ABSTRACT
The COVID-19 pandemic has influenced various aspects of people's lives;for instance, restrictions during the pandemic have forced people to think about sports participation and physical activity in new ways. There has been growing interest in technological interventions to support exercise-related behavioural changes in daily life;in particular, exergames designed to induce full-body movement offer alternatives to physical activity. Since Taiwan has a high rate of ownership of exergame-related equipment, it is worth examining players' perceptions of using exergames for exercise. This study utilised a Means-End Chain analysis with in-depth laddering interviews to investigate Taiwanese perceptions of certain attributes of exergames as most likely to produce desired consequences in accordance with their values. The findings provide researchers and practitioners interested in the use of technology for exercise with valuable implications of Means-End Chain theory and structuration theory and suggestions for exergame design and promotion.
ABSTRACT
When the World Health Organization (WHO) analyzed the culprits of global warming, it was found that in developed countries with relatively few high-polluting heavy industries, the medical sector is one of the sources of high-density carbon emissions. Therefore, the medical industry has a noticeable impact on the environment. Amid the current COVID-19 epidemic, this study adopts the theory of planned behavior (TPB), widely used in decision-making science. We selected a regional teaching hospital with 339 employees in Taiwan to obtain valid questionnaire data. We explore the comparative analysis of different intra-organizational stakeholders' "attitudes,” "subjective norms,” and "perceived behavioral control” on the hospital's behavioral intention to promote green healthcare. The results show that the TPB model has reliable explanatory power. All three factors have a positive and significant effect on promoting green hospital behavior. Among them, perceived behavioral control was the most notable. A comparative analysis of the differences among stakeholders in the research model shows that "medical administrators” and "nursing staff” have a higher proportion of significant influence effects in various hypotheses, highlighting the critical roles of these two groups in promoting green hospitals. This research policy suggests that the cross-departmental staff in the hospital put forward green innovation ideas, strengthen internal environmental education and management, establish a good incentive system for front-line nursing staff, and implement the sustainable development strategy of the hospital. © 2023 by the authors.
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Objectives: In this study, we explored major National Health Insurance (NHI) policies in Taiwan and residents' awareness about, support for, utilization rate of, and satisfaction with them during the COVID-19 pandemic to create a reference for health-care policymakers. Methods: We analyzed data collected through a survey conducted among the residents (age ≥18 years) of Taiwan using the 2021 NHI satisfaction questionnaire. The questionnaire comprised questions on NHI satisfaction, NHI MediCloud system, My Health Bank, referral system, premium payment deferral or installment, telemedicine, virtual NHI cards, and other topics. Results: A total of 3,266 and 2,226 valid samples were obtained through annual and thematic polls, respectively. The rate of satisfaction with NHI and medical institutions was >90%. Of the respondents, 86.3% were satisfied with the travel history, occupation, contact history, and cluster query reminder system;38.4% were aware that My Health Bank can be used to seek medical information;>86.4% were satisfied with their experience;88.8% were willing to participate in the referral system;33.5% did not seek medical care due to the pandemic;86.2% supported the policy related to deferred payment of premiums;and 70% supported telemedicine promotion and virtual NHI card policies. Conclusions: The COVID-19 pandemic appears to have had no negative effects on the general public's attitude toward major NHI policies, which showed an upward trend. In the future, technology may be used to facilitate epidemic prevention and provide immediate support to individuals during severe epidemics. © 2022, Taiwan Public Health Association. All rights reserved.
ABSTRACT
Objectives: In this study, we explored major National Health Insurance (NHI) policies in Taiwan and residents' awareness about, support for, utilization rate of, and satisfaction with them during the COVID-19 pandemic to create a reference for health-care policymakers. Methods: We analyzed data collected through a survey conducted among the residents (age ≥18 years) of Taiwan using the 2021 NHI satisfaction questionnaire. The questionnaire comprised questions on NHI satisfaction, NHI MediCloud system, My Health Bank, referral system, premium payment deferral or installment, telemedicine, virtual NHI cards, and other topics. Results: A total of 3,266 and 2,226 valid samples were obtained through annual and thematic polls, respectively. The rate of satisfaction with NHI and medical institutions was >90%. Of the respondents, 86.3% were satisfied with the travel history, occupation, contact history, and cluster query reminder system;38.4% were aware that My Health Bank can be used to seek medical information;>86.4% were satisfied with their experience;88.8% were willing to participate in the referral system;33.5% did not seek medical care due to the pandemic;86.2% supported the policy related to deferred payment of premiums;and 70% supported telemedicine promotion and virtual NHI card policies. Conclusions: The COVID-19 pandemic appears to have had no negative effects on the general public's attitude toward major NHI policies, which showed an upward trend. In the future, technology may be used to facilitate epidemic prevention and provide immediate support to individuals during severe epidemics. © 2022, Taiwan Public Health Association. All rights reserved.
