A systematic review of artificial intelligence-powered (AI-powered) chatbot intervention for managing chronic illness

BACKGROUND

Utilizing artificial intelligence (AI) in chatbots, especially for chronic diseases, has become increasingly prevalent. These AI-powered chatbots serve as crucial tools for enhancing patient communication, addressing the rising prevalence of chronic conditions, and meeting the growing demand for supportive healthcare applications. However, there is a notable gap in comprehensive reviews evaluating the impact of AI-powered chatbot interventions in healthcare within academic literature. This study aimed to assess user satisfaction, intervention efficacy, and the specific characteristics and AI architectures of chatbot systems designed for chronic diseases.

METHOD

A thorough exploration of the existing literature was undertaken by employing diverse databases such as PubMed MEDLINE, CINAHL, EMBASE, PsycINFO, ACM Digital Library and Scopus. The studies incorporated in this analysis encompassed primary research that employed chatbots or other forms of AI architecture in the context of preventing, treating or rehabilitating chronic diseases. The assessment of bias risk was conducted using Risk of 2.0 Tools.

RESULTS

Seven hundred and eighty-four results were obtained, and subsequently, eight studies were found to align with the inclusion criteria. The intervention methods encompassed health education (n = 3), behaviour change theory (n = 1), stress and coping (n = 1), cognitive behavioural therapy (n = 2) and self-care behaviour (n = 1). The research provided valuable insights into the effectiveness and user-friendliness of AI-powered chatbots in handling various chronic conditions. Overall, users showed favourable acceptance of these chatbots for self-managing chronic illnesses.

CONCLUSIONS

The reviewed studies suggest promising acceptance of AI-powered chatbots for self-managing chronic conditions. However, limited evidence on their efficacy due to insufficient technical documentation calls for future studies to provide detailed descriptions and prioritize patient safety. These chatbots employ natural language processing and multimodal interaction. Subsequent research should focus on evidence-based evaluations, facilitating comparisons across diverse chronic health conditions.

Psychological and sexual problems of cancer survivors

OBJECTIVE

To explore: 1) the unmet needs of breast cancer patients; 2) the sexual needs experienced by breast cancer survivors; 3) the experiences of cancer patients at the time of relapse, including the biopsychosocial- spiritual aspects of their experiences.

MATERIALS AND METHODS

Interpretative phenomenological qualitative research by conducting direct in-depth interviews with participants who met the inclusion criteria. Sample analyzed were breast cancer survivors who had experiences related to unmet needs (14 participants) or sexual problems (12 participants); adult cancer patients who experienced recurrences (10 participants).

RESULTS

Themes identified for breast cancer patients with unmet needs were i) overcoming health problems in breast cancer survivors; ii) need to access the best health services; iii) women's unmet information needs concerning cancer treatment. For breast cancer survivors: i) information is needed to overcome sexual problems, ii) family support is needed to get sexual information, and iii) health care facilities need to provide sexual information. For patients experiencing recurrences: i) the reaction that occurs when receiving bad news; ii) efforts made during a relapse, iii) self-concept during a relapse.

CONCLUSIONS

Health-related problems of breast cancer survivors, such as fatigue and fear of cancer recurrence, can lead them to have trouble with social relationships, question their spirituality, and struggle with sex and sexuality. Oncology nurses and other professionals need to be aware of the unmet needs of breast cancer survivors, especially in relation to resolving the sexuality issues of cancer survivors. Understanding of the experiences of patients with relapse of different types of cancer should be improved.

Stres Kerja Memicu Sindrom Kelelahan Pada Perawat Manajer di Masa Pandemi Covid-19

Sindrom kelelahan menjadi masalah kesehatan akibat stres kerja yang dialami oleh semua manajer keperawatan di masa pandemi Covid-19. Perawat manajer rentan mengalami kelelahan karena beban kerja yang tinggi dan kurang waktu istirahat dalam melakukan peran dan fungsinya sebagai manajer. Peningkatan stres kerja akan menimbulkan kelelahan psikis dan fisik perawat manajer. Penelitian ini bertujuan mengidentifikasi stres kerja sebagai faktor yang berhubungan dengan sindrom kelelahan perawat manajer di masa pandemi Covid-19.Desain penelitian menggunakan korelasi deskriptif dengan pendekatan cross sectional yang dilakukan terhadap 147 responden. Teknik pengambilan sampel dengan menggunakan estimasi proporsi. Analisis yang digunakan analisis univariat dan analisis bivariat dengan menggunakan uji korelasi pearson. Sindrom kelelahan perawat manajer di masa pandemi Covid-19 sebesar 42,04%. Stres kerja perawat manajer di rumah sakit selama pandemi Covid-19 sebesar 57,71%. Terdapat hubungan yang signifikan antara stres kerja dengan sindrom kelelahan (p=0,000). Stres kerja dapat memicu sindrom kelelahan perawat manajer di masa pandemi Covid-19. Penelitian ini merekomendasikan agar pimpinan rumah sakit mengadakan pelatihan manajemen diri, membangun lingkungan kerja yang kondusif, dan meningkatkan kesejahteraan dengan pemberian insentif, gaji, serta penghargaan yang sesuai di masa pandemi. Dukungan organisasi untuk perawat manajer dengan pemberian waktu istirahat yang cukup, makanan sehat, program spiritual, dan olahraga di masa pandemi Covid-19.

