2 research outputs found

    The Effectiveness of a Personalized Digital Health Intervention Plan (Naluri App) on Clinical and Psychological Outcomes Among Cardiac Patients at The National Heart Institute (IJN): A Randomized Controlled Trial

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    Background: Coronary Artery Disease (CAD) continues to be a significant burden in Malaysia that can lead to severe cardiac events and even death. Early interventions like cardiac rehabilitation programs can provide patients the necessary skills to recover from and prevent more cardiac events. EHealth interventions have great potential in complementing hospital based rehabilitation programs to improve the health of cardiac patients. Any behavior change interventions need to be guided by theories in order to obtain meaningful findings. This study aims to investigate the effectiveness of the Naluri app in improving clinical and psychological outcomes in a sample of cardiac patients in Malaysia.  Methods: A randomised controlled trial was conducted whereby patients in the treatment group (n=84) downloaded and used the Naluri app for four months after recruitment. The control group (n=91) received usual care that included lifestyle counselling. The Health Action Process Approach (HAPA) theory was used as the theoretical framework for the Naluri app and to investigate patients’ intention, planning and action in improving diet and physical activity. The clinical and psychological outcomes included BMI, HbA1c, lipid levels, anxiety, depression and health-related quality of life.  Results: The mixed methods analysis found that the Naluri app intervention was effective in increasing physical activity, specifically vigorous physical activity compared to the control group, F(1,173) = 8.47, p = .004, ηp2 = .047. The app was not effective in improving diet, clinical and psychological outcomes. The HAPA theory was a useful theoretical framework to explain patients' health behaviour change. Perceived facilitators and barriers to behaviour change include intra- and interpersonal factors. There was high acceptability of the app although attrition rate was high due to issues with instability and complexity of the app. Conclusion: The Naluri app can be a useful tool in improving physical activity among CAD patients. However, further improvements on the app are required to maximize patient engagement.</p

    "What I thought was so important isn't really that important": international perspectives on making meaning during the first wave of the COVID 19

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    Background: The global COVID-19 pandemic has had a significant impact on the physical and mental health of people everywhere. The aim of the study is to understand how people living in 15 countries around the globe experience an unexpected crisis which threatens their health and that of loved ones, and how they make meaning of this disruption in their narratives.Methods: Data were collected through an anonymous online survey during May-September 2020, which was during or just after the first wave of the COVID-19 pandemic, depending on the country. The questionnaire included demographic and three open-ended questions as prompts for stories about experiences during the initial months of the pandemic. The text was analyzed through inductive thematic content analysis and quantified for full sample description, demographic and subsequently international comparisons.Results: The final qualitative dataset included stories from n = 1685 respondents. The sample was 73.6% women and 26.4% men. The mean age of participants was 39.55 years (SD = 14.71). The identified four groups of overarching themes were: The presence and absence of others; Rediscovering oneself; The meaning of daily life; Rethinking societal and environmental values. We discuss the prevalence of each theme for the sample as a whole and differences by demographic groups. The most prevalent theme referred to disruptions in interpersonal contacts, made meaningful by the increased appreciation of the value of relationships, present in (45.6%) of stories. It was more prevalent in the stories of women compared to men (χ² = 24.88, p = .001).Conclusions: The paper provides a detailed overview of the methodology, the main themes identified inductively in the stories and differences according to select demographic variables. We identify several major ways of making meaning of the pandemic. The pandemic has impacted many aspects of people's lives which give it meaning, no matter where they live.</div
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