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Background: Telemedicine is a method of providing remote healthcare services and consultations to patients using communication technology. Tele-audiology is a sub-branch of telemedicine. It refers to providing audiology services using telehealth strategies. This study aims to compare the satisfaction of patients who come to the hearing aid center and receive device fitting service and patients who have hearing aid fitting using tele-audiology service. For this purpose, hearing aid users were divided into two groups. The study group consisted of 17 participants (10 male, 7 females;mean age 65.17 +/- 13.88) who continued fitting appointments remotely after the first clinic application, while the control group consisted of 23 participants (10 males, 13 females;mean age 62.17 +/- 18.32) who had all hearing aid fittings performed face-to-face in the clinic. The participant's satisfaction was assessed with The International Outcome Inventory for Hearing Aids Turkiye (IOI-HA-TR) questionnaire because it is practical and can be administered over the phone. Result(s): There were no significant differences in hearing aid satisfaction between those who came to the hearing center and filled out the IOI-HA-TR questionnaire personally and those who completed it through the Remote Care application (p < 0.05). In addition, most of the participants stated that using Remote Care solved their problems (35% very good, 24% good) and they were satisfied with the fitting of their hearing aids with this application (35% good, 29% very good). In addition, 13 out of 17 participants stated that they would pay attention to the "remote fitting" feature when purchasing a new hearing aid (76% very good). Moreover, they would like to continue the fitting using the Remote Care application (65% yes). Conclusion(s): Remote fitting technology via smartphone applications can facilitate the lives of hearing aid users and improve their quality of life in cases of risky conditions such as pandemics, various diseases, and physical limitations.Copyright © 2023, The Author(s).
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Background: Nurses who are occupied in emergency departments play a critical role in health services provision and patient care. Considering the importance of providing appropriate and immediate care in emergency departments, nurses need to acquire sufficient skills and up-to-date knowledge. Objective(s): This study aimed to identify the educational needs of nurses working in the emergency department and explore strategies to meet challenges against the elimination of these needs. Method(s): This qualitative study was conducted using a content analysis approach. This study selected the emergency departments of two large educational hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran. This study was conducted on 15 emergency department nurses selected via purposive sampling with maximum variation within January 2020 and March 2021.The data were collected by performing 15 in-depth, semi-structured interviews (11 face-to-face and 4 telephone interviews due to the coronavirus disease 2019 pandemic) and making field notes. Then, the recorded interviews were transcribed verbatim and analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. The consolidated criteria for reporting qualitative studies (COREQ) was used to report the findings of this study. Result(s): Three main themes, namely the need for comprehensive and continuous education, challenges of managing educational needs, and strategies to meet educational needs, were extracted following data analysis. Conclusion(s): Clarifying the educational needs of nurses and exploring strategies to solve these challenges can be effective by providing continuous practical training and adopting effective teaching-learning strategies to promote nurses' education and improve their performance in clinical skills. Accordingly, the provision of appropriate infrastructure for mobile health applications and utilization of mobile-based educational applications in emergency departments have to be taken into account by hospital managers and health policymakers.Copyright © 2023, Author(s).
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[Purpose] This study aimed to determine the effects of a mobile health application, and exercise instructions by a physical therapist on exercise frequency, duration, and intensity for middle-aged and older adults. [Participants and Methods] The study included males and females in their 50s to 70s, who provided consent to participate. Thirty-six people who wished to participate in the online group were divided into groups of five or six each, with a physical therapist as group leader. The frequency, intensity, duration of exercise, and group activities were surveyed using questionnaires: before coronavirus disease (COVID-19) (before March 2020, when the novel coronavirus began to spread in Japan), during COVID-19 (after April 2020), after digital versatile disc (DVD) distribution, and after online group initiation (3 weeks after DVD distribution for the control group). [Results] The online group received significantly more frequent instructions by a physiotherapist than the control group. The control group did not show significant changes over time, whereas the online group exercised significantly, more frequently after the intervention. [Conclusion] The online mode and physical therapist intervention resulted in a significant increase in exercise frequency. Exercise advice from professionals and peer presence to continue exercising together were beneficial.
