scholarly journals Defining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study (Preprint)

2019 ◽  
Author(s):  
Alice Hibbert ◽  
Markku Vesala ◽  
Micky Kerr ◽  
Kathryn Fackrell ◽  
Stephen Harrison ◽  
...  
Keyword(s):  
Health Care ◽  
Discussion Forum ◽  
Delphi Survey ◽  
Core Outcome ◽  
Plain Language ◽  
Web Based ◽  
Core Set ◽  
Outcome Domain ◽  
Health Concepts ◽  
The Web

BACKGROUND A minimum standard based upon consensus decision making recommends a core set of tinnitus-specific health complaints (outcome domains) that should be assessed and reported in all clinical trials as this enables comparisons to be made across studies as well as data pooling for meta-analysis. OBJECTIVE This study aimed to further clarify how the outcome domain concepts should be defined for 5 of the core set: tinnitus intrusiveness, sense of control, acceptance of tinnitus, concentration, and ability to ignore. This step requires a clear and fully elaborated definition for each outcome domain, moving from an abstract or a vague concept to an operationalized and measurable health-related construct, so that a suitable measurement instrument can then be identified. METHODS A series of 5 focus group–style semistructured discussions were conducted via a Web-based discussion forum, each open for 2 weeks and ending with a vote. The participants included 148 tinnitus experts who completed a preceding e-Delphi survey that had generated the original set of minimum standards. The participants were health care users living with tinnitus, health care professionals, clinical researchers, commercial representatives, and funders. RESULTS The Web discussions led to a revision of all 5 original plain language definitions that had been used in the preceding e-Delphi survey. Each revised definition was voted by 8 to 53 participants and reached the prespecified threshold of 70% consensus for all except tinnitus intrusiveness. Although a single definition was not agreed upon for tinnitus intrusiveness, the majority of participants shared the view that the concept should be sufficiently broad to encapsulate a range of subdomains. The examples included tinnitus awareness, unpleasantness, and impact on different aspects of everyday life. Thematic analysis of the 5 Web-based discussion threads gave important insights into expert interpretations of each core outcome domain, generating an operationalized and measurable health construct in each case. CONCLUSIONS The qualitative data gathered during the Web-based discussion forum provided an important in-depth understanding of the health concepts that had raised a debate during earlier face-to-face meetings. The descriptive summaries and definitions provide sufficient operationalization of those concepts to proceed to the second stage of core outcome set development that is to identify and evaluate suitable measurement instruments. This study supports the use of Web-based peer discussion forums in defining health concepts.

scholarly journals Defining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study

10.2196/14446 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e14446
Author(s):  
Alice Hibbert ◽  
Markku Vesala ◽  
Micky Kerr ◽  
Kathryn Fackrell ◽  
Stephen Harrison ◽  
...  
Keyword(s):  
Health Care ◽  
Discussion Forum ◽  
Delphi Survey ◽  
Core Outcome ◽  
Plain Language ◽  
Web Based ◽  
Core Set ◽  
Outcome Domain ◽  
Health Concepts ◽  
The Web

Background A minimum standard based upon consensus decision making recommends a core set of tinnitus-specific health complaints (outcome domains) that should be assessed and reported in all clinical trials as this enables comparisons to be made across studies as well as data pooling for meta-analysis. Objective This study aimed to further clarify how the outcome domain concepts should be defined for 5 of the core set: tinnitus intrusiveness, sense of control, acceptance of tinnitus, concentration, and ability to ignore. This step requires a clear and fully elaborated definition for each outcome domain, moving from an abstract or a vague concept to an operationalized and measurable health-related construct, so that a suitable measurement instrument can then be identified. Methods A series of 5 focus group–style semistructured discussions were conducted via a Web-based discussion forum, each open for 2 weeks and ending with a vote. The participants included 148 tinnitus experts who completed a preceding e-Delphi survey that had generated the original set of minimum standards. The participants were health care users living with tinnitus, health care professionals, clinical researchers, commercial representatives, and funders. Results The Web discussions led to a revision of all 5 original plain language definitions that had been used in the preceding e-Delphi survey. Each revised definition was voted by 8 to 53 participants and reached the prespecified threshold of 70% consensus for all except tinnitus intrusiveness. Although a single definition was not agreed upon for tinnitus intrusiveness, the majority of participants shared the view that the concept should be sufficiently broad to encapsulate a range of subdomains. The examples included tinnitus awareness, unpleasantness, and impact on different aspects of everyday life. Thematic analysis of the 5 Web-based discussion threads gave important insights into expert interpretations of each core outcome domain, generating an operationalized and measurable health construct in each case. Conclusions The qualitative data gathered during the Web-based discussion forum provided an important in-depth understanding of the health concepts that had raised a debate during earlier face-to-face meetings. The descriptive summaries and definitions provide sufficient operationalization of those concepts to proceed to the second stage of core outcome set development that is to identify and evaluate suitable measurement instruments. This study supports the use of Web-based peer discussion forums in defining health concepts.

