JMIR Human Factors最新文献

{"title":"Health Care Professionals' Perspectives on Using eHealth Tools in Advanced Home Care: Qualitative Interview Study.","authors":"Eric Vincent Rivas, Ulf Lesley, Nadia Davoody","doi":"10.2196/60582","DOIUrl":"https://doi.org/10.2196/60582","url":null,"abstract":"<p><strong>Background: </strong>The rising demand for advanced home care services, driven by an aging population and the preference for aging in place, presents both challenges and opportunities. While advanced home care can improve cost-effectiveness and patient outcomes, gaps remain in understanding how eHealth technologies can optimize these services. eHealth tools have the potential to offer personalized, coordinated care that increases patient engagement. However, research exploring health care professionals' (HCPs) perspectives on the use of eHealth tools in advanced home care and their impact on the HCP-patient relationship is limited.</p><p><strong>Objective: </strong>This study aims to explore HCPs' perspectives on using eHealth tools in advanced home care and these tools' impact on HCP-patient relationships.</p><p><strong>Methods: </strong>In total, 20 HCPs from 9 clinics specializing in advanced home care were interviewed using semistructured interviews. The discussions focused on their experiences with 2 eHealth tools: a mobile documentation tool and a mobile preconsultation form. The data were analyzed using content analysis to identify recurring themes.</p><p><strong>Results: </strong>The data analysis identified one main theme: optimizing health care with eHealth; that is, enhancing care delivery and overcoming challenges for future health care. Two subthemes emerged: (1) enhancing care delivery, collaboration, and overcoming adoption barriers and (2) streamlining implementation and advancing eHealth tools for future health care delivery. Five categories were also identified: (1) positive experiences and benefits, (2) interactions between HCPs and patients, (3) challenges and difficulties with eHealth tools, (4) integration into the daily workflow, and (5) future directions. Most HCPs expressed positive experiences with the mobile documentation tool, highlighting improved efficiency, documentation quality, and patient safety. While all found the mobile preconsultation form beneficial, patient-related factors limited its utility. Regarding HCP-patient relationships, interactions with patients remained unchanged with the implementation of both tools. HCPs successfully maintained their interpersonal skills and patient-centered approach while integrating eHealth tools into their practice. The tools allowed more focused, in-depth discussions, enhancing patient engagement without affecting relationships. Difficulties with the tools originated from tool-related issues, organizational challenges, or patient-related complexities, occasionally affecting the time available for direct patient interaction.</p><p><strong>Conclusions: </strong>The study underscores the importance of eHealth tools in enhancing advanced home care while maintaining the HCP-patient relationship. While eHealth tools modify care delivery techniques, they do not impact the core dynamics of the relationships between HCPs and patients. While most of the HCPs in the study ","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e60582"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User Experience of a Bespoke Videoconferencing System for Web-Based Family Visitation for Patients in an Intensive Care Unit: 1-Year Cross-Sectional Survey of Nursing Staff.","authors":"Aoife Murray, Irial Conroy, Frank Kirrane, Leonie Cullen, Hemendra Worlikar, Derek T O'Keeffe","doi":"10.2196/54560","DOIUrl":"https://doi.org/10.2196/54560","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, in-person visitation within hospitals was restricted and sometimes eliminated to reduce the risk of transmission of SARS-CoV-2. Many health care professionals created novel strategies that were deployed to maintain a patient-centered approach. Although pandemic-related restrictions have eased, these systems, including videoconferencing or web-based bedside visits, remain relevant for visitors who cannot be present due to other reasons (lack of access to transport, socioeconomic restraints, geographical distance, etc).</p><p><strong>Objective: </strong>The aims of this study were (1) to report the experience of intensive care nursing staff using a bespoke videoconferencing system called ICU FamilyLink; (2) to examine the scenarios in which the nursing staff used the system; and (3) to assess the future use of videoconferencing systems to enhance communication with families.</p><p><strong>Methods: </strong>A modified Telehealth Usability questionnaire was administered to the nursing staff (N=22) of an intensive care unit in a model 4 tertiary hospital in Ireland 1 year after implementing the bespoke videoconferencing system.