Special Issue on E-Health Services

[EN] The importance of e-health to citizens, patients, health providers, governments, and other stakeholders is rapidly increasing. E-health services have a range of advantages. For instance, e-health may improve access to services, reduce costs, and improve self-management. E-health may allow previously underserved populations to gain access to services. Services utilizing apps, social media, or online video are rapidly gaining ground in most countries. In this special issue, we present a range of up-to-date studies from around the world, providing important insights into central topics relating to e-health services.Wynn, R.; Gabarron, E.; Johnsen, JK.; Traver Salcedo, V. (2020). Special Issue on E-Health Services. International Journal of Environmental research and Public Health (Online). 17(8):1-6. https://doi.org/10.3390/ijerph17082885S16178Risling, T., Martinez, J., Young, J., & Thorp-Froslie, N. (2017). Evaluating Patient Empowerment in Association With eHealth Technology: Scoping Review. Journal of Medical Internet Research, 19(9), e329. doi:10.2196/jmir.7809Wynn, R., Oyeyemi, S. O., Budrionis, A., Marco-Ruiz, L., Yigzaw, K. Y., & Bellika, J. G. (2020). Electronic Health Use in a Representative Sample of 18,497 Respondents in Norway (The Seventh Tromsø Study - Part 1): Population-Based Questionnaire Study. JMIR Medical Informatics, 8(3), e13106. doi:10.2196/13106Pagliari, C., Sloan, D., Gregor, P., Sullivan, F., Detmer, D., Kahan, J. P., … MacGillivray, S. (2005). What Is eHealth (4): A Scoping Exercise to Map the Field. Journal of Medical Internet Research, 7(1), e9. doi:10.2196/jmir.7.1.e9Oyeyemi, S. O., & Wynn, R. (2014). Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case–control study of a Nigerian project. Reproductive Health, 11(1). doi:10.1186/1742-4755-11-8Oyeyemi, S. O., & Wynn, R. (2015). The use of cell phones and radio communication systems to reduce delays in getting help for pregnant women in low- and middle-income countries: a scoping review. Global Health Action, 8(1), 28887. doi:10.3402/gha.v8.28887Acharibasam, J. W., & Wynn, R. (2018). Telemental Health in Low- and Middle-Income Countries: A Systematic Review. International Journal of Telemedicine and Applications, 2018, 1-10. doi:10.1155/2018/9602821Kummervold, P. E., & Wynn, R. (2012). Health Information Accessed on the Internet: The Development in 5 European Countries. International Journal of Telemedicine and Applications, 2012, 1-3. doi:10.1155/2012/297416Andreassen, H. K., Bujnowska-Fedak, M. M., Chronaki, C. E., Dumitru, R. C., Pudule, I., Santana, S., … Wynn, R. (2007). European citizens’ use of E-health services: A study of seven countries. BMC Public Health, 7(1). doi:10.1186/1471-2458-7-53Gabarron, E., & Wynn, R. (2016). Use of social media for sexual health promotion: a scoping review. Global Health Action, 9(1), 32193. doi:10.3402/gha.v9.32193Gabarron, E., Luque, L. F., Schopf, T. R., Lau, A. Y. S., Armayones, M., Wynn, R., & Serrano, J. A. (2017). Impact of Facebook Ads for Sexual Health Promotion Via an Educational Web App. International Journal of E-Health and Medical Communications, 8(2), 18-32. doi:10.4018/ijehmc.2017040102Marco-Ruiz, L., Wynn, R., Oyeyemi, S. O., Budrionis, A., Yigzaw, K. Y., & Bellika, J. G. (2020). Impact of Illness on Electronic Health Use (The Seventh Tromsø Study - Part 2): Population-Based Questionnaire Study. Journal of Medical Internet Research, 22(3), e13116. doi:10.2196/13116Oyeyemi, S. O., Gabarron, E., & Wynn, R. (2014). Ebola, Twitter, and misinformation: a dangerous combination? BMJ, 349(oct14 5), g6178-g6178. doi:10.1136/bmj.g6178Gabarron, E., Serrano, J. A., Wynn, R., & Lau, A. Y. (2014). Tweet Content Related to Sexually Transmitted Diseases: No Joking Matter. Journal of Medical Internet Research, 16(10), e228. doi:10.2196/jmir.3259Wynn, R., Oyeyemi, S. O., Johnsen, J.