International Journal of Environmental Research and Public Health

Research

20 pages, 17463 KiB

Open AccessArticle

Needs and Attitudes of Older Chronic Back Pain Patients towards a Wearable for Ultrasound Biofeedback during Stabilization Exercises: A Qualitative Analysis

by Luis Perotti, Oskar Stamm, Lisa Mesletzky, Susan Vorwerg, Marc Fournelle and Ursula Müller-Werdan

Int. J. Environ. Res. Public Health 2023, 20(6), 4927; https://doi.org/10.3390/ijerph20064927 - 10 Mar 2023

Cited by 2 | Viewed by 1871

Abstract

Chronic back pain has a high prevalence, especially in older adults, and seriously affects sufferers’ quality of life. Segmental stabilization exercise (SSE) is often used during physiotherapy to enhance core stability. The execution of SSE requires the selective contraction of deep abdominal and [...] Read more.

Chronic back pain has a high prevalence, especially in older adults, and seriously affects sufferers’ quality of life. Segmental stabilization exercise (SSE) is often used during physiotherapy to enhance core stability. The execution of SSE requires the selective contraction of deep abdominal and back muscles. Motor learning can be supported using ultrasound imaging as visual biofeedback. ULTRAWEAR is a mobile ultrasound system that provides deep learning-based biofeedback on SSE execution, which is currently under development. We interviewed 15 older chronic back pain patients (CBPPs) to investigate their pain management behavior, experience with SSE, as well as their needs and requirements for ULTRAWEAR. We also gathered information about future-usage scenarios. CBPPs reported a high willingness to use the system as a feedback tool both in physiotherapeutic practices and at home. The automated detection and evaluation of muscle contraction states was highlighted as a major benefit of the system compared to the more subjective feedback provided by traditional methods such as palpation. The system to be developed was perceived as a helpful solution to support learning about SSE. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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14 pages, 2799 KiB

Open AccessArticle

Digital Health Literacy and Person-Centred Care: Co-Creation of a Massive Open Online Course for Women with Breast Cancer

by Yolanda Álvarez-Pérez, Andrea Duarte-Díaz, Ana Toledo-Chávarri, Analía Abt-Sacks, Vanesa Ramos-García, Alezandra Torres-Castaño, Amado Rivero-Santana and Lilisbeth Perestelo-Pérez

Int. J. Environ. Res. Public Health 2023, 20(5), 3922; https://doi.org/10.3390/ijerph20053922 - 22 Feb 2023

Cited by 1 | Viewed by 2744

Abstract

The diagnosis of breast cancer (BC) can make the affected person vulnerable to suffering the possible consequences of the use of low-quality health information. Massive open online courses (MOOCs) may be a useful and efficient resource to improve digital health literacy and person-centred [...] Read more.

The diagnosis of breast cancer (BC) can make the affected person vulnerable to suffering the possible consequences of the use of low-quality health information. Massive open online courses (MOOCs) may be a useful and efficient resource to improve digital health literacy and person-centred care in this population. The aim of this study is to co-create a MOOC for women with BC, using a modified design approach based on patients’ experience. Co-creation was divided into three sequential phases: exploratory, development and evaluation. Seventeen women in any stage of BC and two healthcare professionals participated. In the exploratory phase, a patient journey map was carried out and empowerment needs related to emotional management strategies and self-care guidelines were identified, as well as information needs related to understanding medical terminology. In the development phase, participants designed the structure and contents of the MOOC through a Moodle platform. A MOOC with five units was developed. In the evaluation phase, participants strongly agreed that their participation was useful for the MOOC’s development and participating in the co-creation process made the content more relevant to them (experience in the co-creation); most of the participants positively evaluated the content or interface of the MOOC (acceptability pilot). Educational interventions designed by women with BC is a viable strategy to generate higher-quality, useful resources for this population. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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24 pages, 1399 KiB

Open AccessArticle

Lessons Learned from an Attempted Pragmatic Randomized Controlled Trial for Improvement of Chronic Pain-Associated Disability in Green Professions: Long-Term Effectiveness of a Guided Online-Based Acceptance and Commitment Therapy (PACT-A)

by Lina Braun, Yannik Terhorst, Ingrid Titzler, Johanna Freund, Janika Thielecke, David Daniel Ebert and Harald Baumeister

