Effectiveness of health web-based and mobile app-based interventions designed to improve informal caregiver’s well-being and quality of life: A systematic review

2020 ◽  
Vol 134 ◽  
pp. 104003 ◽  
Author(s):  
Jael Lorca-Cabrera ◽  
Carme Grau ◽  
Rut Martí-Arques ◽  
Laia Raigal-Aran ◽  
Anna Falcó-Pegueroles ◽  
...  
2021 ◽  
pp. 026921632199472
Author(s):  
Natalia Salamanca-Balen ◽  
Thomas V Merluzzi ◽  
Man Chen

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.


2021 ◽  
pp. JDNP-D-20-00078
Author(s):  
Sybilla Myers ◽  
Christopher Kennedy

BackgroundPerceived health-related quality of life (HRQOL) is fundamental to well-being and is a meaningful way to measure physical and mental health.Local ProblemNo standard method exists for measuring perceived HRQOL during the COVID-19 pandemic in participants as they attempt to improve their self-determined wellness goals. An implementation plan that considers the social distancing limitations imposed can be used to predict an individual’s likelihood of long-term success.MethodsDuring the four, 2-week plan-do-study-act (PDSA) cycles, the Social Cognitive Theory model informed the implementation of the four core interventions. To guide iterative changes, the data was analyzed through Excel and run charts.InterventionsThe four core interventions were the shared decision-making tool (SDMT), health mobile app tool (HMAT), wellness tracker tool (WTT), and the team engagement plan.ResultsAmong 28 participants, perceived quality of life increased by 70%, engagement in shared decision-making increased to 82%, app use and confidence increased to 85%, and goal attainment reached 81%.ConclusionsThe SDMT, health app, and wellness tracker created a methodical plan of accountability for increasing participant wellness. The contextual barrier of the COVID-19 pandemic added a negative wellness burden which was mitigated by creating a patient-centered culture of wellness.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Figueras-Puigderrajols ◽  
A Ballesteros ◽  
D Guerra

Abstract Study question The present study aims to explore infertility-related psychosocial outcomes, including fertility quality of life (QoL), as well as anxiety and depression levels, in women diagnosed with infertility. Summary answer Differences on fertility-related QoL appeared when comparing treatment types (gamete donation vs own gamete). Furthermore, statistically significant associations were found between QoL and anxious-depressive symptomatology. What is known already Those who wish to have children and do not achieve their objective just like other peers can see their goals and expectations with pessimism, generating concern and a series of negative emotions. Several psychological implications of infertility have been described, such as increased levels of stress, anxiety, depression, decreased self-esteem, mood and hope, or poor relationship adjustment. The emotional impact of infertility in people’s life cycle can be so strong that reducing it only to biological aspects would lead to a dangerous situation of neglect. For this reason, QoL assessment in ART becomes an important need. Study design, size, duration FertiQol stands as the most widely used tool to assess infertility-related QoL, overcoming the limitations of other instruments that only target specific medical conditions. The present is a multi-site cross-sectional study over patients with infertility (n = 104), aiming to explore their fertility-QoL, as well as their anxiety and depression levels, which are symptoms that have been previously associated.Questionnaire administration, and sociodemographic and medical data gathering took place between January 2019 and December 2020. Participants/materials, setting, methods Participants were 104 female patients (M.age= 39.8) undergoing or expecting a fertility treatment. The FertiQol Spanish version was administered through mobile app, and its paper version distributed at medical/psychological appointments. QoL was self-reported through FertiQol, assessing the influence of infertility problems in various areas (e.g. impact on self-esteem, emotions, general health, family, partners, social relationships, work, life projects...). Additionally, HADS (Hospital Anxiety and Depression Scale) was provided as a measurement of anxiety and depression levels. Main results and the role of chance Regarding treatments, 50.6% of participants were currently undergoing gamete donation while 44.3% were undergoing treatments that involved using their own gametes. After comparing QoL between these treatment types, results showed that patients who underwent egg donation, compared to those who used their own eggs, reported statistically significantly lower scores of QoL in the Social Subscale (p = .03), but not in the other psychological outcomes. Also, statistically significant negative correlations were found between HADS and all core FertiQol subscales (p< .05). Results are consistent with previous studies showing similar associations between fertility QoL and anxiety and depression, as well as with increased psychological negative implications of gamete donation. The majority of participants reported non-pathological scores of anxiety and depression when considering the cut off value of 8 for HADS, thus suggesting the presence of a relatively healthy sample. The number of treatments that patients had previously taken and the years of infertility were not associated with any of the psychological variables. Limitations, reasons for caution Some limitations to consider are presence of co-morbid diagnosis, differences in medication, or patient’s cultural backgrounds.Also, conclusions should be interpreted cautiously since the design doesn’t allow causal inferences. Further investigations should consider a continuous assessment to explore changes in psychological well-being at different points of intervention, specially with gamete donation. Wider implications of the findings: The great advantage we’ve seen so far when using FertiQol is the possibility to identify more accurately the true impact on other aspects of patient’s well-being besides the emotional area.ART professionals, including psychologists and counselors,will have more information within a small amount of time about QoL when using this tool. Trial registration number 1503-BCN–019-DG