scholarly journals The development and process evaluation of the ACTION study: A person-centred communication intervention targeting nurse assistants in home care for older persons

2019 ◽  
Author(s):  
Tanja Gustafsson ◽  
Annelie J Sundler ◽  
Elisabeth Lindberg ◽  
Pernilla Karlsson ◽  
Hanna Maurin Söderholm
Keyword(s):  
Health Care ◽  
Home Care ◽  
Process Evaluation ◽  
Educational Intervention ◽  
Older Persons ◽  
Complex Interventions ◽  
Implementation Process ◽  
Ageing Population ◽  
Web Based ◽  
The Web

Abstract Background A rapidly ageing population challenges the health care system in general and home care services in particular. Communication is a cornerstone of person-centred care. However, little research has been conducted on how to improve communication between health care professionals and older persons in home care contexts, despite research showing the importance of such interactions. The increasing demands on how to best and efficiently improve competence in health professionals is the reason why the ACTION intervention was conducted. This paper aims to describe the development and process evaluation of an educational intervention for nurse assistants (NAs) in home care and highlights the potential of self-directed web-based learning as well as the pitfalls of conducting complex interventions in home care. Methods A web-based educational intervention focusing on person-centred communication was developed that targeted NAs in home care for older persons. Twenty-seven NAs from two units in Sweden were recruited, and 23 NAs were offered the educational intervention. Data were collected from multiple sources before, during and after the intervention and were analysed using quantitative and qualitative methods. Data were extracted from the web platform and analysed to determine the NAs´ engagement in the intervention. Additionally, interviews, evaluation forms and field notes were used to evaluate the feasibility of the intervention. Results The main findings suggest that web-based education seems to be an appropriate strategy in the home care context. The majority of the NAs (91%) participated in full or in part in the intervention. During the implementation process, some adaptions were required to fit the local circumstances regarding technical support, scheduling, and the design of the lectures. The NAs perceived the format to be easy to use and flexible and appreciated the stepwise modules. The content was perceived as valuable. Conclusions Our findings show that the benefits of the web-based educational intervention included the short and focused lectures as well as its accessibility. Challenges with the implementation process included gaining access to the NAs and motivating and involving the NAs. This study emphasizes the environmental support needed to successfully conduct complex interventions, including physical, organizational and cultural aspects.

Health Risk Appraisal Using Internet Technology

2005 ◽  
Vol 44 (02) ◽  
pp. 310-314 ◽  
Author(s):  
K. Yoshida ◽  
M. Suka
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Risk ◽  
Health Examination ◽  
Lifestyle Modifications ◽  
Web Based ◽  
Risk Appraisal ◽  
Health Risk Appraisal ◽  
Individual Health ◽  
The Web

Summary Objective: To develop a Web-based Health Risk Appraisal (HRA) system as a tool for health education based on personal health examination data. Methods: A Japanese health examination database was analyzed to develop models for HRA, which were designed to predict each of ten laboratory values in a year with and without lifestyle modifications. The HRA models were embedded into a server. Results: The Web-based HRA system has been introduced into a Japanese health care association having 37 branch centers. Following a health examination, an individual health education program using the Web-based HRA system is provided to a given client at each branch center or at a client’s office. A measured laboratory value and corresponding predicted laboratory values in a year with and without lifestyle modifications are displayed on the screen in forms of both numerical values and graphs. A trained nurse or another health care provider operates the system and explains the HRA result. Conclusion: The Web-based HRA system will be a practical tool for individual health education following health examination.

