scholarly journals Voice Interface Technology Adoption by Patients With Heart Failure: Pilot Comparison Study (Preprint)

2020 ◽  
Author(s):  
Lida Anna Apergi ◽  
Margret V Bjarnadottir ◽  
John S Baras ◽  
Bruce L Golden ◽  
Kelley M Anderson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care Providers ◽  
Technology Use ◽  
Older Patients ◽  
Self Care ◽  
Ease Of Use ◽  
Care Providers ◽  
Negatively Associated ◽  
Black Patients ◽  
Voice Interface

BACKGROUND Heart failure (HF) is associated with high mortality rates and high costs, and self-care is crucial in the management of the condition. Telehealth can promote patients’ self-care while providing frequent feedback to their health care providers about the patient’s compliance and symptoms. A number of technologies have been considered in the literature to facilitate telehealth in patients with HF. An important factor in the adoption of these technologies is their ease of use. Conversational agent technologies using a voice interface can be a good option because they use speech recognition to communicate with patients. OBJECTIVE The aim of this paper is to study the engagement of patients with HF with voice interface technology. In particular, we investigate which patient characteristics are linked to increased technology use. METHODS We used data from two separate HF patient groups that used different telehealth technologies over a 90-day period. Each group used a different type of voice interface; however, the scripts followed by the two technologies were identical. One technology was based on Amazon’s Alexa (Alexa+), and in the other technology, patients used a tablet to interact with a visually animated and voice-enabled avatar (Avatar). Patient engagement was measured as the number of days on which the patients used the technology during the study period. We used multiple linear regression to model engagement with the technology based on patients’ demographic and clinical characteristics and past technology use. RESULTS In both populations, the patients were predominantly male and Black, had an average age of 55 years, and had HF for an average of 7 years. The only patient characteristic that was statistically different (<i>P</i>=.008) between the two populations was the number of medications they took to manage HF, with a mean of 8.7 (SD 4.0) for Alexa+ and 5.8 (SD 3.4) for Avatar patients. The regression model on the combined population shows that older patients used the technology more frequently (an additional 1.19 days of use for each additional year of age; <i>P</i>=.004). The number of medications to manage HF was negatively associated with use (−5.49; <i>P</i>=.005), and Black patients used the technology less frequently than other patients with similar characteristics (−15.96; <i>P</i>=.08). CONCLUSIONS Older patients’ higher engagement with telehealth is consistent with findings from previous studies, confirming the acceptability of technology in this subset of patients with HF. However, we also found that a higher number of HF medications, which may be correlated with a higher disease burden, is negatively associated with telehealth use. Finally, the lower engagement of Black patients highlights the need for further study to identify the reasons behind this lower engagement, including the possible role of social determinants of health, and potentially create technologies that are better tailored for this population. CLINICALTRIAL

scholarly journals Patient perceptions of the benefits and barriers of virtual postnatal care: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megan Saad ◽  
Sophy Chan ◽  
Lisa Nguyen ◽  
Siddhartha Srivastava ◽  
Ramana Appireddy
Keyword(s):  
Health Care Providers ◽  
Technology Use ◽  
Obstetric Care ◽  
Ease Of Use ◽  
Patient Perceptions ◽  
Care Providers ◽  
Structured Interviews ◽  
New Mothers ◽  
Virtual Care ◽  
Improve Compliance

Abstract Objective The objective of this study is to understand the perceptions of new mothers using virtual care via video conferencing to gain insight into the benefits and barriers of virtual care for obstetric patients. Methods Semi-structured interviews were conducted with 15 patients attending the Kingston Health Sciences Centre. The interviews were 20–25 min in length and recorded through an audio recorder. Thematic analysis was conducted in order to derive the major themes explored in this study. Results New mothers must often adopt new routines to balance their needs and their child’s needs. These routines could impact compliance and motivation to attend follow-up care. In our study, participants expressed high satisfaction with virtual care, emphasizing benefits related to comfort, convenience, communication, socioeconomic factors, and the ease of technology use. Participants also perceived that they could receive emotional support and build trust with their health care providers despite the remote nature of their care. Due to its ease of use and increased accessibility, we argue that virtual care shows promise to facilitate long-term compliance to care in obstetric patients. Conclusions Virtual care is a useful modality that could improve compliance to obstetric care. Further research and clinical endeavours should examine how social factors and determinants intersect to determine how they underpin patient perceptions of virtual and in-person care.

