scholarly journals Supporting Self-Management in Bipolar Disorder: Mixed-Methods Knowledge Translation Study

10.2196/13493 ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. e13493 ◽  
Author(s):  
Erin E Michalak ◽  
Emma Morton ◽  
Steven J Barnes ◽  
Rachelle Hole ◽  
Greg Murray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Mixed Methods ◽  
Chronic Disease ◽  
Knowledge Translation ◽  
Digital Health ◽  
Self Management ◽  
Web Based ◽  
Health Technologies

Background Self-management is increasingly recognized as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life. Digital health technologies have strong potential as a method to support the application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximize user engagement with digital platforms. Objective The aims of this study were (1) to create an innovative Web-based Bipolar Wellness Centre, (2) to conduct a mixed-methods (ie, quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (ie, knowledge translation [KT]), and (3) to support engagement with the self-management information in the Bipolar Wellness Centre. Methods The project was implemented in 2 phases. In phase 1, community-based participatory research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management of BD. In phase 2, a mixed-methods evaluation was conducted to explore the potential impact of 4 KT strategies (Web-based webinars, Web-based videos, Web-based one-to-one Living Library peer support, and in-person workshops). Quantitative assessments occurred at 2 time points—preintervention and 3 weeks postintervention. Purposive sampling was used to recruit a subsample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately 3 weeks postintervention. Results A total of 94 participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the 4 KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (F1,77=5.887; P=.02) and Quality of Life in Bipolar Disorder (F1,77=8.212; P=.005). Nonsignificant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms but increased after the Living Library and workshop arms. A subsample of 43 participants was included in the qualitative analyses, with the majority of participants describing positive experiences with the 4 KT strategies; peer contact was emphasized as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos. Conclusions This study adds incremental evidence to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesized as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed in this paper.

scholarly journals Supporting Self-Management in Bipolar Disorder: Mixed-Methods Knowledge Translation Study (Preprint)

2019 ◽  
Author(s):  
Erin E Michalak ◽  
Emma Morton ◽  
Steven J Barnes ◽  
Rachelle Hole ◽  
Greg Murray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Mixed Methods ◽  
Chronic Disease ◽  
Knowledge Translation ◽  
Digital Health ◽  
Self Management ◽  
Web Based ◽  
Health Technologies

BACKGROUND Self-management is increasingly recognized as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life. Digital health technologies have strong potential as a method to support the application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximize user engagement with digital platforms. OBJECTIVE The aims of this study were (1) to create an innovative Web-based Bipolar Wellness Centre, (2) to conduct a mixed-methods (ie, quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (ie, knowledge translation [KT]), and (3) to support engagement with the self-management information in the Bipolar Wellness Centre. METHODS The project was implemented in 2 phases. In phase 1, community-based participatory research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management of BD. In phase 2, a mixed-methods evaluation was conducted to explore the potential impact of 4 KT strategies (Web-based webinars, Web-based videos, Web-based one-to-one Living Library peer support, and in-person workshops). Quantitative assessments occurred at 2 time points—preintervention and 3 weeks postintervention. Purposive sampling was used to recruit a subsample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately 3 weeks postintervention. RESULTS A total of 94 participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the 4 KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (F1,77=5.887; P=.02) and Quality of Life in Bipolar Disorder (F1,77=8.212; P=.005). Nonsignificant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms but increased after the Living Library and workshop arms. A subsample of 43 participants was included in the qualitative analyses, with the majority of participants describing positive experiences with the 4 KT strategies; peer contact was emphasized as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos. CONCLUSIONS This study adds incremental evidence to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesized as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed in this paper.

Supporting Self-Management and Quality of Life in Bipolar Disorder with the Beta PolarUs App: Protocol for a Mixed-Methods Study (Preprint)

2022 ◽  
Author(s):  
Erin E Michalak ◽  
Steven J Barnes ◽  
Emma Morton ◽  
Heather O'Brien ◽  
Greg Murray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Management Strategies ◽  
Community Based Participatory Research ◽  
Self Management ◽  
Community Based ◽  
Self Monitoring ◽  
Web Based ◽  
Beta Version

