Patient-centered

以患者为中心
  • 文章类型: Journal Article
    慢性肾脏病(CKD)在全球范围内代表着重大的健康挑战,特别是在接受慢性血液透析的患者中。精心的营养和药物处方在有效管理这些患者以优化血清电解质方面起着关键作用,如钾,磷,和蛋白质的摄入。此外,由于饮食限制和严格的用药时间表,这些患者可能会遭受心理困扰。本研究探讨了以人为中心的IARA模型在改善接受血液透析治疗的CKD患者的生理指标和生活质量方面的有效性。为了证明IARA模型的有效性,纳入60例接受每周三次血液透析的患者(M=40;F=20;60.5±9.9岁),并随机和盲目地分配到对照组或IARA组。异常血钾的减少,磷,并调查了总蛋白质水平,通过SF-12问卷进行心理状态。初步发现显示,与对照组相比,IARA组异常血液K(>5.0mmol/L)和P(>4.5mmol/L)水平的频率明显减少。特别是,K降低约40%(OR=0.57;95%CL=0.23/1.46),P降低约15%(OR=0.86;95%CL=0.27/2.74).在每次血液透析期间,患者的液体摄入量也观察到类似的趋势。IARA组中高危患者的频率比对照组低50%(OR=0.50;95%CL=0.07/3.79)。尽管这项研究的初步结果表明,IARA模型可能对CKD患者的主观幸福感和生活质量(QoL)产生积极影响,需要进一步的研究来了解IARA干预的长期影响.
    Chronic kidney disease (CKD) globally represents a significant health challenge, particularly among patients undergoing chronic hemodialysis. A careful nutritional and pharmacological prescription plays a key role in the effective management of these patients to optimize serum electrolytes, such as potassium, phosphorus, and protein intake. Furthermore, these patients can suffer psychological distress due to dietary restrictions and tight medication schedules. The present study explores the effectiveness of the person-centered IARA model in improving physiological markers and quality of life in CKD patients undergoing hemodialysis treatment. To demonstrate the effectiveness of the IARA model, 60 patients (M = 40; F = 20; 60.5 ± 9.9 years) undergoing thrice-weekly hemodialysis sessions were enrolled and randomly and blindly assigned to the Control or IARA group. The reduction in abnormal blood potassium, phosphorus, and total protein levels was investigated, alongside the psychological state through the SF-12 questionnaire. Preliminary findings showed a discernible reduction in the frequency of abnormal blood K (> 5.0 mmol/L) and P (> 4.5 mmol/L) levels in the IARA group compared to the Control group. In particular, such reductions were approximately 40% for K (OR = 0.57; 95% CL = 0.23/1.46) and about 15% for P (OR = 0.86; 95% CL = 0.27/2.74). A similar tendency was also observed for patient fluid intake during each hemodialysis session, with the frequency of higher-risk patients in the IARA group being 50% lower (OR = 0.50; 95% CL = 0.07/3.79) than that of the Control group. Although preliminary findings from this study suggest that the IARA model may have a positive effect on CKD patients\' subjective wellbeing and quality of life (QoL), further research is needed to understand the long-term impact of the IARA intervention.