</p><p><strong>Results: </strong>In total, 22 nurses working in the intensive care department at University Hospital Galway, Ireland, responded to the survey. A total of 23% (n=5) of participants were between the ages of 25 and 34 years, 54% (n=12) were between 35 and 44 years, and 23% (n=5) were between 45 and 54 years. Most (n=15, 68%) of the participants reported never using videoconferencing in the intensive care setting to communicate with family members before March 2020. The modified Telehealth Usability Questionnaire showed overall satisfaction scores for each subcategory of ease of use and learnability, interface quality, interaction quality, reliability, satisfaction and future use, and usefulness. In total, 21 (95%) participants agreed or strongly agreed with the statement, \"I would use the ICU FamilyLink system in future circumstances in which family members cannot be physically present (ie, pandemics, abroad, inability to travel, etc),\" and 1 participant responded neutrally. One participant highlighted a common scenario in intensive care settings in which a videoconferencing system can be used \"Even without COVID, web-based communication is important when patients become unexpectedly ill and when families are abroad.\"</p><p><strong>Conclusions: </strong>This study provides valuable insights into health care professionals' experience using a videoconferencing system to facilitate web-based visits for families. We conclude that videoconferencing systems when appropriately tailored to the environment with the users in mind can be an acceptable solution to maintain communication with family members who cannot be physically present at the bedside. The bespoke videoconferencing system had an overall positive response from 22 nursing staff who interacted with th","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e54560"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Chinese Version of the DigiHealthCom (Digital Health Competence) Instrument for Assessing Digital Health Competence of Health Care Professionals: Translation, Adaptation, and Validation Study.","authors":"Lu Gao, Meilian Chen, Jingxin Wei, Jinni Wang, Xiaoyan Liao","doi":"10.2196/65373","DOIUrl":"https://doi.org/10.2196/65373","url":null,"abstract":"<p><strong>Background: </strong>Digital health competence is increasingly recognized as a core competence for health care professionals. A comprehensive evaluation of knowledge, skills, performance, values, and attitudes necessary to adapt to evolving digital health technologies is essential. DigiHealthCom (Digital Health Competence) is a well-established instrument designed to assess digital health competence across diverse health care professionals.</p><p><strong>Objective: </strong>This study aimed to translate and culturally adapt DigiHealthCom into simplified Chinese (Mandarin) and verify its reliability and validity in assessing digital health competence of Chinese health care professionals.</p><p><strong>Methods: </strong>DigiHealthCom was translated into Chinese following the guideline proposed by its original developers. The cultural adaptation involved expert review and cognitive interviewing. Internal consistency, test-retest reliability, content validity, convergent validity, discriminant validity, and factor structure were examined. Item analysis tested item discrimination, item correlation, and item homogeneity. Internal consistency was assessed using Cronbach α, and test-retest reliability was measured using the intraclass correlation coefficient. Content validity was assessed through both item and scale content validity indices. Convergent validity was measured by the Average Variance Extracted and Composite Reliability, while discriminant validity was measured by the heterotrait-monotrait ratio. A five-dimension model of DigiHealthCom was confirmed using confirmatory factor analysis.</p><p><strong>Results: </strong>The finalized Chinese version of the DigiHealthCom was completed after addressing differences between the back-translations and the original version. No discrepancies affecting item clarity were reported during cognitive interviewing. The validation process involved 398 eligible health care professionals from 36 cities across 15 provinces in China, with 43 participants undergoing a retest after a 2-week interval. Critical ratio values (range 16.05-23.77, P<.001), item-total correlation coefficients (range 0.69-0.89), and Cronbach α if the item deleted (range 0.91-0.96) indicated satisfactory item discrimination, item correlation, and item homogeneity. Cronbach α for dimensions and the scale ranged from 0.94 to 0.98, indicating good internal consistency. The intraclass correlation coefficient was 0.90 (95% CI 0.81-0.95), indicating good test-retest reliability. Item content validity index ranged from 0.82 to 1.00, and the scale content validity index was 0.97, indicating satisfactory content validity. Convergent validity (average variance extracted: 0.60-0.79; composite reliability: 0.94-0.95) and divergent validity (heterotrait-monotrait ratio: 0.72-0.89) were satisfactory. Confirmatory factor analysis confirmed a well-fit five-dimension model (robust chi-square to df ratio=3.10, comparative fit index=0.91, Tucker-Lewi","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e65373"},"PeriodicalIF":2.