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JMIR MHealth and UHealth Nov 2020With the rise of mobile medicine, the development of new technologies such as smart sensing, and the popularization of personalized health concepts, the field of smart... (Review)
Review
BACKGROUND
With the rise of mobile medicine, the development of new technologies such as smart sensing, and the popularization of personalized health concepts, the field of smart wearable devices has developed rapidly in recent years. Among them, medical wearable devices have become one of the most promising fields. These intelligent devices not only assist people in pursuing a healthier lifestyle but also provide a constant stream of health care data for disease diagnosis and treatment by actively recording physiological parameters and tracking metabolic status. Therefore, wearable medical devices have the potential to become a mainstay of the future mobile medical market.
OBJECTIVE
Although previous reviews have discussed consumer trends in wearable electronics and the application of wearable technology in recreational and sporting activities, data on broad clinical usefulness are lacking. We aimed to review the current application of wearable devices in health care while highlighting shortcomings for further research. In addition to daily health and safety monitoring, the focus of our work was mainly on the use of wearable devices in clinical practice.
METHODS
We conducted a narrative review of the use of wearable devices in health care settings by searching papers in PubMed, EMBASE, Scopus, and the Cochrane Library published since October 2015. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion.
RESULTS
A total of 82 relevant papers drawn from 960 papers on the subject of wearable devices in health care settings were qualitatively analyzed, and the information was synthesized. Our review shows that the wearable medical devices developed so far have been designed for use on all parts of the human body, including the head, limbs, and torso. These devices can be classified into 4 application areas: (1) health and safety monitoring, (2) chronic disease management, (3) disease diagnosis and treatment, and (4) rehabilitation. However, the wearable medical device industry currently faces several important limitations that prevent further use of wearable technology in medical practice, such as difficulties in achieving user-friendly solutions, security and privacy concerns, the lack of industry standards, and various technical bottlenecks.
CONCLUSIONS
We predict that with the development of science and technology and the popularization of personalized health concepts, wearable devices will play a greater role in the field of health care and become better integrated into people's daily lives. However, more research is needed to explore further applications of wearable devices in the medical field. We hope that this review can provide a useful reference for the development of wearable medical devices.
Topics: Delivery of Health Care; Health Facilities; Humans; Technology; Wearable Electronic Devices
PubMed: 33164904
DOI: 10.2196/18907 -
Journal of Medical Internet Research Nov 2021Hand hygiene is one of the most effective ways of preventing health care-associated infections and reducing their transmission. Owing to recent advances in sensing... (Review)
Review
BACKGROUND
Hand hygiene is one of the most effective ways of preventing health care-associated infections and reducing their transmission. Owing to recent advances in sensing technologies, electronic hand hygiene monitoring systems have been integrated into the daily routines of health care workers to measure their hand hygiene compliance and quality.
OBJECTIVE
This review aims to summarize the latest technologies adopted in electronic hand hygiene monitoring systems and discuss the capabilities and limitations of these systems.
METHODS
A systematic search of PubMed, ACM Digital Library, and IEEE Xplore Digital Library was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were initially screened and assessed independently by the 2 authors, and disagreements between them were further summarized and resolved by discussion with the senior author.
RESULTS
In total, 1035 publications were retrieved by the search queries; of the 1035 papers, 89 (8.60%) fulfilled the eligibility criteria and were retained for review. In summary, 73 studies used electronic monitoring systems to monitor hand hygiene compliance, including application-assisted direct observation (5/73, 7%), camera-assisted observation (10/73, 14%), sensor-assisted observation (29/73, 40%), and real-time locating system (32/73, 44%). A total of 21 studies evaluated hand hygiene quality, consisting of compliance with the World Health Organization 6-step hand hygiene techniques (14/21, 67%) and surface coverage or illumination reduction of fluorescent substances (7/21, 33%).
CONCLUSIONS
Electronic hand hygiene monitoring systems face issues of accuracy, data integration, privacy and confidentiality, usability, associated costs, and infrastructure improvements. Moreover, this review found that standardized measurement tools to evaluate system performance are lacking; thus, future research is needed to establish standardized metrics to measure system performance differences among electronic hand hygiene monitoring systems. Furthermore, with sensing technologies and algorithms continually advancing, more research is needed on their implementation to improve system performance and address other hand hygiene-related issues.
