mHealth最新文献

Background: The role of technology in disease management has gained significant attention, mobile health technology for obstructive sleep apnea (OSA) remains underdeveloped, with limited research exploring its applications. This study explored OSA individuals' health literacy, perceived needs for improvement, information preferences, and acceptance of smartphone-based messaging interventions.

Methods: The study comprised two parts. Part 1 was a cross-sectional, self-administered online survey using non-probability convenience sampling conducted in the inpatient ward and outpatient clinic of Queen Mary Hospital, Hong Kong, from May to July 2020. The questionnaire assessed health literacy, perceived needs, and views on smartphone-based messaging interventions to enhance self-management of OSA. Written consent was obtained, and the survey took approximately 10 minutes to complete. Part 2 involved a focus group interview in August 2020 with nine randomly selected participants from Part 1, exploring their views on perceived needs and smartphone-based messaging interventions.

Results: A total of 108 participants (82% men; 40.7% aged ≥60 years) were included. Participants self-reported their OSA severity as mild (21.3%), moderate (17.6%), and severe (23.1%), while 38% were unaware of their severity. The results showed low OSA-related health literacy among participants, with no significant differences by age or years since diagnosis. Most participants (76.8%) expressed a strong desire to improve their health. High demand for OSA-related information was reported, including sleep quality (83.3%), OSA-related knowledge (82.4%), weight control (81.5%), habit improvement (78.7%), and emotional management (66.7%). The messaging intervention was well accepted, with high feasibility (82.4%) and usability (72.2%).

Conclusions: This study highlights low OSA-related health literacy and a strong demand for authoritative health information. Most found that the messaging intervention was feasible and useful in improving health-related habits and OSA management. The study underscores the need for tailored health education, personalized interventions targeting perceived needs, and innovative messaging solutions to enhance treatment adherence and self-management in OSA individuals.

The advancement of telemedicine (TM) practices has enabled greater access for allergists to assess suspected drug allergies. While penicillin allergy delabeling by drug challenges may not seem suitable for TM due to the need for close patient observation and rapid access to emergency care, it is important not to shy away from discussing the potential for initial drug hypersensitivity assessments and even direct amoxicillin oral provocation in low-risk patients under TM conditions. Through an extensive literature analysis, this narrative review discusses clinical practices, eligibility criteria, and safety considerations regarding virtual care for safe penicillin allergy delabeling in such patients. Emphasis is placed on risk stratification using recently validated clinical tools and expert opinion strategies, such as PEN-FAST [penicillin (PEN) allergy, an occurrence of five or fewer years ago (F), anaphylaxis or angioedema (A), severe cutaneous adverse reaction/SCAR (S), and treatment required for allergic reaction (T)] score and European Academy of Allergy and Clinical Immunology (EAACI)/European Network on Drug Allergy (ENDA) practical recommendations, to identify the low-risk patients suitable for remote assessment and TM-supported amoxicillin challenges, if necessary, which may be performed in outpatient departments, long-term care facilities or other remote settings, including the patient's home. The clinical practice review summarizes initial evaluation protocols, virtual monitoring procedures in case of low-risk oral provocations, and post-challenge follow-up, underlining the importance of informed consent, patient education, and caregiver presence. Oral H1 antihistamines are recommended for symptomatic relief if needed, and the benefits of acquiring an epinephrine autoinjector solely for the challenge represent a juncture for shared decision-making. While TM offers promising avenues to expand access to penicillin allergy delabeling in low-risk individuals, it is not a substitute for in-person evaluation in high- or intermediate-risk cases. The review also highlights technological, ethical, and legal challenges, serving only as an informational resource.

Background: Mobile applications for health care escort services (MA-HCES) have emerged as an innovative solution to assist patients during hospital visits and improve service delivery efficiency. Despite their growing presence, their adoption among specific populations such as medical students remains understudied. This research aimed to evaluate the effects of perceived ease of use, perceived usefulness, attitudes, facilitating conditions and perceived behavioral control on behavioral intention and the utilization of MA-HCES among medical college students.

Methods: Employing a quantitative research design, data were collected through questionnaires distributed to the target population of medical college students. The data were analyzed and the research hypotheses were tested via the item-objective congruence (IOC) index, pilot test, confirmatory factor analysis (CFA), and structural equation modeling (SEM) methods.

Results: Findings indicated that perceived usefulness exerted the most significant influence on the behavioral intention to utilize MA-HCES. Additionally, perceived ease of use, attitudes, facilitating conditions and perceived behavioral control had positive effects on college students' behavioral intention to use MA-HCES. Consequently, behavioral intention was found to significantly influence actual use behavior.

