Using m-health apps in oncology : A review from 2015 to 2022

The increased use of smartphones and the COVID-19 pandemic directly influenced the development of remote tools in several areas. In the context of oncology, it was no different, as several studies address health care or services related to mobile devices. Apps aimed at the medical field (m-health) focus directly on monitoring symptoms and improving interaction between health professionals and patients, combined with the convenience of smartphones. In this context, this work aims to address recent studies on the use of m-health in the clinical practice of oncological diseases and report the characteristics of the apps involved. For this, a review of m-health focused on oncology was conducted using the PubMed and Science Direct databases. The investigation was carried out using tools inherent in international databases and was limited to articles published between 2015 and 2022. In total, 34 articles were analyzed, with a higher frequency of publications between 2019 and 2022. The resources observed were patient follow-up, prevention of signs and symptoms, monitoring of treatment and aid in prognosis and diagnosis of patients. It is concluded that a close collaboration among patients, health professionals, and information technology professionals is necessary to optimize symptom recognition and improve patientprofessional communication. Although the pandemic has intensified the increase in the use of m-health, its use is expected to increase in the post-pandemic scenario, bearing in mind the changes in social dynamics and the growing dissemination of technologies.This work has been supported by Foundation for Science and Technology (FCT, Portugal) for financial support through national funds FCT/MCTES (PIDDAC) to CeDRI (UIDB/05757/2020 and UIDP/05757/2020), SusTEC (LA/P/0007/2021) and NORTE-01-0247-FEDER-072598 iSafety: Intelligent system for occupational safety and wellbeing in the retail sector. Laíres A. Lima thanks the Fundação para a Ciência e Tecnologia (FCT), Portugal, for the Ph.D. Grant 2022.13393.BD.info:eu-repo/semantics/publishedVersio