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  • 文章类型: Journal Article
    牙周治疗后的患者依从性对于预测疾病的预后和维持治疗结果极为重要。因此,本研究旨在探讨牙周炎患者对治疗结果的认知。通过预先验证的问卷,在单个牙科中心的牙周炎患者中进行了横断面研究,该问卷通过使用便利的抽样技术分发给牙周诊所等候区的每个参与者。除频率和百分比外,还使用了中位数和四分位数范围。使用Mann-WhitneyU和Kruskal-Wallis检验进行双变量分析。在300名男性和女性参与者中,当前疼痛水平的中位数得分(四分位数范围)表明男性比女性经历更多的疼痛,男性的中位数为5分(0-7分),女性为4分(0-6分)。然而,男女期望和预期疼痛水平的中位数(四分位数范围)为0(0-1),0(0-4)。预期的男性和女性之间的中位数得分等级存在显着差异,苦恼,成功,和重要性水平(p值<0.05)。牙周炎患者为接受牙周病治疗的个人提供了宝贵的见解,表明患者对预期的牙周结局水平的总体满意度。
    Patient compliance following periodontal therapy is extremely important in predicting the prognosis of the disease and maintaining treatment outcomes. Therefore, this study aimed to investigate the perception of periodontitis patients about treatment outcomes. A cross-sectional study was conducted among periodontitis patients in a single dental center through a pre-validated questionnaire that was distributed to each participant in the waiting area of periodontal clinics by utilizing a convenience sampling technique. Median and interquartile ranges were used in addition to frequency and percentages. Bivariate analyses were performed using the Mann-Whitney U and Kruskal-Wallis test. Among the 300 male and female participants, the median score (interquartile range) of the current level of pain revealed that males experienced more pain than females, with a median score of 5 (0-7) for males and 4 (0-6) for women. However, the median (interquartile range) for desired and expected pain levels in both genders was 0 (0-1), 0 (0-4). There were significant differences in median score ratings between males and females for expected, distress, success, and importance levels (p-value < 0.05). Patients with periodontitis provided valuable insights into the experiences of individuals undergoing treatment for periodontal disease, indicating overall patient satisfaction with the expected levels of periodontal outcomes.
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  • 文章类型: Journal Article
    背景:为患有多种慢性疾病(MCC)的老年人提供医疗保健具有挑战性。多药和复杂的治疗计划可能导致高治疗负担和不良事件的风险。对于临床医生来说,管理MCC患者的复杂性几乎没有空间来确定什么是重要的,并使护理方案与患者的健康优先事项保持一致。需要新的护理方法来应对这些挑战。在这个临床试验中,我们评估创新的实施和有效性结果,结构化,以患者为中心的护理方法(PatientPrioritiesCare;PPC),用于减轻治疗负担,并使医疗保健决策与MCC老年人的健康优先事项保持一致。
    方法:这是一个多站点,评估员-盲,双臂,平行杂交1型随机对照试验。我们正在招募396名年龄较大(65岁以上)的MCC退伍军人,他们在退伍军人事务医疗中心接受初级保健。退伍军人被随机分配到PPC或常规护理。在PPC臂中,退伍军人可以与研究促进者进行简短的电话通话,以确定他们的个人健康优先事项。然后,初级保健提供者使用这些信息在他们确定的诊所预约期间使医疗保健与退伍军人的优先事项保持一致.在基线和4个月随访时收集数据,以评估治疗负担的变化以及家庭和社区服务的使用。还收集了形成性和总结性评估,以根据Proctor的实施框架评估实施结果。
    结论:这项工作有可能通过个性化医疗保健和帮助患者实现对他们最重要的目标来显着提高护理标准。
    BACKGROUND: Providing healthcare for older adults with multiple chronic conditions (MCC) is challenging. Polypharmacy and complex treatment plans can lead to high treatment burden and risk for adverse events. For clinicians, managing the complexities of patients with MCC leaves little room to identify what matters and align care options with patients\' health priorities. New care approaches are needed to navigate these challenges. In this clinical trial, we evaluate implementation and effectiveness outcomes of an innovative, structured, patient-centered care approach (Patient Priorities Care; PPC) for reducing treatment burden and aligning health care decisions with the health priorities of older adults with MCC.
    METHODS: This is a multisite, assessor-blind, two-arm, parallel hybrid type 1 randomized controlled trial. We are enrolling 396 older (65+) Veterans with MCC who receive primary care at the Veterans Affairs Medical Center. Veterans are randomly assigned to either PPC or usual care. In the PPC arm, Veterans have a brief telephone call with a study facilitator to identify their personal health priorities. Then, primary care providers use this information to align healthcare with Veteran priorities during their established clinic appointments. Data are collected at baseline and 4-month follow up to assess for changes in treatment burden and use of home and community services. Formative and summative evaluations are also collected to assess for implementation outcomes according to Proctor\'s implementation framework.
    CONCLUSIONS: This work has the potential to significantly improve the standard of care by personalizing healthcare and helping patients achieve what is most important to them.
