scholarly journals Electronic, mobile and telehealth tools for vulnerable patients with chronic disease: a systematic review and realist synthesis

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e019192 ◽  
Author(s):  
Sharon Parker ◽  
Amy Prince ◽  
Louise Thomas ◽  
Hyun Song ◽  
Diana Milosevic ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Literacy ◽  
Healthcare Providers ◽  
Chronic Health Condition ◽  
Vulnerable Groups ◽  
Self Management ◽  
Future Research ◽  
Ehealth Literacy ◽  
Health Technologies ◽  
Vulnerable Patients

ObjectivesThe objective of this review was to assess the benefit of using electronic, mobile and telehealth tools for vulnerable patients with chronic disease and explore the mechanisms by which these impact patient self-efficacy and self-management.DesignWe searched MEDLINE, all evidence-based medicine, CINAHL, Embase and PsychINFO covering the period 2009 to 2018 for electronic, mobile or telehealth interventions. Quality was assessed according to rigour and relevance. Those studies providing a richer description (‘thick’) were synthesised using a realist matrix.Setting and participantsStudies of any design conducted in community-based primary care involving adults with one or more diagnosed chronic health condition and vulnerability due to demographic, geographic, economic and/or cultural characteristics.ResultsEighteen trials were identified targeting a range of chronic conditions and vulnerabilities. The data provided limited insight into the mechanisms underpinning these interventions, most of which sought to persuade vulnerable patients into believing they could self-manage their conditions through improved symptom monitoring, education and support and goal setting. Patients were relatively passive in the interaction, and the level of patient response attributed to their intrinsic level of motivation. Health literacy, which may be confounded with motivation, was only measured in one study, and eHealth literacy was not assessed.ConclusionsResearch incorporating these tools with vulnerable groups is not comprehensive. Apart from intrinsic motivation, health literacy may also influence the reaction of vulnerable groups to technology. Social persuasion was the main way interventions sought to achieve better self-management. Efforts to engage patients by healthcare providers were lower than expected. Use of social networks or other eHealth mechanisms to link patients and provide opportunities for vicarious experience could be further explored in relation to vulnerable groups. Future research could also assess health and eHealth literacy and differentiate the specific needs for vulnerable groups when implementing health technologies.

scholarly journals Predisposing Factors Promoting COVID-19 Infection and Mortality

2021 ◽  
pp. 43-48
Author(s):  
Azike, Chidimma Anthonia ◽  
Jeremiah Owubokiri Ngowari ◽  
Orudukobipi Tamunonengiye-Ofori
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Low Income ◽  
Negative Impact ◽  
Healthcare Delivery ◽  
Respiratory Illness ◽  
Vulnerable Groups ◽  
Future Research ◽  
Movement Restriction ◽  
Quality Health Care

The pandemic of COVID-19 infection has had an untold adverse impact on patients living with chronic disease, across various ethnicity/race, age and gender. Underlying hypertension, cardiovascular disease, diabetes and respiratory illness are key risk factors for the development of severe COVID-19 pneumonia and systematic inflammation. Patients who are immunosuppressed by virtue of their chronic disease, age or a therapy have been identified as susceptible groups. The redirection of healthcare services towards the increasing numbers of COVID-19 patients has compromised the healthcare delivery to patients with chronic illness. Movement restriction measures as approach to curb the spread of the infection have also compromised the metabolic health of many patients who need enhanced physical activity to improve their health. Media publications on COVID-19 infection and restrictions may have also contributed to the poor mental health of some individuals, especially patients with underlying mental conditions or its risk factors. The inadequate or availability of quality health care system across low income and developing regions especially, those with older age groups, has further accelerated the spread and death rate from COVID-19. Future research should be directed towards protecting vulnerable groups from possible waves of COVID-19 as a measure to reduce the negative impact of the pandemic on these individuals.

