Healthy Avatars, Healthy People

Recent literature shows that new technologies can be used to promote patient engagement. The present contribution focuses on Virtual Worlds (VWs), namely virtual environments that multiple users can experience together thanks to the use of avatars. Indeed, VWs offer interesting opportunities for patient engagement interventions on two levels. On the individual level, customized avatars are known to have relationships with users' inner experience and Self-conception, so that they may constitute a peculiar additional tool for psychological assessment. Moreover, they are able to promote healthy behaviors thanks to a strong vicarious reinforcement (Proteus effect). On the collective level, VWs constitute an ideal platform to support the emergence of collective flow states (Networked Flow) which are related to the patients' creative activity and well-being. The present contribution deepens these phenomena, presenting VWs as an innovative and interesting tool for the patient engagement interventions of the future.

Patient and Family Engagement in THE Conversation

This chapter uses a patient-centered communication framework to examine observational studies of patient and family engagement in communication about end-of-life care. It analyzes how the literature has connected communication with health outcomes in end-of-life care. Within this analysis, it brings together three main ideas. First, family plays an important and overlooked role in communication about end-of-life care. Second, the literature describes communication that serves multiple functions, and it describes the special challenges presented by end-of-life care communication. Finally, it links these communicative functions with health outcomes and outlines directions for future research.

Best Practices to Promote Patient and Donor Engagement to Care in Living Donor Transplant

Increasing evidence has demonstrated that patients' involvement promotes better health care outcomes and cost-effectiveness of services. However, limited literature is available about the experience of living donor kidney transplantation and best practices to promote patients and donors' engagement. Aim of the present chapter is to review the literature about patient engagement in the context of chronic kidney disease, and to introduce an innovative protocol developed to promote potential donors and recipients' participation and adherence to care at the Niguarda Ca' Granda Hospital in Milan (Italy). Results are critical to reflect on the identification of best practices for patients' engagement in the context of chronic kidney disease. Through a better understanding of the emotional and affective dynamics and the relational implications that may influence the elaboration of the information given by health care providers, it will be possible to develop evidence-informed interventions.

A Stepped Care mHealth-Based Approach for Promoting Patient Engagement in Chronic Care Management of Obesity with Type 2 Diabetes

Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. The financial direct and indirect burden of diabesity is a real challenge in many Western health-care systems. Even if multidisciplinary protocols have been implemented, significant limitations in the chronic care management of obesity with type 2 diabetes concern costs and long-term adherence and efficacy. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of diabesity. The mHealth approach could help clinicians by motivating patients in remote settings to develop healthier lifestyles and could be implemented in the Chronic Care Model. A practical stepped-care model for diabesity, including mhealth approach and psychological treatments with different intensity, is discussed.

Engaging Patients and Lowering Costs

Societies need solutions to achieve the “triple aim” of improved health outcomes, better patient care, and lower costs; and engaging patients in their care by using technological solutions is claimed as a possible strategy to achieve this vital goal. On this basis, the chapter focuses on reviewing, categorizing and synthesizing technological tools currently available in the market today designed to engage patients in their own care process. In particular, the goals of medication adherence, reduced hospital readmission, behavior modification, and health literacy - with related technologies - are assessed, since they are considered todays most expensive health care burdens. The advantages, shortcomings, and potential economic impact of such tools are finally discussed.

The Power of Words

The concept of patient engagement is attracting growing attention from scholars working on doctor-patient interactions. It refers to the condition in which patients are fully aware of their medical condition and willing to be active both in the relationship with their caregivers and towards the health care institutions. However, the operative steps necessary to achieve patient engagement have not yet been fully described. This chapter focuses on the communicative dimension of engagement. Communication is shown to be a pivotal means to improve patient self-efficacy and commitment, both fundamental components of engagement. In particular, the authors take a closer look at the process of decision making in chronic care settings, and propose a normative model to analyze and evaluate the quality of decision making in consultations. It is argued that the model can also be used as a blueprint to create training materials for clinicians.

Communication and Education Processes Involved in COPD Patient Engagement within the Italian Health System

The World Health Organization has estimated that chronic obstructive pulmonary disease (COPD) is the fourth most common cause of death worldwide. Due to the economic and social extent of the problem, patient engagement must be comprised as a new resource for the achievement of higher health outcomes and lower costs. As many key processes involved in the COPD patient engagement consist of communication and education processes, modelling those processes in a whole framework, including actors and content needs, is a requirement. The main scope of this chapter is contributing to design such a framework within the Italian Health System. Final recommendations suggest to create a synergy among patient engagement and a set of legal tools, namely informed consent, integrated care and advance care planning. The synergy is based on the fact that both patient engagement and those legal tools have a common deep root in the universal principle of patient autonomy.

Waiting for Health Care Services

Waiting for health care services have impact on people from several perspectives. First of all, seen from patients' point of view, due to psychologically and physically burden short waiting times are an indication of quality. Second, seen from health care systems' point of view, short waiting times can be a competitive advantage for health care providers. Finally, short-waiting times can contribute to a more effective system applied in health care. In this chapter, the impact of waiting times of patients are analyzed on all three levels based on quantitative and qualitative study carried out by the authors as well as on the foregoing literature review. The situation of patients and their requirements are shown, strategies to reduce waiting times are presented by also considering the role of information and communication technologies, and several relevant questions raised are answered.

Using the Communication AssessmenT Checklist in Health to Assess the Communication Quality of Web Based Resources for Prostate Cancer

Introduction: The communication quality of web resources for patients is unknown. The purpose of this study was to assess prostate cancer websites using the Communication AssessmenT Checklist in Health (CATCH). Methods: CATCH is a theory-based tool consisting of 50 elements nested in 12 concepts. Two raters independently applied it to 35 HON certified websites containing information on prostate cancer treatment. Results: Websites contained a mean 24.1 (SD= 3.6) CATCH items. The concepts Language, Readability, Layout, Typography and Appearance were present in over 80% of sites. Content, Risk Communication, Usefulness, and Scientific Value were present in 50% or less. Discussion: The prostate cancer websites evaluated in this study did not present treatment information in a useful, informative or credible way for patients. The communication quality of these resources could be improved with a clear strategic intent focused on decision-making, using CATCH as a guiding framework.

Why, What and When in-Home Physiotherapy?

In the last decade, rehabilitation process has shifted from medical management to issues that enhance quality of life, community participation, treatment and cost effectiveness. In this context physiotherapists design and implement new and/or tailored interventions that enhance physical and functional abilities, restore, maintain, and promote optimal physical function, wellness, fitness and quality of life. The aim of this review was to assess the extent, content, and outcomes of in-home physiotherapy interventions. A search was conducted in Medline, PEDro, and Cochrane Library and IEEE Xplore. RE-AIM and GRADE guidelines were used to report this review. The findings suggest that in-home physiotherapy tailored specifically to the people needs, functioning and disability has positive results, including patients' engagement in their healthcare. Integration of information and communication technology in-home physiotherapy has great potential to increase accessibility, quality and effectiveness of various interventions provided by physiotherapists.