68,907 research outputs found
Treating Depression with a Behavior Change Support System without Face-to-Face Therapy
In this paper, we present results from a randomized controlled trial (RCT) that examined the impact of persuasive reminders and virtual rehearsal on the effectiveness of a behavior-change support system (BCSS). We developed the Web-based BCSS to support people with mild to moderate depression without face-to-face therapy. We randomized eligible participants into two groups. Both groups rehearsed the target behavior virtually; however, only the first intervention group received email-based reminders. We applied a mixed-methods approach for the analysis. We collected data with semi-structured self-reported questionnaires and post-study interviews. Results indicate that the severity of depression was noticeably decreased and participants’ self-confidence to manage depressive thoughts was generally improved. The influence of persuasive reminders on task completion was less than we anticipated, while the participants felt that virtual rehearsal was an effective technique for learning new behaviors. We discuss possible reasons for the results at the end of the paper
A Review into eHealth Services and Therapies: Potential for Virtual Therapeutic Communities - Supporting People with Severe Personality Disorder
eHealth has expanded hugely over the last fifteen years and continues to
evolve, providing greater benefits for patients, health care professionals and
providers alike. The technologies that support these systems have become
increasingly more sophisticated and have progressed significantly from standard
databases, used for patient records, to highly advanced Virtual Reality (VR)
systems for the treatment of complex mental health illnesses. The scope of this
paper is to initially explore e-Health, particularly in relation to
technologies supporting the treatment and management of wellbeing in mental
health. It then provides a case study of how technology in e-Health can lend
itself to an application that could support and maintain the wellbeing of
people with a severe mental illness. The case study uses Borderline Personality
Disorder as an example, but could be applicable in many other areas, including
depression, anxiety, addiction and PTSD. This type of application demonstrates
how e-Health can empower the individuals using it but also potentially reducing
the impact upon health care providers and services.Comment: Book chapte
Persuasive system design does matter: a systematic review of adherence to web-based interventions
Background: Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence.
Objective: This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention.
Methods: We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence.
Results: We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p < .001), updates (p < .001), frequency of interaction with a counselor (p < .001), the system (p = .003) and peers (p = .017), duration (F = 6.068, p = .004), adherence (F = 4.833, p = .010) and the number of primary task support elements (F = 5.631, p = .005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence.
Conclusions: Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adher
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Usability and Feasibility Study of a Remote Cognitive Behavioral Therapy System with Long-Term Unemployed Women
We present the results of the use of a cognitive behavioral therapeutic intervention tool to improve the mental, physical, and social health of a group of long-term unemployed women in Spain. Method: We sent automated text messages (SMS) to the mobile phones of long-term unemployed women selected at random from public social services. During a 28-day intervention period, women received four daily automated text messages on her mobile phone on a predetermined hourly schedule. We measured depression symptoms at the start and end of the intervention and we analyzed qualitative data to determine the acceptability of a remote SMS program. Results: Depression symptoms using the Personal Health Questionnaire-9 (PHQ-9), went from an average of 13.8 at baseline to 4.9 at the end of 28 days (p = 0.89). One hundred percent of the women reported that they liked receiving the text messages and most found them helpful
Improving the Lives of Young Children: Meeting Parents' Health and Mental Health Needs Through Medicaid and CHIP So Children Can Thrive
Outlines options for two-generational service delivery to help address parental health issues, especially depression, and minimize developmental or behavioral problems in their children when the parents are ineligible for or not enrolled in Medicaid
Bariatric Surgery as a Treatment to Obesity
This paper focuses on the efficiency and effectiveness that bariatric surgery provides as a treatment for the obesity epidemic that is ever-growing in our country. By taking into account scientific, ethnographical, scholarly, statistic-based, and various other forms of research, this paper argues for the widespread use of bariatric surgery for weight loss, decrease in obesity, and resolution of obesity comorbidities. This paper also focuses on the various factors that affect patient success in bariatric surgery, such as gaps in access, economic problems, psychological issues associated with the procedure, and more. Nevertheless, bariatric surgery, if these factors are taken into consideration, is a favorable option in treating morbid obesity and should be readily and enthusiastically utilized to treat this epidemic
RESTRAINT TO SCHIZOPHRENIC FAMILY MEMBER AT HOME:FAMILY EXPERIENCE IN KENDAL DISTRICT CENTRAL JAVA
Background: Schizophrenic is functional psychological disorder with main disruption on thinking process and disharmony. Schizophrenic patients often suffer deprivation by their family.
Objective: This study aimed to identify in-depth description of family’s experience in restraint of schizophrenic patients treated at home in Kendal District Central Java.
Method: This research used descriptive phenomenological design and in-depth interview as data collection method. Participants involved in this study were family member of schizophrenic patients that are being restrained and selected by purposive sampling. Data that has been collected was in the form of recorded interviews and field notes and analyzed by Collaizi technique.