Digital health technologies for long term self-management of osteoporosis: a systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Ghada Alhussein ◽  
Leontios Hadjileontiadis
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Self Management ◽  
Current Status ◽  
Future Research ◽  
Common Chronic Disease ◽  
Health Technologies ◽  
Management Interventions

BACKGROUND Osteoporosis is the fourth most common chronic disease in the world. Adopting preventative measures and effective self-management interventions help in improving bone health. Mobile health (mHealth) technologies can play a key role in osteoporosis patient care and self- management. OBJECTIVE This study presents a systematic review and meta-analysis of the currently available mHealth applications targeting osteoporosis self-management, aiming to determine the current status, gaps and challenges the future research could address, proposing appropriate recommendations. METHODS In this systematic review and meta-analysis, we searched PubMed, Scopus, EBSCO, Web of Science, and IEEExplore databases between Jan 1, 2010 and May 31, 2021, for all English publications that describe apps dedicated to or being useful for osteoporosis, targeting self-management, nutrition, physical activity, risk assessment, delivered on smartphone devices for young and older adults. In addition, a survey of all osteoporosis-related apps available in iOS and Android app stores as of May 31, 2021 was also conducted. Primary outcomes of interest were the prevention or reduction of unhealthy behaviours or improvement in healthy behaviours of the six behaviours. Outcomes were summarised in a narrative synthesis and combined using random-effects meta-analysis. RESULTS In total, 3906 unique articles were identified. Of these, 32 articles met the inclusion criteria and were reviewed in depth. The 32 studies were comprising 14 235 participants, of whom on average 69.5% were female, with a mean age of 49.8 years (SD 17.8). The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth supported interventions resulted in a significant reduction in pain (Hedge’s g -1.09, 95%CI -1.68 to -0.45) and disability (Hedge’s g -0.77, 95%CI -1.59 to 0.05). The post-treatment effect of the digital intervention was significant for physical function (Hedge’s g 2.54, 95%CI -4.08 to 4.08); yet nonsignificant for wellbeing (Hedge’s g 0.17, 95% CI -1.84 to 2.17), physical activity (Hedges’ g 0.09, 95%CI -0.59 to 0.50), anxiety (Hedge’s g -0.29, 95%CI -6.11 to 5.53), fatigue (Hedge’s g -0.34, 95%CI -5.84 to 5.16), calcium (Hedge’s g -0.05, 95%CI -0.59 to 0.50) and vitamin D (Hedge’s g 0.10, 95% CI -4.05 to 4.26) intake, and trabecular score (Hedge’s g 0.06, 95%CI -1.00 to 1.12). CONCLUSIONS Osteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be a valuable tool for patients and health professionals. However, the majority of the apps that are currently available lack clinically validated evidence of their efficacy and they most focus on a limited number of symptoms. A more holistic and personalized approach, within a co-creation design ecosystem, is needed.

Caring for the Family Caregiver

2020 ◽  
pp. 200-214
Author(s):  
Elaine Wittenberg ◽  
Joy V. Goldsmith ◽  
Sandra L. Ragan ◽  
Terri Ann Parnell
Keyword(s):  
Health Literacy ◽  
Family Caregiver ◽  
Contextual Factors ◽  
Healthcare Providers ◽  
Self Care ◽  
Future Research ◽  
Disease Information ◽  
The Family ◽  
Caregiver Needs ◽  
Literacy Framework

There is little evidence for caregiver assessment and interventions based on unique social and contextual factors of caregiving. Current approaches to caring for the family caregiver involve a “one size fits all” approach where caregiver assessment may or may not occur, and there is no link between identification of caregiver needs and recommended resources. When caregiver assessment does occur, it does not involve unique caregiving characteristics that positively impact communication and health literacy. Caring for the Family Caregiver, a communication and health literacy framework, is introduced and consists of teaching healthcare providers to address caregiving types by finding disease information, assessing and integrating information, partnering with the caregiver, finding support, talking with the caregiver, and planning for caregiver self-care. Directions for future research are also summarized.

scholarly journals A Comprehensive Analysis of E-Health Literacy Research Focuses and Trends

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 66
Author(s):  
Chen Wang ◽  
Xiangyi Wu ◽  
Huiying Qi
Keyword(s):  
Health Literacy ◽  
Future Research ◽  
Ehealth Literacy ◽  
Health Promotion Behaviors ◽  
Intervention Measures ◽  
Evolution Path ◽  
Core Dataset ◽  
Research Themes ◽  
Long Term Impact ◽  
Literacy Research

Objective: To sort out the research focuses in the field of e-health literacy, analyze its research topics and development trends, and provide a reference for relevant research in this field in the future. Methods: The literature search yielded a total of 431 articles retrieved from the core dataset of Web of Science using the keywords “ehealth literacy”, “E-health literacy” and “electronic health literacy”. A bibliometric analysis was performed by using CiteSpace to explore the development history, hot themes, and trends of future research in the field of e-health literacy. Results: The thematic evolution path in e-health literacy was divided into three stages. The research focuses were inspected from four aspects: evaluation, correlation with health-promotion behaviors, influencing factors, and intervention measures for improvement. Conclusion: E-health literacy research faces challenges such as the development of the connotation of the term, the objectivity of evaluation methods, and the long-term impact of interventions. Future research themes in e-health literacy will include the standardization of evaluation instruments and the individualization of therapeutic strategies.

