Collapse
|
42
|
Melnychuk E, Sallade TD, Kraus CK. Hospitals as disaster victims: Lessons not learned? J Am Coll Emerg Physicians Open 2022; 3:e12632. [PMID: 35036993 PMCID: PMC8749465 DOI: 10.1002/emp2.12632] [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: 04/16/2021] [Revised: 11/07/2021] [Accepted: 11/17/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Hospitals are a key component to disaster response but are susceptible to the effects of disasters as well, including infrastructure damage that disrupts patient care. These events offer an opportunity for evaluation and improvement of preparedness and response efforts when hospitals are affected directly by a disaster. The objective of this structured review was to evaluate the existing literature on hospitals as disaster victims. METHODS A structured and scoping review of peer-reviewed literature, gray literature, and news reports related to hospitals as disaster victims was completed to identify and analyze themes and lessons observed from disasters in which hospitals are victims, to aid in future emergency operations planning and disaster response. RESULTS The literature search and secondary search of referenes identified 366 records in English. A variety of common barriers to successful disaster response include loss of power, water, heating and ventilation, communications, health information technology, staffing, supplies, safety and security, and structural and non-structural damage. CONCLUSIONS There are common weaknesses in disaster preparedness that we can learn from and account for in future planning with the aim of improving resilience in the face of future disasters.
Collapse
Affiliation(s)
- Eric Melnychuk
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
- Department of Critical Care MedicineGeisinger Medical CenterDanvillePAUSA
| | - Thomas D. Sallade
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
| | - Chadd K. Kraus
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
| |
Collapse
|
43
|
Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study. J Thromb Thrombolysis 2022; 54:20-28. [PMID: 35092566 PMCID: PMC8799972 DOI: 10.1007/s11239-021-02630-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 12/14/2022]
Abstract
This study aimed to explore the effectiveness, and safety of internet-based warfarin management during the pandemic. In this single-center retrospective cohort study, we compared the safety and efficacy of online warfarin management using a smartphone app (the Alfalfa app) versus conventional outpatient clinic management from January 1, 2020 to March 31, 2020. Patients in the online management group used the Alfalfa app to communicate coagulation test results and other relevant information to a doctor or clinical pharmacist, who then responded with the dose adjustment plan and the date of the next blood test. The outcomes examined were the time in therapeutic range (TTR), incidence of clinical events (i.e., bleeding events, thrombotic events, warfarin-related emergency department visits, and warfarin-related hospital admissions), and the distribution of international normalized ratio (INR) values. Data from 117 patients were analyzed in this study. TTR was significantly higher in the online group than in the offline group (61.0% vs. 39.6%, P < 0.01). Incidence of major bleeding events, thrombotic events, and warfarin-related hospital admissions were comparable between the online and offline groups. However, minor bleeds (5.3% vs. 28.3%, P < 0.01) and warfarin-related emergency department visits (1.8% vs. 23.3%, P = 0.02) were significantly fewer in the online group than in the offline group. The proportion of INR values in the therapeutic range (53.8% vs. 40.1%, P < 0.01) was significantly higher in the online group. Warfarin management using the Alfalfa app appears to be a safe and effective method for warfarin management when patients cannot physically visit hospitals for follow-up.
