The role of digital health in supporting cancer patients' mental health and psychological well-being for a better quality of life: A systematic literature review.

BACKGROUND: This work aims to evaluate the role of digital health in supporting the mental and psychological well-being of patients with cancer and identify the associated challenges of use and implementation. METHODS: Eligibility criteria: We included peer-reviewed studies (quantitative/qualitative) published between January 2011 and July 2022, that are written in English using technology to support cancer patients' mental health. We excluded opinion papers, editorials, and commentaries. INFORMATION SOURCES: The systematic review was conducted across ProQuest CENTRAL, Scopus, PubMed, PsycInfo, Web Of Science, and IEEE Xplore. The study selection followed the Preferred Reporting Items for Systematic Reviews, meta-Analysis Reviews, and meta-Analysis guidelines (PRISMA). Risk of bias: All screening steps followed a consensus between the authors to minimize bias or discrepancy. Synthesis of the results: Data were extracted following the Six-factor Model of Psychological Well-being (SMPW). The technology challenges are summarized following the Systems Engineering Initiative for Patient Safety model (SEIPS), focusing on design, impact on processes, and outcomes. RESULTS: We included 25 studies satisfying our inclusion criteria. The studies had little interest in minorities and sociodemographic factors' assessment within their results. The review showed that mental health and psychological well-being tools cover many applications. In addition to allowing personal growth, digital health can help cancer patients gain more autonomy and self-acceptance. Moreover, these health technologies can aid in mastering the environment, shaping social relationships, and pursuing life goals. Many challenges were identified related to the environment, organization, users, and tasks. DISCUSSION: Digital health applications for cancer care cover a broad spectrum of mental health interventions. Challenges warrant analyzing the needs and usability. Lessons learned during COVID-19 may help refine technology interventions for mental health in cancer care. More interest in minorities is needed when designing technologies for patients to ensure more access to equitable care.

Digital Twins for Managing Health Care Systems: Rapid Literature Review.

BACKGROUND: Although most digital twin (DT) applications for health care have emerged in precision medicine, DTs can potentially support the overall health care process. DTs (twinned systems, processes, and products) can be used to optimize flows, improve performance, improve health outcomes, and improve the experiences of patients, doctors, and other stakeholders with minimal risk. OBJECTIVE: This paper aims to review applications of DT systems, products, and processes as well as analyze the potential of these applications for improving health care management and the challenges associated with this emerging technology. METHODS: We performed a rapid review of the literature and reported available studies on DTs and their applications in health care management. We searched 5 databases for studies published between January 2002 and January 2022 and included peer-reviewed studies written in English. We excluded studies reporting DT usage to support health care practice (organ transplant, precision medicine, etc). Studies were analyzed based on their contribution toward DT technology to improve user experience in health care from human factors and systems engineering perspectives, accounting for the type of impact (product, process, or performance/system level). Challenges related to the adoption of DTs were also summarized. RESULTS: The DT-related studies aimed at managing health care systems have been growing over time from 0 studies in 2002 to 17 in 2022, with 7 published in 2021 (N=17 studies). The findings reported on applications categorized by DT type (system: n=8; process: n=5; product: n=4) and their contributions or functions. We identified 4 main functions of DTs in health care management including safety management (n=3), information management (n=2), health management and well-being promotion (n=3), and operational control (n=9). DTs used in health care systems management have the potential to avoid unintended or unexpected harm to people during the provision of health care processes. They also can help identify crisis-related threats to a system and control the impacts. In addition, DTs ensure privacy, security, and real-time information access to all stakeholders. Furthermore, they are beneficial in empowering self-care abilities by enabling health management practices and providing high system efficiency levels by ensuring that health care facilities run smoothly and offer high-quality care to every patient. CONCLUSIONS: The use of DTs for health care systems management is an emerging topic. This can be seen in the limited literature supporting this technology. However, DTs are increasingly being used to ensure patient safety and well-being in an organized system. Thus, further studies aiming to address the challenges of health care systems challenges and improve their performance should investigate the potential of DT technology. In addition, such technologies should embed human factors and ergonomics principles to ensure better design and more successful impact on patient and doctor experiences.

Effect of Patient Portals on Perception of Care Quality, General Health, and Mental Health: An Exploratory Analysis

This study analyzes the relationship between patients’ understanding of online medical records and their perception of care quality. It also explores the mediating role of patients’ general health perception and mental health and the moderating role of age in this relationship. The study develops and tests an exploratory conceptual model by analyzing the 2020 US-based Health Information National Trends Survey (HINTS) collected during the COVID-19 pandemic. We checked the survey for multicollinearity and common method bias and adjusted for family-wise error. Using models 6 and 59 of the Hayes PROCESS macros, the study articulates a sequential mediation and a parallel moderated mediation model to capture the intended relationships. Patients’ understanding of online medical records had a significant positive association with the perception of care quality (Direct: ß=0.17;Indirect: ß=0.12). Additionally, the study captured the significant effect of age and perception of general health (self-health) on the perception of care quality. We also reported significant associations between mental health and general health perception (ß=0.26). These findings suggest that the patient portals' contents should be designed in a way to be easily understood by patients from various backgrounds to improve the overall care experience.