scholarly journals Digital Health Technologies Respond to the COVID-19 Pandemic In a Tertiary Hospital in China: Development and Usability Study

10.2196/24505 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e24505 ◽  
Author(s):  
Wanmin Lian ◽  
Li Wen ◽  
Qiru Zhou ◽  
Weijie Zhu ◽  
Wenzhou Duan ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Health ◽  
Tertiary Hospital ◽  
Service Platform ◽  
Web Based ◽  
Symptom Monitoring ◽  
Health Technologies ◽  
Epidemic Period ◽  
Control And Prevention ◽  
The Web

Background The outbreak of COVID-19 has caused a continuing global pandemic. Hospitals are integral to the control and prevention of COVID-19; however, they are facing numerous challenges during the epidemic. Objective Our study aimed to introduce the practical experience of the design and implementation of a web-based COVID-19 service platform at a tertiary hospital in China as well as the preliminary results of the implementation. Methods The web-based COVID-19 service platform was deployed within the health care system of the Guangdong Second Provincial General Hospital and Internet Hospital; the function of the platform was to provide web-based medical services for both members of the public and lay health care workers. The focal functions of this system included automated COVID-19 screening, related symptom monitoring, web-based consultation, and psychological support; it also served as a COVID-19 knowledge hub. The design and process of each function are introduced. The usage data for the platform service were collected and are represented by three periods: the pre-epidemic period (December 22, 2019, to January 22, 2020, 32 days), the controlled period (January 23 to March 31, 2020, 69 days), and the postepidemic period (April 1 to June 30, 2020, 91 days). Results By the end of June 2020, 96,642 people had used the automated COVID-19 screening and symptom monitoring systems 161,884 and 7,795,194 times, respectively. The number of general web-based consultation services per day increased from 30 visits in the pre-epidemic period to 122 visits during the controlled period, then dropped to 73 visits in the postepidemic period. The psychological counseling program served 636 clients during the epidemic period. For people who used the automated COVID-19 screening service, 160,916 (99.40%) of the total users were classified in the no risk category. 464 (0.29%) of the people were categorized as medium to high risk, and 12 people (0.01%) were recommended for further COVID-19 testing and treatment. Among the 96,642 individuals who used the COVID-19 related symptoms monitoring service, 6696 (6.93%) were symptomatic at some point during the monitoring period. Fever was the most frequently reported symptom, with 2684/6696 symptomatic people (40.1%) having had this symptom. Cough and sore throat were also relatively frequently reported by the 6696 symptomatic users (1657 people, 24.7%, and 1622 people, 24.2%, respectively). Conclusions The web-based COVID-19 service platform implemented at a tertiary hospital in China is exhibited to be a role model for using digital health technologies to respond to the COVID-19 pandemic. The digital solutions of automated COVID-19 screening, daily symptom monitoring, web-based care, and knowledge propagation have plausible acceptability and feasibility for complementing offline hospital services and facilitating disease control and prevention.

scholarly journals Smart Cloud Based Efficient Doctor Patient Portal of Healthcare System

2020 ◽  
Vol 1 (1) ◽  
pp. 53-63
Author(s):  
Zahid U. Rahman
Keyword(s):  
Health Care ◽  
Developed Countries ◽  
Patient Portal ◽  
Private Health Care ◽  
Health Issues ◽  
Web Based ◽  
Internet Connectivity ◽  
Health Related ◽  
The Developed Countries ◽  
The Web

Healthcare is one of the most important priority of every country. Most of the developed countries are trying to bring internet to solve health related problems. Meanwhile, healthcare is not that much developed in populated countries like Pakistan. The private health care sector serves more than half of our country’s population. We have tried to develop a web based model to transfer the clinical system into the cloud to overcome the doctor burden, and further assist the patients to find a doctor easily. This can save time of both the doctor and patient. The web based patient-doctor database shows credibility in bringing both the ends near and accessible even in low internet connectivity regions. However, there is a back draw to educate the end users about the complexities in the web based doctor portal. This will provide more insights after eliminating health issues and provide an adequate approach to the patients.

