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An Ecological Momentary Intervention for people with social anxiety: A descriptive case study. 对社交焦虑患者的生态瞬时干预:一个描述性案例研究。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-12-02 Epub Date: 2021-03-28 DOI: 10.1080/17538157.2021.1896525
Brendan Loo Gee, Philip J Batterham, Amelia Gulliver, Julia Reynolds, Kathleen M Griffiths
ABSTRACT This study describes the development and pilot evaluation of a smartphone- delivered Ecological Momentary Intervention (EMI) for people with social anxiety symptoms. Using a software engineering framework (agile modeling, model-driven development, bottom-up development), mental health experts and software developers collaborated to develop a 4-module EMI app designed to reduce social anxiety in real-time. Fifty-five participants with social anxiety were randomly allocated to the EMI or a wait-list control arm. App downloads, usage and user satisfaction data were collected and mental health outcomes assessed at baseline and post-intervention. Software development practices allowed mental health experts to distil core elements of a psychological intervention into discrete software components but there were challenges in engaging mental health experts in the process. Relative to control there was no significant reduction in social anxiety among the EMI participants in the pilot trial. However, post-test data were available for only 4 intervention and 10 control participants and only 2 (4.0%) of the EMI participants downloaded the app. The two participants who both accessed the app and completed the post-test reported being satisfied with the intervention. Future research should address managing resources and providing additional training to support ongoing engagement with key stakeholders.
本研究描述了智能手机生态瞬间干预(EMI)对社交焦虑症状患者的发展和试点评估。利用软件工程框架(敏捷建模、模型驱动开发、自下而上开发),心理健康专家和软件开发人员合作开发了一个由4个模块组成的EMI应用程序,旨在实时减少社交焦虑。55名患有社交焦虑的参与者被随机分配到EMI组或等候名单控制组。收集应用程序下载、使用和用户满意度数据,并在基线和干预后评估心理健康结果。软件开发实践允许心理健康专家将心理干预的核心要素提炼成离散的软件组件,但在让心理健康专家参与这一过程方面存在挑战。与对照组相比,试验性试验中EMI参与者的社交焦虑没有显著减少。然而,只有4名干预参与者和10名对照参与者的测试后数据可用,只有2名(4.0%)EMI参与者下载了应用程序。两名参与者都访问了应用程序并完成了后测试,他们报告对干预感到满意。未来的研究应解决管理资源和提供额外培训的问题,以支持与关键利益相关者的持续接触。
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引用次数: 0
Quantitative and qualitative evaluation of the COMPASS mobile app: a citizen science project. COMPASS移动应用程序的定量和定性评价:一个公民科学项目。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-12-02 Epub Date: 2021-04-13 DOI: 10.1080/17538157.2021.1902332
Jorge Luis Díaz, Núria Codern-Bové, Maria-Dolors Zomeño, Camille Lassale, Helmut Schröder, María Grau

To evaluate the usability of the COMPASS application with mixed-methodology, using a citizen science approach. Parents/tutors of 10-11 years old children attending a primary school in Barcelona, Spain, were invited to take part in the study. We conducted semi-structured interviews on a subset (n = 7) of participants, two weeks after using the app for the first time. A list of suggestions of improvement was extracted from the interviews. The System Usability Scale (SUS, range 0-100) was administered to all participants before and after the improvements were implemented. We provide both a quantitative analysis (t-test of change in SUS scores) and a qualitative thematic analysis of the interviews. A total of 22 participants were included in the study. The mean score before implementation of changes was 68.5 (Standard deviation, SD = 11.1), and improved to 73.1 (10.5) (p-value = 0.025). Regarding the qualitative assessment, we obtained 24 codes and grouped them into 3 categories. It uncovered problems in the installation phase and the main barriers to use: lack of time and the need for the app to evolve. The new version of COMPASS, improved by taking into account the participants' comments and suggestions, was more usable than the initial version.

