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Health Communication Apr 2024Effective communication between patients and doctors is fundamental to high-quality healthcare, patient safety, and overall satisfaction. However, the onset of COVID-19... (Review)
Review
Effective communication between patients and doctors is fundamental to high-quality healthcare, patient safety, and overall satisfaction. However, the onset of COVID-19 has prompted significant shifts in communication from in-room and face-to-face interactions to virtual consults. The impact of this pandemic-related change on patient-doctor communication goals, processes, attributes, and environment remains unclear. We undertook a scoping review involving the systematic search of seven academic databases for relevant articles published up to and including June 2021. In total, 47 articles were identified that met the inclusion criteria. We applied the patient-doctor communication framework to guide our deductive thematic analysis of articles included, sorting results from reported studies and position papers into themes and sub-themes. The theme of highlighted sub-themes related to patient safety, convenience, affordability, and satisfaction; included sub-themes on technology interventions, workforce training, and digital literacy; included compassion for doctors and rebuilding trust among patients; and included issues related to telemedicine or video conferencing, challenges with diminished patient privacy, and distractions in the patient's home setting. Finally, the theme included insights into doctors' workload, isolation, and anxiety and how changes requiring increases in virtual consults iteratively altered confidence in care provision and communication with patients. Results of the scoping review provide important insights for strengthening virtual patient-doctor interactions, including target areas for training and professional development during and beyond the current pandemic.
Topics: Humans; Communication; COVID-19; Empathy; Quality of Health Care; Telemedicine
PubMed: 36522301
DOI: 10.1080/10410236.2022.2152225 -
Frontiers in Public Health 2023The Hyperledger Fabric (HF) framework is widely studied for securing electronic health records (EHRs) in the healthcare sector. Despite the various cross-domain... (Review)
Review
The Hyperledger Fabric (HF) framework is widely studied for securing electronic health records (EHRs) in the healthcare sector. Despite the various cross-domain blockchain technology (BCT) applications, little is known about the role of the HF framework in healthcare. The purpose of the systematic literature review (SLR) is to review the existing literature on the HF framework and its applications in healthcare. This SLR includes literature published between January 2015 and March 2023 in the ACM digital library, IEEE Xplore, SCOPUS, Springer, PubMed, and Google Scholar databases. Following the inclusion and exclusion criteria, a total of 57 articles emerged as eligible for this SLR. The HF framework was found to be useful in securing health records coming from the Internet of Medical Things (IoMT) and many other devices. The main causes behind using the HF framework were identified as privacy and security, integrity, traceability, and availability of health records. Additionally, storage issues with transactional data over the blockchain are reduced by the use of the HF framework. This SLR also highlights potential future research trends to ensure the high-level security of health records.
Topics: Blockchain; Electronic Health Records; Delivery of Health Care; Privacy; Technology
PubMed: 38089022
DOI: 10.3389/fpubh.2023.1272787 -
Frontiers in Public Health 2023In the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the... (Review)
Review
BACKGROUND
In the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the determinants and describe the measurement of the willingness to disclose personal health information.
METHODS
The study conducted a systematic review of articles assessing willingness to share personal health information as a primary or secondary outcome. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. English and Italian peer-reviewed research articles were included with no restrictions for publication years. Findings were narratively synthesized.
RESULTS
The search strategy found 1,087 papers, 89 of which passed the screening for title and abstract and the full-text assessment.
CONCLUSION
No validated measurement tool has been developed for willingness to share personal health information. The reviewed papers measured it through surveys, interviews, and questionnaires, which were mutually incomparable. The secondary use of data was the most important determinant of willingness to share, whereas clinical and socioeconomic variables had a slight effect. The main concern discouraging data sharing was privacy, although good data anonymization and the high perceived benefits of sharing may overcome this issue.
Topics: Health Records, Personal; Privacy; Information Dissemination; Surveys and Questionnaires
PubMed: 37546309
DOI: 10.3389/fpubh.2023.1213615 -
Journal of Clinical Nursing Aug 2023To analyse research-based evidence about patients' right to know from their own perspective to promote ethically high-quality nursing and to identify future research...
AIMS AND OBJECTIVES
To analyse research-based evidence about patients' right to know from their own perspective to promote ethically high-quality nursing and to identify future research areas.
BACKGROUND
Patients' right to know is a fundamental right. Although of topical research interest, the current state of scientific evidence on patients' right to know has not been reviewed.
DESIGN
A scoping review according to the methodological framework by Arksey & O'Malley and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.