scholarly journals Usability and patients attitudes after implantation of an innovative intracardiac micro-computer system for web-based real-time monitoring of heart failure (Preprint)

2020 ◽  
Author(s):  
Giuseppe D´Ancona ◽  
Monica Murero ◽  
Sebastian Feickert ◽  
Hilmi Kaplan ◽  
Alper Oener ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Technology Use ◽  
Average Score ◽  
Care Providers ◽  
Cardiac Device ◽  
Good Communication ◽  
Empirical Survey

BACKGROUND Heart failure (HF) management guided by the measurement of intracardiac and pulmonary pressure values, obtained through innovative permanent intra-cardiac micro-sensors ("embodied"), has been recently proposed as a valid strategy to individualize treatment and anticipate hemodynamic destabilization, hoping to reduce patients´ hospitalization rate and optimize their quality of life. OBJECTIVE The present manuscript has focused on the analysis and interpretation of an empirical survey evaluating usability and patients’ attitudes towards a new permanent intra-cardiac device implanted to remotely monitor left intra-atrial pressures (V-LAP™, Vectorious Medical Technologies, Tel Aviv, Israel) of chronic HF patients. METHODS The V-LAP system is a miniaturized sensor implanted totally percutaneously across the inter-atrial septum. It communicates wirelessly with a "companion device" (a wearable belt) that is placed on the patient's chest at the time of acquisition /transmission of left heart pressure measurements. At first follow-up after implantation the patients and the health care providers were asked to fill out a questionnaire on the usability of the system, the ease in performing the various required tasks (data acquisition and transmission), and overall satisfaction. Replies to the questions were mainly given using a 5-point Likert scale (1: very poor, 2: poor, 3: average, 4: good, 5: excellent). RESULTS Use and acceptance of in-body technology from the first 8 patients implanted with the V-LAP technology worldwide have been analysed. No peri-procedural morbidity/mortality was observed. Before discharge, a tailored educational session was performed after the device implantation with the participation of patients and health care providers. A pre-determined appropriate measurement position for the external measuring unit (thoracic belt) was identified before discharge to guarantee, for each patient, good communication with the internal cardiac sensor and via wireless/RF communication. At the first follow-up, the overall comfort in technology use was 3.7±1.3 with 87.5 % (7/8) of patients succeeding in applying and operating the system independently. An average score of 3.5±1.4 points was given to the ease in positioning the external measuring belt in the pre-determined measurement position. All health care providers (8/8) were able to support patients with the technology. Health care providers’ average overall ease and comfort in operating the system was 3.8± 0.8 points with 4.1±0.8 points for the ease in positioning the thoracic belt in the appropriate measuring position. CONCLUSIONS Despite the gravity of their HF pathology and the complexity of their comorbid profile, patients are comfortable in using the V-LAP technology and, in the majority of cases they can correctly and consistently acquire and transmit hemodynamic data. The overall patient/care provider satisfaction with the V-LAP system seems to be high. Patients and respective health care providers have reported a score between average to good when assessing the ease in performing simple but crucial tasks such as wearing and fastening the thoracic belt and more specifically in consistently finding its appropriate position for ideal measurements. Improvements in the external thoracic belt design have been very recently introduced and will hopefully further optimize patients´ and health care providers´ acceptance and adoption of this technology. CLINICALTRIAL NCT03775161

Perspectives of health care providers on the role of culture in the self-care of patients with chronic heart failure: a qualitative interview study conducted in Israel

2020 ◽  
Author(s):  
Adam Joensson ◽  
Emilie Cewers ◽  
Jean Marc Weinstein ◽  
Tuvia Ben Gal ◽  
Anna Stromberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Self Care ◽  
Cultural Background ◽  
Care Providers ◽  
Qualitative Interview Study ◽  
Specific Barriers