scholarly journals ehealth literacy and health literacy among immigrants and their descendants compared with women of Danish origin: a cross-sectional study using a multidimensional approach among pregnant women

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e037076
Author(s):  
Sarah Fredsted Villadsen ◽  
Hajer Hadi ◽  
Israa Ismail ◽  
Richard H Osborne ◽  
Claus Thorn Ekstrøm ◽  
...  
Keyword(s):  
Health Literacy ◽  
Health System ◽  
Pregnant Women ◽  
Immigrant Women ◽  
Healthcare Providers ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Ehealth Literacy ◽  
Digital Services ◽  
The Mean

ObjectiveTo explore ehealth literacy, ability to actively engage with healthcare providers and health system navigation among pregnant immigrant women and their descendants compared with women of Danish origin.Design and settingA cross-sectional survey at antenatal clinics in 2016, Denmark.ParticipantsPregnant women attending antenatal care (n=405).Outcome measuresThe eHealth Literacy Questionnaire (eHLQ) and two domains from the Health Literacy Questionnaire (HLQ): ability to actively engage with healthcare providers and health system navigation. Range of response options for eHLQ (1–4) and HLQ (1–5). With mixed-effect linear regressions, eHLQ and HLQ among immigrants and their descendants compared with women of Danish origin were assessed.ResultsThe response rate was 75%. The overall trend was lower ehealth literacy and HLQ domains among immigrants and their descendants compared with women of Danish origin. For ehealth literacy, the results suggest that challenges related more to digital abilities than motivation, trust and access to technology. The mean ability to engage with digital services was 3.20 (SD 0.44) for women of Danish origin. Non-Western descendants (−0.14, 95% CI −0.31 to 0.02), non-Western (−0.20, 95% CI −0.34 to −0.06) and Western (−0.22, 95% CI −0.39 to −0.06) immigrants had lower adjusted means of this outcome. No differences in motivation to engage with digital services were found for descendants (−0.00, 95% CI −0.17 to 0.17), non-Western (0.03, 95% CI −0.11 to 0.18) or Western (−0.06, 95% CI −0.23 to 0.10) immigrants compared with the mean of the reference (2.85, SD 0.45). Lower ability to engage with healthcare providers was found for non-Western born immigrants (−0.15, CI 95% −0.30 to −0.01) compared with the mean of women with Danish origin (4.15, SD 0.47).ConclusionGenerally, descendant and immigrant women had lower levels of ehealth literacy and health literacy than women of Danish origin. These differences are potentially antecedents of adverse birth outcomes and could inform structural efforts to mitigate health inequalities.

scholarly journals Health Literacy in Diabetes management: A priority in health care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D do Ó ◽  
J Raposo ◽  
A Goes ◽  
I Loureiro
Keyword(s):  
Health Literacy ◽  
Glycemic Control ◽  
Health Information ◽  
General Health ◽  
Healthcare Providers ◽  
Well Being ◽  
Good Health ◽  
Self Management ◽  
Sufficient Information ◽  
Positive Perception

Abstract Background Glycemic control and self-management of diabetes are influenced by a range of factors, including health literacy - the ability to access, understand, appraise, and use health information. This study explored associations between domains of health literacy (HL), glycemic control and perceived general health in people with diabetes. Methodology Cross-sectional study, with 453 people with diabetes,attending the Portuguese Diabetes Association (APDP). We collected information on HL, demographics, glycemic control and self-perception of health. HL was assessed using the Health Literacy Questionnaire. Descriptive and correlational analysis were performed. Results 85.4% consider Feeling understood and supported by healthcare providers but only 54.1% have the Ability to actively engage with healthcare providers and 27.8% feel the Ability to find good health information,66.5% consider Having sufficient information to manage my health but only 38.7% are Understanding health information well enough to know what to do and 28.5% refer the Ability to find good health information. Higher HL scores were associated with better glycemic control and more positive perception of general health(GH) across the following domains: Having sufficient information to manage my health, Appraisal of health information, Ability to find good health information, Actively managing my health and social support for health. The domains Ability to actively engage with healthcare providers and Navigating the healthcare system were also associated with more positive perception of GH. Associations achieved either p < 0.001 or p < 0.05. Considering HL levels, a statistically significant negative association was found with the levels of HbA1c and positive association with perceived general health, even for functional HL. Conclusions The results emphasize the importance of improving the level of HL of people with diabetes in order to improve glycemic control and the perceive General Health Key messages Health literacy is critical for diabetes self-management. People with diabetes need to understand and use health information to promote well-being and diabetes control.