使用公民科学方法,以混合方法评估COMPASS应用程序的可用性。西班牙巴塞罗那一所小学10-11岁儿童的家长/导师被邀请参加这项研究。我们对一部分参与者(n = 7)进行了半结构化访谈,时间是他们第一次使用这款应用两周后。从访谈中摘录了一份改进建议清单。在实施改进之前和之后,对所有参与者进行了系统可用性量表(SUS,范围0-100)。我们提供了定量分析(SUS分数变化的t检验)和访谈的定性专题分析。共有22名参与者参与了这项研究。实施改变前的平均得分为68.5分(标准差,SD = 11.1),改善为73.1分(10.5分)(p值= 0.025)。在定性评价方面,我们获得了24个编码,并将其分为3类。它揭示了安装阶段的问题和使用的主要障碍:缺乏时间和应用程序需要发展。新版本的COMPASS在考虑了参与者的意见和建议后得到了改进,比最初的版本更有用。
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引用次数: 3
Technological prescription: evaluation of the effectiveness of mobile applications to improve depression and anxiety. Systematic review. 技术处方:评估移动应用程序改善抑郁和焦虑的有效性。系统的回顾。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-03-08 DOI: 10.1080/17538157.2021.1887196
Raquel Planas, Oriol Yuguero

Several studies have shown that, due to their features, mobile applications have a great potential to address mental health in depression and anxiety. We carried out a systematic review of publications from the last 10 years: from 1 January 2010 until 31 March 2020. Systematic reviews and meta-analyses related to the research question were also selected to identify other potentially eligible studies. The literature search in selected databases returned a total of 3,011 records from which a total of 22 articles were finally selected. The main conclusion of the study is that most of the scientific evidence found supports the hypothesis that mobile applications significantly improve the symptoms associated with depression and anxiety. Therefore, their effectiveness as a digital tool in the treatment of such health problems is proven. However, further studies and further evaluations of mobile applications are required (also in other languages) to incorporate this resource into the healthcare context. In addition, since mobile applications allow reinforcing concepts such as patient empowerment, shared decision-making and health literacy, their use would be highly positive for depression and anxiety, where there is a strong element of self-managing the disease.

几项研究表明,由于它们的特点,移动应用程序在解决抑郁症和焦虑症的心理健康问题方面具有巨大的潜力。我们对过去10年(2010年1月1日至2020年3月31日)的出版物进行了系统评价。还选择了与研究问题相关的系统综述和荟萃分析来确定其他可能符合条件的研究。在选定的数据库中进行文献检索,共返回3011条记录,最终选出22篇文章。这项研究的主要结论是,发现的大多数科学证据都支持这样的假设,即移动应用程序可以显著改善与抑郁和焦虑相关的症状。因此,它们作为治疗此类健康问题的数字工具的有效性已得到证实。然而,需要对移动应用程序(也包括其他语言)进行进一步的研究和进一步的评估,以将这一资源纳入医疗保健环境。此外,由于移动应用程序可以强化诸如患者赋权、共同决策和卫生知识等概念,因此它们的使用将对抑郁症和焦虑症非常积极,因为这些疾病有很强的自我管理因素。
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引用次数: 7
Defining participatory health informatics - a scoping review. 界定参与式卫生信息学——范围审查。
IF 2.5 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-02-23 DOI: 10.1080/17538157.2021.1883028
Kerstin Denecke, Elia Gabarron, Carolyn Petersen, Mark Merolli

Healthcare has been shifting toward individuals participating in decision-making and empowered to be active in their treatment, and health monitoring. The term "participatory health informatics" (PHI) started to appear in literature. A clear definition of PHI is missing, and facets of PHI still have to be shaped. The objective of this paper is to offer a definition of PHI considering themes and technologies that make healthcare participatory. We searched Pubmed, ACM Digital Library, IEEE Xplore, EMBASE, and conference proceedings for articles that reported about use of information technology or informatics in the context of PHI. We performed qualitative synthesis and reported summary statistics. 39 studies were eligible after screening 382 titles and abstracts and reviewing 82 full texts. The top 5 person-centered key themes related to PHI included empowerment, decision-making, informed patient, collaboration, and disease management. Finally, we propose to define PHI as multidisciplinary field that uses information technology as provided through the web, smartphones, or wearables to increase participation of individuals in their care process and to enable them in self-care and shared decision-making. Goals to be achieved through PHI include maintaining health and well-being; improving the healthcare system and health outcomes; sharing experiences; achieving life goals; and self-education.

