SEMPER: A Web-Based Support System for Patient Self-Management

The paper discusses an eHealth project which is currently developing an interactive web-based platform that assists patients to self-manage work-related disorders and alcoholism. The focus is on motivating long-term behaviour change. This is supported by an online assessment component based on the technique of motivational interviewing and a feedback component which visualizes actual behaviour in relation to intended behaviour. Disease-specific information is provided through an information portal that utilizes lightweight ontologies (associative networks) in combination with text mining. Emotional support is provided via virtual communities. The paper discusses the design rationales underlying the approach taken and outlines some implementational aspects. The paper also briefly outlines how the effectiveness of the self-management tool will be measured based on an outcome model particularly suited for health promotion

Physiological measures as indices of moods during human-computer interaction

Emotions are an important factor in human-computer interaction. One of the challenges in building emotionally intelligent systems is the automatic recognition of affective states. We are developing and evaluating a method for measuring user affect that incorporates psychological, behavioral, and physiological measures. During affective stimulation, breathing parameters, skin conductance level (SCL) and corrugator EMG activity correlate with self-reported levels of valence and arousal. Valence, at the level of subjective experience, summarizes how well one is doing, whereas arousal refers to a sense of energy. A stimulus activates appetitive or defensive motivation (the valence dimension) with some degree of energy mobilization (the arousal dimension). In the laboratory, moods are induced using different procedures. Only few studies have investigated the critical question of how long induced moods actually last. Further, knowledge concerning the persistence of physiological responding, when the stimuli are withdrawn, remains spare. The goals of this study were first, to assess the somato-physiological activity during affective stimulation (film clip viewing) and its relation to valence and arousal, and second, to determine if the response patterns persist, dissipate or otherwise change when the stimuli are withdrawn and the subjects perform a computer task. Seventy-six participants viewed a neutral film clip (an educational program) and completed immediately afterward the task (control condition). Then, they viewed either a positive high-arousal clip (sport scenes), a positive low-arousal clip (takes from landscapes), a negative high-arousal clip (scene depicting captives forced to play Russian roulette) or a negative low-arousal clip (a documentary about a slum in Belgium) and completed the task a second time (experimental condition). The task required participants to shop on an e-commerce website for office supplies. After each clip and each task, the participants rated their current mood. We tested valence and arousal effects during the last 90 s of the films, the first and last 90 s of the task of the experimental condition. Viewing of the selected film clips resulted in increasing defensive and appetitive activation in the expected ways both subjectively and physiologically. Corrugator EMG activity was higher at the end of the negative clips than the positive clips, and minute ventilation and SCL were higher for the arousing clips than for the less arousing clips. After the approximately 9-minute task, people who viewed the negative clips still reported more negative valence than those who viewed the positive clips. On the contrary, there were no differences in the arousal ratings. The valence effect in the mood state was paralleled by valence effects in the somato-physiological measures during the task. Increased facial frowning at the end of the negative clips was maintained during the task indicating persistence of defensive activation. SCL was lower for the negative film groups, especially at the end of the task, suggesting that sympathetic activation was lowered in subjects in the negative mood as compared with subjects in the positive mood. The findings of this study have several implications. First, they enrich our knowledge concerning the relationships between subjective feelings and their physiological correlates. Second, they inform us about the effectiveness of film clips as a mood induction instrument. Third, they suggest that induced changes in arousal are quickly overridden by the degree of activation "imposed" by the cognitive task, whereas induced changes in valence are more resistant and thus likely to impact the execution of the task. Finally, they show which physiological measures may be useful in tracking mood states during human-computer interaction (i.e., corrugator EMG activity and SCL). Feedback from these parameters could be used by computers to recognize mood states in the user

Talking about dying and death: Essentials of communicating about approaching death from the perspective of major stakeholders.