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Providers' Challenges and Solutions in Prescribing Over Telemedicine: Content Analysis of Semistructured Interviews.","authors":"Julia Ivanova, Mollie R Cummins, Hiral Soni, Triton Ong, Brian E Bunnell, Esteban López, Brandon M Welch","doi":"10.2196/65419","DOIUrl":"https://doi.org/10.2196/65419","url":null,"abstract":"<p><strong>Background: </strong>In response to the COVID-19 pandemic, the United States extended regulatory flexibilities to make telemedicine more accessible to providers and patients. Some of these flexibilities allowed providers to intake patients over telemedicine and prescribe certain scheduled medications without an in-person visit.</p><p><strong>Objective: </strong>We aim to understand providers' parameters for their comfort in prescribing over telemedicine and report on solutions providers have adopted in response to potential barriers and challenges in prescribing via telemedicine.</p><p><strong>Methods: </strong>As part of a larger mixed methods study between February and April 2024, we conducted 16 semistructured interviews with mental health providers who prescribe via telemedicine within the United States. We used the results of a web-based, cross-sectional survey to develop a codebook and support recruitment. We analyzed a subsection of the 16 interviews using content analysis to capture comfort, barriers, and workarounds in telemedicine prescribing. We reported codes by frequency and by provider.</p><p><strong>Results: </strong>Participants were typically male (11/16, 69%), provided care mostly or completely over telemedicine (11/16, 69%), and were psychiatrists (8/16, 50%) or other physician (3/16, 19%). Providers' primary states (10/16, 62%) of practice included Oregon, Texas, New York, and California. The content analysis yielded a total of 234 codes, with three main codes-comfort (98/234, 41.9%), barriers or challenges (85/234, 36.3%), and workarounds or solutions (27/234, 11.5%)-and two subcodes-uncomfortable prescribing (30/98, 31%) and comfortable prescribing (68/98, 69%) over telemedicine. Participants reported being comfortable prescribing over telemedicine as long as they could meet their main parameters of working within their expertise, having access to needed patient health information, and being compliant with rules and regulations. Participants reported frustrations with e-prescription workflows and miscommunications with pharmacies. Solutions to ease frustrations and alleviate discomforts in prescribing over telemedicine included developing workflows to help patients complete laboratory tests and physical examinations and directly communicating with pharmacies.</p><p><strong>Conclusions: </strong>By applying content analysis to the semistructured provider interviews, we found that physicians are comfortable prescribing via telemedicine when they feel they are practicing within their personal parameters for safety. While many providers experience frustrations such as miscommunication with pharmacies, these barriers appear to not prevent them from telemedicine prescribing. With expected changes in 2024 and 2025 to the US laws and regulations for telemedicine prescribing, we may see changes in provider comfort in prescribing.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e65419"},"PeriodicalIF":2.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI Chatbots for Psychological Health for Health Professionals: Scoping Review.","authors":"Gumhee Baek, Chiyoung Cha, Jin-Hui Han","doi":"10.2196/67682","DOIUrl":"https://doi.org/10.2196/67682","url":null,"abstract":"<p><strong>Background: </strong>Health professionals face significant psychological burdens including burnout, anxiety, and depression. These can negatively impact their well-being and patient care. Traditional psychological health interventions often encounter limitations such as a lack of accessibility and privacy. Artificial intelligence (AI) chatbots are being explored as potential solutions to these challenges, offering available and immediate support. Therefore, it is necessary to systematically evaluate the characteristics and effectiveness of AI chatbots designed specifically for health professionals.</p><p><strong>Objective: </strong>This scoping review aims to evaluate the existing literature on the use of AI chatbots for psychological health support among health professionals.</p><p><strong>Methods: </strong>Following Arksey and O'Malley's framework, a comprehensive literature search was conducted across eight databases, covering studies published before 2024, including backward and forward citation tracking and manual searching from the included studies. Studies were screened for relevance based on inclusion and exclusion criteria, among 2465 studies retrieved, 10 studies met the criteria for review.</p><p><strong>Results: </strong>Among the 10 studies, six chatbots were delivered via mobile platforms, and four via web-based platforms, all enabling one-on-one interactions. Natural language processing algorithms were used in six studies and cognitive behavioral therapy techniques were applied to psychological health in four studies. Usability was evaluated in six studies through participant feedback and engagement metrics. Improvements in anxiety, depression, and burnout were observed in four studies, although one reported an increase in depressive symptoms.