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The high prevalence of mental health problems among university students poses a challenge when developing effective interventions, with digital technologies emerging as a potential resource to address this problem. The inclusion of student input in the design and development of such interventions is critical to improving their impact. This study contributed to the initial phase of a research project that aims to adapt and evaluate the feasibility and acceptability of an early intervention for anxiety and depression based on digital technologies for university students. Three participatory workshops were conducted with 13 university students in Chile to inquire about the features and content that a mental health mobile app should include to meet their needs and preferences. The workshop transcripts were analysed using inductive thematic analysis. The results of this study highlight the value of modifications such as the personalisation of some features of the app. The students recommended incorporating topics related to university life and the possibility of contacting a mental health professional, as well as the inclusion of peer interaction or other forms of support.Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.
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The mobile application RehaGoal app is presented for people with acquired and congenital brain damage who have difficulties with complex planning tasks. The development of the RehaGoal app was based on the Goal Management Training approach, which focuses on breaking down an overarching goal into sub-goals and manageable steps to achieve them. So far, this approach has been paper-based, which makes it difficult to transfer to everyday life. Therefore, the RehaGoal app, which can be used on various digital devices such as smartphones, smartwatches, etc., was developed. Our target group often has additional limitations, which is why the RehaGoal app has a barrierfree design, voice output, visual display options, a user-dependent display, simple menu navigation and an authoring system. We illustrate the possible applications of the RehaGoal app with patients in outpatient neuropsychological rehabilitation, during vocational reintegration and during lockdown due to COVID-19.Copyright © Hippocampus Verlag 2023.
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As COVID-19 spreads across the globe, crowdsourced digital technology harbours the potential to improve surveillance and epidemic control, primarily through increased information coverage, higher information speed, fast case tracking and improved proximity tracing. Targeting those aims, COVID-19-related smartphone and webbased health applications are continuously emerging, leading to a multitude of options, raising ethical and legal challenges and potentially overwhelming end users. Building on an existing trustworthiness checklist for digital health applications, we searched the literature and developed a framework to guide the assessment of smartphone and web-based applications that aim to contribute to controlling the current epidemic or mitigating its effects. It further integrates epidemiological subject knowledge and a legal analysis, outlining the mechanisms through which new applications can support the fight against COVID-19. The resulting framework includes 40 questions across 8 domains on "purpose", "usability", "information accuracy", "organisational attributes / reputation", "transparency", "privacy" and "user control / self-determination". All questions should be primarily answerable from publicly available data, as provided by application manufacturers. The framework aims to guide end users in choosing a transparent, safe and valuable application and suggests a set of information items that developers ideally make available to allow a balanced judgement and facilitate the trustworthiness of their products.Copyright © 2020 EMH Schweizerischer Arzteverlag AG. All rights reserved.
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BACKGROUND: Mobile health (mHealth) apps have facilitated symptom monitoring of COVID-19 symptoms globally and have been used to share data with health care professionals and support disease prediction, prevention, management, diagnostics, and improvements in treatments and patient education. OBJECTIVE: The aim of this review is to evaluate the quality and functionality of COVID-19 mHealth apps that support tracking acute and long-term symptoms of COVID-19. METHODS: We systematically reviewed commercially available mHealth apps for COVID-19 symptom monitoring by searching Google Play and Apple iTunes using search terms such as "COVID-19," "Coronavirus," and "COVID-19 and symptoms." All apps underwent three rounds of screening. The final apps were independently assessed using the Mobile Application Rating Scale (MARS), an informatics functionality scoring system, and the Center for Disease Control and World Health Organization symptom guidelines. The MARS is a 19-item standardized tool to evaluate the quality of mHealth apps on engagement, functionality, aesthetics, and information quality. Functionality was quantified across the following criteria: inform, instruct, record (collect, share, evaluate, and intervene), display, guide, remind or alert, and communicate. Interrater reliability between the reviewers was calculated. RESULTS: A total of 1017 mobile apps were reviewed, and 20 (2%) met the inclusion criteria. The majority of the 20 included apps (n=18, 90%) were designed to track acute COVID-19 symptoms, and only 2 (10%) addressed long-term symptoms. Overall, the apps scored high on quality, with an overall MARS rating of 3.89 out of 5, and the highest domain score for functionality (4.2). The most common functionality among all apps was the instruct function (n=19, 95%). The most common symptoms included in the apps for tracking were fever and dry cough (n=18, 90%), aches and pains (n=17, 85%), difficulty breathing (n=17, 85%), tiredness, sore throat, headache, loss of taste or smell (n=16, 80%), and diarrhea (n=15, 75%). Only 2 (10%) apps specifically tracked long-term symptoms of COVID-19. The top 4 rated apps overall were state-specific apps developed and deployed for public use. CONCLUSIONS: Overall, mHealth apps designed to monitor symptoms of COVID-19 were of high quality, but the majority of apps focused almost exclusively on acute symptoms. Future apps should also incorporate monitoring long-term symptoms of COVID-19 and evidence-based educational materials; they should also include a feature that would allow patients to communicate their symptoms to specific caregivers or their own health care team. App developers should also follow updated technical and clinical guidelines from the Center for Disease Control and the World Health Organization.