Int. J. Environ. Res. Public Health 2022, 19(21), 13858; https://doi.org/10.3390/ijerph192113858 - 25 Oct 2022

Cited by 7 | Viewed by 2948

Abstract

Musculoskeletal symptoms are increased in farmers, whereas the prevalence of chronified pain is unknown. Online interventions based on acceptance and commitment therapy (ACT) have shown encouraging results in the general population, representing a promising approach for reducing pain interference in green professions (i.e., [...] Read more.

Musculoskeletal symptoms are increased in farmers, whereas the prevalence of chronified pain is unknown. Online interventions based on acceptance and commitment therapy (ACT) have shown encouraging results in the general population, representing a promising approach for reducing pain interference in green professions (i.e., farmers, foresters, gardeners). We conducted a pragmatic RCT comparing a guided ACT-based online intervention to enhanced treatment-as-usual in entrepreneurs, contributing spouses, family members and pensioners in green professions with chronic pain (CPG: ≥grade II, ≥6 months). Recruitment was terminated prematurely after 2.5 years at N = 89 (of planned N = 286). Assessments were conducted at 9 weeks (T1), 6 months (T2) and 12 months (T3) post-randomization. The primary outcome was pain interference (T1). The secondary outcomes encompassed pain-, health- and intervention-related variables. No treatment effect for reduction of pain interference was found at T1 (β = −0.16, 95%CI: −0.64–0.32, p = 0.256). Improvements in cognitive fusion, pain acceptance, anxiety, perceived stress and quality of life were found only at T3. Intervention satisfaction as well as therapeutic and technological alliances were moderate, and uptake and adherence were low. Results are restricted by low statistical power due to recruitment issues, high study attrition and low intervention adherence, standing in contrast to previous studies. Further research is warranted regarding the use of ACT-based online interventions for chronic pain in this occupational group. Trial registration: German Clinical Trial Registration: DRKS00014619. Registered: 16 April 2018. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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19 pages, 1045 KiB

Open AccessArticle

Determinants of the Mobile Health Continuance Intention of Elders with Chronic Diseases: An Integrated Framework of ECM-ISC and UTAUT

by Xiu-Fu Tian and Run-Ze Wu

Int. J. Environ. Res. Public Health 2022, 19(16), 9980; https://doi.org/10.3390/ijerph19169980 - 12 Aug 2022

Cited by 29 | Viewed by 3195

Abstract

With the deepening of population aging in China, chronic diseases are a major public health concern that threatens the life and health of nationals. Mobile health or mHealth can effectively monitor chronic diseases, which holds vital significance to the alleviation of social pressure [...] Read more.

With the deepening of population aging in China, chronic diseases are a major public health concern that threatens the life and health of nationals. Mobile health or mHealth can effectively monitor chronic diseases, which holds vital significance to the alleviation of social pressure caused by aging. To patients with chronic diseases, mHealth cannot give full play to its value, only when it is used in the long term. However, there is not yet research exploring mHealth continuance intention from the perspective of elders with chronic diseases. So, this research represents the first attempt to empirically analyze mHealth continuance intention from the perspective of elders with chronic diseases. The purpose of this research is to make up the research gap of the mHealth field and to put forward theoretical and practical implications based on research results. To obtain research data, a questionnaire was conducted. A total of 926 copies were collected online and 527 copies were collected offline. The structural equation model (SEM) was used for data analysis. Research results suggest that confirmation can significantly influence satisfaction, performance expectancy and effort expectancy. Meanwhile, confirmation and performance expectancy can significantly influence satisfaction. Additionally, effort expectancy, performance expectancy, social influence and facilitating conditions can directly and significantly influence continuance intention. Among them, performance expectancy can directly influence continuance intention in the most significant way. This research provides solid evidence for the validity of the integrated model of ECM-ISC and UTAUT in the mHealth field, which can be a theoretical basis for mHealth operators’ product R&D. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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11 pages, 1726 KiB

