The development of an mHealth tool for children with long-term illness to enable person-centred communication: a co-design approach (Preprint)

2021 ◽  
Author(s):  
Angelica Wiljén ◽  
John Chaplin ◽  
Vanessa Crine ◽  
William Jobe ◽  
Ensa Johnson ◽  
...  
Keyword(s):  
Universal Design ◽  
Care Setting ◽  
Healthcare Professionals ◽  
Perceived Support ◽  
Future Research ◽  
Design Development ◽  
Stakeholder Groups ◽  
Need For Support ◽  
Multiple Symptoms

BACKGROUND Children with long-term illness frequently experience symptoms that affect their daily life, and this is underreported in healthcare. Despite the large number of mHealth tools, few are based on a theoretical framework or supported by scientific knowledge. Incorporating universal design when developing a product ensures that all may benefit from the design and that person-centred communication is facilitated. OBJECTIVE Our study aimed to develop a person-centred communication support mHealth tool (i.e. Pictorial support in person-centred care for children: PicPecc) based on universal design principles for children with long-term illness to communicate their symptoms, using the co-design process by involving various stakeholder groups (children with long-term illness, parents, healthcare professionals, developers). METHODS The co-design development process included four phases: (i) interviews with seven children, 8 parents and 19 healthcare professionals to determine needs and wishes for support, (ii) workshop with 19 researchers, (iii) workshop with developers and (iv) interviews with 10 children, 9 parents and 21 healthcare professionals to evaluate the mock-up (prototype) of the developed mHealth tool. Data were synthesised using interpretive description. RESULTS There is a need for children with long-term illness to address symptoms such as fear, fatigue, nausea, pain, and anxiety. Fatigue and anxiety may be overlooked by healthcare professionals and therefore an easy-to-use tool to facilitate communication with the children is needed. Three common aspects were constructed: different perspectives on provided and perceived support, need for an easy tool to assess symptoms and to facilitate communication, as well as mapping the journey to facilitate recall. Parent and children stakeholders expressed a need for support when dealing with psychosocial issues, while parents were simultaneously concerned that children may regard the word anxiety as too alarming. However, the children themselves did not react to the word. Researchers repeated the importance of employing easy-to-use mHealth tools for children to communicate symptoms going beyond pain, e.g. anxiety and fatigue. The developers highlighted the practical and logistical implications of suggestions offered by other stakeholders and proposed best options for the development of the tool. CONCLUSIONS The co-designed developed PicPecc tool demonstrated the capacity to provide support when dealing with multiple symptoms and conditions. PicPecc opens a dialogue between the child and the healthcare professionals, and it addresses symptoms that may otherwise be overlooked. Future research includes usability testing and evaluation in hospitals, as well as in a home care setting. CLINICALTRIAL -

scholarly journals The second-hand effects of antibiotics: communicating the public health risks of drug resistance

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
B J Langford ◽  
N Daneman ◽  
V Leung ◽  
J H C Wu ◽  
K Brown ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Antibiotic Use ◽  
Modern Medicine ◽  
Future Research ◽  
Term Care ◽  
Patient Counselling ◽  
The Public ◽  
Fuel Demand ◽  
The Individual

Abstract Antimicrobial resistance (AMR) poses a threat to modern medicine, but there are challenges in communicating its urgency and scope and potential solutions to this growing problem. It is recognized that AMR has a ‘language problem’ and the way in which healthcare professionals communicate about AMR may not always resonate with patients. Many patients are unaware that antibiotics can have detrimental effects to those beyond the recipient, due to transmission of drug-resistant organisms. The overestimation of benefits and underestimation of risks helps to fuel demand for antibiotic use in situations where they may be of little or no benefit. To better communicate risks, clinicians may borrow the term ‘second-hand’ from efforts to reduce smoking cessation. We present several examples where antibiotics themselves have second-hand effects beyond the individual recipient in hospitals, long-term care homes and the community. Incorporation of the concept of the second-hand effects of antibiotics into patient counselling, mass messaging and future research may help facilitate a more balanced discussion about the benefits and risks of antibiotic use in order to use these agents more appropriately.

scholarly journals Does the responsibility patients exert determine their opportunities for best clinical practice in the healthcare system?

