Using Social Robots in Health Settings: Implications of Personalization on Human-Machine Communication

In view of the shortage of healthcare workers and a growing aging population, it is worthwhile to explore the applicability of new technologies in improving the quality of healthcare and reducing its cost. However, it remains a challenge to deploy such technologies in environments where individuals have limited knowledge about how to use them. Thus, this paper explores how the social robots designed for use in health settings in Australia have sought to overcome some of the limitations through personalization. Deployed in aged care and home-based care facilities, the social robots are person-centered, emphasizing the personalization of care with human-like attributes (e.g., human appearances) to engage in reciprocal communication with users. While there have been debates over the advantages and disadvantages of personalization, this paper discusses the implications of personalization on the design of the robots for enhancing engagement, empowerment and enablement in health settings

A textbook of community nursing.

A Textbook of Community Nursing is a comprehensive and evidence-based introduction covering the full range of professional topics, including professional approaches to care, public health, eHealth, therapeutic relationships and the role of community nursing in mental health. The new edition has been updated throughout, including new guidelines and policies. It also provides a stronger focus on evidence-based practice

Mobile Health Technologies

Mobile Health Technologies, also known as mHealth technologies, have emerged, amongst healthcare providers, as the ultimate Technologies-of-Choice for the 21st century in delivering not only transformative change in healthcare delivery, but also critical health information to different communities of practice in integrated healthcare information systems. mHealth technologies nurture seamless platforms and pragmatic tools for managing pertinent health information across the continuum of different healthcare providers. mHealth technologies commonly utilize mobile medical devices, monitoring and wireless devices, and/or telemedicine in healthcare delivery and health research. Today, mHealth technologies provide opportunities to record and monitor conditions of patients with chronic diseases such as asthma, Chronic Obstructive Pulmonary Diseases (COPD) and diabetes mellitus. The intent of this book is to enlighten readers about the theories and applications of mHealth technologies in the healthcare domain

Development of an Integrated Telerehabilitation Information Management System to Support Remote Wheelchair Prescription

Information technology (IT) is central in providing Telerehabilitation (TR), which enables people with disabilities access to limited number of qualified practitioners with specialty expertise, especially at rural areas. Prior to 2008, most TR utilized non-integrated IT systems to provide its basic infrastructure. Using this approach, data management has to be done manually over multiple non-integrated systems, increasing the possibility of outdated or missing data. An integrated system that is open, flexible, extensible, and cost-effective was designed and developed as a solution to mitigate this problem. The work described in this dissertation elaborates the process of developing such system, called the Versatile and Integrated System for Telerehabilitation (VISYTER). VISYTER was intended to become a platform that is capable of delivering any TR, and was first used to support Remote Wheelchair Prescription (RWP), a TR effort to support clinicians in rural Pennsylvania to prescribe wheeled mobility and seating devices. The development process of VISYTER consisted of three main phases: identification and verification of requirements, validation, and evaluation. The requirement identification and verification phase involved a group of expert clinicians from RWP with the purpose of identifying the requirement of the system to support RWP: a system that can provide real-time teleconsultation and documentation support for prescribing a wheeled mobility intervention. Validation studies were conducted with help from ten individuals, including physicians, clinicians, and suppliers participated to validate VISYTER in their workplaces. All participants agreed that VISYTER can be used to properly support both the teleconsultation and documentation phase of RWP. Afterward, the usability of VISYTER was evaluated through a comparison study with a commonly utilized videoconferencing system in TR, POLYCOM. Twenty-six clinicians participated in a counterbalanced experimental study to measure the difference in usability for completing client assessment tasks using both systems. The study found VISYTER to be more efficient and less prone to error when compared to POLYCOM. Based on these findings, the study concluded that an integrated system could improve the usability TR delivery when compared to non-integrated systems approach

Implementation of interventions to reduce preventable hospital admissions for cardiovascular or respiratory conditions : an evidence map and realist synthesis