</p><p><strong>Conclusions: </strong>AI chatbots show potential tools to support the psychological health of health professionals by offering personalized and accessible interventions. Nonetheless, further research is required to establish standardized protocols and validate the effectiveness of these interventions. Future studies should focus on refining chatbot designs and assessing their impact on diverse health professionals.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e67682"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illustrating User Needs for eHealth With Experience Map: Interview Study With Chronic Kidney Disease Patients.","authors":"Paula Valkonen, Sini Hölsä, Johanna Viitanen, Sini Leinonen, Nina Karisalmi, Virpi Rauta","doi":"10.2196/48221","DOIUrl":"https://doi.org/10.2196/48221","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a common condition worldwide and home dialysis (HD) provides economic, quality of life, and clinical advantages compared to other dialysis modalities. Human-centered design aims to support the development of eHealth solutions with high usability and user experience. However, research on the eHealth needs of patients using HD is scarce.</p><p><strong>Objective: </strong>This study aimed to support the design of eHealth for patients with CKD, particularly for patients using HD, by developing a kidney disease experience map that illustrates user needs, concerns, and barriers. The research questions were (1) what experiences do patients, particularly older adults, have in their everyday lives with CKD? (2) what user needs do patients with CKD have for HD eHealth? (3) how can these needs be illustrated using the experience map technique? The study focused on patients aged >60 years, as they are at a higher risk of chronic conditions. The study was conducted as part of the eHealth in HD project, coordinated by Hospital District of Helsinki and Uusimaa, Finland.</p><p><strong>Methods: </strong>In total, 18 patients in different care modalities participated in retrospective interviews conducted between October 2020 and April 2021. The interviews included a preliminary task with patient journey illustrations and questions about their experiences and everyday lives with CKD. The data analysis was conducted using a thematic analysis approach and the process included several phases.</p><p><strong>Results: </strong>On the basis of the thematic analysis, 5 categories were identified: healthy habits, concerns about and barriers to eHealth use, digital communication, patients' emotions, and everyday life with CKD. These were illustrated in the first version of the kidney disease experience map. The patients had different healthy habits regarding social life, sports, and other activities. They had challenges with poorly functioning eHealth software and experienced other factors, such as a lack of interest and lack of skills for eHealth use. Technical devices do not always meet the emotional or physical needs of their users. This caused feelings of frustration, worry, and fear in patients, yet also fostered situational awareness and hope.</p><p><strong>Conclusions: </strong>The experience map is a promising method for illustrating user needs and communicating the patient's voice for eHealth development. eHealth offers possibilities to support patient's everyday life with chronic disease. The patient's situation and capacity to use eHealth solutions vary with their everyday challenges, opportunities, and their current stage of treatment. The kidney disease experience map will be used and further developed in the ongoing research project \"Better Health at Home-Optimized Human-Centered Care of Predialysis and Home Dialysis Patients\" (2022 to 2026).</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e48221"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User-Centered Prototype Design of a Health Care Robot for Treating Type 2 Diabetes in the Community Pharmacy: Development and Usability Study.","authors":"Ching-Ju Chiu, Lin-Chun Hua, Jung-Hsien Chiang, Chieh-Ying Chou","doi":"10.2196/48226","DOIUrl":"10.2196/48226","url":null,"abstract":"<p><strong>Background: </strong>Technology can be an effective tool for providing health services and disease self-management, especially in diabetes care. Technology tools for disease self-management include health-related applications for computers and smartphones as well as the use of robots. To provide a more effective continuity of care and to better understand and facilitate disease management in middle-aged and older adult patients with diabetes, robots can be used to improve the quality of care and supplement community health resources, such as community pharmacies.</p><p><strong>Objective: </strong>The aim of this study was to develop a health care robot prototype that can be integrated into current community pharmacies.</p><p><strong>Methods: </strong>Three user-centered approaches were used: (1) review of the literature on technology use among older adults, 2) reference to the seven key diabetes self-care behaviors by the American Association of Diabetes Educators (AADE), and (3) meeting with health care providers in the community. Field investigations and interviews were conducted at community pharmacies and diabetes health education centers to determine the appearance, interface, content, and function of the robot.