BACKGROUND Quality of life (QoL) is increasingly recognised as a key outcome of self-management interventions for bipolar disorder (BD). Mobile phone applications (apps) can increase access to evidence-based self-management strategies and provide real-time support. However, while individuals with lived experience desire support with monitoring and improving broader health domains, existing BD apps largely target mood symptoms only. Further, evidence from the broader mHealth literature has shown that the desires and goals of end-users are not adequately taken into account during app development, and as a result engagement with mental health apps is suboptimal. To capitalise on the potential of apps to optimise wellness in BD, there is a need for interventions developed in consultation with real-world users that are designed to support QoL self-monitoring and self-management. Objective: This mixed methods pilot study is designed to evaluate the beta version of the newly developed PolarUs app, which aims to support QoL self-monitoring and self-management in people with BD. Developed using a community-based participatory research framework, the PolarUs app builds on the web-based adaptation of a BD-specific QoL self-assessment measure, and integrates material from a web-based portal providing information on evidence-informed self-management strategies in BD. OBJECTIVE The primary objectives of this project are to: (1) evaluate PolarUs app feasibility (via behavioral usage metrics); (2) evaluate PolarUs impact (via the Brief Quality of Life in Bipolar Disorders, QoL.BD scale, our primary outcomes measure); and (3) explore engagement with the PolarUs app (via both quantitative and qualitative methods). METHODS Study participants will be North American residents (N=150) aged 18-65 years with a DSM-5 diagnosis of BD-I, BD-II or BD not otherwise specified (NOS) as assessed by a structured diagnostic interview. An embedded mixed-methods research design will be adopted; qualitative interviews with a purposefully selected sub-sample (~n=30) of participants will be conducted to explore in more depth feasibility, impact and engagement with the PolarUs app over the 12-week study period. RESULTS At the time of publication of this protocol, the development of the beta version of the PolarUs app is complete. Participant enrollment is expected to begin in February 2022. Data collection is expected to be completed by December 2022. CONCLUSIONS Beyond contributing knowledge on the feasibility and impacts of a novel app to support QoL and self-management in BD, this study is also expected to provide new knowledge on engagement with mHealth apps. Furthermore, it is expected to function as a case study of successful co-design between individuals living with BD, clinicians who specialise in the treatment of BD, and BD researchers, providing a template for future use of community-based participatory research frameworks in mHealth intervention development. Results will be used to further refine the PolarUs app and inform the design of a larger clinical trial.

scholarly journals Pragmatic Randomized Trial Assessing the Impact of Digital Health Technology on Quality of Life in Patients With Congestive Heart Failure: Design and Rationale

2021 ◽  
Author(s):  
Angela M. Victoria-Castro ◽  
Melissa Martin ◽  
Yu Yamamoto ◽  
Tariq Ahmad ◽  
Tanima Arora ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Digital Health ◽  
Digital Technologies ◽  
Management Tool ◽  
Self Management ◽  
Health Technologies ◽  
The Impact

Heart failure is a complex syndrome that contributes significantly to mortality and morbidity in the Unites States. Self- management is an ACC/AHA-recommended management tool for chronic conditions, however, those with congestive heart failure have historically poor compliance, low health literacy, and comorbidities that lead to reduced adherence to therapies and lifestyle modifications. Digital health technologies have the potential to enhance care and improve self-management. This manuscript describes the rationale and challenges of the design and implementation of a pragmatic randomized controlled trial to evaluate the efficacy of three digital health technologies in the management of congestive heart failure. Leveraging the use of a fully electronic enrollment and consent platform, the trial will randomize 200 patients across heart failure clinics in the Yale New Haven Health system to receive either usual care or one of three distinct digital technologies designed to promote self-management and provide critical data to clinicians. Our primary outcome will measure the change in quality of life as assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ) at 3 months. Initial recruitment efforts have highlighted the large digital divide in our population of interest. Assessing not only clinical outcomes, but patient usability and ease of clinical integration of digital technologies will prove beneficial in determining the feasibility and success of the integration of such technologies into the healthcare system. Future learnings will illustrate strategies to improve patient engagement with, and integration of, digital health technologies to enhance the patient-clinician relationship.

scholarly journals Experiences of a Web-Based Quality of Life Self-Monitoring Tool for Individuals With Bipolar Disorder: A Qualitative Exploration (Preprint)

2019 ◽  
Author(s):  
Emma Morton ◽  
Rachelle Hole ◽  
Greg Murray ◽  
Simone Buzwell ◽  
Erin Michalak
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Assessment Tool ◽  
Self Management ◽  
Care Providers ◽  
Self Assessment ◽  
Self Monitoring ◽  
Web Based ◽  
Qualitative Exploration