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  • 文章类型: Journal Article
    背景:以患者为中心的临床试验似乎更成功(例如,临床结果,改善沟通,相互授权,态度改变),因此,行动研究可能是一个重要的领域。本研究探讨了社区学术伙伴关系(CAP)的活动阶段的形成和执行。
    方法:成员由行业利益相关者组成,医疗保健/学术机构,以及有癌症幸存者和/或护理人员生活经验的患者/家庭。回顾过去,CAP成员描述了伙伴关系发展中存在的促进和/或阻碍因素。使用了文件审查程序。三次联合呼吁程序会议的实地说明,专注于了解临床试验的参与,使用主题方法进行了分析。
    结果:存在七个促进因素和三个阻碍因素。人际关系(vs.操作)过程更经常被称为有影响的促进因素。出现的主题包括“作为治疗选择的试验”,\'留下遗产\',和\'时机至关重要。
    结论:这项研究提供了以患者为中心的观点,探讨了参与临床试验的障碍/挑战以及如何改善未来的看法。
    当患者参与时,临床试验更成功,他们的观点在研究设计中得到了考虑。社区-学术伙伴关系(CAPs)是通过建立合作,使所有相关方发挥公平作用,从而确保患者更多地参与研究过程的一种方法。我们提供了一个与行业利益相关者合作的例子,医疗保健/学术机构,和患者以及有癌症幸存者和/或护理人员生活经验的家庭。这里描述了CAP的两个阶段:活动的形成和执行阶段。形成阶段涵盖了CAP的协作过程和开发。在我们的研究中,为了更好地理解这个阶段,CAP成员描述了在伙伴关系发展过程中进展顺利和不顺利的情况。我们发现更多的方面进展顺利,并且与CAP成员之间的关系和沟通质量相关的过程很重要。活动执行阶段侧重于CAP如何努力实现商定的结果。在我们的研究中,为了更好地理解这个阶段,我们回顾了以往CAP会议的记录,重点是探讨参与临床试验作为治疗选择.我们发现,当涉及到参与临床试验时,有癌症生活经历的患者和/或护理人员,认为这种治疗选择的时机很重要,参与的原因包括想要留下遗产。在本文中,我们描述了参与临床试验的一些挑战,由患者和护理人员识别,并讨论如何提高未来临床试验参与的观点。
    BACKGROUND: Clinical trials that are patient-centered appear to be more successful (e.g., clinical outcomes, improved communication, mutual empowerment, changed attitudes), thus, action research may be a field of importance. The current study explores the Formation and Execution of Activities phases of a community-academic partnership (CAP).
    METHODS: Members consisted of industry stakeholders, a healthcare/academic institution, and patients/families with lived experiences as cancer survivors and/or caregivers. Retrospectively, CAP members described the facilitating and/or hindering factors present in the partnership development. A document review process was used. Field notes from three CAP meetings, which focused on understanding clinical trial participation, were analyzed using a thematic approach.
    RESULTS: Seven facilitating and three hindering factors were present. Interpersonal (vs. operational) processes were referenced as influential facilitating factors more often. Themes that emerged included \'trials as a treatment option\', \'leaving a legacy\', and \'timing is critical.\'
    CONCLUSIONS: This study provides a patient-centered perspective on barriers/challenges of clinical trial participation and how to improve future perceptions.
    Clinical trials are more successful when patients are engaged, and their perspectives have been considered in the study design. Community-academic partnerships (CAPs) are one way to ensure patients are more engaged in the research process by creating a collaboration where all parties involved play an equitable role. We provide an example of a CAP with an industry stakeholder, a healthcare/academic institution, and patients as well as families with lived experiences as cancer survivors and/or caregivers. Described here two phases of the CAP: the Formation and the Execution of Activities phases. The Formation phase covers the collaboration process and development of the CAP. In our study, to better understand this phase, CAP members described what did and did not go well during the partnership development. We found more aspects went well than did not and that processes related to the quality of the relationship and communication among CAP members were important. The Execution of Activities phase focuses on how the CAP is working towards an agreed upon outcome. In our study, to better understand this phase, we reviewed notes taken at previous CAP meetings that focused on exploring participation in clinical trials as a treatment option. We found that when it comes to participation in clinical trials, patients and/or caregivers with lived experiences with cancer, felt that timing of this treatment option was important and that reasons for participation included wanting to leave a legacy. In this paper we describe some challenges of clinical trial participation, identified by patients and caregivers, and discuss how to improve views of clinical trial participation in the future.