ABSTRACT
INTRODUCTION: Severe pneumonia is a common indication for admission to the pediatric intensive care unit (PICU) and a leading cause of morbidity and mortality. The lack of epidemiology and outcome data from Asia is a barrier to improving outcomes of severe pneumonia in the region. METHOD(S): This is a prospective multicenter cohort study carried out from April 2019 to April 2022. Fifteen PICUs participated in this study under the Pediatric Acute & Critical Care Medicine Asian Network. Epidemiological, microbiological and outcome data were collected up to hospital discharge. Univariate logistic regression analysis were conducted to explore the association between potential risk factors and severe outcomes [acute respiratory distress syndrome (ARDS) and PICU mortality]. Multivariable analysis was performed withforward stepwise logistic regression adjusted for sites and COVID-19 pandemic including variables with p< 0.05 in univariate model. RESULT(S): There were 786 children with severe pneumonia in PICU with mean (standard deviation) age 2.8 (3.9) years. 384/786 (48.9%) had comorbidities;126/786 (16.0%) had a history of prematurity (gestational age < 37 weeks). Admission Pediatric Index of Mortality 3 (PIM3) and Pediatric Logistic Organ Dysfunction 2 (PELOD2) score were 16.2 (22.9) and 4.1(4.6). A sole viral or bacterial pathogen was identified in 179/786 (22.4%) and 165/786 (21.0%). Co-infections occurred in 114/786 (14.5%) patients. ARDS and mortality occurred in 156/786 (20.1%) and 70/786(8.9%) patients. In the multivariable model, risk factors for ARDS included PIM3 [adjusted odds ratio (aOR) [95% confidence interval (CI)] of 1.02 (1.01, 1.03)], PELOD2 [aOR 1.08 (95%CI 1.02, 1.13)] and involvement of 4 quadrants on chest-x-ray, [aOR 2.69 (95%CI 1.39, 5.18)]. Risk factors for mortality included PIM 3 [aOR 1.03 (95%CI 1.01, 1.04)], involvement of 4 quadrants on chest-x-ray [aOR 2.72 (95%CI 1.10, 6.73)], bacterial [aOR 2.61 (95%CI 1.00, 6.82)], fungus or mycobacterium [aOR 12.30 (95%CI 1.45, 104.57)] and co-infections [aOR 2.72 (95%CI 1.10, 10.35)]. CONCLUSION(S): The rate of ARDS and mortality in severe pneumonia admitted to PICU in Asia was high. Risk factors for poor outcomes were admission severity scores, generalized X-ray involvement and identification of bacteria, fungus/mycobacteria or co-infections.
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Background and objective COVID-19 and Medicare Benefits Schedule rebates have driven the increased use of telehealth in Australian general practice. The aim of this study was to gain an understanding of patients' perspectives towards telehealth in general practice. Methods A 10-question online survey was designed and distributed to patients in the Adelaide Hills via direct email invitation, social media posts and flyers between 6 June and 17 July 2020. Results A total of 154 responses were obtained, 84% indicating interest in ongoing use of telehealth. Telephone consultations made up 100% of consultations. Six per cent of patients would have preferred video consultations. Seventeen per cent would pay an out-of-pocket fee, while the remaining would only use telehealth if bulk billed. No concerns regarding privacy, technical difficulty or lack of confidence in assessments were expressed. Discussion The reception of telephone consultations in general practice has been strongly positive. Key drivers towards this success should be considered by governing bodies if there is to be continued innovation within the area of remote healthcare delivery.