Aikuisten kokemuksia etäpalveluista terveysneuvonnan välineenä

Sähköisten terveyspalveluiden kehittäminen on ollut viime vuosina maailmanlaajuisesti terveydenhuollon yksi suurimmista kehittämisen kärkihankkeista. Niiden avulla haetaan kehittyvän teknologian turvin kustannustehokasta ja turvallista tapaa tuottaa palveluita tavoitellen esimerkiksi tehokkaampaa terveydenhuoltoa ja palveluiden parempaa saatavuutta. Asiakkaiden kokemukset etäpalveluista on tärkeää huomioida palveluita kehitettäessä, jotta heidän tarpeisiinsa päästäisiin vastaamaan mahdollisimman hyvin ja etäpalveluiden suosiota saataisiin kasvatettua. Tämän kirjallisuuskatsauksen tarkoituksena oli kuvata aikuisten kokemuksia etäpalveluista terveysneuvonnan välineenä. Tiedonhaku tehtiin touko-kesäkuussa 2022 terveysalan tietokantoihin Cinahl, Medic, Medline ja Cochrane. Hakusanoina käytettiin eHealth, e-health, chat, telecare, telemedicine, telehealth, online, digital, adult, counselling, terveysneuvonta, interventio, ohjaus, video, applikaatio ja sovellus tai näiden sanojen synonyymejä. Tietokantarajauksiksi asetettiin julkaisukieli (suomi ja englanti) ja vertaisarvioidut tutkimukset. Haun kokonaistulos oli 6489 viitettä. Sisäänottokriteereinä oli, että tutkimus käsittelee asiakkaan kokemuksia etäpalveluista terveysneuvonnan välineenä ja terveysneuvontaa etäpalveluna. Lisäksi kyseessä piti olla suora terveysneuvontatilanne ja kokotekstin tuli olla saatavilla. Lopulliseksi aineistokooksi muodostui 18 viitettä, joista 17 oli tutkimusartikkeleita ja yksi väitöskirja. Kaikille kirjallisuuskatsaukseen valituille aineistoille tehtiin laadunarviointi Joanna Briggs -instituutin (JBI) laadunarviointikriteerien mukaan. Aineisto analysoitiin laadullisella sisällönanalyysillä. Kirjallisuuskatsauksen mukaan asiakkaiden kokemukset etäpalveluista terveysneuvonnan välineenä liittyvät etäpalvelun teknologiaan, etäpalvelun turvallisuuteen, etävastaanoton ja fyysisen vastaanoton vertailuun, arjen helpottumiseen, etäpalvelun arvostukseen, kielteisiin kokemuksiin, vuorovaikutukseen etävastaanotolla, etäpalvelun tulevaisuuteen sekä tarpeisiin vastaamiseen. Etäpalvelu koetaan helppona palvelumuotona, joka säästää aikaa ja resursseja sekä parantaa terveyspalveluiden saatavuutta. Etäpalveluiden koetaan lisäksi helpottavan arkea ja niille osallistuttaisiin mielellään uudelleen. Etävastaanottojen koetaan myös vastaavan hyvin asiakkaiden tarpeisiin ja niitä pidetään turvallisina sekä yksityisyyttä kunnioittavina palvelumuotoina. Tulosten perusteella voidaan sanoa, että kokemukset etäpalveluista terveysneuvonnan välineenä ovat pääasiassa positiivisia ja asiakkaat pitävät etäpalveluista terveysneuvonnan välineenä. Ammattilaisen ja asiakkaan välisellä kohtaamisella on suuri merkitys palvelukokemuksessa. Tulosten perusteella ei voida antaa suoraa vastausta siihen, pitävätkö asiakkaat parempana etävastaanottoa vai fyysistä vastaanottoa. Se, kumpaa palvelumuotoa asiakkaat suosivat, riippuu heidän asenteista, tarpeista ja syystä etävastaanotolle hakeutumiseen. Asiakkaiden kokemusten perusteella terveydenhuollon etäpalvelut ovat toivottava palvelumuoto myös tulevaisuudessa. Tulevaisuudessa olisi syytä tutkia ammattilaisten kokemuksia etäpalveluista terveysneuvonnan välineenä. Jatkossa olisi myös hyödyllistä tutkia millaisia etäpalvelumuotoja asiakkaat mieluiten käyttäisivät ja millaisia palveluita he toivoisivat etänä tuotettavan

Egészségügyi mobilapplikációkra történő használati szándék mérése UTAUT-modellben: tanulmány egy online felmérés eredményei alapján

Mindennapjaink szerves részét képezi az információgyűjtés, -menedzselés és -felhasználás, melyekben – a digitális kultúra az életvitelünk felgyorsítására és az azonnaliságra vonatkozó jellegzetességei miatt – kiemelt hangsúlyt kapnak a mobileszközök és az azokon futó applikációk. Ezek között egy markáns trend az egészséggel kapcsolatos alkalmazások köre, melyek a tudatos életmód terjedésével, illetve a tömegsport népszerűségének növekedésével számos területen segíthetik a felhasználókat. A szerzők elsődleges célkitűzése volt, hogy a fiatal felnőttek körében megvizsgálják, milyen tényezők hatnak leginkább egy egészségügyi mobilapplikáció használati szándékára. Ennek megfelelően egy módosított UTAUT-modellel és a hozzá tartozó kérdőív segítségével mérték fel a kitöltők attitűdjét. A tanulmányból kiderül, hogy a leginkább befolyásoló tényező az egyén motivációja és az egyénre ható szociális ráhatás. A szerzők ezenfelül vizsgálták az egyes egészségügyi mobilapplikációk típusait, használatuk gyakoriságát, és az egyes típusok leggyakoribb feladásának okait. A tanulmány útmutatást adhat a 18 és 35 év közötti korosztály számára történő jövőbeli fejlesztéseknek, mivel a mobilapplikációk piacán ez a korcsoport az, amely a legtöbb applikációt használja. A munka emellett az egészségtudatosság egy szélesebb körű alkalmazására is rámutat. A szerzők továbbá lehetőségként vázolják fel, milyen módszerekkel érdemes attraktívabbá tenni az alkalmazásokat

