Quality of life issues in chronic wound management

BACKGROUND Travel to clinics for chronic wound management is burdensome to patients. Remote assessment and management of wounds using mobile and telehealth approaches can reduce this burden and improve patient outcomes. An essential step in wound documentation is the capture of wound images, but poor image quality can have a negative influence on the reliability of the assessment. To date, no study has investigated the quality of remotely acquired wound images and whether these are suitable for wound self-management and telemedical interpretation of wound status. OBJECTIVE Our goal was to develop a mobile health (mHealth) tool for the remote self-assessment of digital ulcers (DUs) in patients with systemic sclerosis (SSc). We aimed to define and validate objective measures for assessing the image quality, evaluate whether an automated feedback feature based on real-time assessment of image quality improves the overall quality of acquired wound images, and evaluate the feasibility of deploying the mHealth tool for home-based chronic wound self-monitoring by patients with SSc. METHODS We developed an mHealth tool composed of a wound imaging and management app, a custom color reference sticker, and a smartphone holder. We introduced 2 objective image quality parameters based on the sharpness and presence of the color checker to assess the quality of the image during acquisition and enable a quality feedback mechanism in an advanced version of the app. We randomly assigned patients with SSc and DU to the 2 device groups (basic and feedback) to self-document their DU at home over 8 weeks. The color checker detection ratio (CCDR) and color checker sharpness (CCS) were compared between the 2 groups. We evaluated the feasibility of the mHealth tool by analyzing the usability feedback from questionnaires, user behavior and timings, and the overall quality of the wound images. RESULTS A total of 21 patients were enrolled, of which 15 patients were included in the image quality analysis. The average CCDR was 0.96 (191/199) in the feedback group and 0.86 (158/183) in the basic group. The feedback group showed significantly higher (<i>P</i><.001) CCS compared to the basic group. The usability questionnaire results showed that the majority of patients were satisfied with the tool, but could benefit from disease-specific adaptations. The median assessment duration was <50 seconds in all patients, indicating the mHealth tool was efficient to use and could be integrated into the daily routine of patients. CONCLUSIONS We developed an mHealth tool that enables patients with SSc to acquire good-quality DU images and demonstrated that it is feasible to deploy such an app in this patient group. The feedback mechanism improved the overall image quality. The introduced technical solutions consist of a further step towards reliable and trustworthy digital health for home-based self-management of wounds.

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Wound Image Quality From a Mobile Health Tool for Home-Based Chronic Wound Management With Real-Time Quality Feedback: Randomized Feasibility Study

JMIR mhealth and uhealth ◽

10.2196/26149 ◽

2021 ◽

Vol 9 (7) ◽

pp. e26149

Author(s):

Jia Zhang ◽

Carina Mihai ◽

Laura Tüshaus ◽

Gaetano Scebba ◽

Oliver Distler ◽

...

Keyword(s):

Image Quality ◽

Chronic Wound ◽

Feedback Mechanism ◽

Wound Management ◽

Self Management ◽

Feedback Group ◽

Quality Feedback ◽

Home Based ◽

Chronic Wound Management

Background Travel to clinics for chronic wound management is burdensome to patients. Remote assessment and management of wounds using mobile and telehealth approaches can reduce this burden and improve patient outcomes. An essential step in wound documentation is the capture of wound images, but poor image quality can have a negative influence on the reliability of the assessment. To date, no study has investigated the quality of remotely acquired wound images and whether these are suitable for wound self-management and telemedical interpretation of wound status. Objective Our goal was to develop a mobile health (mHealth) tool for the remote self-assessment of digital ulcers (DUs) in patients with systemic sclerosis (SSc). We aimed to define and validate objective measures for assessing the image quality, evaluate whether an automated feedback feature based on real-time assessment of image quality improves the overall quality of acquired wound images, and evaluate the feasibility of deploying the mHealth tool for home-based chronic wound self-monitoring by patients with SSc. Methods We developed an mHealth tool composed of a wound imaging and management app, a custom color reference sticker, and a smartphone holder. We introduced 2 objective image quality parameters based on the sharpness and presence of the color checker to assess the quality of the image during acquisition and enable a quality feedback mechanism in an advanced version of the app. We randomly assigned patients with SSc and DU to the 2 device groups (basic and feedback) to self-document their DU at home over 8 weeks. The color checker detection ratio (CCDR) and color checker sharpness (CCS) were compared between the 2 groups. We evaluated the feasibility of the mHealth tool by analyzing the usability feedback from questionnaires, user behavior and timings, and the overall quality of the wound images. Results A total of 21 patients were enrolled, of which 15 patients were included in the image quality analysis. The average CCDR was 0.96 (191/199) in the feedback group and 0.86 (158/183) in the basic group. The feedback group showed significantly higher (P<.001) CCS compared to the basic group. The usability questionnaire results showed that the majority of patients were satisfied with the tool, but could benefit from disease-specific adaptations. The median assessment duration was <50 seconds in all patients, indicating the mHealth tool was efficient to use and could be integrated into the daily routine of patients. Conclusions We developed an mHealth tool that enables patients with SSc to acquire good-quality DU images and demonstrated that it is feasible to deploy such an app in this patient group. The feedback mechanism improved the overall image quality. The introduced technical solutions consist of a further step towards reliable and trustworthy digital health for home-based self-management of wounds.