Topics: Cross Infection; Electronics; Hand Hygiene; Health Personnel; Humans; Technology
PubMed: 34821565
DOI: 10.2196/27880 -
Cureus Aug 2023Adolescents increasingly find it difficult to picture their lives without social media. Practitioners need to be able to assess risk, and social media may be a new... (Review)
Review
Adolescents increasingly find it difficult to picture their lives without social media. Practitioners need to be able to assess risk, and social media may be a new component to consider. Although there is limited empirical evidence to support the claim, the perception of the link between social media and mental health is heavily influenced by teenage and professional perspectives. Privacy concerns, cyberbullying, and bad effects on schooling and mental health are all risks associated with this population's usage of social media. However, ethical social media use can expand opportunities for connection and conversation, as well as boost self-esteem, promote health, and gain access to critical medical information. Despite mounting evidence of social media's negative effects on adolescent mental health, there is still a scarcity of empirical research on how teens comprehend social media, particularly as a body of wisdom, or how they might employ wider modern media discourses to express themselves. Youth use cell phones and other forms of media in large numbers, resulting in chronic sleep loss, which has a negative influence on cognitive ability, school performance, and socio-emotional functioning. According to data from several cross-sectional, longitudinal, and empirical research, smartphone and social media use among teenagers relates to an increase in mental distress, self-harming behaviors, and suicidality. Clinicians can work with young people and their families to reduce the hazards of social media and smartphone usage by using open, nonjudgmental, and developmentally appropriate tactics, including education and practical problem-solving.
PubMed: 37671234
DOI: 10.7759/cureus.42990 -
Journal of Medical Internet Research May 2021Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific...
BACKGROUND
Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years.
OBJECTIVE
This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies.
METHODS
The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles.
RESULTS
This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public.
CONCLUSIONS
Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns.
Topics: COVID-19; Health Promotion; Humans; Patient Education as Topic; Public Health; SARS-CoV-2; Social Media
PubMed: 33978589
DOI: 10.2196/17917 -
Journal of Medical Internet Research Oct 2020The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a...
BACKGROUND
The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a variety of health-related activities, including behavior change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase the accessibility to health care services for the public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in health care is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption.
OBJECTIVE
This systematic review aims to assess the effectiveness and usability of conversational agents in health care and identify the elements that users like and dislike to inform future research and development of these agents.
METHODS
PubMed, Medline (Ovid), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Association for Computing Machinery Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in health care. EndNote (version X9, Clarivate Analytics) reference management software was used for initial screening, and full-text screening was conducted by 1 reviewer. Data were extracted, and the risk of bias was assessed by one reviewer and validated by another.
RESULTS
A total of 31 studies were selected and included a variety of conversational agents, including 14 chatbots (2 of which were voice chatbots), 6 embodied conversational agents (3 of which were interactive voice response calls, virtual patients, and speech recognition screening systems), 1 contextual question-answering agent, and 1 voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31), and positive or mixed effectiveness was found in three-quarters of the studies (23/30). However, there were several limitations of the agents highlighted in specific qualitative feedback.
CONCLUSIONS
The studies generally reported positive or mixed evidence for the effectiveness, usability, and satisfactoriness of the conversational agents investigated, but qualitative user perceptions were more mixed. The quality of many of the studies was limited, and improved study design and reporting are necessary to more accurately evaluate the usefulness of the agents in health care and identify key areas for improvement. Further research should also analyze the cost-effectiveness, privacy, and security of the agents.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.2196/16934.
Topics: Artificial Intelligence; Communication; Delivery of Health Care; Female; Humans; Male
PubMed: 33090118
DOI: 10.2196/20346 -
Journal of Medical Internet Research Mar 2023Owing to the increasing number of people with palliative care needs and the current shortage of health care professionals (HCPs), providing quality palliative care has... (Review)
Review
BACKGROUND
Owing to the increasing number of people with palliative care needs and the current shortage of health care professionals (HCPs), providing quality palliative care has become challenging. Telehealth could enable patients to spend as much time as possible at home. However, no previous systematic mixed studies reviews have synthesized evidence on patients' experiences of the advantages and challenges of telehealth in home-based palliative care.
OBJECTIVE
In this systematic mixed studies review, we aimed to critically appraise and synthesize the findings from studies that investigated patients' use of telehealth in home-based palliative care, focusing on the advantages and challenges experienced by patients.