BACKGROUND Self-monitoring of symptoms is a cornerstone of psychological interventions in bipolar disorder (BD), but individuals with lived experience also value tracking holistic outcomes, such as quality of life (QoL). Importantly, self-monitoring is not always experienced positively by people with BD and may have lower than expected rates of engagement. Therefore, before progressing into QoL tracking tools, it is important to explore user perspectives to identify possible risks and benefits, optimal methods to support engagement, and possible avenues to integrate QoL self-monitoring practices into clinical work. OBJECTIVE This study aimed to conduct a qualitative exploration of how individuals with BD engaged with a Web-based version of a BD-specific QoL self-monitoring instrument, the QoL tool. METHODS A total of 43 individuals with BD engaged with a self-management intervention with an optional Web-based QoL self-assessment tool as part of an overarching mixed method study. Individuals were later interviewed about personal experiences of engagement with the intervention, including experiences of gauging their own QoL. A thematic analysis was used to identify salient aspects of the experience of QoL self-monitoring in BD. RESULTS In total, 4 categories describing people’s experiences of QoL self-monitoring were identified: (1) breadth of QoL monitoring, (2) highlighting the positive, (3) connecting self-monitoring to action, and (4) self-directed patterns of use. CONCLUSIONS The findings of this research generate novel insights into ways in which individuals with BD experience the Web-based QoL self-assessment tool. The value of tracking the breadth of domains was an overarching aspect, facilitating the identification of both areas of strength and life domains in need of intervention. Importantly, monitoring QoL appeared to have an inherently therapeutic quality, through validating flourishing areas and reinforcing self-management efforts. This contrasts the evidence suggesting that symptom tracking may be distressing because of its focus on negative experiences and positions QoL as a valuable adjunctive target of observation in BD. Flexibility and personalization of use of the QoL tool were key to engagement, informing considerations for health care providers wishing to support self-monitoring and future research into Web- or mobile phone–based apps.

scholarly journals Experiences of a Web-Based Quality of Life Self-Monitoring Tool for Individuals With Bipolar Disorder: A Qualitative Exploration

10.2196/16121 ◽  
2019 ◽  
Vol 6 (12) ◽  
pp. e16121 ◽  
Author(s):  
Emma Morton ◽  
Rachelle Hole ◽  
Greg Murray ◽  
Simone Buzwell ◽  
Erin Michalak
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Assessment Tool ◽  
Self Management ◽  
Care Providers ◽  
Self Assessment ◽  
Self Monitoring ◽  
Web Based ◽  
Qualitative Exploration

Background Self-monitoring of symptoms is a cornerstone of psychological interventions in bipolar disorder (BD), but individuals with lived experience also value tracking holistic outcomes, such as quality of life (QoL). Importantly, self-monitoring is not always experienced positively by people with BD and may have lower than expected rates of engagement. Therefore, before progressing into QoL tracking tools, it is important to explore user perspectives to identify possible risks and benefits, optimal methods to support engagement, and possible avenues to integrate QoL self-monitoring practices into clinical work. Objective This study aimed to conduct a qualitative exploration of how individuals with BD engaged with a Web-based version of a BD-specific QoL self-monitoring instrument, the QoL tool. Methods A total of 43 individuals with BD engaged with a self-management intervention with an optional Web-based QoL self-assessment tool as part of an overarching mixed method study. Individuals were later interviewed about personal experiences of engagement with the intervention, including experiences of gauging their own QoL. A thematic analysis was used to identify salient aspects of the experience of QoL self-monitoring in BD. Results In total, 4 categories describing people’s experiences of QoL self-monitoring were identified: (1) breadth of QoL monitoring, (2) highlighting the positive, (3) connecting self-monitoring to action, and (4) self-directed patterns of use. Conclusions The findings of this research generate novel insights into ways in which individuals with BD experience the Web-based QoL self-assessment tool. The value of tracking the breadth of domains was an overarching aspect, facilitating the identification of both areas of strength and life domains in need of intervention. Importantly, monitoring QoL appeared to have an inherently therapeutic quality, through validating flourishing areas and reinforcing self-management efforts. This contrasts the evidence suggesting that symptom tracking may be distressing because of its focus on negative experiences and positions QoL as a valuable adjunctive target of observation in BD. Flexibility and personalization of use of the QoL tool were key to engagement, informing considerations for health care providers wishing to support self-monitoring and future research into Web- or mobile phone–based apps.

Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

2020 ◽  
Author(s):  
Rebecca O’Hara ◽  
Heather Rowe ◽  
Jane Fisher
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Disease Management ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Self Management ◽  
Cross Sectional ◽  
Female Population ◽  
Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

scholarly journals Correction: Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study

10.2196/33506 ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. e33506
Author(s):  
Anna Hatzioannou ◽  
Andreas Chatzittofis ◽  
Virginia Sunday Koutroubas ◽  
Evridiki Papastavrou ◽  
Maria Karanikola
Keyword(s):  
Bipolar Disorder ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Self Management ◽  
Management Skills ◽  
Web Based ◽  
Combined Use

Clinical Integration of Digital Solutions in Health Care: An Overview of the Current Landscape of Digital Technologies in Cancer Care