Collapse
|
44
|
Fernández MEC, Zarzuelo MJ, Fernández NA, Valverde-Merino MI, Martínez FM. Intervention model for detection, prevention and control of COVID-19 in community pharmacy. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
45
|
Cui W, Zhu W, Li X, Wu D, He P, Yu G. Attitudes and perspectives of 534 Chinese pediatricians toward internet hospitals. Front Pediatr 2022; 10:948788. [PMID: 36245742 PMCID: PMC9554531 DOI: 10.3389/fped.2022.948788] [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: 05/20/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Internet hospitals introduced in China have effectively reduced service time and space, promoted high-quality pediatric medical resources to grassroots areas, solved the contradiction between supply and demand of pediatric medical resources, and met patients' increasing multi-level and diversified medical service needs. However, pediatricians' attitudes toward and satisfaction with the use of internet hospitals remain unknown. OBJECTIVE This study aimed to investigate pediatricians' knowledge of, use of, and satisfaction with internet hospitals in order to identify major issues in internet hospital development, and to understand pediatricians' attitudes and opinions on the construction, development, and use of internet hospitals. MATERIALS AND METHODS A total of 625 pediatricians in 17 public tertiary hospitals in Shanghai were surveyed from November 1-30, 2021. Five hundred and thirty four pediatricians completed the survey, and the response rate was 85.44%. Pediatricians' baseline demographic data were collected and information about their use of and satisfaction with internet hospitals. RESULTS About 70.22% (375/534) of pediatricians knew about internet hospitals and about 54.68% (292/534) use internet hospitals for patient consultation, diagnosis, and treatment. Utilized services mainly focused on online consultation (271/292, 92.81%), online follow-up consultation (174/292, 59.59%), and health sciences (111/292, 38.01%). Online services were provided by 69.18% (202/292) of pediatricians for less than 1 h a day, and 75.00% (219/292) responded to fewer than five patient consultations online every day. Pediatricians' overall satisfaction with internet hospitals was low (3.59 ± 0.92 points), user experience, systems functions, operation processes, service prices, and performance rewards of internet hospitals were main influencing factors. Pediatricians are enthusiastic about further development of internet hospitals, with 87.83% (469/534) willing to provide services on the internet hospital platform. CONCLUSION Most pediatricians view internet hospitals favorably and are eager to contribute to the development of online diagnosis and treatment services. The development of internet hospitals will be more strongly supported by improving pediatricians' satisfaction and mobilizing their enthusiasm and initiative to participate in internet medical services.
Collapse
Affiliation(s)
- Wenbin Cui
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Hospital Development Center, Shanghai, China
| | - Weijun Zhu
- Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojie Li
- Shanghai Hospital Development Center, Shanghai, China
| | - Danmai Wu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping He
- Shanghai Hospital Development Center, Shanghai, China
| | - Guangjun Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
46
|
Bian D, Shi Y, Tang W, Li D, Han K, Shi C, Li G, Zhu F. The Influencing Factors of Nutrition and Diet Health Knowledge Dissemination Using the WeChat Official Account in Health Promotion. Front Public Health 2021; 9:775729. [PMID: 34900917 PMCID: PMC8655680 DOI: 10.3389/fpubh.2021.775729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/04/2021] [Indexed: 01/16/2023] Open
Abstract
Background: The promotion of a healthy diet via health education is a component of the “Healthy China 2030” plan. However, few studies have reported whether health knowledge about nutrition and diet has gained public attention, and whether it is needed by the public. Methods: The numbers of views, shares, and reads of articles published by the official WeChat account of a hospital in China were accessed. The influence index was obtained via the entropy analysis of these three indices. A questionnaire survey was developed based on the purpose of the study and the conclusion of the content analysis, which conducted to analyze users' requirements for health knowledge and their influencing factors. Moreover, risk factors were explored by logistic regression models. Results: Of the 103 articles considered in this study, four articles in the Top 10 were related to nutrition and diet. The influence index of nutrition and diet knowledge was found to be the highest in the content analysis (p < 0.05). The higher degrees of humor (β = 0.224, p = 0.027), nutrition and diet articles (β = 0.776, p = 0.034), and cover articles (β = 0.312, p = 0.021) have significant influences on the influence index. In total, 581 questionnaires were obtained, and 78.1% of the respondents reported believing that the health knowledge of greatest concern was that related to nutrition and diet. Multivariate logistic regression analyses were conducted to explore the associations between the features of the articles and users reading nutrition and diet knowledge; it was found that gender (female, OR: 4.651, 95%Cl: 2.598, 8.325, and p < 0.001), age (young adult, OR: 0.358, 95%Cl: 0.266, 0.481, and p < 0.001), cancer precaution knowledge (OR: 4.333, 95%Cl: 2.262, 8.299, and p < 0.001), traditional Chinese medicine (OR: 2.121, 95%Cl: 1.064, 4.230, and p = 0.033), the knowledge acquisition approach [circle of friends (OR: 2.586, 95%Cl: 1.373, 4.868, and p = 0.003), social media (OR: 2.183, 95%Cl: 1.204, 3.960, and p = 0.010)), hospitals (OR: 3.194, 95%Cl: 1.793, 5.692, and p < 0.001), television media (OR: 4.348, 95%Cl: 2.341, 8.077, and p < 0.001)], and social media strategies [professionalism and authority (OR: 2.354, 95%Cl: 1.231, 4.505, and p = 0.006)] have statistically significant relationships with users reading nutrition and diet knowledge. Conclusion: Nutrition and diet knowledge could contribute to WeChat user engagement of health information dissemination. Nutrition professionals should improve the scientific popularization ability and effectively use social media for health promotion.