Abstract Background: Self-care is recognized as important behaviour in chronic diseases such as heart failure (HF). The cultural background of patients with HF is one of the factors that can be considered to affect their adherence to self-care. The cultural background of the health care providers might also influence their view on self-care behaviour and the education they provide. The aim of this study was to describe health care providers' perceptions of the role of culture in self-care and how those perceptions shape their experiences and their practices.Methods: A qualitative study was performed in Israel, a country with a culturally diverse population. Data was collected using semi-structured interviews with 12 healthcare providers from different cultural backgrounds, selected by purposeful sampling, from two hospitals in Israel. Interviews were audio recorded and transcribed verbatim. Data was analysed using content analysis.Results: Healthcare providers experienced cultural background influenced their patients’ self-care behaviour. Perceived cultural-specific barriers to self-care such as: dietary traditions interfering with the recommended HF diet, willingness to undertake self-care and beliefs conflicting with medical treatment were identified. Healthcare providers described that they adapted their patient education and care based on the cultural background of the patients. Shared cultural background, awareness and knowledge of differences were described as positively influencing self-care education, while cultural differences could complicate this process. These findings are encapsulated within four categories regarding perceptions of health care providers: ‘Culture permeates self-care behaviours’, ‘Culture influence the way care is provided’, ‘Mutual cultural background impacts the mindset to address self-care’ and ‘Culture is only a small piece of the puzzle...’Conclusions: Cultural-specific barriers for self-care were perceived by health care providers and they identified that their own cultural background shapes their experiences and their practices.

scholarly journals Using an Electronic App to Promote Home-Based Self-Care in Older Patients With Heart Failure: Qualitative Study on Patient and Informal Caregiver Challenges

JMIR Cardio ◽  
10.2196/15885 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e15885
Author(s):  
Sahr Wali ◽  
Karim Keshavjee ◽  
Linda Nguyen ◽  
Lawrence Mbuagbaw ◽  
Catherine Demers
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Self Care ◽  
Decision Support Tool ◽  
Daily Basis ◽  
The Self ◽  
Older Individuals ◽  
Care Providers ◽  
Support Tool ◽  
Mhealth Apps

Background Heart failure (HF) affects many older individuals in North America, with recurrent hospitalizations despite postdischarge strategies to prevent readmission. Proper HF self-care can potentially lead to better clinical outcomes, yet many older patients find self-care challenging. Mobile health (mHealth) apps can provide support to patients with respect to HF self-care. However, many mHealth apps are not designed to consider potential patient barriers, such as literacy, numeracy, and cognitive impairment, leading to challenges for older patients. We previously demonstrated that a paper-based standardized diuretic decision support tool (SDDST) with daily weights and adjustment of diuretic dose led to improved self-care. Objective The aim of this study is to better understand the self-care challenges that older patients with HF and their informal care providers (CPs) face on a daily basis, leading to the conversion of the SDDST into a user-centered mHealth app. Methods We recruited 14 patients (male: 8/14, 57%) with a confirmed diagnosis of HF, aged ≥60 years, and 7 CPs from the HF clinic and the cardiology ward at the Hamilton General Hospital. Patients were categorized into 3 groups based on the self-care heart failure index: patients with adequate self-care, patients with inadequate self-care without a CP, or patients with inadequate self-care with a CP. We conducted semistructured interviews with patients and their CPs using persona-scenarios. Interviews were transcribed verbatim and analyzed for emerging themes using an inductive approach. Results Six themes were identified: usability of technology, communication, app customization, complexity of self-care, usefulness of HF-related information, and long-term use and cost. Many of the challenges patients and CPs reported involved their unfamiliarity with technology and the lack of incentive for its use. However, participants were supportive and more likely to actively use the HF app when informed of the intervention’s inclusion of volunteer and nurse assistance. Conclusions Patients with varying self-care adequacy levels were willing to use an mHealth app if it was simple in its functionality and user interface. To promote the adoption and usability of these tools, patients confirmed the need for researchers to engage with end users before developing an app. Findings from this study can be used to help inform the design of an mHealth app to ensure that it is adapted for the needs of older individuals with HF.

scholarly journals The effect of using smartphone applications on self-care in patients with heart failure

2020 ◽  
Author(s):  
Nahid Kiyarosta ◽  
Tahereh Najafi Ghezeljeh ◽  
Farah Naghashzadeh ◽  
Mahshid Feizi ◽  
Shima Haghani
Keyword(s):  
Heart Failure ◽  
Health Care Providers ◽  
Intervention Group ◽  
Self Care ◽  
Smartphone Application ◽  
Care Providers ◽  
Smartphone Applications ◽  
Significant Difference ◽  
Patients With Heart Failure ◽  
The Mean

