Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 274
Filter
1.
Front Public Health ; 9: 803815, 2021.
Article in English | MEDLINE | ID: covidwho-2199439

ABSTRACT

In the ongoing situation, when the world is dominated by coronavirus disease 2019 (COVID-19), the development of self-care programs appears to be insufficient, while their role in mental health may be crucial. The aim of the study was to evaluate the associations between self-care activities and depression in the general Slovak population, but also in its individual gender and age categories. This was achieved by validating the self-care screening instrument, assessing differences, and evaluating the associations using quantile regression analysis. The final research sample consisted of 806 participants [males: 314 (39%), females: 492 (61%)] and data were collected through an online questionnaire from February 12, 2021 to February 23, 2021. Patient Health Questionnaire (PHQ-9) for depression (α = 0.89) and Self-Care Activities Screening Scale (SASS-14) [health consciousness (HC) (α = 0.82), nutrition and physical activity (NPA) (α = 0.75), sleep quality (SLP) (α = 0.82), and interpersonal and intrapersonal coping strategies (IICS) (α = 0.58)] were used as screening measures. Mild depressive symptoms were found in 229 participants (28.41%), moderate depressive symptoms in 154 participants (19.11%), moderately severe depressive symptoms in 60 participants (7.44%) and severe depressive symptoms in 43 participants (5.33%). The main findings revealed the fact that individual self-care activities were associated with depression. This supported the idea that well-practiced self-care activities should be an immediate part of an individual's life in order to reduce depressive symptoms. Sleep quality played an important role, while HC indicated the need for increased attention. Other dimensions of self-care also showed significant results that should not be overlooked. In terms of depression, females and younger individuals need targeted interventions. The supportive educational intervention developed based on the self-care theory can help manage and maintain mental health during a stressful period, such as the COVID-19 pandemic. Health policy leaders should focus on health-promoting preventive self-care interventions, as the demand for them increases even more during the pandemic.


Subject(s)
COVID-19 , Depression/diagnosis , Depression/epidemiology , Female , Humans , Male , Pandemics , Patient Health Questionnaire , SARS-CoV-2 , Self Care , Slovakia/epidemiology
2.
Explore (NY) ; 18(6): 688-697, 2022.
Article in English | MEDLINE | ID: covidwho-2122470

ABSTRACT

CONTEXT: Whole Health is an emerging healthcare framework that emphasizes wellbeing in place of illness. Conflict Analysis (CA), an online self-guided assessment, leverages innovative diagnostic and therapeutic resources that shares Whole Health objectives, including helping users explore their identity and develop a personalized health plan and helping users develop resources to optimize their health. OBJECTIVES: Paper presents CA implementation-effectiveness study in a Veteran Affairs inpatient substance recovery care. DESIGN: Patients were randomized to CA or mindfulness control. Patients completed Whole Health outcomes measures at baseline, completion (post), and three-week follow-up. Interventions took 2.5 h. Attending psychologist assessed CA protocols and completed outcome evaluation. Due to Coronavirus, recruitment and follow-up were curtailed. SETTING: Study took place in a rural northern New England Veteran Affairs inpatient substance recovery unit. OUTCOME MEASURES: Measures include The Personal Growth Initiative Scale, The Beck Cognitive Insight Scale, Perceived Stress Scale, The Patient Health Questionnaire, Perceived Psychological Wellbeing, and Perceived Therapeutic and Diagnostic Benefit. RESULTS: 12 patients were randomized, 11 completed post measures (CA=5; Mindfulness = 6), and 7 completed follow-up measures (CA=3; Mindfulness=4). CA offered significant Whole Health benefits when compared to control. Additionally, participant and clinician evaluations indicated that CA can be personally relevant, meaningful, and motivate therapeutic growth. Implications include extending CA research and expanding Whole Health related interventions. Although initial results suggest implementation feasibility and Whole Health benefit, more research is necessary to establish CA's utility within inpatient substance recovery care in particular and psychiatric rehabilitation in general.