scholarly journals Core Outcome Sets in Miscarriage Trials (COSMisT) study: a study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018535
Author(s):  
Paul Smith ◽  
Natalie Cooper ◽  
Rima Dhillon-Smith ◽  
Emily O’Toole ◽  
T Justin Clark ◽  
...  
Keyword(s):  
Delphi Survey ◽  
Core Outcome ◽  
Potential Core ◽  
Core Outcome Sets ◽  
Face To Face ◽  
The Core ◽  
Modified Delphi ◽  
Key Stakeholders ◽  
Core Set ◽  
Core Outcomes

Introduction‘Core outcome sets’ are an agreed, standardised set of outcomes based on what key stakeholders (clinicians, patients, their partners, researchers, service developers, funding organisations and so on) consider the important outcomes in the management or prevention of a condition. This paper describes the rationale and design for the development of Core Outcome Sets for Miscarriage Trials.Methods and analysisSystematic reviews, interviews and focus groups with patients and their partners will be conducted to identify potential core outcomes that will be introduced into a modified Delphi survey. To ensure all key stakeholders are included, patients, partners, clinicians, charities and researchers will be invited to take part in the modified Delphi survey. There will be three rounds of scoring and rescoring during the Delphi survey to reach consensus regarding outcomes to be included in the core set, which will be subsequently refined through face-to-face consensus discussions.Ethics and disseminationThe use of core outcome sets allows results from different studies to be compared and combined, thereby reducing inconsistency and aiding interpretation of study findings. It also means research is more likely to report relevant outcomes and so can reduce reporting bias. Understanding which outcomes are important to patients has the potential to act as a driver to improve both the quality and cost-effectiveness of miscarriage services.

scholarly journals Adherence of Female Health Care Workers to the Use a Web-Based Tool for Improving and Modifying Lifestyle: Prospective Target Group Pilot Study

10.2196/19500 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e19500
Author(s):  
Tomislav Jukic ◽  
Alojz Ihan ◽  
Marija Petek Šter ◽  
Vojko Strojnik ◽  
David Stubljar ◽  
...  
Keyword(s):  
Health Care ◽  
Physical Fitness ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Demographic Data ◽  
Web Based ◽  
Cd8 Cells ◽  
Care Workers ◽  
High Workload ◽  
The Web

Background Health care professionals are exposed to the psychological and physiological effects of stress, which is a well-known risk factor for various mental and physical health problems. Objective The aims of this study were to assess the adherence of female health care workers to use a web-based tool for improving and modifying lifestyle and to identify the potential factors influencing their adherence. Methods A prospective, observational study was performed. A total of 80 female health care workers (physicians and gradated nurses) from 2 university medical centers and female members of a family medicine society participated. Participants completed a questionnaire that inquired about their basic demographic data and physical fitness. Physical fitness was assessed by the Rockport Fitness Walking Test. Adherence to a web-based application (24@life) was followed for 3 months and the number of log-ins into the application was counted. Results The study was conducted from March to October 2019. Significantly high workload has been detected in all groups (P<.05), except in the general practitioner with normal workload group. The graduated nurse working in the surgery room group showed chronic stress with elevated S-cortisol levels (>690 nmol/L); activated cellular immune system with elevated concentrations of lymphocytes (reference 1.1-2.5 × 109 cells/L), CD3 cells (reference 0.7-1.9 × 109 cells/L), CD8 cells (reference 0.2-0.7 × 109 cells/L), and HLA-DR/CD3 cells (reference 0.04-0.2 × 109 cells/L); and the worst quality of sleep (mean 2.8 [SD 1.2]). Only 32 of 80 participants (40%) were adherent to the web-based application. Participants most frequently viewed web pages on areas of physical activity (497 times) and nutrition (332 times). No factors or participant’s characteristics such as weight (odds ratio [OR] 1.026, 95% CI 0.977-1.078), BMI (OR 0.993, 95% CI 0.834-1.184), age (OR 0.970, 95% CI 0.910-1.034), or stress level (OR 0.997, 95% CI 0.995-1.000) were identified to affect the adherence rates. Conclusions Female health care workers exposed to high workload did not find the web-based application useful for improving and modifying their lifestyle. Therefore, other strategies that might help health care workers facing stress and improve their lifestyle should be identified.