Background & Aim: Due to the chronic nature of heart failure, it is necessary to observe and maintain self-care behaviors accordingly. Tele-monitoring using smartphone applications can be effective in this regard. This study aimed to determine the effect of using smartphone applications on self-care behaviors in patients with heart failure. Methods & Materials: This randomized controlled clinical trial was conducted between August and March in 2018. Using consecutive sampling, 120 patients were selected and were allocated to the two groups by a random quadruple block approach. The participants in both groups completed the European heart failure self-care questionnaire before and after the intervention. Patients in both groups received routine hospital care; however, patients in the intervention group used an Android smartphone application for three months daily as well. Via the application, there were ongoing interactions between patients and researchers, depending on the needs of patients and their conditions. The data were analyzed using SPSS V.16 software. Results: There was a statistically significant difference between groups in terms of the mean score of self-care after the intervention where the mean score in the intervention group was lower (p<0.001), which indicates better self-care. Based on the results, the intervention effect was reported at 0.787. Conclusion: The findings of this study showed that using a smartphone application can improve self-care in patients with heart failure. Therefore, it is recommended to health care providers to use this mobile application to care and monitor remote patients with HF.

scholarly journals Correction: Using an Electronic App to Promote Home-Based Self-Care in Older Patients With Heart Failure: Qualitative Study on Patient and Informal Caregiver Challenges (Preprint)

2020 ◽  
Author(s):  
Sahr Wali ◽  
Karim Keshavjee ◽  
Linda Nguyen ◽  
Lawrence Mbuagbaw ◽  
Catherine Demers
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Self Care ◽  
Decision Support Tool ◽  
Daily Basis ◽  
Older Individuals ◽  
Care Providers ◽  
Support Tool ◽  
Home Based ◽  
Mhealth Apps

BACKGROUND Heart failure (HF) affects many older individuals in North America, with recurrent hospitalizations despite postdischarge strategies to prevent readmission. Proper HF self-care can potentially lead to better clinical outcomes, yet many older patients find self-care challenging. Mobile health (mHealth) apps can provide support to patients with respect to HF self-care. However, many mHealth apps are not designed to consider potential patient barriers, such as literacy, numeracy, and cognitive impairment, leading to challenges for older patients. We previously demonstrated that a paper-based standardized diuretic decision support tool (SDDST) with daily weights and adjustment of diuretic dose led to improved self-care. Objective: The aim of this study is to better understand the self-care challenges that older patients with HF and their informal care providers (CPs) face on a daily basis, leading to the conversion of the SDDST into a user-centered mHealth app.

scholarly journals Using an Electronic App to Promote Home-Based Self-Care in Older Patients With Heart Failure: Qualitative Study on Patient and Informal Caregiver Challenges (Preprint)

2019 ◽  
Author(s):  
Sahr Wali ◽  
Karim Keshavjee ◽  
Linda Nguyen ◽  
Lawrence Mbuagbaw ◽  
Catherine Demers
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Self Care ◽  
Decision Support Tool ◽  
Daily Basis ◽  
The Self ◽  
Older Individuals ◽  
Care Providers ◽  
Support Tool ◽  
Mhealth Apps