2021 ◽  
Author(s):  
Vibe Bolvig Hyldgård ◽  
Søren Paaske Johnsen ◽  
Henrik Støvring ◽  
Andreas Albertsen ◽  
Rikke Søgaard
Keyword(s):  
Healthcare System ◽  
Care Setting ◽  
Equal Opportunity ◽  
Strong Association ◽  
Future Research ◽  
Acute Hospital Care ◽  
Inequality In Health ◽  
Lower Education

Many consider inequality in health unfair if it is caused by inequality within the healthcare system but less unfair when caused by individuals’ health behaviour. However, healthcare systems are challenged when it comes to ensuring equal care for equal need. In Roemer’s equality of opportunity theory, people have equal opportunity for obtaining something if obtaining it reflects their effort instead of their circumstances. Very little is known about how responsibility exerted by patients prior to illness affects the healthcare they are provided by the healthcare system. We aimed to apply Roemer’s theory to an acute care setting where healthcare is most directly in the hands of the healthcare system in order to study the role of patient-exerted responsibility for their opportunities in the healthcare system. We operationalised the responsibility patients exert as Body Mass Index (BMI), smoking and alcohol habits, and their circumstances as demographics, socioeconomics, prognostic factors and year of discharge. Opportunity in healthcare was defined as patients’ attainment of clinical guideline-recommended acute hospital care. In Roemer’s theory, we detected inequality of opportunity as restricted attainment of healthcare was mainly associated with patients’ circumstances, such as lower education, old age or living alone. We also identified a strong association with BMI; being underweight negatively affected patients’ opportunities as it led to suboptimal healthcare, while the opposite was found for being overweight and, in particular, obese. Hence, patient-exerted responsibility affected patients’ opportunities in healthcare, though perhaps in an unexpected way. This improved understanding of inequality may help to focus future research and, in the long term, support clinical and political efforts to achieve equal care for equal needs. Published: Online March 2021.

Issues of Capacity and Decision-Making in the Context of Delirium

2015 ◽  
Vol 24 (4) ◽  
pp. 140-145
Author(s):  
Kevin R. Patterson
Keyword(s):  
Decision Making ◽  
Patient Autonomy ◽  
Care Setting ◽  
Cognitive Change ◽  
Treatment Team ◽  
Precipitating Factors ◽  
Term Care ◽  
Decision Making Capacity ◽  
Fundamental Consideration

Decision-making capacity is a fundamental consideration in working with patients in a clinical setting. One of the most common conditions affecting decision-making capacity in patients in the inpatient or long-term care setting is a form of acute, transient cognitive change known as delirium. A thorough understanding of delirium — how it can present, its predisposing and precipitating factors, and how it can be managed — will improve a speech-language pathologist's (SLPs) ability to make treatment recommendations, and to advise the treatment team on issues related to communication and patient autonomy.

Physical and Psychological Benefits of Written Emotional Expression

2015 ◽  
Vol 20 (4) ◽  
pp. 242-251 ◽  
Author(s):  
Éva Kállay
Keyword(s):  
Mental Health ◽  
Expressive Writing ◽  
Mental Health Problems ◽  
Cost Effective ◽  
Health Problems ◽  
Future Research ◽  
Psychological Benefits ◽  
Cost Effective Treatment ◽  
Meta Analyses

Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.

Using the Change4Life Disney Branded 10-minute Shake Ups During the COVID-19 ‘Lockdown’

2020 ◽  
Author(s):  
Emily Budzynski-Seymour ◽  
James Steele ◽  
Michelle Jones
Keyword(s):  
Perceived Exertion ◽  
Affective Responses ◽  
Online Resources ◽  
Future Research ◽  
Affective States ◽  
Perceived Effort ◽  
Qualitative Feedback ◽  
Bidirectional Relationship ◽  
The Uk

Physical activity (PA) is considered essential to overall health yet it is consistently reported that children are failing to meet the recommended levels. Due to the bidirectional relationship between affective states and PA, affective responses are a potential predictor to long term engagement. Since late March 2020 the UK government enforced ‘lockdown’ measures to help control the spread of Coronavirus (COVID-19); however, this has impacted children’s PA. Using online resources at home to support PA is now common. The primary aim of this research was to investigate the use of the Change4Life 10-minute Shake Ups to support PA by examining the effects of Disney branding upon children’s (n=32) post activity affective responses and perceived exertion. The secondary was to investigate the effect of the lockdown on PA habits. Children had similar positive affective responses and perceived effort to activities; however, branding was considered to be a key contributing factor based upon qualitative feedback from parents. Children’s PA levels dropped slightly since ‘lockdown’ was imposed; though online resources have been utilised to support PA. The use of immersive elements such as characters and narrative in PA sessions, as well as utilising online resources during ‘lockdown’ appear potentially promising for future research.

Chinese Medicine Protein and Peptide in Gene and Cell Therapy

2019 ◽  
Vol 20 (3) ◽  
pp. 251-264 ◽  
Author(s):  
Yinlu Feng ◽  
Zifei Yin ◽  
Daniel Zhang ◽  
Arun Srivastava ◽  
Chen Ling
Keyword(s):  
Chinese Medicine ◽  
Cell Therapy ◽  
Future Research ◽  
The Past ◽  
Promising Strategy ◽  
Wide Range ◽  
New Directions ◽  
Gene And Cell Therapy ◽  
Proteins And Peptides

The success of gene and cell therapy in clinic during the past two decades as well as our expanding ability to manipulate these biomaterials are leading to new therapeutic options for a wide range of inherited and acquired diseases. Combining conventional therapies with this emerging field is a promising strategy to treat those previously-thought untreatable diseases. Traditional Chinese medicine (TCM) has evolved for thousands of years in China and still plays an important role in human health. As part of the active ingredients of TCM, proteins and peptides have attracted long-term enthusiasm of researchers. More recently, they have been utilized in gene and cell therapy, resulting in promising novel strategies to treat both cancer and non-cancer diseases. This manuscript presents a critical review on this field, accompanied with perspectives on the challenges and new directions for future research in this emerging frontier.