Subject(s)
Mindfulness , Substance-Related Disorders , Humans , Inpatients , Outcome Assessment, Health Care , Self Care , Substance-Related Disorders/therapy
3.
J Cardiovasc Nurs ; 36(6): 609-617, 2021.
Article in English | MEDLINE | ID: covidwho-2113475

ABSTRACT

BACKGROUND: Difficulties in coping with and self-managing heart failure (HF) are well known. The COVID-19 pandemic may further complicate self-care practices associated with HF. OBJECTIVE: The aim of this study was to understand COVID-19's impact on HF self-care, as well as related coping adaptations that may blunt the impact of COVID-19 on HF health outcomes. METHODS: A qualitative study using phone interviews, guided by the framework of vulnerability analysis for sustainability, was used to explore HF self-care among older adults in central Texas during the late spring of 2020. Qualitative data were analyzed using directed content analysis. RESULTS: Seventeen older adults with HF participated (mean [SD] age, 68 [9.1] years; 62% female, 68% White, 40% below poverty line, 35% from rural areas). Overall, the COVID-19 pandemic had an adverse impact on the HF self-care behavior of physical activity. Themes of social isolation, financial concerns, and disruptions in access to medications and food indicated exposure, and rural residence and source of income increased sensitivity, whereas adaptations by healthcare system, health-promoting activities, socializing via technology, and spiritual connections increased resilience to the COVID-19 pandemic. CONCLUSIONS: The study's findings have implications for identifying vulnerabilities in sustaining HF self-care by older adults and empowering older adults with coping strategies to improve overall satisfaction with care and quality of life.


Subject(s)
COVID-19 , Heart Failure , Aged , Female , Heart Failure/therapy , Humans , Male , Pandemics , Quality of Life , SARS-CoV-2 , Self Care
4.
Front Public Health ; 10: 993531, 2022.
Article in English | MEDLINE | ID: covidwho-2119747

ABSTRACT

Background: A growing body of research shows that individuals with non-communicable diseases (NCDs), such as hypertension, diabetes, hypercholesterolemia, and heart disease, are more likely to suffer from severe COVID-19 and, subsequently, death. The purpose of this study was to assess the influence of COVID-19-related knowledge on mental health, healthcare behaviors, and quality of life among the elderly with NCDs in Northern Thailand. Methods: In this cross-sectional study, the participants were 450 elderly people with NCDs, living in the Chiang Rai province, Northern Thailand. Random sampling was applied to select the subjects. Data collection included demographic information, COVID-19-related knowledge, healthcare behaviors, the Suanprung Stress Test-20, the Thai General Health Questionnaire (GHQ-28) for the assessment of mental health, and the Thai version of the World Health Organization Quality of Life-BREF. Results: Almost half of the participants (45.6%) had poor knowledge about COVID-19. More than half of the sample had high stress (52.0%) and a low score in healthcare behaviors (64.9%), while approximately one-third of the participants had mental health problems (34.0%). The overall quality of life during the COVID-19 pandemic was moderate (70.7%). The score of COVID-19-related knowledge was significantly correlated with scores of stress (r = -0.85), mental health (r = -0.74), healthcare behaviors (r = 0.50), and quality of life (r = 0.33). Multiple linear regression found that history of COVID-19 detection and COVID-19-related knowledge were associated with scores of stress and quality of life (p < 0.05). Multiple logistic regression showed that history of COVID-19 detection (OR = 4.48, 95% CI = 1.45-13.84) and COVID-19-related knowledge (OR = 0.23, 95% CI = 0.17-0.31) were associated with mental health problem (p < 0.05). Discussion: The findings emphasize the importance of COVID-19-related knowledge concerning the improvement of self-care behaviors and quality of life in the elderly population with NCDs during the pandemic, especially due to the high rate of stress and mental health problems documented in our sample. Health education interventions for this vulnerable population should be organized.


Subject(s)
COVID-19 , Noncommunicable Diseases , Humans , Aged , Mental Health , Quality of Life/psychology , Noncommunicable Diseases/epidemiology , COVID-19/epidemiology , Thailand/epidemiology , Cross-Sectional Studies , Self Care , Pandemics
5.
J Health Care Poor Underserved ; 33(4): 1844-1864, 2022.
Article in English | MEDLINE | ID: covidwho-2109264

ABSTRACT

In the United States, eight million people have disabilities related to self-care (having serious difficulty with bathing and dressing). Of these, approximately 2.3 million receive paid personal assistance services (PAS) to assist with activities of daily living. The National Survey on Health and Disability asked a series of questions about the impacts of COVID-19 for disabled people including disruptions in PAS. We used data from an open-ended question "How did you manage without the help you needed in your home?" to bring light to both the importance of, and vulnerabilities associated with, receipt of PAS. Themes from qualitative responses (n = 108) included (1) causes of unmet need, (2) consequences of unmet need, and (3) adaptations to overcome the loss of PAS. Results provide compelling evidence about the importance of the personal care attendant workforce and needed policies to address worker shortages to support community-based living options.