Open AccessArticle

Tailoring Tofacitinib Oral Therapy in Rheumatoid Arthritis: The TuTOR App

by Massimo Radin, Marta Arbrile, Irene Cecchi, Pierluigi Di Nunzio, Nicola Buccarano, Federico Di Gregorio, Valeria Milone, Sara Osella, Paola Crosasso, Marika Denise Favuzzi, Alice Barinotti, Simone Baldovino, Elisa Menegatti, Daniela Rossi, Savino Sciascia and Dario Roccatello

Int. J. Environ. Res. Public Health 2022, 19(9), 5379; https://doi.org/10.3390/ijerph19095379 - 28 Apr 2022

Cited by 2 | Viewed by 1898

Abstract

To support the management of rheumatoid arthritis (RA) patients treated with tofacitinib, we designed the TuTOR (tailoring tofacitinib oral therapy in rheumatoid arthritis) mobile app. The impact of the app on medical adherence was evaluated using a crossover design alternating a paper-diary and [...] Read more.

To support the management of rheumatoid arthritis (RA) patients treated with tofacitinib, we designed the TuTOR (tailoring tofacitinib oral therapy in rheumatoid arthritis) mobile app. The impact of the app on medical adherence was evaluated using a crossover design alternating a paper-diary and the TuTOR App. Twenty patients with RA (mean age at inclusion, 59 ± 13 years) were included in the study. A statistically significant decrease in DAS28 was observed since the first month of therapy (mean DAS28 at baseline, 3.9 ± 1 vs. 1° month 3.1 ± 1, p = 0.0016). Similarly, the numerical rating scale (NRS) of perceived activity of disease and subjective fatigue progressively decreased. No differences were reported in DAS28 or NRS between the TuTOR app and the paper-diary groups. A significant decrease was observed in HAQ during the follow-up (baseline 1.38 ± 1.11 vs. six months 0.83 ± 0.9; p = 0.01). When filling out the self-reporting questionnaires, most of the patients (82%) preferred the TuTOR App helping them to remember to take the pills. Furthermore, 82% of patients used the app regularly (vs. 53% for the paper diary). Three patients suspended tofacitinib due to gastrointestinal intolerance. Both digital and paper devices can help maximize adherence to therapy; however, the TuTOR app was preferred by the patients for its simplicity and immediacy. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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6 pages, 2892 KiB

Open AccessArticle

Sustained Compression with a Pneumatic Cuff on Skeletal Muscles Promotes Muscle Blood Flow and Relieves Muscle Stiffness

by Masaaki Nakajima, Tomoka Tsuro and Akemi Endo

Int. J. Environ. Res. Public Health 2022, 19(3), 1692; https://doi.org/10.3390/ijerph19031692 - 1 Feb 2022

Cited by 3 | Viewed by 2211

Abstract

(1) Purpose: This study aimed to examine whether a pneumatic cuff could promote muscle blood flow and improve muscle stiffness by continuously compressing muscles with air pressure in healthy college students. (2) Method: Twenty-one healthy collegiate students participated in this study. The probe [...] Read more.

(1) Purpose: This study aimed to examine whether a pneumatic cuff could promote muscle blood flow and improve muscle stiffness by continuously compressing muscles with air pressure in healthy college students. (2) Method: Twenty-one healthy collegiate students participated in this study. The probe of the near-infrared spectrometer was attached to the upper surface of the left gastrocnemius muscle, and a cuff was wrapped around the left lower leg. The cuff was inflated to 200 mmHg. After 10 min, the cuff was deflated, and the patient rested for 10 min. Muscle stiffness and fatigue were assessed before and after the intervention. (3) Results: During 10 min of continuous compression, StO₂ continued to decrease until seven min of compression. After 10 min of continuous compression, StO₂ was 30.8 ± 10.4%, which was approximately half of 69.2 ± 6.1% at rest. After the release of the pneumatic cuff compression, the StO₂ remained higher than that at rest from 1 to 10 min. Muscle hardness was 19.0 ± 8.0 before intervention was 8.7 ± 4.8 after the intervention. Muscle fatigue was 6.6 ± 1.7 cm before the intervention and 4.0 ± 1.6 cm after the intervention. (4) Conclusions: This study suggests that sustained muscle compression using a pneumatic cuff can promote muscle blood flow and improve muscle stiffness and fatigue. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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Review