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  • 文章类型: Journal Article
    背景:以患者为中心的数字干预措施可能是改善和促进社交互动的重要工具,健康,和老年人的幸福。在这方面,我们为老年人群开发了一个名为DigiAdherence的移动应用程序,其中包括易于访问的短视频和消息,提高他们的健康知识,预防常见的健康状况,如瀑布,多药,治疗依从性,营养问题,缺乏体力活动。
    目的:本研究旨在评估DigiAdherence应用程序在65岁或以上的葡萄牙老年人中的可用性和实用性。
    方法:在本中试非对照准实验研究中,在波尔蒂芒初级卫生保健中心的病人,葡萄牙,并拥有智能手机或平板电脑被招募。参与者在基线时进行评估,允许访问DigiAdherence应用程序1个月,并在停止使用应用程序30天后(第一次评估)和60天后立即再次评估(第二次评估)。在第一次随访评估中,使用包含8个项目的结构化问卷分析了应用程序可用性和实用性(主要结果)。在第二次后续评估中,我们的重点是通过应用程序获得的知识。还评估了次要结果,例如治疗依从性和健康相关的生活质量。
    结果:该研究包括26名老年人。大多数参与者对该应用程序的不同功能给予积极评价,并认为该应用程序很有用,有吸引力,和用户友好(7分Likert量表的中位数为6分)。此外,随访后,参与者报告说,他们在预防跌倒(16/24,67%)和管理治疗和多重用药(16/26,62%)方面有安全感和更多知识.
    结论:DigiAdherence移动应用程序非常有用,并且被老年人高度接受,他们对健康相关知识产生了更多的信心。
    RR2-10.2196/29675。
    BACKGROUND: Digital patient-centered interventions may be important tools for improving and promoting social interaction, health, and well-being among older adults. In this regard, we developed a mobile app called DigiAdherence for an older adult population, which consisted of easy-to-access short videos and messages, to improve health-related knowledge among them and prevent common health conditions, such as falls, polypharmacy, treatment adherence, nutritional problems, and physical inactivity.
    OBJECTIVE: This study aimed to assess the usability and utility of the DigiAdherence app among Portuguese older adults 65 years or older.
    METHODS: In this pilot noncontrolled quasi-experimental study, older adults who were patients at the primary health care center in Portimão, Portugal, and owned a smartphone or tablet were recruited. Participants were assessed at baseline, given access to the DigiAdherence app for 1 month, and assessed again immediately after 30 days (first assessment) and 60 days after stopping the use of the app (second assessment). App usability and utility (primary outcomes) were analyzed in the first follow-up assessment using a structured questionnaire with 8 items. In the second follow-up assessment, our focus was on knowledge acquired through the app. Secondary outcomes such as treatment adherence and health-related quality of life were also assessed.
    RESULTS: The study included 26 older adults. Most participants rated the different functionalities of the app positively and perceived the app as useful, attractive, and user-friendly (median score of 6 on a 7-point Likert scale). In addition, after follow-up, participants reported having a sense of security and greater knowledge in preventing falls (16/24, 67%) and managing therapies and polypharmacy (16/26, 62%).
    CONCLUSIONS: The DigiAdherence mobile app was useful and highly accepted by older adults, who developed more confidence regarding health-related knowledge.
    UNASSIGNED: RR2-10.2196/29675.
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  • 文章类型: Journal Article
    通过营养教育改变2型糖尿病患者的饮食行为来改善其临床结局是糖尿病自我管理的重要组成部分。来自文献的重要数据支持这一观点,然而在埃塞俄比亚的背景下,有一个实践差距。因此,本研究的目的是评估以患者为中心的营养教育如何影响未控制的2型糖尿病患者的饮食行为和临床结局.