-A. K., & Gabarron, E. (2017). Tweets are not always supportive of patients with mental disorders. International Journal of Integrated Care, 17(3), 149. doi:10.5334/ijic.3261Del Hoyo, J., Nos, P., Faubel, R., Bastida, G., Muñoz, D., Valero-Pérez, E., … Aguas, M. (2020). Adaptation of TECCU App Based on Patients´ Perceptions for the Telemonitoring of Inflammatory Bowel Disease: A Qualitative Study Using Focus Groups. International Journal of Environmental Research and Public Health, 17(6), 1871. doi:10.3390/ijerph17061871Li, Z., & Xu, X. (2020). Analysis of Network Structure and Doctor Behaviors in E-Health Communities from a Social-Capital Perspective. International Journal of Environmental Research and Public Health, 17(4), 1136. doi:10.3390/ijerph17041136Simonÿ, C., Riber, C., Bodtger, U., & Birkelund, R. (2019). Striving for Confidence and Satisfaction in Everyday Life with Chronic Obstructive Pulmonary Disease: Rationale and Content of the Tele-Rehabilitation Programme >C☺PD-Life>>. International Journal of Environmental Research and Public Health, 16(18), 3320. doi:10.3390/ijerph16183320López-Liria, R., López-Villegas, A., Enebakk, T., Thunhaug, H., Lappegård, K. T., & Catalán-Matamoros, D. (2019). Telemonitoring and Quality of Life in Patients after 12 Months Following a Pacemaker Implant: the Nordland Study, a Randomised Trial. International Journal of Environmental Research and Public Health, 16(11), 2001. doi:10.3390/ijerph16112001Tang, Y., Yang, Y.-T., & Shao, Y.-F. (2019). Acceptance of Online Medical Websites: An Empirical Study in China. International Journal of Environmental Research and Public Health, 16(6), 943. doi:10.3390/ijerph16060943A. Rahim, A., Ibrahim, M., A. Salim, F., & Ariffin, M. (2019). Health Information Engagement Factors in Malaysia: A Content Analysis of Facebook Use by the Ministry of Health in 2016 and 2017. International Journal of Environmental Research and Public Health, 16(4), 591. doi:10.3390/ijerph16040591Kolasa, K., & Kozinski, G. (2020). How to Value Digital Health Interventions? A Systematic Literature Review. International Journal of Environmental Research and Public Health, 17(6), 2119. doi:10.3390/ijerph17062119Almeida, A. F., Rocha, N. P., & Silva, A. G. (2020). Methodological Quality of Manuscripts Reporting on the Usability of Mobile Applications for Pain Assessment and Management: A Systematic Review. International Journal of Environmental Research and Public Health, 17(3), 785. doi:10.3390/ijerph17030785Reiners, F., Sturm, J., Bouw, L. J. W., & Wouters, E. J. M. (2019). Sociodemographic Factors Influencing the Use of eHealth in People with Chronic Diseases. International Journal of Environmental Research and Public Health, 16(4), 645. doi:10.3390/ijerph16040645Menon, A., Fatehi, F., Bird, D., Darssan, D., Karunanithi, M., Russell, A., & Gray, L. (2019). Rethinking Models of Outpatient Specialist Care in Type 2 Diabetes Using eHealth: Study Protocol for a Pilot Randomised Controlled Trial. International Journal of Environmental Research and Public Health, 16(6), 959. doi:10.3390/ijerph16060959Obstfelder, A., Engeseth, K. H., & Wynn, R. (2007). Characteristics of successfully implemented telemedical applications. Implementation Science, 2(1). doi:10.1186/1748-5908-2-25Littauer, H., Sexton, H., & Wynn, R. (2005). Qualities clients wish for in their therapists. Scandinavian Journal of Caring Sciences, 19(1), 28-31. doi:10.1111/j.1471-6712.2005.00315.xWynn, R., & Wynn, M. (2006). Empathy as an interactionally achieved phenomenon in psychotherapy. Journal of Pragmatics, 38(9), 1385-1397. doi:10.1016/j.pragma.2005.09.00