2021 ◽  
Vol 19 ◽  
Author(s):  
Jen Sze Ong ◽  
Shuet Nee Wong ◽  
Alina Arulsamy ◽  
Jessica L. Watterson ◽  
Mohd. Farooq Shaikh

: Epilepsy is a devastating neurological disorder that affects nearly 70 million people worldwide. Epilepsy causes uncontrollable, unprovoked and unpredictable seizures that reduces the quality of life of those afflicted, with 1-9 epileptic patient deaths per 1000 patient occurring annually due to sudden unexpected death in epilepsy (SUDEP). Predicting the onset of seizures and managing them may help patients from harming themselves and may improve their well-being. For a long time, electroencephalography (EEG) devices have been the mainstay for seizure detection and monitoring. This systematic review aimed to elucidate and critically evaluate the latest advancements of medical devices, besides EEG, that have been proposed for the management and prediction of epileptic seizures. A literature search was performed on three databases; PubMed, Scopus and EMBASE. Following title/abstract screening by two independent reviewers, 27 articles were selected for critical analysis in this review. These articles revealed ambulatory, non-invasive and wearable medical devices such as the in-ear EEG devices, the accelerometer-based devices and the subcutaneous implanted EEG devices might be more acceptable than traditional EEG systems. In addition, extracerebral signal-based devices may be more efficient than EEG-based systems, especially when combined with an intervention trigger. Although further studies may still be required to improve and validate these proposed systems before commercialization, these findings may give hope to epileptic patients, particularly those with refractory epilepsy, to predict and manage their seizures. The use of medical devices for epilepsy may improve patients' independence and quality of life and possibly prevent sudden unexpected death in epilepsy (SUDEP).


10.2196/13409 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e13409 ◽  
Author(s):  
Evanthia Giannoula ◽  
Ioannis Iakovou ◽  
Ioannis Katsikavelas ◽  
Panagiotis Antoniou ◽  
Vasilios Raftopoulos ◽  
...  