    在这个准实验试验中,178名不受控制的2型糖尿病患者被故意分配到干预组(n=89)或对照组(n=89)。干预组给予以患者为中心的营养教育,而控制臂接受常规护理。饮食行为和临床结局指标,如HbAc,血脂谱,人体测量指数,在干预开始和结束时评估两组的血压.测试所有尺度变量的正态,并在适当时进行对数变换。对干预组和对照组的基线特征进行比较,连续变量采用t检验,分类变量采用卡方检验。使用差异差异(DID)方法确定营养教育的效果。P<0.05被确立为显著性标准。
    食物选择(DID=15.84,P<0.001),膳食计划(DID=31.11,P<0.001),营养教育组的热量需求(DID=37.65,P<0.001)得分高于统计学。此外,他们的总体饮食行为得分(DID=27.06,P<0.001)在统计学上高于对照组。就临床结果而言,总体情况显示,干预措施的效果并不优于常规护理.然而,与控件相比,干预组显示HbA1c有临床显著改善(DID=-0.258,P=0.485).
    以患者为中心的营养教育使2型糖尿病患者的饮食行为得到了积极的调整。此外,它显示出改善血糖控制的巨大潜力。
    UNASSIGNED: Improving the clinical outcome of people with type 2 diabetes mellitus by modifying their eating behavior through nutrition education is an important element of diabetes self-management. Significant data from the literature supports this idea, however in the Ethiopian setting, there is a practice gap. Therefore, the purpose of this study was to assess how patient-centered nutrition education affected the eating behavior and clinical outcomes of people with uncontrolled type 2 diabetes mellitus.
    UNASSIGNED: In this quasi-experimental trial, 178 people with uncontrolled type 2 diabetes were purposely assigned to the intervention (n = 89) or control (n = 89) arm. The intervention arm was given patient-centered nutrition education, whereas the control arm received the routine care. Eating behavior and clinical outcome indicators such as HbAc, lipid profile, anthropometric indices, and blood pressure were assessed in both groups at the start and completion of the intervention. All scale variables were tested for normality and log transformed when appropriate. The baseline characteristics of the intervention and control groups were compared using the t-test for continuous variables and the chi-square test for categorical variables. The effect of nutrition education was determined using a difference in differences (DID) approach. P < 0.05 was established as the criterion of significance.
    UNASSIGNED: Food selection (DID = 15.84, P < 0.001), meal planning (DID = 31.11, P < 0.001), and calorie needs (DID = 37.65, P < 0.001) scores were statistically higher in the nutrition education arm. Furthermore, their overall eating behavior score (DID = 27.06, P < 0.001) was statistically greater than the controls. In terms of clinical outcomes, the overall picture reveals that the intervention did not outperform over the routine care. However, in comparison to the controls, the intervention arm showed clinically significant improvement in HbA1c (DID = -0.258, P = 0.485).
    UNASSIGNED: Patient-centered nutrition education has resulted in positive adjustments in the eating behavior of people with uncontrolled type 2 diabetes mellitus. Furthermore, it has shown a great potential for improving their glycemic control.