Respiratory Physiotherapy Intervention Strategies in the Sequelae of Breast Cancer Treatment: A Systematic Review

Breast cancer treatments can trigger respiratory sequelae. Respiratory physiotherapy helps to eliminate or mitigate the sequelae by optimizing respiratory function. This systematic review aims to synthesize the scientific evidence and assess its quality regarding the use of respiratory physiotherapy in the sequelae of breast cancer. The Cochrane Library, Physiotherapy Evidence Database, PubMed, Web of Science, Scientific Electronic Library Online, Cumulative Index of Nursing and Allied Literature Complete, and Scopus were searched. Study quality was determined using the PEDro scale, STROBE Statement, and Single-Case Experimental Design Scale. Ten studies, six clinical trials, one case study, and three observational studies were selected. The mean methodological quality of the clinical trials was 5.6, that of the case study was 7, and that of the observational studies was 56%. Respiratory physiotherapy has been observed to improve respiratory capacity, lung function, respiratory muscle strength, effort tolerance, dyspnea, fatigue, thoracic mobility, upper limb volume, sleep quality and quality of life, as well as sensitivity to adverse physiological reactions, nausea, vomiting, and anxiety. However, it is not effective for vasomotor symptoms. More clinical trials are needed. These studies should homogenize the techniques used, as well as improve their methodological qualityThis research was funded by the Department of Nursing and Physiotherapy (University of Cadiz). Partial funding for open access charge: Universidad de Málaga

Efeitos do treinamento físico sobre desfechos físicos e psicológicos de mulheres em tratamento primário para o câncer de mama