Results: Themes identified from this study are chronic sorrow; 2) effective social interaction; 3) enhanced spiritual well-being; 4) decisional conflict; 5) health seeking behaviours; and 6) economic burden.
Conclusion: The results showed similarities on family experience starting from chronic sorrow, effective social interaction; enhanced spiritual well-being; decisional conflict; health seeking behaviours; and economic burden. The care providers have to improve the family coping mechanism to be adaptive by a counseling of the problem.
Keywords: Schizophrenic, family, restrai
Application of Smartphone Technology in the Management and Treatment of Mental Illnesses
Abstract: Background: Mental illness continues to be a significant Public Health problem and the innovative use of technology to improve the treatment of mental illnesses holds great public health relevance. Over the past decade telecommunications technology has been used to increase access to and improve the quality of mental health care. There is current evidence that the use of landline and cellular telephones, computer-assisted therapy, and videoconferencing can be effective in improving treatment outcomes. Smartphones, as the newest development in communications technology, offer a new opportunity to improve mental health care through their versatile nature to perform a variety of functions. Methods: A critical literature review was performed to examine the potential of smartphones to increase access to mental health care, reduce barriers to care, and improve patient treatment outcomes. The review was performed by searching several electronic databases using a combination of keywords related to smartphones and mental health interventions using mobile devices. Literature concerning the use of cell phones, handheld computers, and smartphones to improve access to mental health care and improve treatment outcomes was identified.Results: The majority of studies identified were feasibility and pilot studies on patients with a variety of diagnosed mental illnesses using cell phones and PDAs. Authors report that most study participants, with some exceptions, were capable of using a mobile device and found them acceptable to use. Few studies extensively measured treatment outcomes and instead reported preliminary results and presented case illustrations. Studies which used smartphones successfully used them collect data on patients and deliver multimedia interventions. Discussion: The current literature offers encouraging evidence for the use of smartphones to improve mental health care but also reflects the lack of research conducted using smartphones. Studies which examine care provider use of smartphones to improve care is encouraging but has limited generalizability to mental health care. The feasibility of patient use of smartphones is also encouraging, but questions remain about feasibility in some sub-populations, particularly schizophrenia patients. Pilot testing of mobile devices and applications can greatly increase the feasibility of using smartphones in mental health care. Patients who are unfamiliar with smartphones will likely need initial training and support in their use. Conclusion: The literature identified several ways in which smartphones can increase access to care, reduce barriers, and improve treatment outcomes. Study results were encouraging but scientifically weak. Future studies are needed replicating results of studies using cell phones and PDAs on smartphones. Larger and higher quality studies are needed to examine the feasibility, efficacy, and cost-effectiveness of smartphones to deliver multiple component interventions that improve access to mental health care and improve treatment outcomes
A Virtual Conversational Agent for Teens with Autism: Experimental Results and Design Lessons
We present the design of an online social skills development interface for
teenagers with autism spectrum disorder (ASD). The interface is intended to
enable private conversation practice anywhere, anytime using a web-browser.
Users converse informally with a virtual agent, receiving feedback on nonverbal
cues in real-time, and summary feedback. The prototype was developed in
consultation with an expert UX designer, two psychologists, and a pediatrician.
Using the data from 47 individuals, feedback and dialogue generation were
automated using a hidden Markov model and a schema-driven dialogue manager
capable of handling multi-topic conversations. We conducted a study with nine
high-functioning ASD teenagers. Through a thematic analysis of post-experiment
interviews, identified several key design considerations, notably: 1) Users
should be fully briefed at the outset about the purpose and limitations of the
system, to avoid unrealistic expectations. 2) An interface should incorporate
positive acknowledgment of behavior change. 3) Realistic appearance of a
virtual agent and responsiveness are important in engaging users. 4)
Conversation personalization, for instance in prompting laconic users for more
input and reciprocal questions, would help the teenagers engage for longer
terms and increase the system's utility
The FDA “black box” warning on antidepressant suicide risk in young adults: More harm than benefits?
The decision made in the year 2004 by the U.S. Food and Drug Administration (FDA) to require a boxed warning on antidepressants regarding the risk of suicidality in young adults still represents a matter of controversy. The FDA warning was grounded on industry-sponsored trials carried one decade ago or earlier. However, within the past decade, an increasing number of reports have questioned the actual validity of the FDA warning, especially considering a decline in the prescription of the antidepressant drugs associated with an increase in the rate of suicidal events among people with severe depression. The present report provides an overview of the FDA black box warning, also documenting two Major Depressive Disorder patients whose refusal to undergo a pharmacological antidepressant treatment possibly led to an increased risk for suicidal behaviors. The concerns raised by the FDA black box warning need to be considered in real-world clinical practice, stating the associated clinical and public health implications
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