Predictors of Healthcare Professionals' Work Difficulty Perception during the COVID-19 Pandemic: Study of Work Environment in a Pandemic Hospital.

COVID-19 has dramatically changed the work environment in healthcare, which is creating an additional burden for healthcare professionals. In this study, we investigate the factors that trigger professionals to have negative perceptions of their jobs during the pandemic. A cross-sectional survey is used for this study. The respondents are selected based on convenience random sampling. We use 345 questionaries for the analysis. Respondents are health care professionals (nurses, doctors, midwives, technicians, etc.) working in a pandemic hospital in Turkey. We run a multivariable logistic regression model to analyze the predictors of work difficulty perception. The model is adjusted for the respondents' demographical characteristics and emotional wellbeing. We found that depression and burnout are significantly correlated with the perception of job difficulty (OR Severe PHQ-9 = 10.8, p = 0.004; OR Severe Burnout = 7.83, p < 0.001). The professionals who are changed from one department to another are also more likely to perceive the job as difficult (OR Department Change = 1.60, p = 0.045). However, the professionals that received sufficient applause from society are more likely to think that they did not face any difficulties doing their job during the pandemic (OR Applause = 0.56, p < 0.016). Anxiety, monetary motivation, religious beliefs, and information availability did not contribute to the perceived difficulty in their jobs. Thus, efforts need to be made to give them more social support and smooth their changes in departments and functions to facilitate their jobs.

Anxiety, Burnout and Depression, Psychological Well-Being as Predictor of Healthcare Professionals' Turnover during the COVID-19 Pandemic: Study in a Pandemic Hospital.

Turnover of healthcare professionals' is a rapidly growing human resource issue that affects healthcare systems. During the COVID-19 pandemic, healthcare professionals have faced stressful situations that have negatively impacted their psychological health. In this study, we explored impacts of the emotional wellbeing of healthcare professionals on their intention to quit their jobs. A cross-sectional survey design was used for this study. The respondents were selected based on simple random sampling. In total, 345 questionaries were returned and used for the analysis. Respondents were healthcare professionals (nurses, doctors, midwives, technicians, etc.) working in a pandemic hospital in Turkey. A multivariable logistic regression model was used to predict the emotions that encouraged the respondents to intend to quit their jobs. Emotions including anxiety, burnout, and depression were measured using validated scales. We found that the COVID-19 situation increased the turnover intention, especially among doctors and nurses (ORnurse/midwife = 22.28 (2.78-41.25), p = 0.01; ORdoctors = 18.13 (2.22-2.27), p = 0.01) mediating the emotional pressure it was putting them under. Anxiety related to work-pressure and burnout especially were the main emotional predictors of turnover intention. The more severe the anxiety was, the more the professional considered quitting (ORmoderate = 18.96 (6.75-137.69), p = 0.005; ORsevere = 37.94 (2.46-107.40), p = 0.016). Only severe burnout, however, engendered such an intention among them (ORsevere = 13.05 (1.10-33.48), p = 0.000).

Online Medical Record Nonuse Among Patients: Data Analysis Study of the 2019 Health Information National Trends Survey.

BACKGROUND: Online medical records are being used to organize processes in clinical and outpatient settings and to forge doctor-patient communication techniques that build mutual understanding and trust. OBJECTIVE: We aimed to understand the reasons why patients tend to avoid using online medical records and to compare the perceptions that patients have of online medical records based on demographics and cancer diagnosis. METHODS: We used data from the Health Information National Trends Survey Cycle 3, a nationally representative survey, and assessed outcomes using descriptive statistics and chi-square tests. The patients (N=4328) included in the analysis had experienced an outpatient visit within the previous 12 months and had answered the online behavior question regarding their use of online medical records. RESULTS: Patients who were nonusers of online medical records consisted of 58.36% of the sample (2526/4328). The highest nonuser rates were for patients who were Hispanic (460/683, 67.35%), patients who were non-Hispanic Black (434/653, 66.46%), and patients who were older than 65 years (968/1520, 63.6%). Patients older than 65 years were less likely to use online medical records (odds ratio [OR] 1.51, 95% CI 1.24-1.84, P<.001). Patients who were White were more likely to use online medical records than patients who were Black (OR 1.71, 95% CI 1.43-2.05, P<.001) or Hispanic (OR 1.65, 95% CI 1.37-1.98, P<.001). Patients who were diagnosed with cancer were more likely to use online medical records compared to patients with no cancer (OR 1.31, 95% CI 1.11-1.55, 95% CI 1.11-1.55, P=.001). Among nonusers, older patients (≥65 years old) preferred speaking directly to their health care providers (OR 1.76, 95% CI 1.35-2.31, P<.001), were more concerned about privacy issues caused by online medical records (OR 1.79, 95% CI 1.22-2.66, P<.001), and felt uncomfortable using the online medical record systems (OR 10.55, 95% CI 6.06-19.89, P<.001) compared to those aged 18-34 years. Patients who were Black or Hispanic were more concerned about privacy issues (OR 1.42, 1.09-1.84, P=.007). CONCLUSIONS: Studies should consider social factors such as gender, race/ethnicity, and age when monitoring trends in eHealth use to ensure that eHealth use does not induce greater health status and health care disparities between people with different backgrounds and demographic characteristics.