scholarly journals Complex Reporting of the COVID-19 Epidemic in the Czech Republic: Use of an Interactive Web-Based App in Practice

10.2196/19367 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e19367 ◽  
Author(s):  
Martin Komenda ◽  
Vojtěch Bulhart ◽  
Matěj Karolyi ◽  
Jiří Jarkovský ◽  
Jan Mužík ◽  
...  
Keyword(s):  
Health Care ◽  
Czech Republic ◽  
Daily Basis ◽  
Primary Objective ◽  
Health Care Sector ◽  
Web Based ◽  
The Czech Republic ◽  
Current Spread ◽  
Visualization Of Data ◽  
The Web

Background The beginning of the coronavirus disease (COVID-19) epidemic dates back to December 31, 2019, when the first cases were reported in the People’s Republic of China. In the Czech Republic, the first three cases of infection with the novel coronavirus were confirmed on March 1, 2020. The joint effort of state authorities and researchers gave rise to a unique team, which combines methodical knowledge of real-world processes with the know-how needed for effective processing, analysis, and online visualization of data. Objective Due to an urgent need for a tool that presents important reports based on valid data sources, a team of government experts and researchers focused on the design and development of a web app intended to provide a regularly updated overview of COVID-19 epidemiology in the Czech Republic to the general population. Methods The cross-industry standard process for data mining model was chosen for the complex solution of analytical processing and visualization of data that provides validated information on the COVID-19 epidemic across the Czech Republic. Great emphasis was put on the understanding and a correct implementation of all six steps (business understanding, data understanding, data preparation, modelling, evaluation, and deployment) needed in the process, including the infrastructure of a nationwide information system; the methodological setting of communication channels between all involved stakeholders; and data collection, processing, analysis, validation, and visualization. Results The web-based overview of the current spread of COVID-19 in the Czech Republic has been developed as an online platform providing a set of outputs in the form of tables, graphs, and maps intended for the general public. On March 12, 2020, the first version of the web portal, containing fourteen overviews divided into five topical sections, was released. The web portal’s primary objective is to publish a well-arranged visualization and clear explanation of basic information consisting of the overall numbers of performed tests, confirmed cases of COVID-19, COVID-19-related deaths, the daily and cumulative overviews of people with a positive COVID-19 case, performed tests, location and country of infection of people with a positive COVID-19 case, hospitalizations of patients with COVID-19, and distribution of personal protective equipment. Conclusions The online interactive overview of the current spread of COVID-19 in the Czech Republic was launched on March 11, 2020, and has immediately become the primary communication channel employed by the health care sector to present the current situation regarding the COVID-19 epidemic. This complex reporting of the COVID-19 epidemic in the Czech Republic also shows an effective way to interconnect knowledge held by various specialists, such as regional and national methodology experts (who report positive cases of the disease on a daily basis), with knowledge held by developers of central registries, analysts, developers of web apps, and leaders in the health care sector.

scholarly journals Digital Health Technologies Respond to the COVID-19 Pandemic In a Tertiary Hospital in China: Development and Usability Study (Preprint)

2020 ◽  
Author(s):  
Wanmin Lian ◽  
Li Wen ◽  
Qiru Zhou ◽  
Weijie Zhu ◽  
Wenzhou Duan ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Health ◽  
Tertiary Hospital ◽  
Service Platform ◽  
Web Based ◽  
Symptom Monitoring ◽  
Health Technologies ◽  
Epidemic Period ◽  
Control And Prevention ◽  
The Web