Subject(s)
COVID-19 , Mobile Applications , Telemedicine , COVID-19/diagnosis , Health Personnel , Humans , Reproducibility of ResultsABSTRACT
The emergence of mobile health applications (MH-Apps) has enhanced the healthcare field's services, particularly in the treatment, diagnosis, and follow-up. AMAN Mobile Health Application (AMAN MH-App) is one of the health-tech solutions used to fight the Coronavirus pandemic. It has a built-in feature to track users' activities to protect users from contacting an infected person. However, the acceptance of AMAN MH-App in Jordan is still in an early stage, and the number of users has reached 15% of the country's population. Therefore, this study aims to assess the use of AMAN MH-App among young people using the quantitative method. A total of (450) valid samples participated in the study after removing 33 invalid samples. Smart-PLS 3.2.7 was used for data analysis. The findings showed that all independent variables (Perceived usefulness, Perceived ease of use value, Subjective norms, Perceived behavioral control, Information Credibility, and Optimism) positively impact on the dependent variable (Behavioural Intention to use AMAN MH-App). We believe that AMAN MH-App's information's credibility (i.e. providing up-to-date, authoritative, accurate, and trustworthy information) will increase the number of the App's users. The results of this research can be applied to similar context and applications in different countries.
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BACKGROUND: Mobile health projects have been implemented worldwide, using mobile phones for record keeping, data collection, or patient communication. Further, mobile health tools have been used to promote behavior change in health workers and/or patients. For example, text message reminders have been shown to increase health-care-seeking behavior or medication adherence in some patients, and mobile data collection and communication tools for health workers have improved follow-up of patients and data reporting. METHODS: This literature review was conducted through a keyword search of the following databases to identify relevant peer-reviewed articles: Google Scholar, PubMed, Embase, and EKB. Keywords used in these searches included mHealth, mobile health, mobile phone, coverage, usage, delivery, vaccination, immunization, and COVID-19. RESULTS: Eleven studies that satisfied the inclusion criteria were included. They examined awareness, applications, challenges, and strengths of Mobile-Health applications. All studies showed some evidence that mHealth intervention had a positive impact on increasing the coverage and use of the COVID-19 vaccine. Bad awareness of people was strongly associated with declines in vaccination intent. The use of mobile applications has made a great revolution in tracking and data gathering about vaccination status. The main limitations were reporting bias and malfunctioning of mobile applications. The main strengths were getting real-time data, improving surveillance, using geographic mapping to monitor populations. CONCLUSION: Growing usage of smartphones and Internet penetration in African countries opens the door to mHealth applications such as health literacy, vaccine supply and control, disease monitoring and intervention, and virtual consultations with health professionals worldwide.