Conclusions: A survey was conducted among 511 medical college students to collect data, and a SEM was used to test the research model. The findings suggest that perceived ease of use, attitudes, facilitating conditions, and perceived behavioral control positively influence college students' intention to utilize MA-HCES. Therefore, behavioral intention has a substantial effect on use behavior. This study introduces a novel model that can accurately forecast the behavioral intentions of medical college students to use MA-HCES, making valuable contributions to both practical application and theoretical understanding.

Background: The digital divide significantly influences healthcare accessibility and outcomes, particularly regarding eHealth technologies. Disparities in eHealth adoption between Europe and Southeast Asia underscore the impact of E-government development on eHealth performance. This study focuses on digital literacy as a mediating factor and religious beliefs as a moderating variable, recognizing that these elements can shape the effectiveness of eHealth initiatives.

Methods: A quantitative analysis was conducted using secondary data from 31 geographically diverse countries, representing both developed and emerging economies, spanning the years 2019 to 2022. This period was chosen due to the coronavirus disease 2019 (COVID-19) pandemic, which exacerbated the digital divide in eHealth adoption and accessibility. The analysis examined the relationships between E-government development, digital literacy, religious beliefs, and eHealth performance.

Results: The findings indicate that E-government development positively influences eHealth performance, with digital literacy playing a significant mediating role in this relationship. Additionally, religious beliefs, particularly Atheism, were found to moderate the relationship between E-government development and eHealth performance. Regions with lower levels of religiosity demonstrated a greater receptiveness to eHealth technologies, suggesting that cultural factors significantly affect technology adoption.

Conclusions: The results underscore the necessity of integrating digital literacy initiatives alongside E-government development to enhance eHealth performance effectively. Policymakers should consider the cultural and religious landscape when designing eHealth strategies to ensure equitable access to healthcare resources. By addressing both technological and cultural barriers, it is possible to improve healthcare accessibility and outcomes for diverse populations, ultimately bridging the digital divide in healthcare.

Background: Gaucher disease (GD) is a rare genetic disorder caused by variants in the GBA1 gene, leading to a deficiency of β-glucocerebrosidase. This enzyme deficiency results in glucocerebroside accumulation in macrophages, forming "Gaucher" cells and causing symptoms such as hepatosplenomegaly, anemia, thrombocytopenia, and severe bone issues like osteonecrosis. While enzyme replacement therapy (ERT) and substrate reduction therapy (SRT) have improved the management of non-neuronopathic GD, type 1 Gaucher disease (GD1), patients still face significant challenges. Digital health technologies offer potential solutions by enabling continuous patient monitoring, treatment adherence, and patient-reported outcome measures. The aim of this study was to evaluate the use of a GD-specific app in adults with GD1.

Methods: With input from GD experts and patient groups, the INTEGRA^TM platform was customized to meet the needs of patients with GD, resulting in the development of the MyGauch^TM v1.0 app. This app, integrated with the INTEGRA^TM platform, facilitated patient care through the capture of genetic, clinical, laboratory, and biomarker data and secure data transmission. The app included components for tracking pain, fatigue, physical activity, nutrition, and medication adherence. It featured a structured GD-specific patient-reported outcome measurements (PROMs) questionnaire assessing disease burden and treatment satisfaction. Additional tools included medication reminders, communication with the Gaucher clinic, access to lab results, and educational resources. All components were integrated into a centralized dashboard. Adults (≥18 years) with GD1, access to a mobile phone, and receiving ERT or SRT at enrollment were eligible for the study. Improvement in satisfaction with GD treatment was assessed using a question on treatment satisfaction from the electronic PROMs questionnaire.

Results: The study enrolled 90 adults with GD1 who received ERT or SRT and had access to the necessary technology. The improvement in satisfaction with the medical management of the GD with the use of MyGauch^TM was modest and not associated with demographic, disease, or treatment-related factors. The high non-participation rate, limited use of the app's features, and lack of personalized feedback on physical activity and nutrition were noted as limitations.

Conclusions: Although the development of MyGauch^TM v1.0 represents a novel approach, low user engagement highlights the need for a newer app with improved features and patient education that would enhance patient's health. Future research should prioritize understanding and overcoming obstacles to successfully adopting digital tools in rare disease management and creating more comprehensive self-management solutions tailored to patient behaviors and needs.

Background: Type 2 diabetes mellitus (T2DM) presents a significant global health challenge due to its complex aetiology and widespread impact on various bodily systems. Its prevalence and associated mortality rates have been steadily rising, imposing substantial economic burdens and deteriorating quality of life. With the advent of mobile and computer applications (apps), there has been growing interest in utilizing technology to promote healthier lifestyles among T2DM patients. The Shae platform, an online platform, takes a personalized approach to lifestyle recommendations. This study aims to evaluate the impact of engagement with Shae on T2DM risk using the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) tool and associated lifestyle and anthropometric values, highlighting the potential of targeted and personalized health apps in improving health outcomes and user adherence.