Subject(s)
COVID-19 , Disabled Persons , Humans , Activities of Daily Living , COVID-19/epidemiology , COVID-19/psychology , Self Care , United States/epidemiology
6.
Psychiatr Danub ; 32(3-4): 557-562, 2020.
Article in English | MEDLINE | ID: covidwho-2100778

ABSTRACT

The world is amidst the COVID-19 pandemic that has used social distancing as a tool for containing the virus from spreading exponentially among other individuals. Previous literature suggests that human contact and attachment is a key for well-being which is why punishments like solitary confinement in detention centers like jail has always been debated as being torturous (Wolfendal 2020). With this notion, anxiety and stress may become more prevalent in individuals who experience self-isolation or are under a forced lockdown. For health-care workers like doctors and psychologists, who advocate for physical health, mental health and wellbeing; the challenges might increase during the pandemic phase as they are expected to go through the crises just like others while simultaneously contributing in rendering services related to dealing with physical and psychological health issues present in patients and clients with their continued practice from either on-site or online platforms. Although all health care professional's training inoculates the ill effects of compassion fatigue by other's overwhelming situations and discussions but they might still be prone to vicarious burnout, trauma and stress. Hence, they may become exposed to being at risk of experiencing anxiety more than the general population. This review discusses facets of the importance of self-care as mental health first aid tool for health care professionals including doctors and psychologists using research and supportive techniques to help them process stress and anxiety during and after the global pandemic.


Subject(s)
COVID-19 , Communicable Disease Control , Health Personnel , Humans , Pandemics , SARS-CoV-2 , Self Care
7.
Rev Bras Enferm ; 75Suppl 4(Suppl 4): e20210933, 2022.
Article in English, Portuguese | MEDLINE | ID: covidwho-2089505

ABSTRACT

OBJECTIVES: to analyze self-care deficit among older men in the COVID-19 pandemic in Brazil and to discuss the implications for nursing practice. METHODS: web survey, multicentric, qualitative. A total of 120 older men participated, applying a form from April to June 2020 and April to August 2021. Reflective Thematic Analysis, interpreted by Orem's Self-Care Deficit Theory, was used. RESULTS: temporally, the self-care of older men was manifested in the self-care requirements - affective bonds, self-care for development - meditation and self-care with health deviations - remote consultations. Fully, partially compensatory, educational/support systems mobilized self-care. FINAL CONSIDERATIONS: as care managers, nurses can strengthen the support network for older men by activating professionals from the multidisciplinary team, family members, caregivers and the community to promote self-care and correct health deviations in times of crisis.


Subject(s)
COVID-19 , Nursing Theory , Male , Humans , Aged , Self Care , Pandemics , Surveys and Questionnaires
8.
J Integr Complement Med ; 28(10): 799-810, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2077567

ABSTRACT

Background: Complementary medicine (CM) is often used as an opportunity for preventive health measures and supportive self-care practices. This study aimed to explore the use of self-care practices and preventive health strategies and the aspects of the experienced emotions during the COVID-19 pandemic in a population with an affinity for CM. Methods: The authors conducted an exploratory cross-sectional study using an anonymous 41-item online survey in the German language. The survey respondents were recruited among adults with an affinity for CM (e.g., as targeted through their memberships in CM associations) from September 2020 to February 2021. A selection of self-care methods, mainly from CM, was presented in the questionnaire. Numerical rating scales (NRSs), ranging from 0 = minimum to 10 = maximum, were used to measure the intensity of different emotions experienced during the pandemic. Statistical analysis was carried out descriptively. Results: A total of 1605 participants (80.6% female; mean age: 55.4 ± 12.6 [SD] years; 43.9% holding a university degree) were included. The use of self-care methods for health promotion during the pandemic was reported by 86.8% of the respondents. Respondents favored staying in nature (85.6%), healthy nutrition (85.6%), and physical activities (83.6%). More than 60% of the respondents made use of vitamin C and/or D, herbal medicines, nutritional supplements, relaxation techniques, breathing exercises, homeopathy, or meditation for health promotion. The analysis of emotional status by NRS (0-10) revealed the lowest mean ± SD (standard deviation) for "feeling lonely" (2.6 ± 2.9) and "feeling anxious" (2.8 ± 2.6), and the highest mean for "feeling connected to others" (6.2 ± 2.5) and "well-being" (5.8 ± 2.4). Conclusions: Participants used a wide variety of self-care methods and prevention strategies to promote their health during the COVID-19 pandemic and showed, overall, a balanced emotional status. Further research should include a control group representative of the general population, to investigate the possible impact of self-care strategies. Clinical Trial Registration Number: "Deutsches Register Klinischer Studien" (German Clinical Trial Register); registration number: DRKS00022909.