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BACKGROUND: African-Americans (AA) are underrepresented in mobile health (mHealth) intervention research studies which can perpetuate health inequities and the digital divide. A community based, user-centered approach to designing mHealth interventions may increase their sociocultural relevance and effectiveness, especially with increased smartphone use during the COVID-19 pandemic. We aimed to refine an existing mHealth intervention via a virtual focus group series for use in a randomized controlled trial (RCT) aiming to improve cardiovascular health (CVH) in AAs. METHODS: AA community members (N=15) from churches in Minneapolis and Rochester, Minnesota were enrolled in a virtual, 3-session focus group series over 5 months to refine an existing CVH focused mHealth application (FAITH! App). Participants completed a baseline electronic survey capturing sociodemographics, mobile technology use, and electronic health information sources prior to start of focus groups. Participants accessed the FAITH! App via their smartphones and received a Fitbit synced to the app. Participants engaged with multimedia CVH focused education modules, a sharing board for social networking, and diet/PA self-monitoring. Participant feedback on app features prompted iterative revisions to yield a refined app. Primary outcomes were app usability (assessed via Health Information Technology Usability Evaluation Scale [Health-ITUES], range 0-5) and user satisfaction which were evaluated via electronic survey after the final focus group. A predetermined goal of mean overall Health-ITUES score of ≥4 was set for the app to advance for use in the RCT. RESULTS: Participants (mean age [SD] 56.9 [12.3] years, 13, 86.7% female) attended a mean 2.8 focus groups (80% attended all sessions). Participant feedback resulted in app refinements to increase visual appeal, increase diversity and gender balance in testimonial videos, further improve ease of diet/PA self-monitoring, and add fitness videos as well as a moderated sharing board. The revised FAITH! App achieved a mean overall Health-ITUES score of ≥4 (mean 4.39, range 3.20-4.95). Participants positively rated updated app content, visual appeal, and use of social incentives to maintain engagement. Increasing user control and further refinement of the moderated sharing board were identified as areas for future improvement. CONCLUSIONS: Virtual focus group data can improve usability and increase participant satisfaction in mHealth lifestyle interventions aiming to promote CVH in AAs.
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Background: Studies of mobile diabetes applications (apps) have demonstrated improvements in glycemia, and patient-reported outcomes (PROs). In addition, shift to shorter pen needles (PN) and guidance on proper injection techniques have shown the potential for reduced glycemic variability. The purpose is to determine the impact of using a diabetes mobile app plus a novel 4 mm PN on PROs and glycemic outcomes in type 2 diabetes mellitus (T2DM) for multiple daily injection (MDI) insulin users. Materials and methods: In this 8-week prospective, parallel-group, randomized controlled trial, subjects either received (1:1) intervention (BD Diabetes Care [DC] App + BD Nano TM 2nd Gen PN) or control therapy. Controls used their current PN and did not use diabetes apps. Results: Fifty-eight subjects were randomized. Fifty-seven completed the study (intervention n = 27, control n = 30). At study end, there were no significant differences in PROs between groups, except improved medication adherence (ARMS-D) in controls. From flash glucose monitoring (fGM) data, there were no significant differences in most glycemic measures between groups except for a trend for improved glycemic variability [mean amplitude of the glycemic excursions (MAGE)] in the Intervention (p = 0.06). Controls had significantly reduced time spent in hypoglycemia but had 2 to 3-fold higher incidence at baseline. In general, Intervention subjects reported satisfaction with both the app and PN. Conclusions: This is the first BD DC App study, in combination with BD Nano TM 2nd Gen PN, to assess glycemic outcomes. This combination intervention shows promising results for reduced glycemic variability and the potential to positively impact self-management.
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Background: The use of teledermatology has increased rapidly especially during the COVID-19 pandemic and the use of mobile health applications (mHealth app) may provide patients and health care professionals to maintain a relationship and facilitate person-centered care. However, involving patients and health care professions in the design and development of future suitable mHealth solutions is a sparsely investigated field. Purpose: For patients with psoriasis and health care professionals to co-design and develop a person-centered mHealth solution based on their needs. Methods: A Participatory design study was conducted in three phases: 1) identification of needs, 2) design and development, and 3) test and evaluation of the solution. Qualitative methods such as participant observation and interviews were used in combination with various user activities. Results: Both patients and health care professionals requested a new approach as the existing consultations were characterized by a biomedical approach and set of routines and did not necessarily include the patients' needs and perspectives. An mHealth app, adaptable to clinical practice, was designed to support patients at in-person visits, and to accommodate patients' request for fewer visits. Conclusion: Patients experienced the use of video consultations as a clear advantage and that the mHealth app gave them a voice with regard to what to address during consultations. Health care professionals experienced that they were more attentive during consultations;however, they felt some loss of control when they were not able to assess the patient's skin. Conversely, patients felt both secure and confident in self-assessing their skin.