METHODS
In June 2022, a literature search was conducted in the Ovid Medline, CINAHL and Cochrane Library databases. The inclusion criteria were peer-reviewed, empirical studies on the right to know with samples comprising adult patients. Data were analysed with inductive content analysis, and methodological quality was assessed with Mixed Methods Appraisal Tool.
RESULTS
Out of 2658 identified reports, 12 were selected for analysis. Based on the results, the research on patients' right to know can be classified into two main content categories: (1) expectations of the right and (2) realisation of the right. In the quality assessment, most of the reports did not meet all the quality criteria, the most common deficits being related to instrumentation and risk of bias.
CONCLUSIONS
Research-based evidence on patients' right to know provided a general insight into expectations and realisation of the right to know and not to know. The results indicate a need for continued efforts for novel approaches with high-quality methodological choices in future studies.
RELEVANCE TO CLINICAL PRACTICE
Nurses make constantly ethical decisions: The findings of this study can be useful for their decision-making and understanding of the patient's perspective on knowledge issues, and therefore, support ethically high-quality patient education.
PATIENT OR PUBLIC CONTRIBUTION
No direct patient or public contribution to the review.
Topics: Adult; Humans; Patient Rights; Access to Information
PubMed: 36550593
DOI: 10.1111/jocn.16603 -
BMC Medical Informatics and Decision... Oct 2023An awareness of antecedents of acceptance of digital contact tracing (DCT) can enable healthcare authorities to design appropriate strategies for fighting COVID-19 or... (Meta-Analysis)
Meta-Analysis
An awareness of antecedents of acceptance of digital contact tracing (DCT) can enable healthcare authorities to design appropriate strategies for fighting COVID-19 or other infectious diseases that may emerge in the future. However, mixed results about these antecedents are frequently reported. Most prior DCT acceptance review studies lack statistical synthesis of their results. This study aims to undertake a systematic review and meta-analysis of antecedents of DCT acceptance and investigate potential moderators of these antecedents. By searching multiple databases and filtering studies by using both inclusion and exclusion criteria, 76 and 25 studies were included for systematic review and meta-analysis, respectively. Random-effects models were chosen to estimate meta-analysis results since Q, I , and H index signified some degree of heterogeneity. Fail-safe N was used to assess publication bias. Most DCT acceptance studies have focused on DCT related factors. Included antecedents are all significant predictors of DCT acceptance except for privacy concerns and fear of COVID-19. Subgroup analysis showed that individualism/collectivism moderate the relationships between norms/privacy concerns and intention to use DCT. Based on the results, the mean effect size of antecedents of DCT acceptance and the potential moderators may be more clearly identified. Appropriate strategies for boosting the DCT acceptance rate can be proposed accordingly.
Topics: Humans; Contact Tracing; COVID-19; Databases, Factual; Group Processes; Health Facilities
PubMed: 37821864
DOI: 10.1186/s12911-023-02313-1 -
Journal of Child Health Care : For... Apr 2024Adolescents face issues regarding physical health, mental health, sexual health, drug and alcohol problems, stress, and peer pressure. Little is known about adolescents'... (Review)
Review
Adolescents face issues regarding physical health, mental health, sexual health, drug and alcohol problems, stress, and peer pressure. Little is known about adolescents' help-seeking behaviours in relation to health concerns. The general practitioner (GP) is usually the first point of contact for adolescents. The aim of this systematic review was to identify, describe, and summarize evidence on barriers and enablers experienced by adolescents when accessing GP-led primary care services. Systematic searches using four electronic databases (PsycINFO, MEDLINE, CINAHL, and SocINDEX) were conducted and the quality of the included studies was appraised. Six studies were included in this review. Findings indicate that barriers to GP access relate to trust, confidentiality, privacy, and communication. Adolescents also reported barriers such as transport, cost, and lack of information. Adolescents reported enablers being services that are sensitive to their needs, healthcare professionals who understand them, and services that are flexible regarding out of hours access. Listening to and acting on the voice of adolescents is important to developing youth-friendly services.
PubMed: 38629615
DOI: 10.1177/13674935241239837 -
Journal of Medical Internet Research Aug 2023Video recordings of patients may offer advantages to supplement patient assessment and clinical decision-making. However, little is known about the practice of video... (Review)
Review
BACKGROUND
Video recordings of patients may offer advantages to supplement patient assessment and clinical decision-making. However, little is known about the practice of video recording patients for direct care purposes.
OBJECTIVE
We aimed to synthesize empirical studies published internationally to explore the extent to which video recording patients is acceptable and effective in supporting direct care and, for the United Kingdom, to summarize the relevant guidance of professional and regulatory bodies.