BACKGROUND The outbreak of COVID-19 has caused a continuing global pandemic. Hospitals are integral to the control and prevention of COVID-19; however, they are facing numerous challenges during the epidemic. OBJECTIVE Our study aimed to introduce the practical experience of the design and implementation of a web-based COVID-19 service platform at a tertiary hospital in China as well as the preliminary results of the implementation. METHODS The web-based COVID-19 service platform was deployed within the health care system of the Guangdong Second Provincial General Hospital and Internet Hospital; the function of the platform was to provide web-based medical services for both members of the public and lay health care workers. The focal functions of this system included automated COVID-19 screening, related symptom monitoring, web-based consultation, and psychological support; it also served as a COVID-19 knowledge hub. The design and process of each function are introduced. The usage data for the platform service were collected and are represented by three periods: the pre-epidemic period (December 22, 2019, to January 22, 2020, 32 days), the controlled period (January 23 to March 31, 2020, 69 days), and the postepidemic period (April 1 to June 30, 2020, 91 days). RESULTS By the end of June 2020, 96,642 people had used the automated COVID-19 screening and symptom monitoring systems 161,884 and 7,795,194 times, respectively. The number of general web-based consultation services per day increased from 30 visits in the pre-epidemic period to 122 visits during the controlled period, then dropped to 73 visits in the postepidemic period. The psychological counseling program served 636 clients during the epidemic period. For people who used the automated COVID-19 screening service, 160,916 (99.40%) of the total users were classified in the no risk category. 464 (0.29%) of the people were categorized as medium to high risk, and 12 people (0.01%) were recommended for further COVID-19 testing and treatment. Among the 96,642 individuals who used the COVID-19 related symptoms monitoring service, 6696 (6.93%) were symptomatic at some point during the monitoring period. Fever was the most frequently reported symptom, with 2684/6696 symptomatic people (40.1%) having had this symptom. Cough and sore throat were also relatively frequently reported by the 6696 symptomatic users (1657 people, 24.7%, and 1622 people, 24.2%, respectively). CONCLUSIONS The web-based COVID-19 service platform implemented at a tertiary hospital in China is exhibited to be a role model for using digital health technologies to respond to the COVID-19 pandemic. The digital solutions of automated COVID-19 screening, daily symptom monitoring, web-based care, and knowledge propagation have plausible acceptability and feasibility for complementing offline hospital services and facilitating disease control and prevention.

scholarly journals The Impact of a Web-Based Course Concerning Patient Education for Mental Health Care Professionals: Quasi-Experimental Study (Preprint)

2018 ◽  
Author(s):  
Anna Laine ◽  
Maritta Välimäki ◽  
Eliisa Löyttyniemi ◽  
Virve Pekurinen ◽  
Mauri Marttunen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Self Efficacy ◽  
Self Esteem ◽  
Team Climate ◽  
Post Intervention ◽  
Web Based ◽  
Advantages And Disadvantages ◽  
The Impact ◽  
The Web

BACKGROUND Continuing education has an important role in supporting the competence of health care professionals. Although Web-based education is a growing business in various health sectors, few studies have been conducted in psychiatric settings to show its suitability in demanding work environments. OBJECTIVE We aimed to describe the impact of a Web-based educational course to increase self-efficacy, self-esteem, and team climate of health care professionals. Possible advantages and disadvantages of the Web-based course are also described. METHODS The study used nonrandomized, pre-post intervention design in 1 psychiatric hospital (3 wards). Health care professionals (n=33) were recruited. Self-efficacy, self-esteem, and team climate were measured at 3 assessment points (baseline, 8 weeks, and 6 months). Possible advantages and disadvantages were gathered with open-ended questions at the end of the course. RESULTS Our results of this nonrandomized, pre-post intervention study showed that health care professionals (n=33) had higher self-efficacy after the course, and the difference was statistically significant (mean 30.16, SD 3.31 vs mean 31.77, SD 3.35; P=.02). On the other hand, no differences were found in the self-esteem or team climate of the health care professionals before and after the course. Health care professionals found the Web-based course useful in supporting their work and relationships with patients. The tight schedule of the Web-based course and challenges in recruiting patients to use the patient education program with health care professionals were found to be the disadvantages. CONCLUSIONS Web-based education might be a useful tool to improve the self-efficacy of health care professionals even in demanding work environments such as psychiatric hospitals. However, more studies with robust and sufficiently powered data are still needed.

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