BackgroundUse of mobile technology has made a huge impact on communication, access, and information/resource delivery to adolescents. Mobile technology is frequently used by adolescents.ObjectiveThe purpose of this study was to understand the health information needs of adolescents in the context of their everyday lives and to assess how they meet their information needs.MethodsWe gave 60 adolescents smartphones with unlimited text messaging and data for 30 days. Each smartphone had applications related to asthma, obesity, human immunodeficiency virus, and diet preinstalled on the phone. We sent text messages 3 times per week and asked the following questions: (1) What questions did you have about your health today? (2) Where did you look for an answer (mobile device, mobile application, online, friend, book, or parent)? (3) Was your question answered and how? (4) Anything else?ResultsOur participants ranged from 13-18 years of age, 37 (62%) participants were male and 22 (37%) were female. Of the 60 participants, 71% (42/60) participants identified themselves as Hispanic and 77% (46/60) were frequent users of mobile devices. We had a 90% (1935/2150) response rate to our text messages. Participants sent a total of 1935 text messages in response to the ecological momentary assessment questions. Adolescents sent a total of 421 text messages related to a health information needs, and 516 text messages related to the source of information to the answers of their questions, which were related to parents, friends, online, mobile apps, teachers, or coaches.ConclusionsText messaging technology is a useful tool for assessing adolescents’ health behavior in real-time. Adolescents are willing to use text messaging to report their health information. Findings from this study contribute to the evidence base on addressing the health information needs of adolescents. In particular, attention should be paid to issues related to diet and exercise. These findings may be the harbinger for future obesity prevention programs for adolescents.
Background Mobile health (mHealth) is a growing field aimed at developing mobile information and communication technologies for healthcare. Adolescents are known for their ubiquitous use of mobile technologies in everyday life. However, the use of mHealth tools among adolescents is not well described. Objective We examined the usability of four commonly used mobile devices (an iPhone, an Android with touchscreen keyboard, an Android with built-in keyboard, and an iPad) for accessing healthcare information among a group of urban-dwelling adolescents. Methods Guided by the FITT (Fit between Individuals, Task, and Technology) framework, a think-aloud protocol was combined with a questionnaire to describe usability on three dimensions: 1) task-technology fit; 2) individual-technology fit; and 3) individual-task fit. Results For task-technology fit, we compared the efficiency, and effectiveness of each of the devices tested and found that the iPhone was the most usable had the fewest errors and prompts and had the . lowest mean overall task time For individual-task fit, we compared efficiency and learnability measures by website tasks and found no statistically significant effect on tasks steps, task time and number of errors. Following our comparison of success rates by website tasks, we compared the difference between two mobile applications which were used for diet tracking and found statistically significant effect on tasks steps, task time and number of errors. For individual-technology fit, interface quality was significantly different across devices indicating that this is an important factor to be considered in developing future mobile devices. Conclusions All of our users were able to complete all of the tasks, however the time needed to complete the tasks was significantly different by mobile device and mHealth application. Future design of mobile technology and mHealth applications should place particular importance on interface quality.
Objectives Patient-generated health data (PGHD) are clinically relevant data captured by patients outside of the traditional care setting. Clinical use of PGHD has emerged as an essential issue. This study explored the evidence to determine the extent of and describe the characteristics of PGHD integration into electronic health records (EHRs). Methods In August 2019, we conducted a systematic scoping review. We included studies with complete, partial, or in-progress PGHD and EHR integration within a clinical setting. The retrieved articles were screened for eligibility by 2 researchers, and data from eligible articles were abstracted, coded, and analyzed. Results A total of 19 studies met inclusion criteria after screening 9463 abstracts. Most of the study designs were pilots and all were published between 2013 and 2019. Types of PGHD were biometric and patient activity (57.9%), questionnaires and surveys (36.8%), and health history (5.3%). Diabetes was the most common patient condition (42.1%) for PGHD collection. Active integration (57.9%) was slightly more common than passive integration (31.6%). We categorized emergent themes into the 3 steps of PGHD flow. Themes emerged concerning resource requirements, data delivery to the EHR, and preferences for review. Discussion PGHD integration into EHRs appears to be at an early stage. PGHD have the potential to close health care gaps and support personalized medicine. Efforts are needed to understand how to optimize PGHD integration into EHRs considering resources, standards for EHR delivery, and clinical workflows.