BACKGROUND Heart failure (HF) affects many older individuals in North America, with recurrent hospitalizations despite postdischarge strategies to prevent readmission. Proper HF self-care can potentially lead to better clinical outcomes, yet many older patients find self-care challenging. Mobile health (mHealth) apps can provide support to patients with respect to HF self-care. However, many mHealth apps are not designed to consider potential patient barriers, such as literacy, numeracy, and cognitive impairment, leading to challenges for older patients. We previously demonstrated that a paper-based standardized diuretic decision support tool (SDDST) with daily weights and adjustment of diuretic dose led to improved self-care. OBJECTIVE The aim of this study is to better understand the self-care challenges that older patients with HF and their informal care providers (CPs) face on a daily basis, leading to the conversion of the SDDST into a user-centered mHealth app. METHODS We recruited 14 patients (male: 8/14, 57%) with a confirmed diagnosis of HF, aged ≥60 years, and 7 CPs from the HF clinic and the cardiology ward at the Hamilton General Hospital. Patients were categorized into 3 groups based on the self-care heart failure index: patients with adequate self-care, patients with inadequate self-care without a CP, or patients with inadequate self-care with a CP. We conducted semistructured interviews with patients and their CPs using persona-scenarios. Interviews were transcribed verbatim and analyzed for emerging themes using an inductive approach. RESULTS Six themes were identified: usability of technology, communication, app customization, complexity of self-care, usefulness of HF-related information, and long-term use and cost. Many of the challenges patients and CPs reported involved their unfamiliarity with technology and the lack of incentive for its use. However, participants were supportive and more likely to actively use the HF app when informed of the intervention’s inclusion of volunteer and nurse assistance. CONCLUSIONS Patients with varying self-care adequacy levels were willing to use an mHealth app if it was simple in its functionality and user interface. To promote the adoption and usability of these tools, patients confirmed the need for researchers to engage with end users before developing an app. Findings from this study can be used to help inform the design of an mHealth app to ensure that it is adapted for the needs of older individuals with HF.

Empowered to Self-Care: A Photovoice Study in Patients With Heart Failure

2017 ◽  
Vol 29 (5) ◽  
pp. 410-419 ◽  
Author(s):  
Han Shi Jocelyn Chew ◽  
Violeta Lopez
Keyword(s):  
Heart Failure ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Meaning In Life ◽  
Self Care ◽  
Care Providers ◽  
Active Process ◽  
Self Reflection ◽  
Patients With Heart Failure ◽  
Cardiology Clinic

Introduction: Heart failure–related hospitalization is preventable through self-care but remains a common cardiovascular reason for rehospitalization. The purpose of this study was to explore the promotion of self-care in Singaporean patients with heart failure. Method: A descriptive qualitative design was adopted using Photovoice. Sixteen participants with heart failure were recruited from an outpatient cardiology clinic in Singapore. The participants were asked to take photographs that represented their promotion of self-care and used them in the subsequent interviews. Data were transcribed verbatim and analyzed using thematic analysis. Results: Four themes emerged: (1) accepting life; (2) appreciating life; (3) maintaining meaning in life; and (4) establishing a new normal life. The four themes provided insights into how they empowered themselves to self-care. Discussion: Participants were empowered to self-care through active and passive processes. Self-reflection served as an active process internally. Support from health care providers served as a passive process externally.

scholarly journals Perspectives of Health Care Providers on the Role of Culture in the Self-Care of Patients with Chronic Heart Failure: A Qualitative Interview Study

2020 ◽  
Vol 17 (14) ◽  
pp. 5051
Author(s):  
Adam Jönsson ◽  
Emilie Cewers ◽  
Tuvia Ben Gal ◽  
Jean Marc Weinstein ◽  
Anna Strömberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Self Care ◽  
Cultural Background ◽  
Care Providers ◽  
Qualitative Interview Study ◽  
Specific Barriers

Background: Self-care is important in chronic diseases such as heart failure. The cultural background of health care providers might influence their view on self-care behaviour and education they provide. The aim of this study was to describe health care providers’ perceptions of the role of culture in self-care and how those perceptions shape their experiences and their practices. Methods: A qualitative study was performed in Israel, a country with a culturally diverse population. Data were collected using semi-structured interviews with 12 healthcare providers from different cultural backgrounds. Interviews were recorded and transcribed verbatim and analysed using content analysis. Results: Healthcare providers experienced cultural background influenced their patients’ self-care behaviour. Perceived culture-specific barriers to self-care such as dietary traditions interfering with the recommended diet, willingness to undertake self-care and beliefs conflicting with medical treatment were identified. Healthcare providers described that they adapted patient education and care based on the cultural background of the patients. Shared cultural background, awareness and knowledge of differences were described as positively influencing self-care education, while cultural differences could complicate this process. Conclusions: Cultural-specific barriers for self-care were perceived by health care providers and they identified that their own cultural background shapes their experiences and their practices.

Self-care advice for health-care providers during COVID-19

2020 ◽  
Author(s):  
Helen L. Coons ◽  
Steven Berkowitz ◽  
Rachel Davis
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Self Care ◽  
Care Providers
Sign in / Sign up

Export Citation Format

Share Document