scholarly journals Determinants of and barriers to adoption of digital therapeutics for mental health at scale in the NHS

2020 ◽  
Vol 6 (3) ◽  
pp. 92-98
Author(s):  
Matt G Williams ◽  
Richard Stott ◽  
Nicki Bromwich ◽  
Susie K Oblak ◽  
Colin A Espie ◽  
...  

ObjectivesAlthough it is widely acknowledged that digital therapeutics will play a significant role in the future delivery of healthcare, the method by which these innovations may be commissioned by the National Health Service, at scale, remains unclear. This study explores English health commissioners’ experiences of, and attitudes towards, adopting digital healthcare innovations.Methods37 commissioners and decision-makers from a range of sectors within the health profession were invited to participate in structured interviews to gather relevant examples of experience and opinions. 14 commissioners participated and the notes from the resulting interviews were interpreted using qualitative content analysis. Controlled interpretation was applied to the categorised responses, paraphrasing and classifying into themes.ResultsCommon determinants and barriers to adoption of digital mental health expressed during the interview process included commissioners’ lack of familiarity with technology, information governance, digital literacy of users and decision-makers.ConclusionsRecognition of identified barriers may be helpful for innovators when developing engagement and market access strategies and suggest areas for focus and further development within the commissioning process to accommodate digital health solutions.

Author(s):  
M.Siyabend KAYA ◽  
Yavuz KOŞAN

The current study focused on exploring the psychological impact of the COVID -19 outbreak on university students and participants' expectations of mental health professionals. Semi-structured interviews were conducted with 80 university students aged 18 to 33 years from 19 cities in Turkey. Qualitative content analysis was used to identify important aspects of the students' experiences. According to the results, the main effects of the epidemic COVID -19 on the participants were depression and anxiety. We found that participants used various ways to cope with COVID -19 such as reading books and paying attention to hygiene. Participants also indicated that they perceived some positive situations, such as the value of nature and humanity, the importance of family, and various negative situations, such as mental exhaustion. Finally, participants stressed that they had different expectations regarding psychosocial support and the planning of individual activities by mental health professionals


Author(s):  
Olenka Dworakowski ◽  
Marie Drüge ◽  
Michelle Schlunegger ◽  
Birgit Watzke

Abstract Purpose This work focuses on the experiences and practices of obstetrician–gynecologists (ob–gyns) with patients suffering from body dysmorphic disorder (BDD) and issues with their aesthetics, specifically focusing on female genitalia. Ob–gyns are likely to play an important role in the recognition and treatment of women facing such issues. Methods This study took a qualitative, explorative approach. Semi-structured interviews were conducted with 11 ob–gyns about their experiences with patients who presented symptoms of BDD of female genitalia, their treatments, and interest in further education and supportive material. Interviews were analyzed through qualitative content analysis. Results A categorization system was created. The results showed that the participating ob–gyns are often confronted with genital dissatisfaction of patients. The study sample demonstrated a lack of mental health literacy concerning BDD. The treatments that the ob–gyns of this sample suggested for BDD of female genitalia were not in line with what evidence suggests. Finally, interest in further education and supportive material for consultation was evidenced in this sample. Conclusions The findings encourage further studies to identify the recognition of BDD concerning genitalia or etiological factors. Furthermore, practical implications (e.g., need of supportive material) can be derived from the results.


2018 ◽  
Author(s):  
Lisa Gualtieri ◽  
Jeffrey Phillips ◽  
Sandra Rosenbluth ◽  
Steph Synoracki