METHODS
Five electronic databases (MEDLINE, Embase, APA PsycINFO, CENTRAL, and HMIC) were searched from 2012 to 2022. Eligible studies evaluated an intervention involving video recording of adult patients (≥18 years) to support diagnosis, care, or treatment. All study designs and countries of publication were included. Websites of UK professional and regulatory bodies were searched to identify relevant guidance. The acceptability of video recording patients was evaluated using study recruitment and retention rates and a framework synthesis of patients' and clinical staff's perspectives based on the Theoretical Framework of Acceptability by Sekhon. Clinically relevant measures of impact were extracted and tabulated according to the study design. The framework approach was used to synthesize the reported ethico-legal considerations, and recommendations of professional and regulatory bodies were extracted and tabulated.
RESULTS
Of the 14,221 abstracts screened, 27 studies met the inclusion criteria. Overall, 13 guidance documents were retrieved, of which 7 were retained for review. The views of patients and clinical staff (16 studies) were predominantly positive, although concerns were expressed about privacy, technical considerations, and integrating video recording into clinical workflows; some patients were anxious about their physical appearance. The mean recruitment rate was 68.2% (SD 22.5%; range 34.2%-100%; 12 studies), and the mean retention rate was 73.3% (SD 28.6%; range 16.7%-100%; 17 studies). Regarding effectiveness (10 studies), patients and clinical staff considered video recordings to be valuable in supporting assessment, care, and treatment; in promoting patient engagement; and in enhancing communication and recall of information. Observational studies (n=5) favored video recording, but randomized controlled trials (n=5) did not demonstrate that video recording was superior to the controls. UK guidelines are consistent in their recommendations around consent, privacy, and storage of recordings but lack detailed guidance on how to operationalize these recommendations in clinical practice.
CONCLUSIONS
Video recording patients for direct care purposes appears to be acceptable, despite concerns about privacy, technical considerations, and how to incorporate recording into clinical workflows. Methodological quality prevents firm conclusions from being drawn; therefore, pragmatic trials (particularly in older adult care and the movement disorders field) should evaluate the impact of video recording on diagnosis, treatment monitoring, patient-clinician communication, and patient safety. Professional and regulatory documents should signpost to practical guidance on the implementation of video recording in routine practice.
TRIAL REGISTRATION
PROSPERO CRD42022331825: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=331825.
Topics: Humans; Aged; Patient Participation; Empirical Research; Communication; Narration; Clinical Decision-Making
PubMed: 37585249
DOI: 10.2196/46478 -
IEEE Journal of Biomedical and Health... Mar 2024The analysis of human locomotion is highly dependent on the quantity and quality of available data to obtain reliable evidence, due to the great variability of gait...
The analysis of human locomotion is highly dependent on the quantity and quality of available data to obtain reliable evidence, due to the great variability of gait characteristics between subjects. Researchers usually have to make significant efforts to generate well-structured and trustworthy datasets. This situation is aggravated when patients are involved, due to experimental, privacy, and safety constraints. The availability of public datasets can facilitate this process. In this work, we systematically review the scientific and technical literature to identify the human locomotion databases publicly available nowadays. Within the 93 datasets identified, we observed that the most basic motor skills, e.g., flat or sloped walking, are well covered, whereas many other daily-life motor skills are poorly represented. The most common sensors used to record gait are optical motion capture systems, followed by RGB cameras and inertial sensors. We observed a lack of consistency in the data formats and limited sample size in most reviewed datasets. These issues hinder researchers from systematically standing on previous research results and represent a major barrier to using Artificial Intelligence and Big Data algorithms. With this work, we aim to provide the scientific community with a comprehensive, critical, and efficient guide to human locomotion datasets across different application domains.
Topics: Humans; Algorithms; Artificial Intelligence; Gait; Locomotion; Walking; Datasets as Topic
PubMed: 37665701
DOI: 10.1109/JBHI.2023.3311677 -
Journal of Clinical Nursing Mar 2024To explore the educational preparation of nurse practitioners to deliver telehealth services and their impact on access to care. (Review)
Review
AIM
To explore the educational preparation of nurse practitioners to deliver telehealth services and their impact on access to care.
DESIGN
Scoping review.
METHODS
A search was undertaken 4 April 2022. Primary studies that focused on nurse practitioners and their patients/clients engaging in telehealth services in any healthcare setting or clinical area within Australia, New Zealand, United States, Canada, United Kingdom, and Ireland, published between 2010 to 2022, were included. Study findings were analysed using the Levesque et al. (2013) access to care framework and the Patterns, Advances, Gaps, Evidence for Practice and Research Recommendations framework (Bradbury-Jones et al., 2021). The PRISMA-ScR checklist was used to guide reporting.
