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Jørgensen SW, Petersen EN, Harnow S, Lee K, Nørgaard B. The meaning that people with severe mental illnesses ascribe to e-health in encounters with healthcare professionals - A repeat interview study. Int J Ment Health Nurs 2024; 33:62-72. [PMID: 37658655 DOI: 10.1111/inm.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
This study sought to explore the meaning that people with severe mental illnesses attribute to e-health solutions regarding user involvement and encounters with healthcare professionals. A qualitative design with a social phenomenological approach was applied, and data were collected via repeat interviews. Using a purposive sampling strategy, eight people with severe mental illness were interviewed two times between August 2021 to May 2022, at three different treatment sites in southern Denmark. To be included, participants needed to be 18-65 years of age, diagnosed with severe mental illness (schizophrenia, bipolar disorder, or depression), and using an e-health solution in collaboration with a health professional. The interviews lasted between 20 and 70 min and were audio recorded and then transcribed. The data were analysed with Braun and Clarke's 6-step thematic analysis. Participants experienced the use of an e-health solution as helpful for structuring their everyday lives, and e-health used together with healthcare professionals was considered to have a positive impact on the collaboration. The participants experienced feeling involved and in control when e-health solutions were used, which engaged them in their treatment. Furthermore, the participants found it important to have had some in-person meetings with healthcare professionals to build trust before the e-health solutions could be implemented successfully. E-health solutions used in collaboration with a trusted healthcare professional whom the participants had met in person tended to affect treatment engagement positively.
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Affiliation(s)
| | - Esben Nedenskov Petersen
- Department of Media, Design, Education and Cognition, University of Southern Denmark, Odense, Denmark
| | - Søren Harnow
- Department of Media, Design, Education and Cognition, University of Southern Denmark, Odense, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- University College South Denmark, Esbjerg, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Vroegindeweij A, Levelt L, Houtveen J, Van de Putte EM, Wulffraat NM, Swart JF, Nijhof SL. Dynamic modeling of experience sampling methodology data reveals large heterogeneity in biopsychosocial factors associated with persistent fatigue in young people living with a chronic condition. J Psychosom Res 2023; 167:111195. [PMID: 36801659 DOI: 10.1016/j.jpsychores.2023.111195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To evaluate associations between self-reported biopsychosocial factors and persistent fatigue with dynamic single-case networks. METHODS 31 persistently fatigued adolescents and young adults with various chronic conditions (aged 12 to 29 years) completed 28 days of Experience Sampling Methodology (ESM) with five prompts per day. ESM surveys consisted of eight generic and up to seven personalized biopsychosocial factors. Residual Dynamic Structural Equation Modeling (RDSEM) was used to analyze the data and derive dynamic single-case networks, controlling for circadian cycle effects, weekend effects, and low-frequency trends. Networks included contemporaneous and cross-lagged associations between biopsychosocial factors and fatigue. Network associations were selected for evaluation if both significant (α < 0.025) and relevant (β ≥ 0.20). RESULTS Participants chose 42 different biopsychosocial factors as personalized ESM items. In total, 154 fatigue associations with biopsychosocial factors were found. Most associations were contemporaneous (67.5%). Between chronic condition groups, no significant differences were observed in the associations. There were large inter-individual differences in which biopsychosocial factors were associated with fatigue. Contemporaneous and cross-lagged associations with fatigue varied widely in direction and strength. CONCLUSIONS The heterogeneity found in biopsychosocial factors associated with fatigue underlines that persistent fatigue stems from a complex interplay between biopsychosocial factors. The present findings support the need for personalized treatment of persistent fatigue. Discussing the dynamic networks with the participant can be a promising step towards tailored treatment. TRIAL REGISTRATION No. NL8789 (http://www.trialregister.nl).
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Affiliation(s)
- Anouk Vroegindeweij
- Department of Paediatric Rheumatology/Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Lisa Levelt
- Department of Experimental Psychology, Utrecht University, Utrecht, the Netherlands.