BACKGROUND Adoption and effective use of digital health technologies is especially important for older adults, who bear the greatest burden of chronic disease. However, some older adults lack the digital literacy skills needed to reap the benefits of these tools. Despite the greater infiltration of smartphones in all age groups, including older adults, smartphone ownership does not equate to adept smartphone use. Impediments to smartphone use can impede adoption and use of digital health technologies that rely on apps. OBJECTIVE Our objectives were to 1) determine the barriers to adoption and use of digital health technologies, specifically wearable activity trackers, by older adults; and 2) identify and test facilitators to adoption and use. METHODS We recruited more than 100 older adults aged 50-75 who owned a smartphone for our tracker studies. We provided each participant with a tracker and hands-on support for its setup and use. Support was tailored to each participant’s level of comfort and adeptness with his or her smartphone and new tracker, with the goal of having participants leave with a working tracker and an app they could engage with. RESULTS While all participants owned a smartphone, we identified several barriers to successful engagement with their own smartphones as well as with their new trackers. Some older model or pay-as-you-go phones could not download apps. Many participants required assistance to download and setup an app, as well as sync their tracker to the app. In several cases, the use of jargon such as “sync with Bluetooth” required an explanation. Some app features required guidance, such as changing the default of 10,000 steps to one that was more achievable and realistic for older adults. Furthermore, the design of some tracker faces and bands were preferred or more comfortable for participants. We found that once participants were able to overcome barriers to setup through hands-on training, other facilitators, such as a visual reminder of their commitment to physical activity and the immediate gratification of seeing their activity reflected in the tracker and the app, kept them engaged with the tracker. CONCLUSIONS The digital health market is growing rapidly and has great potential to improve health outcomes, yet it is failing to reach and meet the needs of older adults. Poor digital literacy skills impede adoption of digital health technologies, and their effective use once adopted. While a high-touch approach to helping older adults overcome barriers to adoption and use of digital health technologies has proven to be a successful facilitator in our studies, the challenge is in bringing this approach to scale and applying it to both consumer- and medical-grade technologies. In future studies, we hope to build on this knowledge and further identify design and training solutions that can be scaled to increase successful engagement of digital health technologies by older adults.


2015 ◽  
Vol 16 (05) ◽  
pp. 470-480 ◽  
Author(s):  
Gunilla Borglin ◽  
Johanna Hentzel ◽  
Doris M. Bohman

AimTo investigate public health nurses’ perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services.BackgroundAlthough maternal health following childbirth should be a priority within primary care, it is known that women postpartum do not always receive the support they need to adapt to and cope with motherhood. Research implies that postnatal problems lack recognition and are not always acknowledged in routine practice. Few studies have been presented on this topic or from the perspective of nurses.MethodsFor this study, eight semi-structured interviews were conducted with public health nurses, and the transcribed texts were analysed through a process inspired by Burnard’s description of the four-step qualitative content analysis.FindingsThree categories – external influences on postpartum mental health, screening for and preventing postpartum mental ill health and paediatric healthcare services as a platform for support – were interpreted to reflect the nurses’ perceptions and experiences of mental health among women postpartum and of the prevention of mental ill health among women postpartum.ConclusionWe found that public health nurses can have an important role in supporting mothers’ mental health postpartum. Although caution is warranted in interpreting our results, the findings concur with those of other studies, highlighting that an equal care emphasis on both the mother and child can be an important aspect of successful support. Implementing person-centred care might be one strategy to create such an emphasis, while also promoting the mental health of new mothers. Public health nurses have a unique opportunity to support mothers’ transition into healthy motherhood, especially because they are likely to meet both mothers and children on a regular basis during the first year after birth.


2020 ◽  
Vol 66 (3) ◽  
pp. 263-269
Author(s):  
Ina Otte ◽  
Anna Werning ◽  
Alexa Nossek ◽  
Jochen Vollmann ◽  
Georg Juckel ◽  
...  

Background: Being aware of the challenges that may occur during the implementation of peer support work in psychiatry is important to facilitate the integration of peer support workers (PSWs) into multidisciplinary mental health-care teams. Aim: The purpose of this study is to explore the challenges faced by PSWs during their integration into hospital-based mental health-care teams. Methods: Qualitative content analysis of nine open-ended, semi-structured interviews with PSWs is undertaken in five adult psychiatric hospitals in North Rhine-Westphalia, Germany. Results: The analysis of the data revealed three themes: (1) ‘Pioneers and the pressure to succeed’; (2) ‘a colleague, a rival or yet another patient?’ and (3) ‘sharing of information, boundaries and professionalism’. All three themes relate to several concrete challenges on different systemic levels and have the potential to impede the PSWs’ integration process. Conclusion: Specific implementation strategies which address potential barriers on the different systemic levels should be developed and applied prior to the start of the integration of PSWs into multidisciplinary mental health-care teams.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Siamak Amiri ◽  
Parvaneh Vasli ◽  
Jamileh Mohtashami ◽  
Nadereh Memaryan