Stigma and discrimination against breast cancer survivors in indonesia: an interpretive phenomenology study

Introduction: Breast cancer is the most common malignancy in women worldwide. Breast cancer and its treatment have a direct impact on all aspects of a woman's life, as well as on breast cancer survivors, thereby affecting the fulfillment of her needs. The purpose of the study is to explore stigma and discrimination against breast cancer sufferers. Methods: This study uses a qualitative method of interpretive phenomenology. Semi-structured interviews were purposively conducted from March to June 2022 with 14 women breast cancer survivors. Results: The three themes identified in this study include: a short duration of survival, being labeled as a suffering person, and social discrimination. Conclusions: Breast cancer survivors experienced stigma regarding their cancer diagnosis. Thus, highlighting the rising need of health professionals’ intervention in resolving and adapting to stigma and discrimination regarding breast cancer diagnosis in Indonesia.

Impacts of age and marital status on the elderly's quality of life in an elderly social institution

Background: Living a life of good quality is important for everyone. This research aimed to get an overview of the quality of life (QOL) of the elderly in an elderly social institution in Jakarta, Indonesia.

Design and Methods: This descriptive study with a cross-sectional design included 107 participants using simple random sampling technique. Data were collected using an abbreviated World Health Organization Quality of Life (WHOQOL-BREF) and analyzed using statistical software, Mann Whitney and Kruskal Wallis test.

Results: The mean quality of life of the elderly’s was 66.09 (scale: 0–100), with a mean QOL of 67.58 in the physical domain, 66.26 in the psychological domain, 64.64 in the social relationships domain, and 65.88 in the environment domain. Regarding age and marital status, there was a significant difference in the mean QOL of the elderly living in the elderly social institution (p=0.017 and 0.001). In contrast, there was no significant difference in their mean QOL in terms of gender, level of education, and length of stay (p=0.323, 0.164, and 0.697).

Conclusions: The low quality of life of the elderly is our concern. The staff in the elderly social institution could develop some activities for the elderly to increase the elderly’s QOL, such as making daily activities plans and the evaluation of those activities.

Nurses' critical thinking and clinical decision-making abilities are correlated with the quality of nursing handover

Critical thinking skills are instrumental for nurses to address patients complex situations and needs to ensure continuity of care. It's aimed to identify the relationship between nurses critical thinking and clinical decision-making abilities with the quality of nursing handover. A cross-sectional, descriptive correlational study was conducted with 205 nurses. Simple random sampling was used for participant recruitment. Data were collected by a questionnaire analyzed using Pearson's correlation test. In this study, nurses had good critical thinking, clinical decision-making abilities and handover quality. There is a strong relationship between critical thinking and clinical decision-making and the quality of nursing handover (p=0.001; r=0.384; r=0.247). This study confirms the relationships of nurses critical thinking and clinical decision-making abilities with the quality of nursing handover. Education level appears to have the largest influence, the results imply a need for nurses to have higher education.

Spirituality-Focused Palliative Care to Improve Indonesian Breast Cancer Patient Comfort

Background:

Palliative care is an approach that focuses on improving a patient's quality of life. This research aimed to develop a path model of the relationships between the variables of nursing care (information, emotional support, technical support, and palliative care), patient coping, family support, patient spirituality, and patient comfort expressed through physical and emotional mediators.

Method:

This cross-sectional study involved 308 breast cancer patients from 3 referral hospitals in Jakarta, Indonesia. A structural equation model with Kolcaba's theory was used to develop a theoretical model estimating the path or relationships between the key variables.

Results:

The results showed that palliative care significantly improved breast cancer patient comfort by reducing anxiety and depression. Furthermore, the study demonstrated a significant positive relationship between spirituality and emotional well-being.

Conclusion:

Spirituality-focused palliative care is fundamentally importance for breast cancer patients. Nurses play an essential role in providing spirituality-focused palliative care to promote comfort in breast cancer patients in Indonesia.

Terapi Kelompok Terapeutik Anak dengan Orang Tua dan Guru Meningkatkan Perkembangan Mental Anak Usia Sekolah

Introduction: School aged called as intelectual time in industrial development stage. Industrial development stage is important in human development stages. The purpose of this tudy was to know the effect of school aged therapeutic group therapy to mental development.Methods: The design was quasi experimental pre-post test with control group. One hundred and sixteen children at 9–11 years old were used as sample of this study that divided to 38 children on first intervention group (childparents), 36 children on second intervention group (child-teacher) and 40 children on control group.Results: Result of the study showed that cognitive, psychomotor and industrial development ability had increased significantly after therapeutic group therapy was given (p-value < 0.005) in intervention group.Conclusion: The study was recomended in child-parents and child-teacher to increase mental development in school aged children.