医疗保健已经转向个人参与决策,并授权积极参与他们的治疗和健康监测。“参与式卫生信息学”(PHI)一词开始出现在文献中。PHI的一个明确的定义是缺失的,PHI的各个方面仍然需要塑造。本文的目的是提供PHI的定义,考虑主题和技术,使医疗保健参与性。我们检索了Pubmed、ACM数字图书馆、IEEE explore、EMBASE和会议记录,以寻找有关在PHI环境中使用信息技术或信息学的文章。我们进行了定性综合并报告了汇总统计数据。在筛选了382篇标题和摘要以及审阅了82篇全文后,39篇研究入选。与PHI相关的前5个以人为中心的关键主题包括授权、决策、知情患者、协作和疾病管理。最后,我们建议将PHI定义为多学科领域,该领域使用通过网络、智能手机或可穿戴设备提供的信息技术来增加个人在其护理过程中的参与,并使他们能够自我护理和共同决策。通过PHI实现的目标包括保持健康和福祉;改善卫生保健系统和卫生结果;经验分享;实现人生目标;和自我教育。
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引用次数: 0
myPainPal: Co-creation of a mHealth app for the management of chronic pain in young people. myPainPal:与他人合作开发的移动健康应用程序,用于管理年轻人的慢性疼痛。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-03-30 DOI: 10.1080/17538157.2021.1892697
Marie Cooke, Julianne Richards, Dian Tjondronegoro, Prithwi Raj Chakraborty, Jacqueline Jauncey-Cooke, Elizabeth Andresen, Joanne Theodoros, Rebecca Paterson, Jessica Schults, Bhavesh Raithatha, Susan Wilson, Mark Alcock

Chronic pain is common in young people aged 10-14 years. Interdisciplinary, clinician-delivered treatments, while effective, are often criticized for failing to be readily accessible. Mobile health applications (mHealth apps) have been proposed as effective treatment adjuncts that address these challenges, while meeting the needs of tech-savvy young people. The objectives of this study were to co-create a mHealth app with consumers and health care professionals and evaluate the acceptability and feasibility of the resulting mHealth app (myPainPal). A phased, qualitative approach within a consumer engagement framework was employed. Interviews with young people (n = 14), parents (n = 12) and health care professionals (n = 8) identified key health needs that formed the underlying structure of the myPainPal app. Testing showed that the app is an acceptable and feasible platform to facilitate young people's self-management of chronic pain. The myPainPal app has the potential to positively influence young people's experiences of chronic pain. Further testing in controlled settings is required.

慢性疼痛在10-14岁的年轻人中很常见。跨学科的、由临床医生提供的治疗方法虽然有效,但往往因不易获得而受到批评。移动健康应用程序(移动健康应用程序)已被提议作为应对这些挑战的有效治疗辅助手段,同时满足精通技术的年轻人的需求。本研究的目的是与消费者和医疗保健专业人员共同创建一个移动健康应用程序,并评估由此产生的移动健康应用程序(myPainPal)的可接受性和可行性。采用了消费者参与框架内的阶段性定性方法。通过对青少年(n = 14)、父母(n = 12)和医疗保健专业人员(n = 8)的访谈,确定了构成myPainPal应用程序底层结构的关键健康需求。测试表明,该应用程序是一个可接受且可行的平台,可以促进年轻人对慢性疼痛的自我管理。myPainPal应用程序有可能对年轻人的慢性疼痛体验产生积极影响。需要在受控环境下进行进一步测试。
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引用次数: 5
Enhancing smart healthcare in dentistry: an approach to managing patients' stress. 加强牙科智能医疗:一种管理患者压力的方法。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-03-30 DOI: 10.1080/17538157.2021.1893322
Aleksandra Labus, Božidar Radenković, Branka Rodić, Dušan Barać, Adam Malešević

This paper presents a model of a smart healthcare service for stress management in dental patients during the interventions. The main goal is to provide dental clinics with a model that enables introducing a stress management service into everyday practice and provides patients with a better experience in a typically stressful situation. The approach is based on employing wearable sensors for monitoring physiological parameters, and a mobile application for progressive muscle relaxation therapy. Dental patients were divided into experimental and control groups. Participants from the experimental group were treated with progressive muscle relaxation through mobile health application with audio content, and patients from the control group were not exposed to any relaxation method. Heart rate was measured in both groups through three test phases: pre-intervention, intervention, and post-intervention. Evaluation of the anxiety level was performed using the STAI test. Results show that the measured heart rate in the post-intervention phase is lower than in the intervention phase in both testing groups, as well as in the pre-intervention phase. STAI scores were significantly higher in the control group through all test phases. The research found that the proposed system applied to dentist patients may relieve their anxiety symptoms and decrease stress level, which improves the patients' experience and leads to higher patients' satisfaction.