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Digital technologies are transforming society and our way of life. The Covid- 19 emergency has further accelerated this transformation, making available remote services that have replaced those we used to use in presence. This transformation has given a further boost to digital health. Many services for telemedicine in all its forms (remote televisit, telehealth, telerehabilitation, telemonitoring) are now available and in some cases can be prescribed and reimbursed by national health systems or insurance companies. Apps and wearables are increasingly used to collect health data and can help promote healthy lifestyles, disseminate information for the prevention and management of certain diseases, involve the patient in treatment, and improve adherence to therapy and doctor-patient communication. Digital therapeutics, providing software that modify lifestyles and deliver cognitive-behavioural interventions, offer therapeutic interventions based on solid scientific evidence to prevent, manage, or treat a wide range of physical, mental and behavioural conditions. Artificial intelligence and machine learning systems help to analyse and interpret data produced in the medical field to create diagnostic and predictive systems, systems for defining the best treatment to administer to a patient, and systems for identifying new drugs. It is essential, however, that digital health tools be rigorously tested and regulated before widespread adoption, as is the case with normal medical devices and drug therapies.
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Background Cognitive-behavioural therapy (CBT) is recommended for all patients with psychosis, but is offered to only a minority. This is attributable, in part, to the resource-intensive nature of CBT for psychosis. Responses have included the development of CBT for psychosis in brief and targeted formats, and its delivery by briefly trained therapists. This study explored a combination of these responses by investigating a brief, CBT-informed intervention targeted at distressing voices (the GiVE intervention) administered by a briefly trained workforce of assistant psychologists. Aims To explore the feasibility of conducting a randomised controlled trial to evaluate the clinical and cost-effectiveness of the GiVE intervention when delivered by assistant psychologists to patients with psychosis. Method This was a three-arm, feasibility, randomised controlled trial comparing the GiVE intervention, a supportive counselling intervention and treatment as usual, recruiting across two sites, with 1:1:1 allocation and blind post-treatment and follow-up assessments. Results Feasibility outcomes were favourable with regard to the recruitment and retention of participants and the adherence of assistant psychologists to therapy and supervision protocols. For the candidate primary outcomes, estimated effects were in favour of GiVE compared with supportive counselling and treatment as usual at post-treatment. At follow-up, estimated effects were in favour of supportive counselling compared with GiVE and treatment as usual, and GiVE compared with treatment as usual. Conclusions A definitive trial of the GiVE intervention, delivered by assistant psychologists, is feasible. Adaptations to the GiVE intervention and the design of any future trials may be necessary.
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BACKGROUND: The use of mobile technology or smartphones has grown exponentially in the United States, allowing more individuals than ever internet access. This access has been especially critical to households earning less than US $30,000, the majority of whom indicate that smartphones are their main source of internet access. The increasing ubiquity of smartphones and virtual care promises to offset some of the health disparities that cut through the United States. However, disparities cannot be addressed if the medical information offered though smartphones is not accessible or reliable. OBJECTIVE: This study seeks to create a framework to review the strengths and weaknesses of mobile Health (mHealth) apps for diverse, low-income populations. METHODS: Focusing on smoking cessation, diabetes management, and medication adherence as models of disease management, we describe the process for selecting, evaluating, and obtaining patient feedback on mHealth apps. RESULTS: The top 2 scoring apps in each category were QuitNow! and Smoke Free-Quit Smoking Now for smoking cessation, Glucosio and MyNetDiary for diabetes management, and Medisafe and MyMeds for medication adherence. CONCLUSIONS: We believe that this framework will prove useful for future mHealth app development, and clinicians and patient advisory groups in connecting culturally, educationally, and socioeconomically appropriate mHealth apps with low-income, diverse communities and thus work to bridge health disparities.