| | - Jan Houtveen
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elise M Van de Putte
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Nico M Wulffraat
- Department of Paediatric Rheumatology/Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Joost F Swart
- Department of Paediatric Rheumatology/Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Sanne L Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
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McLeod B, Meyer C, Meyer D, Nunan C, Murray G, Farhall J, Thomas N. Do recovery-oriented messages improve self-efficacy and positive emotions amongst people with lived experience of psychosis? Experimental investigation. Psychol Psychother 2022; 95:1003-1017. [PMID: 35906746 PMCID: PMC9796912 DOI: 10.1111/papt.12415] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Recovery-oriented perspectives have become accepted worldwide as an alternative to the biomedical approach to conceptualizing and managing severe mental health problems. It has been proposed that one advantage of this is to support self-efficacy amongst people with a lived experience of psychosis, especially when recovery messages are presented by lived experience peers. The aim of the present study was to investigate the proposed psychological benefits of the recovery paradigm, by testing for possible differential impacts of recovery versus biomedical messages on self-efficacy beliefs and positive emotional state amongst people with experience of psychosis. It was hypothesized that (1) recovery-oriented messages, when presented by lived experience peers, would generate improvements in self-efficacy and positive emotions relative to biomedical messages presented by a professional and (2) recovery-oriented messages delivered by a professional would generate improvements in self-efficacy and positive emotions relative to biomedical messages delivered by a professional. We also explored whether recovery-oriented messages were more impactful when delivered by a lived experience peer versus a professional. DESIGN Experimental design with three within-subject video-based conditions. METHODS Fifty-three participants with lived experience of psychosis viewed three videos: (i) people with lived experience sharing their experiences of recovery; (ii) mental health professionals presenting traditional biomedical conceptualizations of psychosis; and (iii) mental health professionals presenting recovery perspectives. Participants provided baseline clinical and demographic information, and post-viewing ratings of experienced changes in self-efficacy and emotional state. RESULTS Hypothesis 1 was supported: both self-efficacy and positive emotions were significantly increased by a video of peers sharing personal recovery stories relative to professionals presenting biomedical messages. Hypothesis 2 was partially supported: when comparing videos of recovery versus biomedical messages delivered by professionals, significant relative benefits were found for positive emotions, but not self-efficacy. CONCLUSIONS This experimental investigation generated a pattern of findings broadly supportive of the assumed psychological benefits of the recovery paradigm for people with lived experiences of psychosis. Findings must be interpreted with caution given the limitations of the present design, but encourage further experimental research to directly test the interpersonal impacts of the recovery paradigm.
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Affiliation(s)
- Bronte McLeod
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Catherine Meyer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Denny Meyer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Cassy Nunan
- Wellways AustraliaMelbourneVictoriaAustralia
| | - Greg Murray
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - John Farhall
- La Trobe UniversityMelbourneVictoriaAustralia,NorthWestern Mental HealthMelbourneVictoriaAustralia
| | - Neil Thomas
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia,Alfred HospitalMelbourneVictoriaAustralia
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Farhall J, Castle D, Constantine E, Foley F, Kyrios M, Rossell S, Arnold C, Leitan N, Villagonzalo KA, Brophy L, Fossey E, Meyer D, Mihalopoulos C, Murray G, Nunan C, Sterling L, Thomas N. Using a digital personal recovery resource in routine mental health practice: feasibility, acceptability and outcomes. J Ment Health 2022; 32:567-574. [PMID: 36072983 DOI: 10.1080/09638237.2022.2118688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Digital technologies enable the dissemination of multimedia resources to support adults with serious mental illness in their self-management and personal recovery. However, delivery needs to accommodate engagement and accessibility challenges. AIMS We examined how a digital resource, designed for mental health workers and consumers to use together in session, would be used in routine practice. METHODS Thirty consumers and their workers participated. The web-based resource, Self-Management And Recovery Technology (SMART), was available to use within and between sessions, for a 6-month period. Workers initiated in-session use where relevant. Feasibility was explored via uptake and usage data; and acceptability and impact via questionnaires. A pre-post design assessed recovery outcomes for consumers and relationship outcomes for consumers and workers. RESULTS In participating mental health practitioner-consumer dyads, consumers gave strong acceptability ratings, and reported improved working relationships. However, the resource was typically used in one-third or fewer appointments, with consumers expressing a desire for greater in-session use. Improvements in self-rated personal recovery were not observed, possibly contributed to by low usage. CONCLUSIONS In-session use was found helpful by consumers but may be constrained by other demands in mental health care delivery: collaborative use may require dedicated staff time or more formal implementation.