Collapse
Affiliation(s)
- Dongsheng Bian
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongmei Shi
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjia Tang
- Department of Hospital Publicity, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Li
- Department of Hospital Publicity, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kangni Han
- Department of Hospital Publicity, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenshu Shi
- Center for Health Technology Assessment, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Zhu
- Department of Hospital Publicity, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
47
|
Xiong Z, Zhang L, Li Z, Xu W, Zhang Y, Ye T. Frequency of Online Health Information Seeking and Types of Information Sought Among the General Chinese Population: Cross-sectional Study. J Med Internet Res 2021; 23:e30855. [PMID: 34860676 PMCID: PMC8686457 DOI: 10.2196/30855] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The internet is one of the most popular health information resources, and the Chinese constitute one-fifth of the online users worldwide. As internet penetration continues to rise, more details on the Chinese population seeking online health information need to be known based on the current literature. OBJECTIVE This study aims to explore the sociodemographic differences in online health information seeking (OHIS), including the frequency of OHIS and the types of online health information sought among the general Chinese population in mainland China. METHODS A cross-sectional study for assessing the residents' health care needs with self-administered questionnaires was implemented in 4 counties and districts in China from July 2018 to August 2018. Pearson's chi-square test was used to identify the sociodemographic differences between infrequent and frequent online health information seekers. We also performed binary logistic regression for the 4 types of online health information as the dependent variables and the sociodemographic factors as the independent variables. RESULTS Compared with infrequent online health information seekers, frequent seekers were more likely to be female (infrequent: 1654/3318; 49.85%; frequent: 1015/1831, 55.43%), older (over 60 years old; infrequent: 454/3318, 13.68%; frequent: 282/1831, 15.40%), married (infrequent: 2649/3318, 79.84%; frequent: 1537/1831, 83.94%), and better educated (bachelor's or above; infrequent: 834/3318, 25.14%; frequent: 566/1831, 30.91%). They were also more likely to earn a higher income (over RMB ¥50k [RMB ¥1=US $0.15641]; infrequent: 1139/3318, 34.33%; frequent: 710/1831, 34.78%), have commercial health insurance (infrequent: 628/3318, 18.93%; frequent: 470/1831, 25.67%), and have reported illness in the past 12 months (infrequent: 659/3318, 19.86%; frequent: 415/1831, 22.67%). Among the 4 health information types, health science popularization was the most searched for information by Chinese online health information seekers (3654/5149, 70.79%), followed by healthy behaviors (3567/5149, 69.28%), traditional Chinese medicine (1931/5149, 37.50%), and medical concerns (1703/5149, 33.07%). The binary logistic regression models showed that males were less likely to seek information on healthy behaviors (adjusted odds ratio [AOR] 0.69, 95% CI 0.61-0.78) and traditional Chinese medicine (AOR 0.64, 95% CI 0.57-0.73), and respondents who had at least 1 chronic disease were more likely to seek information on medical concerns (AOR 1.27, 95% CI 1.07-1.51) and traditional Chinese medicine (AOR 1.26, 95% CI 1.06-1.49). CONCLUSIONS Sociodemographic factors were associated with the frequency of OHIS and types of information sought among the general Chinese population. The results remind providers of online health information to consider the needs of specific population groups when tailoring and presenting health information to the target population.
Collapse
Affiliation(s)
- Zihui Xiong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
| | - Liang Zhang
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Zhong Li
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Wanchun Xu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
| | - Yan Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
| | - Ting Ye
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
| |
Collapse
|
48
|
Telemedicine maybe an effective solution for management of chronic disease during the COVID-19 epidemic. Prim Health Care Res Dev 2021; 22:e48. [PMID: 34583801 PMCID: PMC8488977 DOI: 10.1017/s1463423621000517] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: Based on the development of telemedicine and the experience of using it during the COVID-19 epidemic, we aimed to explore its convenience and shortcomings to provide a reference for the further improvement of telemedicine. Background: Traditional healthcare has been significantly affected by the outbreak of COVID-19, which has increased fear in patients with chronic diseases and increased the difficulty of obtaining hospitalized treatment. Methods: This is a conceptual article. The literature search is based on Pubmed, including articles published between January 2015 and December 2020. The purpose was to determine whether telemedicine is effective in the management of chronic diseases in the epidemic situation and to develop telemedicine and chronic disease management for long-term epidemic situations in the future. Findings: Telemedicine has demonstrated its advantages during the COVID-19 epidemic and can provide diversified clinical care services for patients with chronic diseases; these services have played a vital role in epidemic prevention and control, greatly alleviated the shortage of medical resources, increased the utilization level of medical resources, and reduced the cross-infection risk during treatment in hospitals. Furthermore, the epidemic situation presents opportunities for the development of diagnosis and treatment methods via the internet and active health management modalities.
