Personalized Management of Fatigue in Individuals With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Using a Smart Digital mHealth Solution: Protocol for a Participatory Design Approach.

BACKGROUND: Fatigue is the most common symptom in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, impacting patients' quality of life; however, there is currently a lack of evidence-based context-aware tools for fatigue self-management in these populations. OBJECTIVE: This study aimed to (1) address fatigue in ME/CFS and long COVID through the development of digital mobile health solutions for self-management, (2) predict perceived fatigue severity using real-time data, and (3) assess the feasibility and potential benefits of personalized digital mobile health solutions. METHODS: The MyFatigue project adopts a patient-centered approach within the participatory health informatics domain. Patient representatives will be actively involved in decision-making processes. This study combines inductive and deductive research approaches, using qualitative studies to generate new knowledge and quantitative methods to test hypotheses regarding the relationship between factors like physical activity, sleep behaviors, and perceived fatigue in ME/CFS and long COVID. Co-design methods will be used to develop a personalized digital solution for fatigue self-management based on the generated knowledge. Finally, a pilot study will evaluate the feasibility, acceptance, and potential benefits of the digital health solution. RESULTS: The MyFatigue project opened to enrollment in November 2023. Initial results are expected to be published by the end of 2024. CONCLUSIONS: This study protocol holds the potential to expand understanding, create personalized self-management approaches, engage stakeholders, and ultimately improve the well-being of individuals with ME/CFS and long COVID. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50157.

Dificultades y barreras encontradas por los profesionales sanitarios en la atención de pacientes paliativos en un distrito sanitario / Difficulties and barriers found by healthcare professionals in palliative care in a healthcare district

Objetivo: Conocer las dificultades y barreras encontradas por distintos profesionales sanitarios para la asistencia a personas en cuidados paliativos. Diseño: Diseño observacional descriptivo transversal. Emplazamiento: Hospital San Juan de Dios y centros de atención primaria circundantes pertenecientes al distrito sanitario Aljarafe, Sevilla. Participantes: 118 profesionales sanitarios de estos centros: internistas, médicos de urgencias y médicos de familia, así como profesionales de enfermería de las mismas áreas asistenciales. Mediciones principales: Mediante una encuesta se recogieron variables sociodemográficas y profesionales sobre la formación y experiencia en cuidados paliativos, así como los ítems de la Escala de Dificultades en Cuidados Paliativos (PCDS, Palliative Care Difficulties Scale). Resultados: Se incluyeron un total de 118 profesionales con una edad media de 42,2 años, de los cuales el 57,6 % eran mujeres. Las mayores barreras encontradas por los profesionales fueron la escasa formación en cuidados paliativos y la dificultad de acceso a la información en el domicilio, con un rango observado de entre 2,27 y 3,26. No se encuentran diferencias estadísticamente significativas al estudiar las dificultades percibidas en función de la categoría profesional. En la comparación de ámbitos asistenciales sí hay diferencias (p = 0,03): se detectan mayores dificultades en urgencias, siendo el médico de urgencias el que presenta mayor dificultad frente al internista (p < 0,01). Entre los profesionales de enfermería de los tres ámbitos asistenciales no se identifican diferencias. Conclusión: Los médicos y el personal de enfermería de urgencias son los profesionales que mayores dificultades encuentran en la prestación de cuidados paliativos en su práctica asistencial, principalmente en la coordinación interniveles y en la formación, mientras que los internistas son los que menos las perciben. (AU)

Objective: To know the difficulties and barriers found by health professionals when tending to palliative care patients in a health district. Design: a cross-sectional, descriptive, observational design. Location: The regional hospital and primary care centers of a health district. Participants: 118 healthcare professionals in said centers: internists, emergency physicians and family doctors, as well as nurses in the same healthcare areas.Main measurements: Sociodemographic and professional variables were collected on the participants’ training and experience in palliative care through a survey, as well as by using the Palliative Care Difficulties Scale (PCDS). Results: A total of 118 professionals were included, with an average age of 42.2 years and 57.6% being women. Limited training in palliative care and the difficulty of accessing information at home were the greatest barriers found by these professionals, with an observed range between 2.27 and 3.26. No statistically significant differences were found when studying the perceived difficulties according to professional category. In the comparison of care settings differences were found (p = 0.03), with greater difficulties being detected in the emergency department, and with emergency physicians having the greatest difficulty compared to internists (p < 0.01). Among the nurses in the three care areas no differences were identified. Conclusions: Emergency physicians and nurses were the professionals who experienced the greatest difficulties in providing palliative care in their care practice, while internists were the ones who reported the least difficulties. (AU)

Mapping the Access of Future Doctors to Health Information Technologies Training in the European Union: Cross-Sectional Descriptive Study.

BACKGROUND: Health information technologies (HITs) such as electronic health records (EHR) and telemedicine services are currently used to assist clinicians provide care to patients. There are many barriers to HIT adoption, including mismatches between investments and benefits, disruptions in the workflow, and concerns about privacy and confidentiality. The lack of HIT training of health professionals as a workforce is an increasingly recognized and understudied barrier. OBJECTIVE: The purpose of this study is to describe what courses on HIT topics are available at the graduate level for future health professionals in the European Union (EU) and to explore possible determining factors for their exposure to these courses. METHODS: A cross-sectional descriptive study of EU medical schools was performed to explore the prevalence of HIT courses. The curricula of all identified higher learning institutions that offer a medical degree were manually explored to identify graduate-level courses that offer specific training on HIT topics. HIT topics were defined as courses or subjects that provided knowledge on the design, development, use, and implementation of HIT. Associations among potential factors such as population, yearly medical graduates, total number of physicians, EHR presence, and gross domestic product (GDP) were explored. RESULTS: A total of 302 medical schools from the 28 member states of the EU were explored. Only about one-third (90/302, 29.80%) of all medical degree curricula offered any kind of HIT course at the graduate level; in the medical schools that offered HIT courses, the courses were often mandatory (58/90, 64.44%). In most EU countries, HIT courses are offered in less than half of the medical schools, regardless of the country's GDP per capita. Countries with the highest percentages of HIT course presence have the lowest GDP per capita. There seems to be a weak inverse correlation (-0.49) between the two variables (GDP per capita and HIT course presence). There is a trend between the availability of medical human resources and an increase in the presence of HIT courses, with Romania, Croatia, and Greece as outliers in this respect. CONCLUSIONS: The current state of medical training in the EU leaves much room for improvement. Further studies are required for in-depth analysis of the content and manner of instruction that would fit present and future needs of HIT.