Background: Spiritual care (SC) is an appropriate source for adaptation and coping with disease and life stressors. Although SC contributes to the quality of life and mental health of clients, there are barriers to the provision of such care. Objectives: This study aimed to explore barriers to the provision of SC in mental health care centers from the viewpoints of mental health care provider (MHCP) experts. Methods: This qualitative study was conducted based on conventional content analysis on 19 participants who were selected from different groups of MHCPs. The participants were selected by purposive sampling method from December 2019 to December 2020 in Karaj and Tehran, Iran, by considering the maximum diversity. Data were collected through semi-structured interviews with participants during an average time of 60 min per interview until data saturation. The transcripts of the interviews were analyzed by qualitative content analysis. Results: Barriers to SC were obtained in four categories and 10 subcategories. The categories included “SC concept-related barriers”, “barriers related to MHCPs”, “organizational barriers”, and “barriers related to SC recipients.” Conclusions: This study demonstrated various barriers to the provision of SC to the clients of health care centers that should be removed to promote the level and quality of SC.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Broholm-Jørgensen ◽  
Siff Monrad Langkilde ◽  
Tine Tjørnhøj-Thomsen ◽  
Pia Vivian Pedersen

Abstract Background The aim of this article is to explore preventive health dialogues in general practice in the context of a pilot study of a Danish primary preventive intervention ‘TOF’ (a Danish acronym for ‘Early Detection and Prevention’) carried out in 2016. The intervention consisted of 1) a stratification of patients into one of four groups, 2) a digital support system for both general practitioners and patients, 3) an individual digital health profile for each patient, and 4) targeted preventive services in either general practice or a municipal health center. Methods The empirical material in this study was obtained through 10 observations of preventive health dialogues conducted in general practices and 18 semi-structured interviews with patients and general practitioners. We used the concept of ‘motivational work’ as an analytical lens for understanding preventive health dialogues in general practice from the perspectives of both general practitioners and patients. Results While the health dialogues in TOF sought to reveal patients’ motivations, understandings, and priorities related to health behavior, we find that the dialogues were treatment-oriented and structured around biomedical facts, numeric standards, and risk factor guidance. Overall, we find that numeric standards and quantification of motivation lessens the dialogue and interaction between General Practitioner and patient and that contextual factors relating to the intervention framework, such as a digital support system, the general practitioners’ perceptions of their professional position as well as the patients’ understanding of prevention —in an interplay—diminished the motivational work carried out in the health dialogues. Conclusion The findings show that the influence of different kinds of context adds to the complexity of prevention in the clinical encounter which help to explain why motivational work is difficult in general practice.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahboobeh Asadi ◽  
Mahnaz Noroozi ◽  
Mousa Alavi

Abstract Background Numerous changes occur in different aspects of women’s lives in the postpartum period. Women’s adjusting with problems and taking advantage of this opportunity can develop their personality. In this regard, accurate knowledge of their experiences and feelings is necessary to help them to benefit from this period. Therefore, the present study aimed to explore the experiences related to postpartum changes in women. Methods In the present qualitative study, 23 participants, including women of childbearing age who gave birth and healthcare providers (midwives and obstetricians) in Isfahan, Iran were selected using purposive sampling with a maximum variation strategy. Data were collected through in-depth semi structured interviews, field notes, and daily notes, and simultaneously analyzed using the conventional qualitative content analysis. Results The data analysis results led to the extraction of three main categories including “feeling of decreased female attractiveness” (with two sub-categories of “ feeling of decreased beauty” and “feeling of decreased sexual function”), “feeling of insolvency and helplessness” (with two sub-categories of “physical burnout”, and “mental preoccupations”) and “beginning a new period in life” (with three sub-categories of “changing the meaning of life”, “feeling of maturity” and “deepening the communication”). Conclusions Findings of this study can provide a good context for designing interventions to improve the women’s quality of life by explaining and highlighting their experiences in the postpartum period. In this regard, providing sufficient empathy, social and psychological support from family members (especially husband), performing appropriate educational interventions and also regular assessment of women’s psychological state by healthcare providers in postpartum period can reduce their concerns and help to improve their health.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Åse Lundin ◽  
Anna Bergenheim

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.


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