Background In 2012, a series of systematic reviews summarised the evidence regarding interventions to reduce preventable hospital admissions. Although intervention effects were dependent on context, the reviews revealed a consistent picture of reduction across different interventions targeting cardiovascular and respiratory conditions. The research reported here sought to provide an in-depth understanding of how interventions that have been shown to reduce admissions for these conditions may work, with a view to supporting their effective implementation in practice. Objectives To map the available evidence on interventions used in the UK NHS to reduce preventable admissions for cardiovascular and respiratory conditions and to conduct a realist synthesis of implementation evidence related to these interventions. Methods For the mapping review, six databases were searched for studies published between 2010 and October 2017. Studies were included if they were conducted in the UK, the USA, Canada, Australia or New Zealand; recruited adults with a cardiovascular or respiratory condition; and evaluated or described an intervention that could reduce preventable admissions or re-admissions. A descriptive summary of key characteristics of the included studies was produced. The studies included in the mapping review helped to inform the sampling frame for the subsequent realist synthesis. The wider evidence base was also engaged through supplementary searching. Data extraction forms were developed using appropriate frameworks (an implementation framework, an intervention template and a realist logic template). Following identification of initial programme theories (from the theoretical literature, empirical studies and insights from the patient and public involvement group), the review team extracted data into evidence tables. Programme theories were examined against the individual intervention types and collectively as a set. The resultant hypotheses functioned as synthesised statements around which an explanatory narrative referenced to the underpinning evidence base was developed. Additional searches for mid-range and overarching theories were carried out using Google Scholar (Google Inc., Mountain View, CA, USA). Results A total of 569 publications were included in the mapping review. The largest group originated from the USA. The included studies from the UK showed a similar distribution to that of the map as a whole, but there was evidence of some country-specific features, such as the prominence of studies of telehealth. In the realist synthesis, it was found that interventions with strong evidence of effectiveness overall had not necessarily demonstrated effectiveness in UK settings. This could be a barrier to using these interventions in the NHS. Facilitation of the implementation of interventions was often not reported or inadequately reported. Many of the interventions were diverse in the ways in which they were delivered. There was also considerable overlap in the content of interventions. The role of specialist nurses was highlighted in several studies. The five programme theories identified were supported to varying degrees by empirical literature, but all provided valuable insights. Limitations The research was conducted by a small team; time and resources limited the team’s ability to consult with a full range of stakeholders. Conclusions Overall, implementation appears to be favoured by support for self-management by patients and their families/carers, support for services that signpost patients to consider alternatives to seeing their general practitioner when appropriate, recognition of possible reasons why patients seek admission, support for health-care professionals to diagnose and refer patients appropriately and support for workforce roles that promote continuity of care and co-ordination between services. Future work Research should focus on understanding discrepancies between national and international evidence and the transferability of findings between different contexts; the design and evaluation of implementation strategies informed by theories about how the intervention being implemented might work; and qualitative research on decision-making around hospital referrals and admissions. Funding The National Institute for Health Research Health Services and Delivery Research programme

Conflicting aims and values in the application of smart sensors in geriatric rehabilitation: ethical analysis

BACKGROUND: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. OBJECTIVE: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. METHODS: On the basis of a systematic literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. RESULTS: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. CONCLUSIONS: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access

Ubiquitous Computing for Remote Cardiac Patient Monitoring: A Survey

New wireless technologies, such as wireless LAN and sensor networks, for telecardiology purposes give new possibilities for monitoring vital parameters with wearable biomedical sensors, and give patients the freedom to be mobile and still be under continuous monitoring and thereby better quality of patient care. This paper will detail the architecture and quality-of-service (QoS) characteristics in integrated wireless telecardiology platforms. It will also discuss the current promising hardware/software platforms for wireless cardiac monitoring. The design methodology and challenges are provided for realistic implementation

Telehealth Etiquette Education: Preparing Practitioners for Successful Patient Encounters

Abstract Background: During the COVID 19 pandemic, access to healthcare was impacted tremendously. The utilization of electronic information and communications in healthcare is known as telehealth. Telehealth is a technology to deliver care when patients and practitioners are not at the same site. Although telehealth has been suggested as a solution to the access to care concern, a major limitation was the lack of education on delivering successful telehealth visits. Quality of care can be negatively affected if proper etiquette is not utilized to ensure an effective telehealth visit. Objective: This DNP project aimed to increase the practitioners’ comfort and competence in telehealth etiquette, by delivering an educational intervention on telehealth etiquette and allowing the practitioners the opportunity to practice the skill. Method: A total of 13 individuals (NPs and PAs) were recruited and agreed to participate. Pre-intervention, participants completed a self-rating on telehealth etiquette comfort and competence and completed a virtual simulated telehealth visit with a trained standardized patient. Following that, the participants were delivered a virtual educational intervention focused on telehealth etiquette. Post-intervention, the participants were able to complete another simulated telehealth patient visit and re-rate themselves on telehealth etiquette comfort and competence using a Likert Scale of 1 to 10, with 1 = not comfortable/competent and 10 = very comfortable/competent. Findings: The average reported rating by each participant before the intervention was 7.46 (SD 2.18) for telehealth comfort and 7.23 (SD 1.92) for telehealth competence. Post-intervention, the average reported rating by each participant was 9.1 (SD .64) for telehealth comfort and 9.4 (SD .77) for telehealth etiquette competence. A dependent t-test showed a statistically significant increase in participants’ self-rating in telehealth comfort (M 1.61, SD 1.89) t (12) = 3.1, p\u3c .001. There was also a statistically significant increase of competence in the participants’ self-rating in telehealth etiquette (M 2.15, SD 1.77) t (12) = 4.4, p = .001. Conclusion: Telehealth is here to stay and is a viable avenue to improve access to healthcare. Practitioners must be adequately trained in telehealth etiquette to maintain the quality of care delivered through telehealth. The DNP project was a success in that the finings indicated a statistically significant increase in the pre-and post-intervention ratings. The telehealth etiquette education significantly increased the ratings of the practitioners\u27 comfort in delivering patient care through telehealth and their competence in telehealth etiquette. The results of this research may be used to make informed practice recommendations and replicated, or similar studies aimed at improving the practitioner-patient telehealth experience Keywords: “telehealth, telemedicine, telemonitoring, telehealth etiquette, COVID-19, video conferencing