METHODS
This is a systematic mixed studies review with a convergent design. The review is reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A systematic search was performed in the following databases: Allied and Complementary Medicine Database, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Latin American and Caribbean Health Sciences Literature, MEDLINE, PsycInfo, and Web of Science. The inclusion criteria were as follows: studies using quantitative, qualitative, or mixed methods; studies that investigated the experience of using telehealth with follow-up from HCPs of home-based patients aged ≥18; studies published between January 2010 and June 2022; and studies published in Norwegian, Danish, Swedish, English, Portuguese, or Spanish in peer-reviewed journals. Five pairs of authors independently assessed eligibility of the studies, appraised methodological quality, and extracted data. The data were synthesized using thematic synthesis.
RESULTS
This systematic mixed studies review included 41 reports from 40 studies. The following 4 analytical themes were synthesized: potential for a support system and self-governance at home; visibility supports interpersonal relationships and a joint understanding of care needs; optimized information flow facilitates tailoring of remote caring practices; and technology, relationships, and complexity as perpetual obstacles in telehealth.
CONCLUSIONS
The advantages of telehealth were that patients experience a potential support system that could enable them to remain at home, and the visual features of telehealth enable them to build interpersonal relationships with HCPs over time. Self-reporting provides HCPs with information about symptoms and circumstances that facilitates tailoring care to specific patients. Challenges with the use of telehealth were related to barriers to technology use and inflexible reporting of complex and fluctuating symptoms and circumstances using electronic questionnaires. Few studies have included the self-reporting of existential or spiritual concerns, emotions, and well-being. Some patients perceived telehealth as intrusive and a threat to their privacy at home. To optimize the advantages and minimize the challenges with the use of telehealth in home-based palliative care, future research should include users in the design and development process.
Topics: Humans; Palliative Care; Telemedicine; Health Personnel; Home Care Services; Ethnicity
PubMed: 36912876
DOI: 10.2196/43684 -
Journal of Medical Internet Research Nov 2019Young people frequently make use of the internet as part of their day-to-day activities, and this has extended to their help-seeking behavior. Offline help-seeking is...
BACKGROUND
Young people frequently make use of the internet as part of their day-to-day activities, and this has extended to their help-seeking behavior. Offline help-seeking is known to be impeded by a number of barriers including stigma and a preference for self-reliance. Online help-seeking may offer an additional domain where young people can seek help for mental health difficulties without being encumbered by these same barriers.
OBJECTIVE
The objective of this systematic literature review was to examine young peoples' online help-seeking behaviors for mental health concerns. It aimed to summarize young peoples' experiences and identify benefits and limitations of online help-seeking for this age group. It also examined the theoretical perspectives that have been applied to understand online help-seeking.
METHODS
A systematic review of peer-reviewed research papers from the following major electronic databases was conducted: PsycINFO, Cumulative Index of Nursing and Allied Health Literature, PubMed, Cochrane Library, Association for Computing Machinery Digital Library, and Institute of Electrical and Electronics Engineers Xplore. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The search was conducted in August 2017. The narrative synthesis approach to reviews was used to analyze the existing evidence to answer the review questions.
RESULTS
Overall, 28 studies were included. The most common method of data collection was through the use of surveys. Study quality was moderate to strong. Text-based query via an internet search engine was the most commonly identified help-seeking approach. Social media, government or charity websites, live chat, instant messaging, and online communities were also used. Key benefits included anonymity and privacy, immediacy, ease of access, inclusivity, the ability to connect with others and share experiences, and a greater sense of control over the help-seeking journey. Online help-seeking has the potential to meet the needs of those with a preference for self-reliance or act as a gateway to further help-seeking. Barriers to help-seeking included a lack of mental health literacy, concerns about privacy and confidentiality, and uncertainty about the trustworthiness of online resources. Until now, there has been limited development and use of theoretical models to guide research on online help-seeking.
CONCLUSIONS
Approaches to improving help-seeking by young people should consider the role of the internet and online resources as an adjunct to offline help-seeking. This review identifies opportunities and challenges in this space. It highlights the limited use of theoretical frameworks to help conceptualize online help-seeking. Self-determination theory and the help-seeking model provide promising starting points for the development of online help-seeking theories. This review discusses the use of these theories to conceptualize online help-seeking and identify key motivations and tensions that may arise when young people seek help online.
Topics: Adolescent; Adult; Child; Female; Help-Seeking Behavior; Humans; Internet; Male; Mental Health; Qualitative Research; Young Adult
PubMed: 31742562
DOI: 10.2196/13873 -
Family Medicine and Community Health May 2020The objective of this review was to clarify what health literacy represents. A systematic review with qualitative syntheses was performed (CRD42017065149). Studies...