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  • 文章类型: Journal Article
    背景:阿片类药物使用障碍(OUD)的自我管理是治疗的重要组成部分。在美沙酮维持治疗环境中接受阿片类激动剂治疗的许多患者受益于咨询治疗,以帮助他们提高恢复技能,但在诊所预约之间无法获得这些治疗。此外,在普通医疗诊所中治疗OUD患者的许多成瘾医学临床医生无法一致地获得患者的咨询转诊.这可能导致治疗保留和患者从物质滥用中恢复的总体进展减少。数字应用程序可能有助于通过指导来弥合这一差距,支持,并加强由其心理社会和医疗提供者发起和指导的行为改变。
    目的:本研究旨在获得可接受性,可用性,以及KIOS应用程序的公用事业试点研究,以满足这些临床需求。
    方法:我们开发了一种独特的,以患者为中心的计算软件系统(KIOS;生物医学开发公司),以协助管理门诊病人的OUD,美沙酮维持诊所设置。KIOS追踪自我报告的互动症状(渴望,情绪低落,焦虑,烦躁,疼痛,躁动或不安,睡眠困难,旷工,通常的活动有困难,以及与他人的冲突),以确定症状模式随时间的轨迹和严重程度的变化。然后,KIOS根据OUD专家先前建立的模型,应用专有算法来评估个体的症状相互作用模式。经过分析,KIOS提供特定的行为建议,以解决个人不断变化的症状轨迹,以帮助患者自我管理症状。KIOS软件还提供对患者可以使用的自我报告数据的分析,临床医生,和研究人员来跟踪结果。
    结果:在为期4周的可接受性中,可用性(平均系统可用性量表-修改分数89.5,SD9.2,最大值10.0),和效用(平均KIOS效用问卷得分6.32,SD0.25,最大值7.0)对15名美沙酮维持的OUD参与者进行的初步研究,用户体验,可用性,软件生成的建议获得了较高和积极的评估分数。KIOS临床变量与渴望自我报告指标密切相关。因此,使用KIOS软件生成的建议管理这些变量可能会对渴望和最终物质使用产生影响。
    结论:KIOS跟踪关键临床变量,并产生与患者当前和不断变化的临床状态特别相关的建议。这项试点研究中的患者为KIOS用户体验分配了很高的正值,易用性,以及适当性,相关性,以及他们收到的特定行为指导的有用性,以匹配他们不断发展的经历。因此,KIOS可能有助于增强阿片类激动剂患者的当面治疗,并有助于填补目前在连续护理中存在的治疗空白。国家药物滥用研究所资助的KIOS随机对照试验目前正在进行中,以加强对OUD患者的当面治疗。
    BACKGROUND: Self-management of opioid use disorder (OUD) is an important component of treatment. Many patients receiving opioid agonist treatment in methadone maintenance treatment settings benefit from counseling treatments to help them improve their recovery skills but have insufficient access to these treatments between clinic appointments. In addition, many addiction medicine clinicians treating patients with OUD in a general medical clinic setting do not have consistent access to counseling referrals for their patients. This can lead to decreases in both treatment retention and overall progress in the patient\'s recovery from substance misuse. Digital apps may help to bridge this gap by coaching, supporting, and reinforcing behavioral change that is initiated and directed by their psychosocial and medical providers.
    OBJECTIVE: This study aimed to conduct an acceptability, usability, and utility pilot study of the KIOS app to address these clinical needs.
    METHODS: We developed a unique, patient-centered computational software system (KIOS; Biomedical Development Corporation) to assist in managing OUD in an outpatient, methadone maintenance clinic setting. KIOS tracks interacting self-reported symptoms (craving, depressed mood, anxiety, irritability, pain, agitation or restlessness, difficulty sleeping, absenteeism, difficulty with usual activities, and conflicts with others) to determine changes in both the trajectory and severity of symptom patterns over time. KIOS then applies a proprietary algorithm to assess the individual\'s patterns of symptom interaction in accordance with models previously established by OUD experts. After this analysis, KIOS provides specific behavioral advice addressing the individual\'s changing trajectory of symptoms to help the person self-manage their symptoms. The KIOS software also provides analytics on the self-reported data that can be used by patients, clinicians, and researchers to track outcomes.
    RESULTS: In a 4-week acceptability, usability (mean System Usability Scale-Modified score 89.5, SD 9.2, maximum of 10.0), and utility (mean KIOS utility questionnaire score 6.32, SD 0.25, maximum of 7.0) pilot study of 15 methadone-maintained participants with OUD, user experience, usability, and software-generated advice received high and positive assessment scores. The KIOS clinical variables closely correlated with craving self-report measures. Therefore, managing these variables with advice generated by the KIOS software could have an impact on craving and ultimately substance use.
    CONCLUSIONS: KIOS tracks key clinical variables and generates advice specifically relevant to the patient\'s current and changing clinical state. Patients in this pilot study assigned high positive values to the KIOS user experience, ease of use, and the appropriateness, relevance, and usefulness of the specific behavioral guidance they received to match their evolving experiences. KIOS may therefore be useful to augment in-person treatment of opioid agonist patients and help fill treatment gaps that currently exist in the continuum of care. A National Institute on Drug Abuse-funded randomized controlled trial of KIOS to augment in-person treatment of patients with OUD is currently being conducted.