Subject(s)
COVID-19 , Adult , Humans , Female , Middle Aged , Aged , Male , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Self Care , Adaptation, Psychological , Ascorbic Acid
9.
Psychiatr Danub ; 34(3): 615-616, 2022.
Article in English | MEDLINE | ID: covidwho-2073318
10.
Diabetes Metab Syndr ; 16(10): 102618, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2061069

ABSTRACT

AIMS: A number of reports have illustrated the barriers that the war in Ukraine puts to diabetes care. While their recommendations are valuable for glycemic control and the prevention or early detection of life - threatening diabetes complications, such as hypoglycemia and ketoacidosis, the discourse on diabetic foot is limited. This letter emphasizes the implications of the war in diabetic foot care and discusses potential solutions. METHODS: The authors searched peer - reviewed and grey literature to identify records related to the prevalence of diabetic foot in Ukraine and the standards of care before and after the invasion of Ukraine. RESULTS: Thousands of people in Ukraine sustain diabetic foot ulcers and, thus, are at high risk for lower limb amputations due to the limited access to healthcare services in the country. If not addressed, disability associated with chronic ulcers and amputations can severely affect individual and public health in Ukraine. Strengthening primary and remote care, educating people on self - care and providing adequate supplies for the management of diabetic foot have a major potential to prevent amputations, disability and death. CONCLUSIONS: Providing adequate diabetic foot care in Ukraine and other regions tormented by armed conflicts is vital for the health of the local population and the potential of the affected countries to recover after the crisis.


Subject(s)
Diabetes Mellitus , Diabetic Foot , Humans , Diabetic Foot/epidemiology , Diabetic Foot/therapy , Diabetic Foot/etiology , Ukraine/epidemiology , Amputation , Self Care , Prevalence
11.
Sex Health ; 19(4): 278-285, 2022 08.
Article in English | MEDLINE | ID: covidwho-2050705

ABSTRACT

Increased demand for sexual health services (including prevention and treatment) have spurred the development of digital STI/HIV services. Earlier advances in testing technologies opened the door for self-testing and self-sampling approaches, in line with broader self-care strategies. Advances in HIV management mean that many people are living well with HIV and no longer need intensive in-person monitoring, whereas those at-risk of HIV are recommended to have regular asymptomatic STI screening and pre-exposure prophylaxis. This narrative review examines the evidence and implications of digital STI/HIV services, focused on promoting testing, facilitating testing, clinical management and referrals, partner services, and prevention. We have used a prevention and care continuum to structure the review to increase utility to policy as well as practice. Digital STI/HIV services can be interwoven into existing clinical pathways to enhance face-to-face services or standalone digital STI/HIV services. A growing evidence base, including randomised controlled trials and observational studies, should help inform strategies for designing effective digital STI/HIV services. However, most studies to date have focused on high-income countries and people with smartphones, despite a substantial burden of STI/HIV in low- and middle-income countries. There are also important differences between digital STI and HIV services that require careful consideration. We discuss digital STI/HIV service evidence and implications to inform research and programs in this exciting field.


Subject(s)
HIV Infections , Sexually Transmitted Diseases , Continuity of Patient Care , HIV Infections/diagnosis , HIV Infections/prevention & control , Humans , Self Care , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/prevention & control , Smartphone
12.
Health Psychol ; 41(11): 833-842, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2028651