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Shivank Garg ◽  
Noelle L. Williams ◽  
Andrew Ip ◽  
Adam P. Dicker
Keyword(s):  
Quality Of Life ◽  
Artificial Intelligence ◽  
Health Care ◽  
Data Collection ◽  
Patient Outcomes ◽  
Cancer Care ◽  
Digital Health ◽  
Health Technologies ◽  
Health Care Value

Digital health constitutes a merger of both software and hardware technology with health care delivery and management, and encompasses a number of domains, from wearable devices to artificial intelligence, each associated with widely disparate interaction and data collection models. In this review, we focus on the landscape of the current integration of digital health technology in cancer care by subdividing digital health technologies into the following sections: connected devices, digital patient information collection, telehealth, and digital assistants. In these sections, we give an overview of the potential clinical impact of such technologies as they pertain to key domains, including patient education, patient outcomes, quality of life, and health care value. We performed a search of PubMed ( www.ncbi.nlm.nih.gov/pubmed ) and www.ClinicalTrials.gov for numerous terms related to digital health technologies, including digital health, connected devices, smart devices, wearables, activity trackers, connected sensors, remote monitoring, electronic surveys, electronic patient-reported outcomes, telehealth, telemedicine, artificial intelligence, chatbot, and digital assistants. The terms health care and cancer were appended to the previously mentioned terms to filter results for cancer-specific applications. From these results, studies were included that exemplified use of the various domains of digital health technologies in oncologic care. Digital health encompasses the integration of a vast array of technologies with health care, each associated with varied methods of data collection and information flow. Integration of these technologies into clinical practice has seen applications throughout the spectrum of care, including cancer screening, on-treatment patient management, acute post-treatment follow-up, and survivorship. Implementation of these systems may serve to reduce costs and workflow inefficiencies, as well as to improve overall health care value, patient outcomes, and quality of life.

scholarly journals Digital Health Literacy in Bipolar Disorder: International Web-Based Survey (Preprint)

2021 ◽  
Author(s):  
Emma Morton ◽  
Kendall Ho ◽  
Steven J Barnes ◽  
Erin E Michalak
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Health Literacy ◽  
Technology Use ◽  
Digital Health ◽  
Health Resources ◽  
Postgraduate Education ◽  
Ease Of Use ◽  
Self Management ◽  
Web Based

BACKGROUND Web-based resources can support people with bipolar disorder (BD) to improve their knowledge and self-management. However, publicly available resources are heterogeneous in terms of their quality and ease of use. Characterizing digital health literacy (the skillset that enable people to navigate and make use of health information in a web-based context) in BD will support the development of educational resources. OBJECTIVE The aim of this study was to develop understanding of digital health literacy and its predictors in people with BD. METHODS A web-based survey was used to explore self-reported digital health literacy (as measured by the e-Health Literacy Scale [eHEALS]) in people with BD. Multiple regression analysis was used to evaluate potential predictors, including demographic/clinical characteristics and technology use. RESULTS A total of 919 respondents (77.9% female; mean age 36.9 years) completed the survey. Older age (β=0.09; <i>P</i>=.01), postgraduate education (β=0.11; <i>P</i>=.01), and current use of self-management apps related to BD (β=0.13; <i>P</i>&lt;.001) were associated with higher eHEALS ratings. CONCLUSIONS Levels of self-reported digital health literacy were comparable or higher than other studies in the general population and specific physical/mental health conditions. However, individuals with BD who are younger, have completed less education, or are less familiar with mental health apps may require extra support to safely and productively navigate web-based health resources. Relevant educational initiatives are discussed. Future studies should evaluate skill development interventions for less digitally literate groups.

A Collaborative m-Health Platform for Evidence-Based Self-Management and Detection of Chronic Multimorbidity Development and Progression

2016 ◽  
pp. 52-71
Author(s):  
Kostas Giokas ◽  
Panagiotis Katrakazas ◽  
Dimitris Koutsouris
Keyword(s):  
Quality Of Life ◽  
Chronic Disease ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Evidence Based ◽  
Age Group ◽  
Guidelines Development ◽  
Utilization Of Healthcare

The ageing process of EU population has played a key role raising the prevalence of chronic disease, with more than 80% of people in the last age group (65-74) reported to be having three or more long-term Multimorbidity or Multiple Chronic Conditions (MCCs). The main problem is that currently, clinicians have limited guidance, as well as evidence of how to approach care decisions for such patients. As a consequence, the understanding of how to best take care of patients with multimorbidity conditions, may lead to improvements in Quality of Life (QoL), utilization of healthcare, safety, morbidity and mortality. The root of this problem is not narrowly confined to guidelines development and application, but is inherent throughout the translational path from the generation of evidence to the synthesis of the evidence upon which guidelines depend.

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