Physician Response Time When Communicating With Patients Over the Internet

Patients want to use electronic communication to access health services more easily. Health authorities in several countries see this as a way to improve health care. Physicians appear to have conflicting opinions regarding the suitability of electronic communication in clinical settings. The aim of our study was to measure how long it actually takes physicians to answer questions from patients through an electronic communication channel, and whether some of the questions are especially time consuming. We monitored electronic patient–physician communication. A total of 1113 messages from 14 participating physicians from 7 medical offices were analyzed. The length of questions and answers, and the time physicians spent answering the questions were recorded and analyzed. Results: Physicians spent an average of 2.3 minutes (median 2 minutes) answering questions from patients. The patients’ questions had an average length of 507.1 characters (95% CI 487.4–526.9, SD 336.2), while physicians’ answers averaged 119.9 characters (95% CI 189.8–210.0, SD 172.6). The results show that the influence of patient question length on time spent responding was negligible. For the shortest 25% of the questions the answer time was 2.1 minutes (95% CI 1.9–2.3), while it was 2.4 minutes (95% CI 2.2–2.7) for the longest 25%. Even extremely long questions had a minimal impact on the time spent answering them. A threefold increase in question length from patients resulted in only an 18% increase in physician response time. The study shows the potential clinical usefulness of electronic communication between patients and health care services by demonstrating the potential for saving time

Is Dental Anxiety Associated with Oral Health-Related Quality of Life? Assessment of Statistical Significance and Clinical Meaningfulness in a Sample of Russian Medical and Dental Students

Information about oral health-related quality of life (OHRQoL) and dental anxiety (DA) in Russian young adults is scarce. We investigated how DA is associated with OHRQoL in a group of medical and dental students in North-West Russia. The study had a cross-sectional design and included 807 students aged 18–25 years who attended the Northern State Medical University in Arkhangelsk. OHRQoL and DA were measured by the Oral Health Impact Profile (OHIP-14) and Corah’s Dental Anxiety Scale (DAS), respectively. A questionnaire collected information on socio-demographics and self-reported oral health (OH) characteristics. A dental examination was executed to assess dental caries and oral hygiene. We observed differences in the OHIP-14 scores between dentally anxious and non-anxious students: unadjusted incidence rate ratio [IRR] = 1.65, 95% confidence interval [CI]: 1.29–2.12; after adjustment for socio-demographics and clinically assessed OH: IRR = 1.58, 95% CI: 1.23–2.02; after adjustment for socio-demographics, clinically assessed OH, and self-reported OH characteristics: IRR = 1.27, 95% CI: 0.99–1.63. The differences between estimated marginal means for the DAS categories in the models were 2.92, 2.51, and 1.24, respectively. Minimal clinically important differences of OHIP-14 fell between 1.68 and 2.51. We found a negative statistical association between DA and OHRQoL in our study sample, but after adjustment for potential confounders, the association lost its clinical importance

Dental anxiety and potentially traumatic events: a cross-sectional study based on the Tromsø Study—Tromsø 7

Objective The objectives of the study were to describe the prevalence of dental anxiety and the possible associations between dental anxiety and potentially traumatic events in an adult population. Method The study is based on cross-sectional questionnaire data from the 7th wave of the Tromsø Study, a study of the adult general population in the municipality of Tromsø carried out in 2015–2016. The Modified Dental Anxiety Scale was used to measure dental anxiety across potentially traumatic events, oral health, dental attendance (avoidance) and current mental health symptoms (Hopkins Symptom Checklist). Individuals with high and low dental anxiety scores were compared to investigate differences in the distribution of potentially traumatic events, current mental health symptoms, avoidance, sex and oral health, and hierarchical multivariable regression was used to study the influence of traumatic events on dental anxiety. Results High dental anxiety was reported by 2.9% of the sample and was most prevalent among females and in the youngest age groups. Individuals with high dental anxiety reported more current mental health symptoms, and they were more likely to report poorer oral health and more irregular dental visits compared to individuals with no or lower dental anxiety scores. Concerning traumatic events, the reporting of painful or frightening dental treatment showed the biggest difference between those with high dental anxiety and low dental anxiety scores (a moderate effect). The hierarchical regression model indicated that reporting sexual abuse, traumatic medical treatment in hospital and childhood neglect significantly predicted dental anxiety in the step they were entered in, but only sexual abuse remained a significant individual contributor after controlling for current mental health symptoms. Conclusions The prevalence of high dental anxiety was lower than expected (2.9%), but dentally anxious individuals expressed a high burden of mental health symptoms, poor oral health and the avoidance of dental care. The regression analysis indicated that experiences with sexual abuse could affect dental anxiety levels in the absence of generalised symptoms of anxiety and depression