My health, myself: a qualitative study on motivations for effective chronic disease self-management among community dwelling adults

2020 ◽  
Vol 37 (6) ◽  
pp. 839-844
Author(s):  
Muhammad Danial Hadi ◽  
Yongxing Patrick Lin ◽  
Ee-Yuee Chan
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Good Health ◽  
Community Dwelling ◽  
Self Control ◽  
Self Management ◽  
Management Support ◽  
Healthcare Provision

Abstract Background Chronic diseases continue to be a significant cause of morbidity and mortality despite modifiable risk factors. This suggests that current primary healthcare provision needs to delve beyond patient education, to understand the motivators that drive patients to undertake chronic disease self-management. Understanding these motivations within the context of a multi-cultural community can facilitate tailored support for chronic disease self-management. Objectives To explore the motivations behind effective chronic disease self-management in community dwelling adults in Singapore. Methods A qualitative descriptive study was carried out in five clinics in a large medical centre. Twelve participants who were assessed to be optimally managing their chronic diseases were recruited using purposive sampling. Individual in-depth interviews were conducted until data saturation, with data thematically analysed. Results Three salient themes emerged from the data. Firstly, ‘Regaining self-control, avoiding complications’ describes the participants’ journey towards personal mastery in self-management, as well as a fear of debilitating complications resulting in their desire for good health. Secondly, ‘Preserving social identities and roles’ illustrates how participants yearn to maintain their pre-existing roles and functions through maintenance of their health. Finally, ‘Accessing proximal support systems’ highlights resources and supports surrounding the participants that encourage continued chronic disease self-management. Within each theme, specific motivators and challenges encountered by participants in their self-management journey were discussed. Conclusions Findings can prompt primary healthcare providers to leverage on the patients’ life goals and social roles in chronic disease self-management support. This may empower patients to engage in self-management and strengthen primary care provision.

scholarly journals “Sometimes I don’t have a pulse, and I’m still alive!” Healthcare providers on digital health techs

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Tomasella ◽  
H M Morgan
Keyword(s):  
Digital Health ◽  
Healthcare Providers ◽  
Future Research ◽  
Structured Interviews ◽  
Clinical Value ◽  
Health Technologies ◽  
Advantages And Disadvantages ◽  
Health Related ◽  
Potential Benefits ◽  
Change Promotion

Abstract Background Digital health technologies (DHTs) are increasingly becoming an integral part of our lives, healthcare field included. The WHO recently has even released the first digital health guidelines for worldwide intervention. Commercially available DHTs (e.g. smartphones, smartwatches, apps) may hold significant potential in healthcare, upon successful and constructive integration. Literature on the topic is split between enthusiasm for the potential benefits, and concerns about reliability and effectiveness. Little is known about what healthcare professionals (HCPs) have experienced so far with patients and what they believe the main issues for implementation may be. This study aims to investigate current perceptions of HCPs towards self-tracked health-related outputs from devices and apps available to the public. Methods Nine HCPs volunteered to take part in semi-structured interviews. Data were thematically analysed adopting a pre-constructed framework (deductive approach) based on current (April 2019) literature and the findings from the first two interviews. Results The following main themes were identified and explored in detail: HCPs' experience, perceived knowledge and views on DHTs; advantages and disadvantages; barriers towards healthcare implementation and solutions; future perspectives. While most participants were adopters of DHTs and held positive views about them, their overall experience with patients and the technology was limited. Potential reasons for this included factors such as time/resources availability; colleagues' mindset; lack of evidence of effectiveness for practice; privacy/data security concerns. Conclusions The potential advantages of DHTs' adoption in healthcare are substantial - e.g. patient autonomy, time/resources saving, health and behaviour change promotion. However, future research is warranted focussing on addressing barriers, minimising disadvantages, and assessing the clinical value of commercially available DHTs. Key messages We explored healthcare providers’ views on the role of commercial digital health techs in clinical practice. Despite some privacy and reliability concerns, commercial digital health techs show promise.

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