OBJECTIVES Although caring for dying patients and their family caregivers (FC) is integral to patient care, training in communication about approaching death is almost inexistent in medical and nursing curricula. Consequently, many health professionals have insufficient knowledge about conducting these conversations. In order to gain a broader insight into essential aspects of this communication from different perspectives, we conducted focus groups with key stakeholders. METHODS Medical specialists, nurses, medical students, bereaved FC and patient representatives participated in five focus groups (n = 30). Following a focus group schedule, we elicited relevant aspects of communication about approaching death, associated emotions, and appropriate communication frameworks. We analyzed data thematically. RESULTS Four main themes were central to conversations about approaching death: (1) embracing care within medical expertise, (2) preparing the conversation while remaining open to the unexpected, (3) recognizing and reflecting on own emotions and reactions, and (4) establishing a meaningful connection with others. SIGNIFICANCE OF RESULTS Communicating about approaching death with dying patients and their FC can be complex and challenging at a professional and personal level. With the recognition of the dying phase, a process is initiated for which health professionals need solid clinical knowledge about but also effective communication skills, constant self-reflection and self-care strategies. Comprehensive training and supervision while dealing with the challenges of communicating approaching death to dying patients and their FC are key, particularly for trainees, less experienced physicians and nurses. The essential components identified in this study can help health professionals to master these conversations

Gezielt auf Nutzen in der täglichen Pflegepraxis ausrichten

Die kontinuierliche Fort-und Weiterbildung der Pflegenden ist unabdingbar für eine sichere Patient:innenversorgung. Gemäss einer qualitativen Studie braucht es in den Betrieben ein förderndes Klima für berufliche Fort- und Weiterbildungen und sie sollten sich positiv auf die Karriere auswirken. Prüfenswert ist auch die Frage, ob sie obligatorisch sein müssten, analog zur Fort- und weiterbildungspflicht der Ärzt:innen

Valence lasts longer than arousal : persistence of induced moods as assessed by psychophysiological measures

How long induced moods last is a critical question for mood research but has been only poorly addressed. In particular, physiological parameters have been rarely included to assess the effectiveness of mood induction procedures. We investigated the persistence of four different moods (positive high-arousal, positive low-arousal, negative high-arousal and negative low-arousal) induced by film clips during a computer task. We measured subjective affective state, respiration, skin conductance level (SCL), heart rate, and corrugator activity. People who watched the two negative clips reported more negative valence after the task and showed more facial frowning and lower SCL during the task than the people who watched the two positive clips. No arousal effects persisted throughout the task. The results suggest that induced changes in the valence dimension of moods are maintained throughout an intervening task and are physiologically best reflected by corrugator activity and SCL, whereas induced changes in the arousal dimension dissipate quickly. The implications of these findings for mood research are discussed. [Authors]]]> Mood Disorders ; Arousal eng oai:serval.unil.ch:BIB_41F26993B0C0 2022-02-19T02:20:02Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_41F26993B0C0 L'abord de la spiritualité dans les soins aux patients atteints d'un cancer Attitude des médecins oncologues de Suisse romande MATHEY-DORET, M.-E. Université de Lausanne, Faculté de biologie et médecine info:eu-repo/semantics/masterThesis masterthesis 2015 <![CDATA[Objectifs: Cette étude explore les représentations des médecins oncologues suisses romands à l'égard de la spiritualité, la place qu'ils lui donnent dans les soins aux patients, les barrières rencontrées à son intégration et leur intérêt à l'égard d'une formation sur cette thématique. Elle émet l'hypothèse qu'une définition non exhaustive de la spiritualité et que des facteurs environnementaux, personnels, professionnels et éthiques sont des barrières à son abord dans la pratique clinique. Méthode: Sur la base d'une revue de la littérature, une enquête par questionnaire a été adressée anonymement en 2014, par voie postale, aux 119 médecins oncologues suisses romands avec un rappel un mois plus tard. Résultats: Le taux de réponse est de 60%. Parmi les répondants, 97% considèrent que spiritualité et religion représentent deux concepts différents, parmi lesquels plus de la moitié considèrent que la spiritualité englobe la religion. 69% pensent que leurs patients désirent aborder cette thématique en consultation et 83% estiment qu'il est important de l'aborder. Ils sont 91% à estimer que l'abord de la spiritualité pourrait faciliter les discussions relatives à la fin de vie. Plus ils ont abordé cette thématique en la jugeant utile, plus ils la considèrent comme importante (p : 0.001). Les principaux obstacles identifiés par 80% d'entre eux sont le manque de formation et de disponibilité et 80% considèrent d'autres professionnels de santé comme plus compétents. Les obstacles personnels et éthiques sont moins relevants. En effet, 65% déclarent n'éprouver aucune difficulté à discuter de spiritualité avec leurs patients et 85% ne pas craindre les questions susceptibles d'en résulter. Ils sont 94% respectivement 96% à penser que de tels échanges ne brouillent pas leur image de médecin auprès de leurs patients ni de leurs collègues. 97% pensent qu'en parler n'est pas contraire à l'éthique et 53% n'identifient pas de limites éthiques. Enfin, 78% sont ouverts à une formation. Les oncologues du secteur public sont significativement plus intéressés par une telle offre (p : 0.01). Conclusion La majorité des oncologues romands ont une représentation de la spiritualité qui dépasse le concept de la religion, estiment que cette thématique est importante dans leur communication avec les patients et que son abord ne pose pas de difficultés personnelles ni éthiques majeures. Hormis leur disponibilité insuffisante, ils se disent insuffisamment formés et sont majoritairement intéressés par une offre de formation