Collapse
|
49
|
Lim HM, Abdullah A, Ng CJ, Teo CH, Valliyappan IG, Abdul Hadi H, Ng WL, Noor Azhar AM, Chiew TK, Liew CS, Chan CS. Utility and usability of an automated COVID-19 symptom monitoring system (CoSMoS) in primary care during COVID-19 pandemic: A qualitative feasibility study. Int J Med Inform 2021; 155:104567. [PMID: 34536808 PMCID: PMC8420087 DOI: 10.1016/j.ijmedinf.2021.104567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/27/2021] [Accepted: 08/26/2021] [Indexed: 11/26/2022]
Abstract
Background COVID-19 telemonitoring applications have been developed and used in primary care to monitor patients quarantined at home. There is a lack of evidence on the utility and usability of telemonitoring applications from end-users’ perspective. Objectives This study aimed to evaluate the feasibility of a COVID-19 symptom monitoring system (CoSMoS) by exploring its utility and usability with end-users. Methods This was a qualitative study using in-depth interviews. Patients with suspected COVID-19 infection who used CoSMoS Telegram bot to monitor their COVID-19 symptoms and doctors who conducted the telemonitoring via CoSMoS dashboard were recruited. Universal sampling was used in this study. We stopped the recruitment when data saturation was reached. Patients and doctors shared their experiences using CoSMoS, its utility and usability for COVID-19 symptoms monitoring. Data were coded and analysed using thematic analysis. Results A total of 11 patients and 4 doctors were recruited into this study. For utility, CoSMoS was useful in providing close monitoring and continuity of care, supporting patients’ decision making, ensuring adherence to reporting, and reducing healthcare workers’ burden during the pandemic. In terms of usability, patients expressed that CoSMoS was convenient and easy to use. The use of the existing social media application for symptom monitoring was acceptable for the patients. The content in the Telegram bot was easy to understand, although revision was needed to keep the content updated. Doctors preferred to integrate CoSMoS into the electronic medical record. Conclusion CoSMoS is feasible and useful to patients and doctors in providing remote monitoring and teleconsultation during the COVID-19 pandemic. The utility and usability evaluation enables the refinement of CoSMoS to be a patient-centred monitoring system.
Collapse
Affiliation(s)
- Hooi Min Lim
- Department of Primary Care Medicine, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia; University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Adina Abdullah
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Chirk Jenn Ng
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chin Hai Teo
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Indra Gayatri Valliyappan
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Haireen Abdul Hadi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Wei Leik Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Abdul Muhaimin Noor Azhar
- Department of Emergency Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Thiam Kian Chiew
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Software Engineering, Faculty of Computer Science & Information Technology, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chee Sun Liew
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Computer System & Technology, Faculty of Computer Science & Information Technology, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chee Seng Chan
- University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Artificial Intelligence, Faculty of Computer Science & Information Technology, University of Malaya, 50603 Kuala Lumpur, Malaysia
| |
Collapse
|
50
|
Zhi L, Yin P, Ren J, Wei G, Zhou J, Wu J, Shen Q. Running an Internet Hospital in China: Perspective Based on a Case Study. J Med Internet Res 2021; 23:e18307. [PMID: 34342267 PMCID: PMC8485192 DOI: 10.2196/18307] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 11/25/2020] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Internet hospitals, as a new forum for doctors to conduct diagnosis and treatment activities based on the internet, are emerging in China and have become integral to the development of the medical field in conjunction with increasing reforms and policies in China's medical and health system. Here, we take the Internet Hospital of the First Affiliated Hospital, Zhejiang University (FAHZU Internet Hospital) as an example to discuss the operations and functional positioning of developing internet hospital medical services in relation to physical hospitals. This viewpoint considers the platform operation, management, and network security of FAHZU Internet Hospital, and summarizes the advantages and limitations in the operation to provide a reference for other areas with interest in developing internet hospitals.
Collapse
Affiliation(s)
- Lihua Zhi
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Pei Yin
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guoqing Wei
- Department of Medical Administration, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Zhou
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Wu
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Qun Shen
- Department of Internet Hospital Office, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|