</p><p><strong>Results: </strong>The results show that diabetes health care prototype robots can be established through user-centered design. The following important features were revealed: (1) perceived ease of use is considered a friendly operating interface; therefore, we used less than 3 buttons in an interface; (2) minimization of the interface between blue and yellow, which is unfriendly to older adults; (3) the health education mode was the most preferred mode with sound, image, and video presentation; (4) the most predilected functions are health education resources and health records, and that patient data can be easily collected through health education games and dialogue with robots; and (5) touching the screen is the most preferred operation mode.</p><p><strong>Conclusions: </strong>An evidence-based health care robot can be developed through user-centered design, an approach in which a model that connects medical needs to people with health conditions can be built, thereby facilitating the sustainable development of technology in the diabetes care field.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e48226"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Early Language Disorder Detection in Preschools: Evaluation and Future Directions for the Gades Platform.","authors":"María Dolón-Poza, Ana-Marta Gabaldón-Pérez, Santiago Berrezueta-Guzman, David López Gracia, María-Luisa Martín-Ruiz, Iván Pau De La Cruz","doi":"10.2196/60424","DOIUrl":"https://doi.org/10.2196/60424","url":null,"abstract":"<p><strong>Background: </strong>Language acquisition is a critical developmental milestone, with notable variability during the first 4 years of life. Developmental language disorder (DLD) often overlaps with other neurodevelopmental disorders or simple language delay (SLD), making early detection challenging, especially for primary caregivers.</p><p><strong>Objective: </strong>We aimed to evaluate the effectiveness of the Gades platform, an adaptive screening tool that enables preschool teachers to identify potential language disorders without direct support from nursery school language therapists (NSLTs).</p><p><strong>Methods: </strong>The study took place in a nursery school and an early childhood educational and psychopedagogical center in Madrid, Spain, involving 218 children aged 6 to 36 months, 24 preschool teachers, and 2 NSLTs. Initially, NSLTs conducted informational sessions to familiarize teachers with DLDs and how to identify them. Following this, the teachers used the Gades platform to conduct language screenings independently, without ongoing support from NSLTs. The Gades platform was enhanced to collect detailed profiles of each child and implemented an adaptive screening model tailored to account for variability in language development. This setup allowed preschool teachers, who are not language experts, to observe and assess language development effectively in natural, unsupervised educational environments. The study assessed the platform's utility in guiding teachers through these observations and its effectiveness in such settings.</p><p><strong>Results: </strong>Gades identified language difficulties in 19.7% (43/218) of the children, with a higher prevalence in boys (29/218, 13.3%) than in girls (14/218, 6.4%). These challenges were most frequently observed in children aged 15 to 27 months. The platform demonstrated a high accuracy rate of 97.41%, with evaluators largely agreeing with its recommendations. Teachers also found Gades to be user friendly and a valuable tool for supporting language development observations in everyday educational settings.</p><p><strong>Conclusions: </strong>Gades demonstrates potential as a reliable and accessible tool for early detection of language disorders, empowering educators to identify DLD and SLD in the absence of NSLTs. However, further refinement of the platform is required to effectively differentiate between DLD and SLD. By integrating Gades into routine preschool assessments, educators can facilitate timely interventions, bridging gaps in early childhood education and therapy.</p><p><strong>Trial registration: </strong>Pan-African Clinical Trial Registry (PACTR) PACTR202210657553944; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=24051.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e60424"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experiences With a Mobile Self-Care Solution for Low-Complex Orthopedic Injuries: Mixed Methods Study.","authors":"Jelle Spierings, Gijs Willinge, Marike Kokke, Sjoerd Repping, Wendela de Lange, Thijs Geerdink, Ruben van Veen, Detlef van der Velde, Carel Goslings, Bas Twigt","doi":"10.2196/53074","DOIUrl":"10.2196/53074","url":null,"abstract":"<p><strong>Background: </strong>The Dutch acute health care system faces challenges with limited resources and increasing patient numbers. To reduce outpatient follow-up, direct discharge (DD) has been implemented in over 30 out of 80 Dutch hospitals. With DD, no routine follow-up appointments are scheduled after the emergency department (ED) visit for low-complex, isolated, and stable musculoskeletal injuries. This policy is supported by information leaflets, a smartphone app, and a telephone helpline with human support. Growing evidence shows that DD is satisfactory, safe, and effective in reducing secondary health care use, but thorough patient experiences are lacking.