The objective of this review was to clarify what health literacy represents. A systematic review with qualitative syntheses was performed (CRD42017065149). Studies concerning health literacy in all settings were included. Studies before 15 March 2017 were identified from PubMed, Medline, Embase, Web of Science, Scopus, PsycARTICLES and the Cochrane Library. The included literature either had defined the concept of health literacy or made a detailed explanation of health literacy. A total of 34 original studies met the inclusion criteria, including 13 involved in previous systematic reviews and 21 new studies. Health literacy was commonly conceptualised as a set of knowledge, a set of skills or a hierarchy of functions (functional-interactive-critical). The construct of health literacy covers three broad elements: (1) knowledge of health, healthcare and health systems; (2) processing and using information in various formats in relation to health and healthcare; and (3) ability to maintain health through self-management and working in partnerships with health providers. Health literacy is defined as the ability of an individual to obtain and translate knowledge and information in order to maintain and improve health in a way that is appropriate to the individual and system contexts. This definition highlights the diversity of needs from different individuals and the importance of interactions between individual consumers, healthcare providers and healthcare systems.
Topics: Access to Information; Cooperative Behavior; Health Literacy; Self Efficacy; Self-Management
PubMed: 32414834
DOI: 10.1136/fmch-2020-000351 -
PloS One 2021On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers...
INTRODUCTION
On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribute to the development of aggression on psychiatric wards.
METHOD
In Pubmed and Embase, a search was performed aimed at: prevalence data, ward characteristics, patient and staff factors that are associated with aggressive behaviour and from this search 146 studies were included.
RESULTS
The prevalence of aggressive behaviour on psychiatric wards varied (8-76%). Explanatory factors of aggressive behaviour were subdivided into patient, staff and ward factors. Patient risk factors were diagnosis of psychotic disorder or bipolar disorder, substance abuse, a history of aggression, younger age. Staff risk factors included male gender, unqualified or temporary staff, job strain, dissatisfaction with the job or management, burn-out and quality of the interaction between patients and staff. Staff protective factors were a good functioning team, good leadership and being involved in treatment decisions. Significant ward risk factors were a higher bed occupancy, busy places on the ward, walking rounds, an unsafe environment, a restrictive environment, lack of structure in the day, smoking and lack of privacy.
CONCLUSION
Despite a lack of prospective quantitative data, results did show that aggression arises from a combination of patient factors, staff factors and ward factors. Patient factors were studied most often, however, besides treatment, offering the least possibilities in prevention of aggression development. Future studies should focus more on the earlier stages of aggression such as agitation and on factors that are better suited for preventing aggression such as ward and staff factors. Management and clinicians could adapt staffing and ward in line with these results.
Topics: Aggression; Bed Occupancy; Female; Health Personnel; Humans; Male; Mental Health; Prevalence; Psychiatric Department, Hospital; Risk Factors; Substance-Related Disorders; Time Factors; Violence
PubMed: 34624057
DOI: 10.1371/journal.pone.0258346 -
Sensors (Basel, Switzerland) Oct 2022Intelligent transportation systems will play a key role in the smart cities of the future. In particular, railway transportation is gaining attention as a promising... (Review)
Review
Intelligent transportation systems will play a key role in the smart cities of the future. In particular, railway transportation is gaining attention as a promising solution to cope with the mobility challenges in large urban areas. Thanks to the miniaturisation of sensors and the deployment of fast data networks, the railway industry is being augmented with contextual, real-time information that opens the door to novel and personalised services. Despite the benefits of this digitalisation, the high complexity of railway transportation entails a number of challenges, particularly from security and privacy perspectives. Since railway assets are attractive targets for terrorism, coping with strong security and privacy requirements such as cryptography and privacy-preserving methods is of utmost importance. This article provides a thorough systematic literature review on information security and privacy within railway transportation systems, following the well-known methodology proposed by vom Brocke et al. We sketch out the most relevant studies and outline the main focuses, challenges and solutions described in the literature, considering technical, societal, regulatory and ethical approaches. Additionally, we discuss the remaining open issues and suggest several research lines that will gain relevance in the years to come.
Topics: Privacy; Computer Security; Transportation
PubMed: 36298049
DOI: 10.3390/s22207698