Background Thyroid cancer (TC) is one of the fastest growing cancers all over the world. Differentiated thyroid cancer (DTC) is the most frequent subtype of TC. When appropriate treatment is given, the prognosis for the patient is generally excellent. Despite the generally good prognosis of thyroid carcinomas, the symptoms may range from emotional to physical discomfort, depending on the thyroid hormone status, which can severely affect the patient. Moreover, the diagnostic and therapeutic procedures that DTC patients have to undergo, such as thyroidectomy and radioiodine therapy, significantly affect their mental and physical well-being. Often, the physician only addresses the favorable prognosis of DTC compared with other cancer types and neglects to assess issues related to the quality of life (QoL) of the patient; this was the reason we decided to design a mobile app for DTC patients and their caregivers. Objective The aim of this study is to research the feasibility and applicability of an mHealth app tailored to DTC patients, as reflected in their QoL. The main features of the developed app offer access to useful information about thyroid cancer, diagnostic tests, and the appropriate therapy administered to DTC patients. Methods Based on the existing literature, we created an up-to-date information platform regarding TC and especially DTC. In order to develop an effective app that can be implemented in current health care, we designed a section where the patient and physician can keep a medical record in an effort to enable access to such information at any time. Finally, we designed a user-friendly notification program, including pill prescription, follow-up tests, and doctor visit reminders in order to equally facilitate the lives of the patient and physician. Results Having developed this mobile app, we aim to conduct a pilot quasiexperimental interventional trial. Our intention is to enroll at least 30 TC patients and assign them to intervention or control groups. Both groups will receive standard care for treating and monitoring TC, and the intervention group will also receive and use the DTC app. TC patients’ QoL will be assessed for both control and intervention groups in order to examine the effectiveness of the DTC app. QoL will be assessed through the QoL core questionnaire European Organisation for Research and Treatment of Cancer (EORTC) QLQ-THY34 in combination with the EORTC QLQ-C30 questionnaire through quantitative statistical analysis. Conclusions The use of mHealth apps can play a significant role in patient education, disease self-management, remote monitoring of patients, and QoL improvement. However, the main limitation of the majority of existing studies has been the lack of assessing their usefulness as well as the absence of specific instruments to carry out this assessment. In light of those considerations, we developed a mobile app tailored to the needs of DTC patients. Furthermore, we evaluated its contribution to the QoL of the patients by using the EORTC QLQ-THY34 questionnaire, an accurate and safe instrument for the evaluation of the QoL in TC patients, while supporting future planned endeavors in the field. International Registered Report Identifier (IRRID) PRR1-10.2196/13409


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Racaite ◽  
G Surkiene ◽  
M Jakubauskiene ◽  
R Sketerskiene ◽  
L Wulkau

Abstract Background Children left behind (CLB) are those, who have been left behind at their original residence while one or both parents migrate to other places for work. The aim of this study was to systematically review studies where the physical health consequences for CLB were analysed. Methods We searched the Web of Science, PubMed, Academic Search Complete, PsycINFO and Cochrane databases. We included studies reporting physical health outcomes of children affected by parent migration. Results We selected 35 studies from a total of 2191. The results reveal that, overall, the absence of one or both parents is related to poorer child health - the nutrition of CLB is not healthy or balanced and is insufficient, leading to higher rates of anaemia and poor growth indicators of affected children. Boys left by parents are smaller than boys who were never left behind. CLB face lower underweight or stunted growth risks due to the additional income from remittances which ensures sufficient food for the household, this can also lead, however, to overweight and obesity. Unhealthy lifestyle behaviours such as smoking, alcohol, food preferences, lower physical activity and higher risk of injuries were more prevalent among CLB. CLB were more likely not to have completed the recommended vaccination programme than those living with their parents. Opinions vary on how emigration of parents affects children’s well-being and quality of life. CLB had higher probabilities of higher well-being than children living in non-migrant households. However, health-related quality of life (HRQoL) of CLB scored significantly lower than HRQoL of non-left-behind children. Conclusions The migration of parents has negative impacts on the child’s physical health, however it can also have positive impacts on children’s well-being when basic needs for sufficient nutrition are not satisfied in the home countries. Public health interventions should be taken to ensure the health of the CLB population. Key messages This is the first systematic review on the physical health of CLB. The well-being of CLB is poorer and they are at risk of health problems, such as insufficient and/or unbalanced diet, unhealthy behaviours and incomplete vaccination status.


2018 ◽  
Vol 48 (13) ◽  
pp. 2130-2139 ◽  
Author(s):  
Anthony Martyr ◽  
Sharon M. Nelis ◽  
Catherine Quinn ◽  
Yu-Tzu Wu ◽  
Ruth A. Lamont ◽  
...  

AbstractCurrent policy emphasises the importance of ‘living well’ with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1–0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.


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