DATA SOURCES
CINAHL, Medline, Scopus, and Embase databases.
RESULTS
Forty-two studies were included. Studies (n = 28) relating to access to care focused on appropriateness/ability to engage (n = 14), affordability/ability to pay (n = 1), and availability/ability to reach (n = 13). High levels of telehealth satisfaction were reported, including reduced travel time and costs, and appointment flexibility. Telehealth satisfaction was reduced when a perceived need for physical assessment, or privacy concerns were present. Service providers reported decreased emergency presentations, fewer missed appointments and improved consumer engagement. Fourteen studies related to nurse practitioner education, using a range of approaches such as didactic education modules, simulations and clinical experiences, all published within the past 3 years.
CONCLUSION
Findings suggest that nurse practitioner-led telehealth has improved access to care. High levels of satisfaction indicate patients accept nurse practitioner-led telehealth. Impacts to healthcare service use and patient engagement further support the viability of nurse practitioner-led telehealth. The recent increase in telehealth education studies reflects the rapid uptake of telehealth care in the mainstream.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE
Patients perceive telehealth as acceptable and appropriate to meet their healthcare needs and improve access to care. Telehealth is likely to be a mainstay in ongoing healthcare delivery, therefore, nurse practitioners must have educational preparation to provide telehealth.
IMPACT
This scoping review provides insight into the ways nurse practitioners deliver telehealth services, how they are educated to provide telehealth services, and their impact on access to care. Nurse practitioner-led telehealth improves access to care across service provision and consumer perspective domains. Nurse practitioner telehealth education is an emerging topic. This research is valuable for nurse practitioners using telehealth, nurse practitioner educators and telehealth policy decision makers.
REPORTING METHOD
Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).
PATIENT OR PUBLIC CONTRIBUTION
No Patient or Public Contribution.
Topics: Humans; Delivery of Health Care; Telemedicine; Nurse Practitioners; Educational Status; Costs and Cost Analysis
PubMed: 37859576
DOI: 10.1111/jocn.16898 -
BMC Geriatrics Mar 2024Currently, there is no systematic review to investigate the effectiveness of digital interventions for healthy ageing and cognitive health of older adults. This study... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Currently, there is no systematic review to investigate the effectiveness of digital interventions for healthy ageing and cognitive health of older adults. This study aimed to conduct a systematic review to evaluate the effectiveness of digital intervention studies for facilitating healthy ageing and cognitive health and further identify the considerations of its application to older adults.
METHODS
A systematic review and meta-analysis of literature were conducted across CINAHL, Medline, ProQuest, Cochrane, Scopus, and PubMed databases following the PRISMA guideline. All included studies were appraised using the Mixed Methods Appraisal Tool Checklist by independent reviewers. Meta-analyses were performed using JBI SUMARI software to compare quantitative studies. Thematic analyses were used for qualitative studies and synthesised into the emerging themes.
RESULTS
Thirteen studies were included. Quantitative results showed no statistically significant pooled effect between health knowledge and healthy behaviour (I =76, p=0.436, 95% CI [-0.32,0.74]), and between cardiovascular-related health risks and care dependency I=0, p=0.426, 95% CI [0.90,1.29]). However, a statistically significant cognitive function preservation was found in older adults who had long-term use of laptop/cellphone devices and had engaged in the computer-based physical activity program (I=0, p<0.001, 95% CI [0.01, 0.21]). Qualitative themes for the considerations of digital application to older adults were digital engagement, communication, independence, human connection, privacy, and cost.
CONCLUSIONS
Digital interventions used in older adults to facilitate healthy ageing were not always effective. Health knowledge improvement does not necessarily result in health risk reduction in that knowledge translation is key. Factors influencing knowledge translation (i.e., digital engagement, human coaching etc) were identified to determine the intervention effects. However, using digital devices appeared beneficial to maintain older adults' cognitive functions in the longer term. Therefore, the review findings suggest that the expanded meaning of a person-centred concept (i.e., from social, environmental, and healthcare system aspects) should be pursued in future practice. Privacy and cost concerns of technologies need ongoing scrutiny from policy bodies. Future research looking into the respective health benefits can provide more understanding of the current digital intervention applied to older adults.
STUDY REGISTRATION
PROSPERO record ID: CRD42023400707 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=400707 .
Topics: Aged; Humans; Cell Phone; Cognition; Communication; Healthy Aging; Digital Health
PubMed: 38438870
DOI: 10.1186/s12877-023-04617-3