O exercício físico tem sido reconhecido por combater diversos efeitos adversos relacionados ao tratamento do câncer de mama (CM). No entanto, evidências a respeito da dose-resposta ideal, assim como a melhor organização das variáveis do treinamento (i.e., intensidade, volume, frequência semanal, modalidade, entre outros), a viabilidade e tipo de atividade que deva ser prescrita para todos pacientes oncológicos visando atingir diferentes desfechos de interesse ainda não foram estabelecidas. Assim, a adoção de diferentes estratégias de treinamento (i.e., menor volume; e/ou supervisão telehealth) poderia contribuir de forma viável e eficaz para abrandar consequências físicas e psicológicas da doença em pacientes de CM. Desta forma, os objetivos dos dois ensaios clínicos randomizados que compõem este estudo foram: I) determinar os efeitos de dois programas de treinamento utilizando diferentes volumes de exercícios de força combinados com exercício aeróbio (i.e., treino concorrente), comparando-os aos de um grupo de controle (sem exercício), sobre desfechos físicos e psicológicos de pacientes diagnosticadas com CM recebendo tratamento quimioterápico; e II) determinar os efeitos de um programa de treinamento físico multicomponente (i.e. exercícios de força, aeróbico, equilíbrio e flexibilidade) associado a um programa de educação em saúde supervisionado de maneira remota, comparando-os aos de um programa somente de educação em saúde, sobre desfechos psicológicos e físicos de mulheres em tratamento primário para o CM. Em ambos os estudos, as participantes realizaram as intervenções duas vezes por semana durante 12 semanas. O primeiro estudo incluiu 28 mulheres, com idade ≥18 anos, diagnosticadas com CM entre os estágios I-III, iniciando quimioterapia adjuvante/neoadjuvante que foram randomizadas para um grupo de treinamento de força realizando séries múltiplas (i.e., 3 séries) mais treinamento aeróbio (SM; n = 9), ou treinamento de força utilizando séries simples (i.e., 1 série) mais treinamento aeróbio (SS; n = 9), ou um grupo controle (GC; n = 10), sem exercício. Os resultados para a fadiga total relacionada ao câncer mostraram que todos os grupos diminuíram significativamente do pré para o pósintervenção (SS: -22,7%; SM: -24,4%; GC: -4,9; p = 0,015), sem diferença entre os grupos (p = 0,491). Interessantemente, para esse desfecho, foi observado um tamanho de efeito (TE) moderado nos grupos SS e SM (d = -0,61 e -0,68, respectivamente), e, insignificante para o grupo GC. Em relação à fadiga neuromuscular, avaliada pelo índice de fadiga em dinamômetro isocinético, o grupo SM apresentou redução significativa após a intervenção (-31,4%; p = 0,045), enquanto o GC aumentou significativamente (+32,7%; p = 0,024). O grupo SS não apresentou modificações significativas desta variável (p = 0,093). Adicionalmente, foram encontrados prejuízos com TE moderado para o GC (d = 0,76), pequeno para o SS (d = 0,28), e benefícios de TE pequeno para o SM (d = -0,28) em relação a esta variável. A força máxima de extensão de joelhos (1-RM) não modificou após as 12 semanas de duração do estudo em todos os grupos (p = 0,326). Todavia, foi encontrado TE moderado para o grupo SS (d = 0,79), pequeno para o grupo SM (d = 0,30), enquanto um TE insignificante encontrou-se para o GC. O consumo de oxigênio de pico não modificou após as 12 semanas de intervenção nos 3 grupos (p = 0,230). A qualidade de vida (QoL) relacionada com o status de saúde global melhorou significativamente do período pré para o pós-intervenção em todos os grupos (SS: 25,6%; SM: 15,3%; GC: 5,1%; p = 0,005), sem diferença entre eles (p = 0,361). No entanto, foi identificado grande TE 6 para o SS (d = 1,02), moderado para o SM (d = 0,59) e insignificante para o GC nesta variável. Conclui-se então que o treinamento de força realizado com baixo volume, combinado com exercício aeróbio, apresenta-se como uma terapia complementar eficaz e suficiente para redução de efeitos adversos relacionados ao tratamento primário de CM. Em relação ao segundo estudo, 19 mulheres diagnosticadas com CM nos estágios I-III que estavam realizando tratamento primário foram randomizadas para realizar um programa de treinamento físico multicomponente telehealth mais educação em saúde (TMES; n=9), ou participar de um programa de educação em saúde isolado (ES; n=10). Os principais achados deste trabalho foram que ambos os grupos reduziram significativamente a fadiga relacionada ao câncer do período pré para o pós intervenção (TMES: -10%; ES: -32%; p = 0,001) sem diferença entre os grupos (p = 0,928). Ainda, melhoraram a QoL em diversas subescalas dos domínios de funcionalidade, de sintomas, e em sua extensão específica para pacientes com CM, contudo, maiores TE favoreceram o grupo TMES na maior parte das subescalas de QoL. Ainda, somente o grupo TMES apresentou benefícios na QoL para os desfechos de função física (TMES: +22%; ES: +4%; p = 0,044) e redução do sintoma de náusea e vômitos (TMES: -100%; ES: -72%%; p = 0,030). Não foi encontrada significância estatística para os desfechos de sintomas de ansiedade-traço (p = 0,505), ansiedade estado (p = 0,235), sintomas depressivos (p = 0,183), capacidade funcional (p = 0,842) e nível de atividade física (p = 0,686). Os resultados do presente estudo demonstram bons níveis de adesão e satisfação para esta população, independentemente