ABSTRACT

OBJECTIVE: Self-care behaviors aimed at maintaining physical and mental health are often recommended during stressful contexts. We tested emotional predictors of self-care behaviors (healthy eating, exercise, engaging in a hobby, relaxation/meditation, time spent with a supportive person, talking online with friends/family) during the COVID-19 pandemic and their emotional consequences. We hypothesized a reciprocal within-person process whereby positive affect increases self-care behaviors (Hypothesis 1) and self-care behaviors increase positive affect while decreasing negative affect (Hypothesis 2). METHOD: A 10-day daily diary was completed by 289 adult participants in the United States during spring 2020 when counties in 40 out of 50 states had some form of stay-at-home orders. RESULTS: Lagged analyses for Hypothesis 1 suggested that positive affect did not significantly predict residualized change in self-care behaviors; however, more intense negative affect predicted increased self-care behaviors from one day to the next. Concurrent analyses for Hypothesis 2 indicated most self-care behaviors were associated with more positive affect and some with less negative affect on the same day. Lagged analyses for Hypothesis 2 indicated that self-care behaviors largely did not predict residualized change in positive or negative affect from one day to the next. At the between-person level, people who experienced more positive affect engaged in more self-care behaviors across the sampling period. CONCLUSION: Self-care behaviors continue to have mental health benefits during stressful environments such as the COVID-19 pandemic and stay-at-home orders. Negative affect can play an adaptive role during times of stress by facilitating self-care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Adult , Exercise , Humans , Mental Health , Pandemics , Self Care , United States
13.
Aust J Gen Pract ; 51(9): 705-711, 2022 09.
Article in English | MEDLINE | ID: covidwho-2026511

ABSTRACT

BACKGROUND AND OBJECTIVES: Self-care strategies are important to maintain psychological wellbeing. The aim of this study was to explore how self-care changed during the first COVID-19 lockdown in winter 2020 and identify targets for interventions. METHOD: This was a cross-sectional study. Participants attending a COVID-19 testing clinic completed the Mindful Self-Care Scale (MSCS) and Hospital Anxiety and Depression Scale (HADS). RESULTS: A total of 332 participants completed questionnaires (mean age 38 years, 55% female). Self-care strategies used less frequently during lockdown when compared with pre-lockdown were in MSCS domains of Physical Care (P <0.001), Supportive Relationships (P <0.001), Supportive Structures (P <0.001) and Mindful Awareness (P <0.001). Mean anxiety and depression scores were 5.97 (standard deviation [SD] = 4.36) and 4.12 (SD = 3.594). DISCUSSION: Several pre-pandemic strategies were used less frequently, including individual activities not restricted during lockdown ('listening'; 'using images' to relax). This study provides insight into activities that are practised and reduced during a lockdown, which can guide wellbeing interventions to assist people in isolation.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , Communicable Disease Control , Cross-Sectional Studies , Female , Humans , Male , Mental Health , Self Care
14.
Front Public Health ; 10: 964944, 2022.
Article in English | MEDLINE | ID: covidwho-2022991

ABSTRACT

Background: The unprecedented crisis during the fifth wave of the COVID-19 pandemic in Hong Kong placed a significant burden on the health care system. Therefore, the Hong Kong government advocated that individuals with no or mild COVID-19 symptoms should self-care at home. This study aimed to understand intrapersonal and interpersonal level factors that shaped self-care practices among home-quarantined individuals with COVID-19 during the peak of the pandemic. Methods: This study used convenience and snowball sampling whereby a total of 30 semi-structured telephone interviews were conducted between March and April 2022. Inductive content analysis was used to analyze the data. Results: Factors reported at the intrapersonal level included socioeconomic status and housing conditions, information and knowledge about COVID-19, long COVID, and psychological adjustments brought about by home quarantine. Factors identified at the interpersonal level included caregiving responsibilities, family relationships, and social support. Conclusions: Findings from this study identified a combination of intra and interpersonal level factors influenced an individual's self-care practices as a result of pandemic-induced quarantine. It was particularly concerning for those individuals in socially and economically deprived groups, where access to services was challenging. This study also raised awareness of the ineffectual and insufficient knowledge individuals held of self-medication and overall COVID-19 management. A key recommendation is developing family-based resilience programmes to support and empower vulnerable families to better cope with the realities of self-quarantine.