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Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease

10.1093/oso/9780195169850.001.0001 ◽

2006 ◽

Keyword(s):

Quality Of Life ◽

Sickle Cell Disease ◽

Childhood Cancer ◽

Children And Adolescents ◽

Peer Relationships ◽

Sickle Cell ◽

Cell Disease ◽

Life Issues ◽

Art Research

Over recent decades, tremendous advances in the prevention, medical treatment, and quality of life issues in children and adolescents surviving cancer have spawned a host of research on pediatric psychosocial oncology. This important volume fulfills the clear need for an up-to-date, comprehensive handbook for practitioners that delineates the most recent research in the field--the first of its kind in over a decade. Over 60 renowned authors have been assembled to provide a thorough presentation of the state-of-the art research and literature, with topics including: -Neuropsychological effects of chemotherapy and radiation therapy -Bone marrow transplantation -Important issues about quality of life during and following treatment -Collaborative research among child-focused psychologists -Standards of psychological care for children and adolescents -Stress and coping in the pediatric cancer experience -The role of family and peer relationships The Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease represents both multidisciplinary and international efforts, an alliance between physicians and parents, and a combination of research and service. With a wealth of information of great interest to patients and their families, this volume will also be a welcome resource to the psychologists, psychiatrists, pediatricians, oncologists, nurses, and social workers who confront these issues as they help children and their families through the treatment, recovery, and grieving processes.

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Fluorescent Imaging and Precise Suppression of Bacterial Infection in Chronic Wounds by Porphyrin-Based Metal-Organic Framework Nanorod

Journal of Materials Chemistry B ◽

10.1039/d1tb01649k ◽

2021 ◽

Author(s):

zhen zou ◽

Lihua Zhang ◽

Minzhi Ouyang ◽

Yufei Zhang ◽

Huanxiang Wang ◽

...

Keyword(s):

Bacterial Infection ◽

Antibacterial Agents ◽

Chronic Wounds ◽

Chronic Wound ◽

Metal Organic Framework ◽

Critical Role ◽

Fluorescent Imaging ◽

Wound Management ◽

Metal Organic ◽

Chronic Wound Management

Nano-antibacterial agents play a critical role in chronic wound management. However, an intelligent nanosystem that can provide both visual warning of infection and precise sterilization remains a hurdle. Herein, a...

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COVID-19 and Quality of Life: Twelve Reflections

Applied Research in Quality of Life ◽

10.1007/s11482-020-09898-z ◽

2021 ◽

Author(s):

Daniel T. L. Shek

Keyword(s):

Quality Of Life ◽

Digital Divide ◽

Well Being ◽

Sudden Onset ◽

Economic Disadvantage ◽

Conflict Prevention ◽

Collective Rights ◽

The World ◽

Life Issues

AbstractCOVID-19 has severely affected the world since December 2020. Because of its sudden onset and highly contagious nature, the world has responded in a “crisis management” manner. With effective vaccines almost available, it is appropriate at this time to have some reflections about COVID-19 in relation to the quality of life issues. In this paper, we highlight twelve issues for reflection, which can help us better prepared for future pandemics. These include: digital divide, health inequality, gender inequality, economic disadvantage, family well-being, impact on holistic well-being, economic development versus saving lives, consumption versus environmental protection, individual rights versus collective rights, international collaboration versus conflict, prevention of negative well-being, and promotion of positive well-being.

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