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  • 文章类型: Journal Article
    数字健康干预提供了提高健康素养的潜力,这对于有效的糖尿病管理至关重要,尤其是青少年。糖尿病是一个重大的全球性公共卫生问题。导致毁灭性的并发症和增加的死亡率。1型糖尿病(T1DM)的发病率也在上升,特别是在青少年中,必须采取多部门战略来防治这一疾病。本研究探讨了德国T1DM青少年对数字健康干预的看法,旨在通过解决特定需求和指导未来研究来改善医疗保健。
    本研究采用定性方法,对德国14至18岁的T1DM(n=20)青少年进行半结构化个人访谈,以探讨他们对数字干预措施促进健康素养的看法。本研究根据Kuckartz等人的观点采用内容分析法。研究遵循了定性研究报告综合标准(COREQ)清单。道德考虑至关重要,使用编码和迭代过程对数据进行严格分析,以确保数据质量和可靠性。
    研究结果表明,在三个突出的领域中,即利用数字健康干预来获取和理解信息,促进点对点互动,加强医患沟通和互动,数字卫生干预措施要么利用不足,要么部署不足。此外,一个值得注意的观察结果是,在数字健康干预和健康素养方面,T1DM青少年明显缺乏以患者为中心的方法.
    为了提高数字健康干预措施的利用率和提高健康素养,必须通过以患者为中心的方法来关注能力建设。促进数字健康素养,培养参与式文化。这项研究的结果提供了有价值的见解,可以为实际应用提供信息,进一步的研究努力,影响政策制定。
    Digital health intervention offers the potential to enhance health literacy, which is crucial for effective diabetes management, especially among adolescents. Diabetes is a major global public health issue, leading to devastating complications and increasing mortality rates. The incidence of type 1 diabetes mellitus (T1DM) is also on the rise, particularly among adolescents, necessitating multisectoral strategies to combat this disease. This study explores the perceptions of adolescents with T1DM in Germany regarding digital health interventions, with the aim of improving healthcare by addressing specific needs and guiding future research.
    This study employed a qualitative approach using semi-structured individual interviews with adolescents with T1DM (n = 20) aged 14 to 18 years old in Germany to explore their perspectives on digital interventions for health literacy promotion. The study adopted content analysis according to Kuckartz et al. and the research followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Ethical considerations were paramount and data were rigorously analyzed using coding and iterative processes to ensure data quality and reliability.
    The findings indicate that within three prominent domains, namely the utilization of digital health intervention for accessing and comprehending information, facilitating peer-to-peer interactions, and enhancing physician-patient communication and interaction, digital health interventions are either underutilized or insufficiently deployed. In addition, a notable observation is the apparent lack of patient-centered approaches for adolescents with T1DM in relation to digital health interventions and health literacy.
    In order to enhance the utilization of digital health interventions and enhance health literacy it is essential to focus on capacity building through a patient-centered approach, to promote digital health literacy, and foster the cultivation of a participatory culture. The outcomes of this study offer valuable insights that can inform practical applications, further research endeavors, and influence policymaking.