Methods: Participants for this study were drawn from those engaging with the Shae online platform from May 2014 to March 2018, totalling 1,690 participants after accounting for exclusion criteria. Measures included anthropometric data, survey responses, and AUSDRISK risk score calculations. Statistical analysis involved paired sample t-tests and generalized additive model adjusting for relevant variables.

Results: The data primarily comprises females, constituting 86.9% (1,468 individuals), with males making up 13.1% (222 individuals). Notably, both female and male participants showed reductions in average AUSDRISK scores from baseline to follow-up. Female participants saw a decrease from 8.95 to 7.87, while male participants experienced a decrease from 10.82 to 9.79. Additionally, improvements were observed in average anthropometric measures such as body mass index (BMI), body fat index (BFI), and waist-to-height ratio (WHt) across both genders.

Conclusions: While improvements were noted in diabetes risk and anthropometric measures, challenges in reducing sedentary behavior were evident, emphasizing the need for targeted interventions. Reductions in BMI and WHt suggest positive shifts in body composition, crucial for mitigating metabolic risks. Integrating mobile health platforms into diabetes prevention strategies holds promise for enhancing outcomes and empowering individuals to manage their health effectively.

Background: Primary dysmenorrhea (PD) is a prevalent gynecological condition characterized by menstrual pain. Women with PD often experience functional disability, absenteeism, and presenteeism, leading to increased healthcare costs. Health education is a proven strategy for improving self-management behaviors, and mobile health (mHealth) technologies, such as smartphone applications (apps), offer a promising avenue for delivering educational interventions. However, existing menstrual cycle apps have limited functionality and do not focus on PD self-management. We aimed to develop and validate a health education app-ColicApp-to improve knowledge and self-management of PD and to assess adherence, self-efficacy, and satisfaction among users.

Methods: This was a descriptive technology development study. The content of the app was designed based on a literature review, incorporating scientific evidence on PD self-management. A prototype was developed following structured guidelines and included sections on the definition, prevalence, pathophysiology, symptoms, self-care strategies, and pain management techniques. The content was reviewed for accessibility and comprehension by a group of women from the community. The app was validated by women's health physiotherapists and women with PD using the content validity index (CVI) and percentage of absolute agreement. Adherence, self-efficacy, and satisfaction were assessed over three menstrual cycles using standardized instruments. Data were collected online using Google Forms.

Results: The content of the app was evaluated by 22 women's health physiotherapists and 17 women with PD. The experts rated the app with a CVI greater than 0.76, while women with PD rated it greater than 0.80, with overall agreement levels of 96% and 94%, respectively. Participants provided suggestions for improvement, including the addition of explanatory videos for women with low literacy. Among 99 women who used the app, adherence rates were 76.8% in the first cycle, 68.7% in the second cycle, and 55.6% in the third cycle. A significant correlation was observed between adherence in the third cycle and pain reduction. Self-efficacy scores were high, indicating improved confidence in managing PD symptoms. Most participants reported high satisfaction with the app's design, functionality and educational content of the app.

Conclusions: ColicApp was successfully developed and validated as an educational tool for PD self-management. High levels of adherence, self-efficacy, and satisfaction ratings suggest strong clinical applicability. This mHealth intervention has the potential to enhance self-care practices among women with PD and could serve as a valuable resource for both individuals and healthcare professionals. Future studies should evaluate the performance of the app when integrated into operating system platforms.

Background: Home care and teleassistance emerge as effective, patient-centered approaches to meet the healthcare needs of older adults, enabling them to remain in familiar environments while receiving personalized care. Despite technological advancements driving teleassistance, the success of these interventions hinges on the acceptance and adherence of older person and their caregivers. This study explores the impact of teleassistance on older adults' health, focusing on daily and simple care, through a randomized clinical trial.

Methods: Individuals aged 60 years or older were recruited and divided into two groups: the application group (APPG, n=21) and the control group (CG, n=19). Various anthropometric, motor, clinical, and biochemical measures were utilized for participant assessments. Throughout the 14-week experimental period, participants utilized the "Viva" application, receiving teleassistance and educational resources. Personalized support was provided to address any difficulties.

