A Theoretical Framework and Conceptual Design for Engaging Children in Therapy at Home-The Design of a Wearable Breathing Trainer

The Limitations of User-and Human-Centered Design in an eHealth Context and How to Move Beyond Them

Human-centered design (HCD) is widely regarded as the best design approach for creating eHealth innovations that align with end users’ needs, wishes, and context and has the potential to impact health care. However, critical reflections on applying HCD within the context of eHealth are lacking. Applying a critical eye to the use of HCD approaches within eHealth, we present and discuss 9 limitations that the current practices of HCD in eHealth innovation often carry. The limitations identified range from limited reach and bias to narrow contextual and temporal focus. Design teams should carefully consider if, how, and when they should involve end users and other stakeholders in the design process and how they can combine their insights with existing knowledge and design skills. Finally, we discuss how a more critical perspective on using HCD in eHealth innovation can move the field forward and offer 3 directions of inspiration to improve our design practices: value-sensitive design, citizen science, and more-than-human design. Although value-sensitive design approaches offer a solution to some of the biased or limited views of traditional HCD approaches, combining a citizen science approach with design inspiration and imagining new futures could widen our view on eHealth innovation. Finally, a more-than-human design approach will allow eHealth solutions to care for both people and the environment. These directions can be seen as starting points that invite and support the field of eHealth innovation to do better and to try and develop more inclusive, fair, and valuable eHealth innovations that will have an impact on health and care.

Chinese adult segmentation according to health skills and analysis of their use for smart home: a cross-sectional national survey

BACKGROUND

Digital health has become a heated topic today and smart homes have received much attention as an important area of digital health. Smart home is a device that enables automation and remote control in a home environment via the internet. However, most of the existing studies have focused on discussing the impact of smart home on people. Only few studies have focused on relationship between health skills and use of smart home.

AIMS

To analyze the health skills of Chinese adults and segment them to compare and analyze the use of smart home for each group.

METHODS

We used data from 11,031 participants aged 18 and above. The population was clustered based on five health skills factors: perceived social support, family health, health literacy, media use, and chronic diseases self-behavioral management. A total of 23 smart homes were categorized into three sub-categories based on their functions: entertainment smart home, functional smart home, and health smart home. We analyzed demographic characteristics and utilization rate of smart home across different cluster. Each groups' features and the differences in their needs for smart home functions were compared and analyzed.

RESULTS

As a result of the survey on health skills, three groups with different characteristics were clustered: good health skills, middle health skills, and poor health skills. The utilization rate of smart home was the highest was good health skills group (total smart home: 92.7%; entertainment smart home: 61.1%, functional smart home: 77.4%, and health smart home: 75.3%; P < 0.001). For entertainment smart home, smart TV had the highest utilization rate (good health skills: 45.7%; middle health skills: 43.5%, poor health skills: 33.4%, P < 0.001). For functional smart home, smart washing machine (good health skills: 37.7%, middle health skills: 35.11%, poor health skills: 26.5%; P < 0.001) and smart air conditioner (good health skills: 36.0%, middle health skills: 29.1%, poor health skills: 24.6%) were higher than other of this category. For health smart home, sports bracelet has the highest utilization rate (good health skills: 37.3%, middle health skills: 24.5%, poor health skills: 22.8%).

CONCLUSION

People can be divided into different categories based on health skill profiles, those with good health skills had a better utilization rate of smart home. The government and smart home companies need to focus on people with poor smart home use in various ways to promote their use of smart homes for personal health management.

Change Management and Digital Innovations in Hospitals of Five European Countries

The objective of the paper is to evaluate the quality of systemic change management (CHM) and readiness for change in five Central European countries. The secondary goal is to identify trends and upcoming changes in the field of digital innovations in healthcare. The results show that all compared countries (regardless of their historical context) deal with similar CHM challenges with a rather similar degree of success. A questionnaire distributed to hospitals clearly showed that there is still considerable room for improvement in terms of the use of specific CHM tools. A review focused on digital innovations based on the PRISMA statement showed that there are five main directions, namely, data collection and integration, telemedicine, artificial intelligence, electronic medical records, and M-Health. In the hospital environment, there are considerable reservations in applying change management principles, as well as the absence of a systemic approach. The main factors that must be monitored for a successful and sustainable CHM include a clearly defined and widely communicated vision, early engagement of all stakeholders, precisely set rules, adaptation to the local context and culture, provision of a technical base, and a step-by-step implementation with strong feedback.

Chronic fatigue syndrome/myalgic encephalomyelitis in children aged 5 to 11 years: A qualitative study

Treatments for paediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) have not been designed or evaluated for younger children (5-11-years). The development of a complex intervention for this population requires an in-depth understanding of the perspectives and psychosocial context of children and families. Children with CFS/ME (5-11-years) and their families were recruited from a specialist CFS/ME service, and interviewed using semi-structured topic guides. Data were analysed thematically. Twenty-two participants were interviewed; eight parents, two children (aged nine and ten) and six parent-child dyads (aged 5-11-years). Theme 1: CFS/ME in younger children is complex and disabling. Theme 2: Children aged eight and over (in comparison to those under eight) were more able to describe their illness, engage in clinical consultation, understand diagnosis and self-manage. Theme 3: Parents of children under eight took full responsibility for their child's treatment. As children got older, this increasingly became a joint effort between the parent and child. Parents felt unsupported in their caring role. Clinicians should consider different treatment approaches for children under eight, focusing on: parent-only clinical sessions, training parents to deliver treatment, and increasing support for parents. Children over eight may benefit from tools to help them understand diagnosis, treatment and aids for self-management.