Jump to: Research, Other

18 pages, 5019 KiB

Open AccessReview

Impact of Telehealth Care among Adults Living with Type 2 Diabetes in Primary Care: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

by Natalie Robson and Hassan Hosseinzadeh

Int. J. Environ. Res. Public Health 2021, 18(22), 12171; https://doi.org/10.3390/ijerph182212171 - 19 Nov 2021

Cited by 30 | Viewed by 8815

Abstract

Primary health care physicians are increasingly offering telehealth services to patients not only for its cost and time saving advantages but for the additional benefits telehealth can provide for patients with type 2 diabetes (T2D) such as improved self-management behaviours. To support the [...] Read more.

Primary health care physicians are increasingly offering telehealth services to patients not only for its cost and time saving advantages but for the additional benefits telehealth can provide for patients with type 2 diabetes (T2D) such as improved self-management behaviours. To support the development of telehealth based T2D clinical care models in primary health care settings, a narrative synthesis and meta-analysis of randomised controlled trial studies was completed for 29 studies that evaluated the effect of one or more types of telehealth interventions on HbA1c levels compared to usual care alone. Results from the random effects meta-analysis demonstrated that telehealth interventions had a stronger influence on HbA1c compared to usual care with a mean difference in HbA1c \% −0.18 (CI −0.35, −0.01), p = 0.04. Results from the subgroup meta-analysis demonstrated that telehealth interventions, when grouped by type of telemonitoring (mHealth and telephone communication), all have a stronger effect on lowering HbA1c levels; however, none of these findings were significant. Key findings from this review demonstrate that telehealth interventions that address T2D self-management behaviours and have higher levels of health care provider engagement, have greater effects on lowering HbA1c levels compared to usual care alone. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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Other

Jump to: Research, Review

26 pages, 1087 KiB

Open AccessSystematic Review

Lung Cancer and Self-Management Interventions: A Systematic Review of Randomised Controlled Trials

by Rachel Anne Rowntree and Hassan Hosseinzadeh

Int. J. Environ. Res. Public Health 2022, 19(1), 536; https://doi.org/10.3390/ijerph19010536 - 4 Jan 2022

Cited by 10 | Viewed by 4954

Abstract

Background: Lung cancer is the most common cancer worldwide. Evidence suggests self-management (SM) interventions benefit cancer patients. This review aims to determine the effectiveness of SM interventions for lung cancer patients. Method: Searches occurred in PubMed, Cinahl, ProQuest, Psych Info, Scopus, and Medline, [...] Read more.

Background: Lung cancer is the most common cancer worldwide. Evidence suggests self-management (SM) interventions benefit cancer patients. This review aims to determine the effectiveness of SM interventions for lung cancer patients. Method: Searches occurred in PubMed, Cinahl, ProQuest, Psych Info, Scopus, and Medline, using predefined criteria, assessing randomised controlled trials (RCTs). Results: Five hundred and eighty-seven studies were yielded, 10 RCTs met criteria. Of the total patient pool, 1001 of 1089 had Non-Small Cell Lung Cancer (NSCLC). Six studies tested home-based SM exercise, two studies SM education, and one each for diary utilisation and symptom reporting. Fatigue was the most targeted function. Other functions targeted included exercise capacity, anxiety, depression, quality of life (QoL), sleep quality, and symptom burden. Six studies met their primary endpoints (five SM exercise, one SM education). Positive outcomes are described for fatigue, anxiety/depression, sleep quality, self-efficacy, and exercise capacity. With exception to fatigue, early-stage NSCLC, younger age, female, never smokers, partnered patients experienced increased treatment effect. Conclusions: SM interventions improve outcomes among some lung cancer patients. Interventions targeting fatigue yield benefit despite histology, stage or gender and could encourage broader cohort engagement. Consideration of patient characteristics may predict SM effect. Effectiveness of home-based SM exercise by NSCLC stage and SM tailored to sociodemographic variables requires further research. Full article

(This article belongs to the Special Issue Chronic Disease Management and Digital Health)

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