Subject(s)
COVID-19 , COVID-19/complications , Hong Kong , Humans , Pandemics , Self Care
15.
PLoS One ; 17(8): e0273074, 2022.
Article in English | MEDLINE | ID: covidwho-2021905

ABSTRACT

BACKGROUND: Diabetes Mellitus (DM), a chronic metabolic disorder that caused about 4.2 million deaths and at least 760 billion dollars' expenditure in 2019, has been targeted for action by leaders of WHO member countries. In Ethiopia deaths, due to DM reached 34,262 in 2013. Studies show effective lifestyle interventions; particularly medical nutrition therapy reduces HbA1c by 0.5 to 2%. However, practicing recommended diet is reported to be difficult. Not only Knowledge and practice but also perception studies are therefore necessary to design future health programs. OBJECTIVE: To assess diabetic self-care, dietary practice and associated factors among diabetes patients. METHOD: Institution-basedbased cross-sectional study design was employed from february15-May15, 2020 in Jimma university medical Centre (JUMC). Systematic sampling of every other patient (K = 2.7) was employed to interview 371 participants. A previously validated tool was used to collect data through a face-to-face interview. A path analysis was used to fit the structural model and tests the hypothesized Health Belief Model (HBM) relationships. RESULT: Response rate was 95.4% (354). Around 52% of the participants were male and 76.8% follow diabetic education at least some times. 42.4% and 48% of respondents have good dietary and general self-care practices respectively. With unstandardized coefficient (standard error) self-efficacy0.10 (0.01) being the strongest cues to action0.10 (0.02), perceived threat0.02 (0.01), and perceived barrier-0.08(0.01) constructs of HBM have a significant effect on dietary practice. Knowledge, social support and diabetes distress exert a significant indirect effect on dietary practice through health belief constructs with unstandardized path coefficient (standard error) of 0.22(0.03), 0.02(0.01), and -0.03(0.004) respectively. CONCLUSION: In this study, the proportion of good practice is found to be lower for both dietary as well as general self-care. HBM can best fit to explain variability in dietary self-care practice; therefore, future interventions should be designed to address the vast perception and psychosocial factors influencing dietary self-care practices.


Subject(s)
Diabetes Mellitus , Self Care , Academic Medical Centers , Cross-Sectional Studies , Diabetes Mellitus/psychology , Diabetes Mellitus/therapy , Diet , Ethiopia , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Self Care/psychology
16.
J Med Internet Res ; 24(9): e40108, 2022 09 07.
Article in English | MEDLINE | ID: covidwho-2022425

ABSTRACT

BACKGROUND: The demand for health services to meet the chronic health needs of the aging population is significant and remains unmet because of the limited supply of clinical resources. Specifically, in managing heart failure (HF), digital health sought to address this gap during the COVID-19 pandemic but highlighted an access issue for those who could not use technology-mediated health care services without the support of their informal caregivers (ICs). The complexity of managing HF symptoms and recurrent exacerbations requires many patients to comanage their illness with their ICs in a care dyad, working together to optimize patient outcomes and health-related quality of life. However, most HF programs have missed the opportunity to consider the dyadic perspective despite interdependencies on HF outcomes. OBJECTIVE: This study aims to characterize the value of technology in supporting caregiving for individuals living with HF. METHODS: Motivated by an observed unique pattern of engagement in patients enrolled in our Medly HF management program at the Peter Munk Cardiac Centre in Toronto, Canada, we conducted 20 semistructured interviews with a convenience sample of ICs. All interviews were analyzed using the iterative refinement of a codeveloped codebook. The team maintained reflexivity journals to reflect the impact of their positionality on their coding. Themes were first derived deductively using HF typologies (patient-oriented dyads, caregiver-oriented dyads, and collaboratively oriented dyads) and then inductively refined and recategorized based on concepts from the van Houtven et al framework. RESULTS: We believe that there is a need to formally and intentionally expand HF technologies to include dyadic needs and goals. We suggest defining 3 opportunities in which value can be added to technological design. First, identify how technology may be leveraged to increase psychological bandwidth by reducing uncertainty and providing peace of mind. We found that actionable feedback was highly desired by both partners. Second, develop technology that can serve as a member of the dyad's support system. In our experience, automated prompts for patients to take measurements can mimic the support typically provided by ICs and ease their workload. Third, consider how technology can mitigate the dyad's clinical knowledge requirements and learning curve. Our approach includes real-time actionable feedback paired with a human-in-the-loop, nurse-led model of care. CONCLUSIONS: Our findings identified a need to focus on improving the dyadic experience as a whole by building IC functionality into digital health self-management interventions. Through a shared model of care that supports the role of the patient in their own HF management, includes ICs to expand and enhance the patient's capacity to care, and acknowledges the need of ICs to care for themselves, we anticipate improved outcomes for both partners.