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  • 文章类型: Journal Article
    背景以患者为中心的结果问卷(PCOQ)是一个自我报告问卷,旨在评估四个基本领域(疼痛,疲劳,苦恼,和干扰)在慢性病中从0到10的11点数字评分量表上。该工具的实施将有助于评估慢性病;因此,这项研究旨在将PCOQ转化为牙周炎患者的样本。方法本研究通过内容效度指标。阿拉伯语PCOQ使用Cronbach的alpha来提高300名参与者的可靠性。2023年7月至8月,前往利雅得门诊牙科中心的牙周炎患者被邀请参加这项研究。语言,内容,问卷结构合适,以及向前和向后翻译,实现了外部实体翻译。结果关于参与者的性别,男性人数较多,为61%。关于年龄分布,50.7%的参与者年龄在30至50岁之间。在内容效度分析中报告的清晰度得分为95.2%,代表性得分为97.3%。阿拉伯PCOQ问卷的Cronbachα为0.85,分量表介于0.68和0.93之间。结论阿拉伯文PCOQ的翻译版本是阿拉伯国家使用的有效工具。尽管如此,该仪器可以为医疗保健专业人员提供见解,政策制定者,和管理人员,以提高患者满意度和医疗保健系统的交付。
    Background The patient-centered outcomes questionnaire (PCOQ) is a self-report questionnaire that aims to assess four fundamental domains (pain, fatigue, distress, and interference) on an 11-point numerical rating scale from 0 to 10 in chronic diseases. The implementation of this tool will help assess chronic diseases; hence, this study aimed to translate the PCOQ to a sample of periodontitis patients. Methodology This study went through the content validity index. Arabic PCOQ used Cronbach\'s alpha for reliability with 300 participants. From July to August 2023, patients with periodontitis visiting an outpatient dental center in Riyadh were invited to participate in the study. The language, content, and structure of the questionnaire were appropriate, and with forward and backward translation, external entity translation was implemented. Results Regarding the participants\' gender, the number of males was higher at 61%. Regarding age distribution, 50.7% of the participants were between 30 and 50 years old. A clarity score of 95.2% and a representativeness score of 97.3% were reported in the content validity analysis. The Cronbach\'s alpha of the Arabic PCOQ questionnaire was 0.85, and the subscales ranged between 0.68 and 0.93. Conclusions The translated version of the Arabic PCOQ is a valid tool to be used in Arab countries. Nonetheless, this instrument can provide insights for healthcare professionals, policymakers, and managers to improve patient satisfaction and healthcare system delivery.
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  • 文章类型: Journal Article
    临床聊天机器人越来越多地用于帮助将基因检测整合到临床环境中,但是,对于非洲血统的活体肾脏供体(LKD)候选人的载脂蛋白L1(APOL1)基因检测,没有chatbot存在。我们的研究旨在从文化上适应和评估Gia®聊天机器人的认知,以帮助将APOL1测试整合到LKD评估中。共进行了十次焦点小组及焦点小组后调查,调查对象为54名LKD,社区成员,和非洲血统的肾移植受者。通过专题分析和描述性统计对数据进行分析。使Gia具有文化针对性的关键主题包括:(1)通过提供BlackLKD\'推荐来确保透明度,解释患者隐私和保密保护,并解释基因检测如何帮助LKD评估;(2)内容是通过教育黑人LKD关于APOL1测试的信息,而不是旨在说服他们接受测试,提供统计数据,并描述了如何在法律上防止遗传歧视;以及(3)内容避免了黑人社区对生活捐赠的污名。大多数人认为Gia是中立和公正的(82%),值得信赖(82%),和文字,短语,和表达是熟悉的目标受众(85%)。我们的文化适应APOL1Gia聊天机器人很受欢迎。未来的研究应该评估这个聊天机器人如何在基因测试之前补充提供者的讨论,以扩大APOL1咨询和LKD候选临床评估的测试。
    Clinical chatbots are increasingly used to help integrate genetic testing into clinical contexts, but no chatbot exists for Apolipoprotein L1 (APOL1) genetic testing of living kidney donor (LKD) candidates of African ancestry. Our study aimed to culturally adapt and assess perceptions of the Gia® chatbot to help integrate APOL1 testing into LKD evaluation. Ten focus groups and post-focus group surveys were conducted with 54 LKDs, community members, and kidney transplant recipients of African ancestry. Data were analyzed through thematic analysis and descriptive statistics. Key themes about making Gia culturally targeted included ensuring: (1) transparency by providing Black LKDs\' testimonials, explaining patient privacy and confidentiality protections, and explaining how genetic testing can help LKD evaluation; (2) content is informative by educating Black LKDs about APOL1 testing instead of aiming to convince them to undergo testing, presenting statistics, and describing how genetic discrimination is legally prevented; and (3) content avoids stigma about living donation in the Black community. Most agreed Gia was neutral and unbiased (82%), trustworthy (82%), and words, phrases, and expressions were familiar to the intended audience (85%). Our culturally adapted APOL1 Gia chatbot was well regarded. Future research should assess how this chatbot could supplement provider discussion prior to genetic testing to scale APOL1 counseling and testing for LKD candidate clinical evaluation.
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