</p><p><strong>Objective: </strong>The aim of this study was to explore the experiences of patients with DD to ensure durable adoption and to improve the treatment protocol.</p><p><strong>Methods: </strong>A mixed method study was conducted parallel to the implementation of DD in 3 hospitals. Data were collected through a survey directly after the ED visit, a survey 3 months post injury, and semistructured interviews. Quantitative data were reported descriptively, and qualitative data used thematic analysis. Outcomes included the Bowen feasibility parameters: implementation, acceptance, preliminary efficacy, and demand. All patients who consented to the study face-to-face with one of the 12 low-complex musculoskeletal injuries were included in the study during the implementation period.</p><p><strong>Results: </strong>Of the 429 patients who started the primary survey, 138 patients completed both surveys. A total of 18 semistructured interviews were conducted and analyzed. Patients reported a median treatment satisfaction score of 7.8 (IQR 6.6-8.8) on a 10-point scale of DD at the ED. Information quality was experienced as good (106/138, 77%), and most preferred DD over face-to-face follow-up (79/138, 59%). Patient information demands and app use varied among patients, with a median frequency of use of 4 times (ranging from 1 to 30).</p><p><strong>Conclusions: </strong>This study shows that patients consider DD a feasible and safe alternative to traditional treatment, with a favorable perception of its acceptability, efficacy, applicability, and demand. Nevertheless, response rates were relatively low, and personal nuances and preferences must be considered when implementing DD. Clinicians and policy makers can use the insights to improve DD and work towards the integration of DD into clinical practice and future guidelines.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e53074"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Wearable Transdermal Alcohol Sensors for Monitoring Alcohol Consumption After Detoxification With Contingency Management: Pilot Randomized Feasibility Trial.","authors":"Eileen Brobbin, Colin Drummond, Stephen Parkin, Paolo Deluca","doi":"10.2196/64664","DOIUrl":"https://doi.org/10.2196/64664","url":null,"abstract":"<p><strong>Background: </strong>Wearable transdermal alcohol sensor (TAS) devices generate continuous data on alcohol consumption through the indiscernible sweat vapors on the skin. This continuous alcohol monitoring capability could provide a new method for alcohol services to monitor service users at various stages of their alcohol treatment.</p><p><strong>Objective: </strong>We aimed to assess the feasibility of using a TAS as part of alcohol treatment with alcohol service users using the device with or without contingency management (CM).</p><p><strong>Methods: </strong>A feasibility study was conducted of a convenience sample of 29 current service users from 3 South London alcohol services. Participants were randomized into either a control (treatment as usual) or CM group (treatment as usual+CM). We assessed the feasibility of enrollment, participation, device tampering and return, and device wearability and the accuracy of data capture. These data were reported descriptively where appropriate, the groups were compared, and alcohol self-report data were compared to the transdermal alcohol concentration to assess accuracy.</p><p><strong>Results: </strong>A total of 34 individuals were approached, and 32 (94%) were enrolled and randomized (n=17, 53% to the control group and n=15, 47% to the CM group) over 5 months. In total, 3 participants withdrew (n=2, 67% from the control group and n=1, 33% from the CM group). There was a total of 203 meetings arranged (29 participants × 7 meetings), and 185 (91.1%) were attended. Only 1 of the 29 participants (3%) admitted to turning the TAS off to avoid monitoring. There were some issues with the TAS not functioning properly and not being able to be cleaned. Removals were recorded, but the definition of TAS removal may need to be improved for future trials. There was a high TAS return rate (28/29, 97% of the participants returned the TAS). Secondary outcomes suggest that the BACtrack Skyn remains an accurate tool to monitor alcohol consumption compared to self-report data and that it is acceptable to wearers over 2 weeks, with many participants (27/28, 96%) answering that they would wear it again and for longer but that the CM procedure could be made clearer.</p><p><strong>Conclusions: </strong>The delivery of CM via a TAS was feasible in this study, but recommendations for a future larger trial include that the study design should be changed to provide an operationalized rather than manual method of checking whether TAS data meet CM criteria. This would reduce researcher burden and researcher and participant time. Current recruitment and research meeting design seem suitable for a future larger trial.</p><p><strong>Trial registration: </strong>International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN46845361; https://www.isrctn.com/ISRCTN46845361.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"12 ","pages":"e64664"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}