In pursuit of desktop evolution: User problems and practices with modern desktop systems

This study deals with the problems users encounter in their daily work with computers and the typical practices that they employ. Sixteen daily computer users were interviewed about their habits and problems that they encountered during document classification and retrieval. For both these areas, we provide an overview of identified user practices and a citation-based analysis of the problems users encountered, including those related to the use of the screen real estate (the actual desktop). Two types of problems were identified: (1) Problems that concern the actual use of the system installed on the computer. (2) Problems that arise when people realise that they are using a system that does not allow for the desired work or organizational functions sought. We were able to show that skill continues to be an important factor with respect to the ease of using today’s systems. We suggest the following necessary improvements for the evolution of personal information systems: A storage facility that represents the user’s view of information; replacing pure technical file metadata with more user-friendly attributes; and introduction of annotations as a new information type

METADATA IN E-LEARNING SYSTEMS: FOCUS ON ITS VALUE FOR THE USER

It is widely agreed upon that ‘good ’ metadata are a key factor for efficient use of e-learning systems. Generally, two fundamentally different types of metadata exist: Metadata generated by the system when content is created or added, and metadata generated by humans for humans. The latter takes one of two forms: (I) A number of fields in a form that have to be filled in by the creator of a piece of learning content; and (II) A list of pre-defined, standardised descriptors from which the applying ones have to be selected (ontology). Either approach aims at overcoming potentially differing valuations of metadata descriptors due to individual interpretations. Both approaches heavily depend on the e-learning application’s underlying knowledge domain, and are often driven by the requirements imposed by the services defined for the data repository in use. E-learning systems per definition incorporate at least two roles: the teacher’s and the student’s. The teacher produces and codifies, students and other teachers search and retrieve learning content. Each of these tasks relies eventually on a set of metadata descriptors. As a consequence, a considerable number of efforts have been undertaken in order to improve metadata applications for elearning systems. Unfortunately however, most of these efforts have been directed towards more automated systems, that devalue the teacher and student by assigning them merely the roles of information source and sink. We think that it has been overseen, that it is eventually the teachers and their students that need to work with and hence access resources within an e-learning system. The crucial question is: What are the relevant metadata descriptors in order to suitably support the users ’- the teacher’s an