Subject(s)
COVID-19 , Heart Failure , Aged , Heart Failure/therapy , Humans , Pandemics , Quality of Life , Self Care , Technology
17.
J Med Internet Res ; 24(8): e37641, 2022 08 16.
Article in English | MEDLINE | ID: covidwho-2022374

ABSTRACT

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.


Subject(s)
Delivery of Health Care , Self Care , Humans , Privacy , Technology
18.
BMJ Open ; 12(8): e056962, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-2020029

ABSTRACT

BACKGROUND/OBJECTIVES: Remote monitoring as a component of chronic heart failure (CHF) management programmes has demonstrated utility in reducing the risk of rehospitalisation and mortality. There is little evidence on mobile health app facilitated remote monitoring in India. We conducted a pilot usability and feasibility assessment of a smartphone-based application (Suhriday) to remotely monitor patients with CHF. METHODS: We used a mixed-methods design. Usability testing consisted of the think-aloud approach followed by semistructured in-depth interviews (SSIs) and a satisfaction questionnaire. Feasibility testing was done using acceptability and user satisfaction questionnaires in addition to SSIs. We trained five purposively sampled patients with CHF (based on health literacy and gender) and their caregivers (n=10) in self-care monitoring and app use. Usability was assessed using metrics such as task completion, time required for task completion and user satisfaction using Brooke's System Usability Scale (SUS). Content analysis of the transcripts with deductive coding was performed for both usability and feasibility interviews. The number and types of medical alerts transmitted through the app were captured and escalated to the treating team. RESULTS: Critical tasks involving (1) opening the app and identifying task list, (2) reporting blood pressure, weight, heart rate and fluid intake and (3) reporting symptoms were completed within 60 s by four patients. Median (IQR) SUS score was 85 (75-92.5) indicating high level of usability. There were 62 alerts from four patients over 4 weeks, with 36 (58.1%) excess fluid intake alerts and 16 (25.8%) blood pressure variations being the most frequent. One participant had challenges using the app and was monitored through active phone calls. CONCLUSION: Overall usability and satisfaction with Suhriday were good and we were able to remotely manage patients. However, patients with limited health literacy and those facing technological challenges required active structured telephone support.


Subject(s)
Heart Failure , Mobile Applications , Telemedicine , Feasibility Studies , Heart Failure/therapy , Humans , Self Care , Smartphone
19.
Am J Nurs ; 122(9): 20-22, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-2018178

ABSTRACT

Despite practical and policy barriers, new technologies support the case for greater flexibility.


Subject(s)
Diabetes Mellitus, Type 2 , Diabetes Mellitus , Self-Management , Diabetes Mellitus/therapy , Health Behavior , Humans , Self Care
20.
Int J Environ Res Public Health ; 19(17)2022 Aug 24.
Article in English | MEDLINE | ID: covidwho-1997636

ABSTRACT

Diabetes numeracy skills are required in the interpretation of food labels, insulin pump dosage, the interpretation of blood glucose meter data, and the determination of carbohydrate intake. This study assessed the levels and correlates of numeracy skills in Lebanese adults with diabetes to identify those most at risk of uncontrolled diabetes. In total, 299 adults with diabetes, mean age 47.4 ± 19.8 years, took the questionnaire. It consisted of self-developed items on sociodemographic and health-related factors, in addition to the Diabetes Numeracy Test-15 (DNT-15) and the Single Item Literacy Screener. Many participants (62%) scored < 10 on the DNT-15 indicating insufficient numeracy skills. DNT-15 scores were positively associated with literacy, exercise, healthy diet, perceived diabetes control, frequency of glycaemia measurement, ability to afford treatment, and ease of understanding information related to diabetes. Age, BMI, and complications were negatively correlated with DNT-15 score. Numeracy skills were higher in males, single individuals, and in people with type 1 diabetes, fewer complications, controlled HbA1c, higher income, higher education, a prior visit to a dietician, and ability to maintain personal care despite COVID-19. Interventions to strengthen numeracy skills would empower individuals with diabetes, lead to appropriate self-management behaviors, and prevent health complications in at-risk individuals.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 1 , Health Literacy , Adult , Aged , Cross-Sectional Studies , Humans , Male , Middle Aged , Self Care , Surveys and Questionnaires
SELECTION OF CITATIONS
SEARCH DETAIL