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Affiliation(s)
- John Farhall
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,NorthWestern Mental Health, Melbourne, Australia
| | - David Castle
- Department of Psychiatry, St Vincent's Hospital and The University of Melbourne, Melbourne, Australia
| | | | - Fiona Foley
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | - Michael Kyrios
- Órama Institute for Mental Health & Wellbeing Flinders University, Adelaide, Australia
| | - Susan Rossell
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Chelsea Arnold
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | - Nuwan Leitan
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | | | - Lisa Brophy
- School of Allied Health Human Services and Sport, La Trobe University and the Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Ellie Fossey
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.,Living with Disability Research Centre La Trobe University, Melbourne, Australia
| | - Denny Meyer
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics Institute for Health Transformation Deakin University, Geelong, Australia
| | - Greg Murray
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | | | - Leon Sterling
- Centre for Design Innovation Swinburne University of Technology, Melbourne, Australia
| | - Neil Thomas
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia.,Alfred Health, Melbourne, Australia
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Abstract
Human-computer interaction (HCI) has contributed to the design and development of some efficient, user-friendly, cost-effective, and adaptable digital mental health solutions. But HCI has not been well-combined into technological developments resulting in quality and safety concerns. Digital platforms and artificial intelligence (AI) have a good potential to improve prediction, identification, coordination, and treatment by mental health care and suicide prevention services. AI is driving web-based and smartphone apps; mostly it is used for self-help and guided cognitive behavioral therapy (CBT) for anxiety and depression. Interactive AI may help real-time screening and treatment in outdated, strained or lacking mental healthcare systems. The barriers for using AI in mental healthcare include accessibility, efficacy, reliability, usability, safety, security, ethics, suitable education and training, and socio-cultural adaptability. Apps, real-time machine learning algorithms, immersive technologies, and digital phenotyping are notable prospects. Generally, there is a need for faster and better human factors in combination with machine interaction and automation, higher levels of effectiveness evaluation and the application of blended, hybrid or stepped care in an adjunct approach. HCI modeling may assist in the design and development of usable applications, and to effectively recognize, acknowledge, and address the inequities of mental health care and suicide prevention and assist in the digital therapeutic alliance.
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Bonnechère B, Rintala A, Spooren A, Lamers I, Feys P. Is mHealth a Useful Tool for Self-Assessment and Rehabilitation of People with Multiple Sclerosis? A Systematic Review. Brain Sci 2021; 11:brainsci11091187. [PMID: 34573208 PMCID: PMC8466296 DOI: 10.3390/brainsci11091187] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 12/19/2022] Open
Abstract
The development of mobile technology and mobile Internet offers new possibilities in rehabilitation and clinical assessment in a longitudinal perspective for multiple sclerosis management. However, because the mobile health applications (mHealth) have only been developed recently, the level of evidence supporting the use of mHealth in people with multiple sclerosis (pwMS) is currently unclear. Therefore, this review aims to list and describe the different mHealth available for rehabilitation and self-assessment of pwMS and to define the level of evidence supporting these interventions for functioning problems categorized within the International Classification of Functioning, Disability and Health (ICF). In total, 36 studies, performed with 22 different mHealth, were included in this review, 30 about rehabilitation and six for self-assessment, representing 3091 patients. For rehabilitation, most of the studies were focusing on cognitive function and fatigue. Concerning the efficacy, we found a small but significant effect of the use of mHealth for cognitive training (Standardized Mean Difference (SMD) = 0.28 [0.12; 0.45]) and moderate effect for fatigue (SMD = 0.61 [0.47; 0.76]). mHealth is a promising tool in pwMS but more studies are needed to validate these solutions in the other ICF categories. More replications studies are also needed as most of the mHealth have only been assessed in one single study.
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Affiliation(s)
- Bruno Bonnechère
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
- Correspondence:
| | - Aki Rintala
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, FI-15210 Lahti, Finland;
| | - Annemie Spooren
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
| | - Ilse Lamers
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
- University MS Center Hasselt-Pelt, B-3500 Hasselt, Belgium
| | - Peter Feys
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
- University MS Center Hasselt-Pelt, B-3500 Hasselt, Belgium
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Lederman R, D'Alfonso S. The Digital Therapeutic Alliance: Prospects and Considerations. JMIR Ment Health 2021; 8:e31385. [PMID: 34283035 PMCID: PMC8335609 DOI: 10.2196/31385] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 06/19/2021] [Indexed: 11/22/2022] Open
Abstract
The growing prevalence of digital approaches to mental health care raises a range of questions and considerations. A notion that has recently emerged is that of the digital therapeutic alliance, prompting consideration of whether and how the concept of therapeutic alliance, which has proven to be a central ingredient of successful traditional psychotherapy, could translate to mental health care via digital technologies. This special issue editorial article outlines the topic of digital therapeutic alliance and introduces the five articles that comprise the special issue.
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Affiliation(s)
- Reeva Lederman
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
| | - Simon D'Alfonso
- School of Computing and Information Systems, The University of Melbourne, Carlton, Australia
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