do protocolo de intervenção realizado. Dessa forma, a utilização da tecnologia (i.e., chamada de vídeo) para dar suporte às intervenções demonstrou ser uma estratégia viável e eficaz no cuidado de pacientes oncológicos.Physical exercise has been recognized to counteract several adverse effects related to breast cancer (BC) treatment. However, evidence regarding the optimal dose-response and the best training variables organization (i.e., intensity, volume, frequency, and modality), the feasibility and type of activity that should be prescribed to all oncology patients aiming to reach different outcomes are not established in the literature. In this way, the adoption of different training strategies (i.e., lower volume and/or telehealth supervision) could contribute to mitigating the physical and psychological consequences of the disease in patients with BC. So, the aims of the two randomized clinical trials which compose this study were: I) to determine the effects of two training programs using different resistance training volumes combined with aerobic exercise (i.e., concurrent training), comparing them to a control group (without exercise), on physical and psychological outcomes in BC patients undertaken chemotherapy treatment; and II) to determine the effects of a multicomponent training program (i.e., resistance, aerobic, balance and flexibility exercises) associated to a health education program remotely supervised, in psychological and physical outcomes in women receiving primary treatment to BC. In both studies, the participants performed the interventions twice a week for 12 weeks. The first study included 28 women, with ≥18 years old, diagnosed with BC in I-III stage, initiating adjuvant/neoadjuvant chemotherapy that were randomized to a multiple set (i.e., 3 sets) resistance training group plus aerobic training (MS; n = 9), or a single set (i.e., 1 set) resistance training group plus aerobic training (SS; n = 9), or to a control group (CG; n = 10), without exercise. The cancer-related fatigue results showed that all group significantly reduced from pre to post-intervention (SS: -22.7%; SM: -24.4%; GC: -4.9; p = 0.015), without difference between groups (p = 0.491). Interestingly, to this outcome, a moderate effect size (ES) was observed in SS and MS groups (d = -0.61 e -0.68, respectively), and, insignificant to CG. Regarding the neuromuscular fatigue, evaluated by isokinetic dynamometer, the MS group presented significant reduction after the intervention (- 31.4%; p = 0.045), while the CG significantly increased (+32.7%; p = 0.024). The SS group did not present any significant change in this variable (p = 0.093). Additionally, impairments were found with moderate ES to CG (d = 0.76), small ES to SS (d = 0.28), and benefits of small ES to MS group (d = -0.28) in this variable. The maximal extension knee strength (1-RM) did not change after 12 weeks in all groups (p = 0.326). However, a moderate ES was found in SS group (d= 0.79), a small ES in MS group (d = 0.30), and an insignificant ES was found in CG. The peak oxygen consumption did not change after 12 weeks in the 3 groups (p = 0.230). The quality of life (QoL) concerning the health global status improved significantly after the intervention in all groups (SS: 25.6%; SM: 15.3%; GC: 5.1%; p = 0.005), without difference between them (p = 0.361). Nonetheless, a big ES to SS (d = 1.02) was identified, a moderate to MS (d = 0.59) and insignificant to CG in this variable. To conclude, the resistance training performed with low volume, combined with aerobic exercise, presents itself as an efficient and enough complementary therapy to reduce adverse effects related to the primary treatment of BC. Regarding the second study, 19 women with BC diagnosis between I-III stage undertaken primary treatment were randomized to a telehealth multicomponent training program plus health education (MTHE; n = 9), or to a health education program alone (HE; n=10). The main results were that both groups significantly reduced the cancer-related fatigue after the intervention period (TMES: - 10%; ES: -32%; p = 0.001), without difference between groups (p = 0,928). Moreover, improved several QoL subscales in the functionality and symptoms domains, and in the specific extension to BC patients, however, higher ES favored TMES in most QoL subscales. Furthermore, only the TMES group presented QoL benefits to physical function (TMES: +22%; ES: +4%; p = 0.044) and reduction in the nausea and vomiting symptoms (TMES: -100%; ES: -72%%; p = 0.030). Statistical significance was not found to trait-anxiety (p = 0.505), state-anxiety (p = 0.235), depressive symptoms (p = 0.183), functional capacity (p = 0.842) and physical activity level (p= 0.686). The results of the present study show high adherence and satisfaction levels to this population, regardless of the intervention protocol performed. Thus, the use of technology (i.e., videocall supervision) to support the intervention programs seems to be a viable and effective strategy in cancer care to reduce treatment adverse effects in BC patients

eHealth in Chronic Diseases

This book provides a review of the management of chronic diseases (evaluation and treatment) through eHealth. Studies that examine how eHealth can help to prevent, evaluate, or treat chronic diseases and their outcomes are included