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In recent years, mobile health applications (mHealth apps) have created a new social context in the clinical diagnosis process based on technology innovation. To improve understanding of digital transformation in healthcare and determinants for its implementation, this article examines the available mHealth apps addressed to medical practitioners and explores these apps features' trustworthiness, quality, and popularity. Based on the normalization process theory, we explain the process from the introduction of mHealth innovation in the clinical practice to the intention of professional engagement. We conduct content analysis of the apps' descriptions, functions, and user reviews;measured available app features and performance metrics;and applied statistical analysis to understand features intercorrelations and users' preferences. We observe moderate levels of reliability and quality in the existing mHealth apps, revealing margins for potential improvement. The mHealth app star rating, quality score, and downloads are all highly intercorrelated. The apps with more features score higher in quality, especially those with credible sources, feedback opportunities, and "how to use" instructions. App development from credible sources can increase their trustworthiness. Further, technological advances in these apps can greatly benefit health professionals' everyday practice and, thus, healthcare for society. This article contributes to the information systems research by using social theories to reveal the importance of app features to the adoption of professional health applications and underline the sets of policies/practices that should apply in the app development process to strengthen clinical efficiency and effectiveness.
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Keywords: mHealth;Applications;Arthroplasty Purpose: Length of hospital-stay following total knee arthroplasty (TKA) is approximately 1-3 days, with associated costs of revisions around £75,000 per patient. Patient control of recovery, self-management and compliance to home-based rehabilitation is therefore of utmost importance. The use of mHealth applications (apps), to promote independence and self-management, provides potential for a cost-effective, patient-centred strategy to achieve this. The objective of this study was to scope and review the quality of publicly available, patient-focused apps for TKA, with the aim of identifying and recommending one for trial and clinical implementation within a Hampshire hospital. Methods: A scoping review was chosen to systematically map, synthesise and review the latitude of apps available via the Apple Store and Google Play. Apps were identified if they were free of charge to the user, suitable for use within the UK and in English;due to the ubiquitous nature of app usage, apps were selected if they targeted both total knee or hip arthroplasty. Quality analysis of each app was conducted using the Mobile App Rating Scale (MARS);a simple 4-dimension, objective, and reliable tool for classifying and assessing quality of mhealth apps. Results: Nine apps, from 692 screened, met the inclusion criteria and were reviewed using MARS. The mean overall MARS score (where 1 = inadequate and 5 = excellent) was 3.57 (SD = ±0.87). Four apps had a score above 4, three of which were identified as utilising an app platform already in use by NHS Trusts. Five apps had a score of less than 3. The highest rated app was the Northumbria Orthopaedic NHS Trust App (4.57) which utilised the app platform ‘My Patient Journey’. This app was noted to consider features that ensured the app was engaging and also likely to promote positive rehabilitative behaviours. Conclusion(s): This study provides an overview of mHealth apps available to health-care professionals and patients post-TKA. Further investigation into the use of this platform is required, to personalise and adjust it for specific Trust use. Randomised trials are now required in order to characterise the use and efficacy of this app on health knowledge, behaviours and use. Moreover, to understand their effectiveness in rehabilitation and improve quality of life following TKA, hereby reducing its burden on public health and clinical systems. Impact: The NHS finds itself in the midst of an mHealth revolution and mobile technology offers the opportunity to access clinical apps, evidence-based resources and advanced mobile communication in one device. The mobility of such apps enables patients to use them in their home setting, reducing the need for face-to-face contact and, in light of the COVID-19 pandemic, has shown itself to be a technology that presents a future healthcare option. This study provides an overview of the mHealth apps available to a range of health-care professionals across all disciplines and patients post-TKA surgery;summarising their strengths and limitations to make recommendations for future implementation. The introduction of such management will take time, funding, a shift in clinician approach and patient expectation-management, in addition to further research to optimise delivery. Funding acknowledgements: This study is a final year physiotherapy dissertation, courtesy of University of Winchester. No funding was received from internal/external sources.