本文提出了一种智能医疗服务模型,用于干预期间牙科患者的压力管理。主要目标是为牙科诊所提供一种模式,使其能够将压力管理服务引入日常实践,并在典型的压力情况下为患者提供更好的体验。该方法基于使用可穿戴传感器来监测生理参数,以及用于渐进式肌肉放松治疗的移动应用程序。将牙科患者分为实验组和对照组。实验组患者通过带有音频内容的移动健康应用程序进行渐进式肌肉放松治疗,对照组患者不进行任何放松方法。通过三个测试阶段测量两组的心率:干预前、干预后和干预后。焦虑水平评估采用STAI测试。结果表明,两组患者干预后的心率均低于干预前和干预后的心率。在所有测试阶段,对照组的STAI得分均显著高于对照组。研究发现,该系统应用于牙科患者,可以缓解患者的焦虑症状,降低患者的压力水平,改善患者的体验,提高患者的满意度。
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引用次数: 3
Heart sound recognition technology based on convolutional neural network. 基于卷积神经网络的心音识别技术。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-04-04 DOI: 10.1080/17538157.2021.1893736
Ximing Huai, Satoshi Kitada, Dongeun Choi, Panote Siriaraya, Noriaki Kuwahara, Takashi Ashihara

The mortality rate of heart disease continues to rise each year: developing mechanisms to reduce mortality from heart disease is a top concern in today's society. Heart sound auscultation is a crucial skill used to detect and diagnose heart disease. In this study, we propose a heart sound signal classification algorithm based on a convolutional neural network. The algorithm is based on heart sound data collected in the clinic and from medical books. The heart sound signals were first preprocessed into a grayscale image of 5 seconds. The training samples were then used to train and optimize the convolutional neural network; obtaining a training result with an accuracy of 95.17% and a loss value of 0.23. Finally, the convolutional neural network was used to test the test set samples. The results showed an accuracy of 94.80%, sensitivity of 94.29%, specificity of 95.54%, precision of 93.44%, F1_score of 93.84%, and an AUC of 0.943. Compared with other algorithms, the accuracy and sensitivity of the algorithms were improved. This shows that the method used in this study can effectively classify heart sound signals and could prove useful in assisting heart sound auscultation.

心脏病的死亡率每年都在持续上升:开发降低心脏病死亡率的机制是当今社会最关心的问题。心音听诊是检测和诊断心脏病的一项关键技术。在本研究中,我们提出了一种基于卷积神经网络的心音信号分类算法。该算法基于在诊所和医学书籍中收集的心音数据。心音信号首先被预处理成5秒的灰度图像。然后使用训练样本对卷积神经网络进行训练和优化;得到准确率为95.17%,损失值为0.23的训练结果。最后,利用卷积神经网络对测试集样本进行测试。结果表明,该方法准确率为94.80%,灵敏度为94.29%,特异性为95.54%,精密度为93.44%,F1_score为93.84%,AUC为0.943。与其他算法相比,提高了算法的精度和灵敏度。这表明本研究中使用的方法可以有效地对心音信号进行分类,并可用于辅助心音听诊。
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引用次数: 7
Depiction of Obsessive-Compulsive Disorder in YouTube videos. YouTube视频中对强迫症的描述。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-02-23 DOI: 10.1080/17538157.2021.1885036
Priyadarshee Abhishek, Vijay Gogoi, Lakshyahira Borah
ABSTRACT Videos on obsessive-compulsive disorder (OCD) are widely available on YouTube. Individuals with OCD and their caregivers would likely watch these videos to understand this disorder. Videos presenting the information related to symptomatology and available treatment accurately and in an easy-to-understand manner would benefit the patients and the caregivers. On the other hand, inaccurate information may create confusion. Given this, the present research is aimed at analyzing the content, accuracy, and appropriateness of the YouTube videos on OCD. The quality of the YouTube videos on OCD, in terms of accuracy of the information provided, was assessed. Out of 330 videos, resulting from various search terms, 82 were found to be suitable for analysis. The videos were assessed for the accuracy of presented content on clinical symptoms, biological underpinnings, and treatment (pharmacological and non-pharmacological) as well as their educational utility. Majority of the videos provided accurate description of obsessions (82.9%) and compulsions (74.4%) and 21.9% of the videos mentioned biological underpinnings of OCD. Treatment options, both pharmacotherapy and psychotherapy, were mentioned in 32.71% and 41.5% of the videos, respectively. Overall, 69.5% of the videos had useful educational utility. Findings have been discussed in terms of their practical utility.
关于强迫症(OCD)的视频在YouTube上随处可见。强迫症患者和他们的照顾者可能会观看这些视频来了解这种疾病。视频以易于理解的方式准确地呈现与症状学和可用治疗相关的信息,将使患者和护理人员受益。另一方面,不准确的信息可能会造成混乱。鉴于此,本研究旨在分析强迫症YouTube视频的内容,准确性和适当性。就所提供信息的准确性而言,对YouTube上关于强迫症的视频的质量进行了评估。从各种搜索词中选出的330个视频中,有82个适合分析。评估视频内容的准确性,包括临床症状、生物学基础、治疗(药理学和非药理学)以及它们的教育效用。大多数视频准确描述了强迫症(82.9%)和强迫行为(74.4%),21.9%的视频提到了强迫症的生物学基础。治疗方案,包括药物治疗和心理治疗,分别在32.71%和41.5%的视频中提到。总体而言,69.5%的视频具有有用的教育效用。研究结果已根据其实际用途进行了讨论。
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引用次数: 3
A system of concepts to support the integration of Health and social care and assistive domotics services: the Health@Home project. 支持保健和社会护理与辅助家庭服务一体化的概念系统:Health@Home项目。
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-03-28 DOI: 10.1080/17538157.2021.1895167
Fabrizio Pecoraro, Daniela Luzi, Elaheh Pourabbas, Fabrizio L Ricci

