ABSTRACT
Objectives: There is often an assumption that remote monitoring is challenging to implement among individuals with schizophrenia, due to symptoms such as paranoia and suspicion of technology, however the promise of digital approaches for passive and real-time data collection has recently been emphasized as a result of the COVID-19 pandemic and increased need for digitally-enabled approaches to care and research. This research describes the use of a mHealth app by a self-selected population of users with Schizophrenia to assess the feasibility of using mobile apps for remote monitoring and research. Methods: Data from Health Storylines users between 2016-2021 who self-identified as being diagnosed with Schizophrenia is described. Data includes quantitative tracking and free text journal entries from tools designed to support the self-management of a variety of health conditions, including Schizophrenia. Results: 5,012 app users reported Schizophrenia as a diagnosed condition, all of whom reported having additional comorbidities with 70% reporting two comorbid conditions. The most frequently reported comorbidities are Anxiety disorder, Depression, Bipolar Disorder and ADD/ADHD. The three most commonly used tools were the Medication Tracker, Symptom Tracker, and Daily Moods. The most commonly reported symptoms were Hallucinations, Paranoid behavior, Hearing voices, Anxiety, Depressed mood and Delusions. Among the qualitative data, several broad themes were consistently the most frequently reported across the duration of the time period examined: Psychosocial impact of the condition, Quality of life, and Experience of the condition. Conclusions: This descriptive analysis of patient engagement with the Health Storylines app reveals that many people with Schizophrenia are willing and able to engage in mobile health technology for the purpose of self-monitoring, engagement, and research. Further research is required to understand the degree of representation of the full spectrum of patients’ experience with Schizophrenia, and the role of patient engagement in completeness and quality of data collected using mobile health apps.
ABSTRACT
Introduction: The physical, social and occupational restrictions imposed by the COVID-19 pandemic have affected the health and well-being of the world population. Objective: To identify the repercussions of the pandemic on the occupational participation of students, lecturers and technicians from three public universities in Northern Brazil, to compare the changes reported by participants in occupational participation before and during the pandemic, and to identify symptoms of depression, anxiety and stress self-reported. Method: This is a Cross-sectional, descriptive and comparative study with a quantitative approach. One hundred and ninety-nine (n = 199) participants (students, lecturers and technicians) responded to an online questionnaire, the "Occupational Participation Checklist" and the Anxiety, Stress and Depression Scale (DASS-21). Data analysis were descriptive and also performed by applying the Wilcoxon and Mann-Whitney tests. Results: During the pandemic, an increase in occupational participation was identified for all participants in domestic activities (p <0.001) and a decrease in work and study face to face (p <0.001). Students reported more symptoms of depression, anxiety and stress when compared to lecturers (p<0.001). Most students did not organise their time to fulfil their occupations with satisfaction. Such difficulties were associated with symptoms of depression, anxiety and stress, especially among the student's group (p<0.001). Conclusion: This study provided preliminary evidence about differences in occupational participation before and during the Covid-19 pandemic. The organization of time and difficulties in occupational participation were associated to levels of anxiety, depression and stress, especially in the sample of students.