Ketamine Treatment in Depression: A Systematic Review of Clinical Characteristics Predicting Symptom Improvement

2020 ◽  
Vol 20 (15) ◽  
pp. 1398-1414 ◽  
Author(s):  
Darby J.E. Lowe ◽  
Daniel J. Müller ◽  
Tony P. George
Keyword(s):  
Clinical Features ◽  
Clinical Characteristics ◽  
Bipolar Depression ◽  
Antidepressant Effect ◽  
Future Research ◽  
Symptom Improvement ◽  
Randomized Controlled ◽  
Treatment Of Depression ◽  
Future Direction

Ketamine has been shown to be efficacious for the treatment of depression, specifically among individuals who do not respond to first-line treatments. There is still, however, a lack of clarity surrounding the clinical features and response periods across samples that respond to ketamine. This paper systematically reviews published randomized controlled trials that investigate ketamine as an antidepressant intervention in both unipolar and bipolar depression to determine the specific clinical features of the samples across different efficacy periods. Moreover, similarities and differences in clinical characteristics associated with acute versus longer-term drug response are discussed. Similarities across all samples suggest that the population that responds to ketamine’s antidepressant effect has experienced chronic, long-term depression, approaching ketamine treatment as a “last resort”. Moreover, differences between these groups suggest future research to investigate the potential of stronger efficacy towards depression in the context of bipolar disorder compared to major depression, and in participants who undergo antidepressant washout before ketamine administration. From these findings, suggestions for the future direction of ketamine research for depression are formed.

A Downward Spiral? A Panel Study of Misinformation and Media Trust in Chile

2021 ◽  
pp. 194016122110252
Author(s):  
Sebastián Valenzuela ◽  
Daniel Halpern ◽  
Felipe Araneda
Keyword(s):  
News Media ◽  
Panel Study ◽  
Future Research ◽  
Panel Survey ◽  
Downward Spiral ◽  
The Media ◽  
Media Trust ◽  
People’S Attitudes ◽  
Over Time

Despite widespread concern, research on the consequences of misinformation on people's attitudes is surprisingly scant. To fill in this gap, the current study examines the long-term relationship between misinformation and trust in the news media. Based on the reinforcing spirals model, we analyzed data from a three-wave panel survey collected in Chile between 2017 and 2019. We found a weak, over-time relationship between misinformation and media skepticism. Specifically, initial beliefs on factually dubious information were negatively correlated with subsequent levels of trust in the news media. Lower trust in the media, in turn, was related over time to higher levels of misinformation. However, we found no evidence of a reverse, parallel process where media trust shielded users against misinformation, further reinforcing trust in the news media. The lack of evidence of a downward spiral suggests that the corrosive effects of misinformation on attitudes toward the news media are less serious than originally suggested. We close with a discussion of directions for future research.

Capabilities of Bottom of the Pyramid Organizations

2021 ◽  
pp. 000765032110018
Author(s):  
Farley Simon Nobre ◽  
Rodrigo L. Morais-da-Silva
Keyword(s):  
Business Model ◽  
Integrative Review ◽  
Responsible Innovation ◽  
Future Research ◽  
Bottom Of The Pyramid ◽  
Main Question ◽  
Responsible Management ◽  
Responsible Consumption ◽  
Short And Long Term

Bottom of the Pyramid (BoP) organizations are the ones that develop a set of capabilities that contribute to create short- and long-term sustainability values inside and outside the boundaries of BoP ecosystems. Capabilities have an important role in BoP organizations’ strategies that aim to solve BoP issues. Notwithstanding its developments, BoP research still lacks theoretical contributions for the analysis of organizations. We suggest special attention to the need of advancing knowledge on capabilities of BoP organizations because this field is scattered and fragmented, misinterpreted, and still underdeveloped in the literature. We oriented our research formulating and seeking answers to our main question on what are the capabilities needed to enable organizations to create sustainability values in BoP ecosystems? We conducted an integrative review of BoP research for the period from 1998 to 2019, and we found 22 key capabilities of BoP organizations. We organized the capabilities into four major categories including BoP Responsible Consumption, BoP Responsible Business Model, BoP Responsible Management, and BoP Responsible Innovation. We advanced propositions and discussions regarding the capabilities and major categories’ popularity, interdependence and combination, short- and long-term temporal functions, sustainability roles, and effectiveness to address BoP issues. Our article organizes the field of capabilities of BoP organizations; advances contributions and implications for management, organizations, and policymaking; and opens fruitful avenues for future research.

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