The main objective of this work is to define a common shared conceptual model that describes the health care environment using the ContSys standard, harmonizing it with the social care and assistive domotics concepts. The development of this model supports the integration of services, the interoperability among systems and the continuity of care across domains.Starting from the identification and extraction of the portion of the ContSys model suitable for the healthcare part, the article provides the methodology adopted to extend it with social and home automation concepts and to integrate them in a unique framework that supports the continuity of care.The integrated model defined in this paper has been adopted in the design phase of an interoperable open platform, called Health@Home, that organizes the provision of a set of health, social and home automation integrated services provided at home.Our model is a starting point to analyze the various determinants of wellbeing able to guarantee a high-level individual's quality of life. At the moment the Health@Home system is at the implementation phase.

这项工作的主要目标是定义一个通用的共享概念模型,该模型使用ContSys标准描述医疗保健环境,使其与社会护理和辅助家庭概念相协调。该模型的开发支持服务的集成、系统之间的互操作性和跨领域护理的连续性。从识别和提取ContSys模型中适合医疗保健部分的部分开始,本文提供了采用的方法,用于将其扩展为社会和家庭自动化概念,并将它们集成到支持护理连续性的独特框架中。本文定义的集成模型已在一个名为Health@Home的可互操作开放平台的设计阶段被采用,该平台组织提供一套在家提供的健康、社会和家庭自动化集成服务。我们的模型是分析能够保证高水平个人生活质量的幸福的各种决定因素的起点。目前,Health@Home系统正处于实施阶段。
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引用次数: 1
Association between ICU interruptions and physicians trainees' electronic health records efficiency. ICU中断与医生培训生电子健康记录效率的关系
IF 2.4 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2021-09-02 Epub Date: 2021-02-18 DOI: 10.1080/17538157.2021.1885037
Saif Khairat, Eman Metwally, Cameron Coleman, Elaine James, Samantha Eaker, Thomas Bice

The intensive care unit (ICU) is a stressful and complex environment in due to its dynamic nature and severity of admitted patients. EHR interface design can be cumbersome and lead to prolonged times to complete tasks. This paper investigated the relationship between a prominent EHR interface design and interruptions with physician's efficiency during patient chart review at ICU Pre-Rounds. We conducted a live observation of ICU physicians in a 30-bed MICU at a tertiary, southeastern medical center. Directly after the observation sessions, the physicians completed a modified System Usability Scale (SUS) survey. A total of 52 EHR patient chart reviews were observed at the MICU Pre-rounds. There was statistically significant positive correlation between time spent to review patient EHR with both number of scrolling(p-value<0.0001) across EHR interface; and with number of visited EHR  screens (p-value=0.0444). There was positive correlation between number of interruptions with time spent to review patient EHR during ICU prerounds. EHR design and the occurrence of interruptions lead to reduced physician-EHR efficiency levels. We report that the number of scrolling and visited screens executed by physicians to gather the required information was associated with increased screen time and consequently decreased physician efficiency.

重症监护病房(ICU)是一个压力和复杂的环境,由于其动态性质和入院患者的严重性。EHR界面设计可能很麻烦,导致完成任务的时间延长。本文研究了突出的EHR界面设计与ICU查房前患者图表审查期间医生效率中断之间的关系。我们对东南三级医疗中心30张床位的MICU的ICU医生进行了现场观察。观察结束后,医生直接完成了修改后的系统可用性量表(SUS)调查。在MICU查房前,共观察到52例EHR患者图表回顾。查看患者电子病历的时间与滚动次数(p值)之间存在统计学上显著的正相关
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引用次数: 2
期刊
Informatics for Health & Social Care
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