Results: The study demonstrated that the "Viva" application had significant positive impacts on the health and well-being of older adult participants. Specifically, the APPG showed no-table improvements in flexibility [sit and reach (S&R): +5.1 cm, P<0.001], lower limb strength [sit and stand test (S&ST): +5.2 reps, P<0.001], and walking performance [6-minute walk test (6MWT): +41.3 m, P<0.001], compared to the CG. Additionally, the APPG exhibited enhanced overall health (P<0.001), cognitive function [Montreal Cognitive Assessment (MoCA): +4.7 points, P<0.001], and significant reductions in total cholesterol levels (-25 mg/dL, P<0.05). These findings were complemented by improvements in healthy food consumption patterns, reduced daytime sleepiness, and greater health literacy, further emphasizing the application's role in promoting healthy aging and improved quality of life. With technological advances and expanding internet access, telecare has the potential.

Conclusions: With technological advances and expanding internet access, telecare has the potential to revolutionize care for older adults by enabling them to safely and autonomously remain at home while receiving personalized support. This study demonstrated significant improvements in health outcomes, including reduced sedentary time, enhanced physical activity, better sleep quality, lower cholesterol levels, improved cognitive function, and healthier dietary habits in the teleassisted group. These results highlight teleassistance as an essential strategy for promoting healthy and active aging, reducing the risk of chronic diseases, and improving the overall quality of life for older adults.

Trial registration: This study is registered in the Brazilian Clinical Trials Registry (RBR-6wgkzs8).

Wireless communication devices and networks are currently prevalent in human environment. Some persons claim to be sensitive to emitted by them microwave radiation. Commonly, this sensitivity is called electromagnetic hypersensitivity (EHS) or microwave disease. However, because of the yet scientifically unproven link between radiation exposures and EHS symptoms, this sensitivity is also called idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF). The sensitivity is not recognized by the World Health Organization as a disease or as being caused by exposures to wireless radiation. There are no medical tests for detecting sensitivity to wireless radiation. Physicians are not being educated to deal with persons who claim to be sensitive to wireless radiation. However, some persons who consider themselves to be sensitive to wireless radiation exposures claim to have medical diagnoses made by physicians or other health professionals. This project looked at the contradiction of the lack of diagnostic criteria for sensitivity to wireless radiation with the medical diagnoses claimed by some of the self-declared sensitive persons. Analysis of questionnaire responses of 142 self-declared sensitive persons suggests that, currently, it is not possible to diagnose sensitivity to wireless radiation exposures. The claimed medical diagnoses appear to be based on the anecdotal evidence presented by the self-declared sensitive persons. In some cases, medical tests were used but these tests lacked scientific proof of their ability to detect the sensitivity of a person to wireless radiation exposure. The proof of the existence of sensitivity to wireless radiation remains inadequate. However, logically and by analogy to other environmental stressors, it is likely that individual sensitivity to wireless radiation exists. Because provocation studies in wireless radiation-exposed volunteers alone seem unable to provide definite answers, further research using both, provocation and biochemical methods with controlled wireless radiation exposures in volunteers is necessary to discover diagnostic biomarkers of EHS.

Background: Digital storytelling (DST) encourages participants to use technology to create narratives and share personal experiences. Although DST can amplify the voices of groups experiencing marginalization, it is unclear how DST has been used among young adults of color. We also lack a comprehensive understanding of DST's role in addressing health-related outcomes. We conducted a systematic review to examine the role of DST in influencing health-related knowledge, attitudes, and behaviors among young adults of color.

Methods: We searched three databases for peer-reviewed literature between January 1, 2000, through December 31, 2023, for references examining DST methods among young adults (aged 18-39 years) of color that included at least one health-related outcome. We used a two-stage review process to assess eligibility. Data were analyzed by DST type and health outcome.

Results: From 877 references, we identified 33 eligible articles, most of which were from Canada and the USA. Studies addressed infectious diseases (n=13), including human immunodeficiency virus (HIV); mental health issues (n=10); maternal and reproductive health (n=5); and behavioral or other health themes (n=5). Across health areas, studies were divided by DST type: media creation (e.g., participants created digital stories) or media consumption (e.g., participants or other community members were exposed to stories). Studies using media creation often use qualitative methods to identify social determinants of health or reveal complex health-related issues. Studies using media consumption often used quantitative methods to measure knowledge, attitudes, and behaviors. Across health topics, DST demonstrated some effect in changing health knowledge and attitudes, but mixed results in terms of shifting health behaviors.

Conclusions: DST can amplify the voices of young adults of color, especially regarding complex issues, such as managing HIV or mental health issues. Media creation studies explored lived experiences, while media consumption studies showed that DST was effective at improving knowledge and attitudes related to certain health issues. More randomized controlled trials may be necessary to better assess the effect of DST interventions on modifying health behaviors. Researchers should also consider the value of DST beyond health outcomes intended to be measured, including the ability to empower young adults of color to be more fully engaged throughout the research process.