AKI is a recognized complication of coronavirus disease 2019 (COVID-19) (1). In this study, we characterized the AKI incidence and outcomes in patients with COVID-19 and AKI. We conducted a retrospective cohort study of 1002 patients admitted from March 1 to April 19, 2020 through the Emergency Department at NewYork-Presbyterian/ Weill Cornell Medical Center. Patient follow-up was until at least June 20, 2020, at which time 22 patients were still hospitalized and nine were transferred to another hospital facility. Baseline creatinine was defined as the closest creatinine prior to March 1, 2020 or, if none was available, the creatinine at time of hospital presentation. The Weill Cornell Institutional Review Board approved this study. AKI, defined by the Kidney Disease Improving Global Outcomes criteria (2), occurred in 294 (29%) of the 1002 patients: stage 1 AKI (n5182, 18%); stage 2 AKI (n529, 3%); and stage 3 AKI (n583, 8%). KRT was performed in 59 patients (6%); 53 received hemodialysis and/or continuous venovenous hemodialysis, five received a combination of acute peritoneal dialysis and hemodialysis/continuous venovenous hemodialysis, and one received acute peritoneal dialysis. The time from hospitalization to AKI was a median of 2.2 days in stage 1 AKI, 2.4 days in stage 2 AKI, and 1.6 days in stage 3 AKI. We evaluated the urine electrolytes and microscopy associated with the AKI event within 3 days. Among those available, the fractional excretion of sodium (FENa) was ,1% in 76%, and urine microscopy had granular casts in 21%. The presumed etiology of stage 3 AKI on the basis of manual chart review was acute tubular necrosis (ATN) in 28%, prerenal in 13%, prerenal/ATN in 11%, other causes in 4%, and unknown in 45% of patients. Granular casts were observed more frequently in stage 3 AKI than stage 1 AKI and stage 2 AKI (33% versus 16%, P50.006). We compared clinical characteristics of the patients with AKI with those without AKI (Table 1). Patients who developed AKI were older and more frequently had a history of hypertension, diabetes mellitus, congestive heart failure, CKD, and kidney transplantation than patients without AKI (P,0.001). Proteinuria and hematuria were
:Nurses have a vital role in addressing social and health inequities to promote quality healthcare for all. This article discusses the tools to screen for social determinants of health (SDOH) and key considerations for nurses and nurse leaders to advance the integration of SDOH information into their workflows.
Chronic pain is a significant health issue that affects approximately 50 million adults in the United States. Traditional interventions are not always an effective treatment strategy for pain control. However, the wide adoption of smartphones and the rapid growth of health information technologies over the past decade have created opportunities to use mobile health (mHealth) applications (apps) for pain tracking and self-management. In this PRISMA-compliant systematic review, we assessed the current U.S.-based research on pain-related mHealth apps to describe the app components and determine the efficacy of these interventions for persons with acute or chronic pain. We conducted a comprehensive search of five databases based on methodological guidelines from the Joanna Briggs Institute. We included articles reporting original data on mHealth interventions with pain intensity as a primary or secondary outcome and excluded articles that utilized multimodal interventions. Of the original 4959 articles, only five studies met the eligibility criteria. Most of the interventions included feasibility or pilot studies, and all studies were published between 2015 and 2018. Two of the five studies used visual analog scales. Only two of the studies reported statistically significant pain intensity outcomes, and considerable heterogeneity between the studies limited our ability to generalize findings or conduct a meta-analysis. Research investigating the components and efficacy of pain-related mHealth apps as interventions is an emerging field. To better understand the potential clinical benefits of mHealth apps designed to manage pain, further research is needed.
Nurses' role in patient care has evolved and so has their role in the use of technology to improve health care delivery. Nursing informatics research seeks to study the science of nursing, computer technology, and information science to enhance the quality of nursing practice. In an effort to increase patient safety and reduce health care-associated costs, nursing administrators have been challenged to incorporate technology and nursing practice. Unfortunately, health care institutions may not benefit from this body of work, as nursing informatics research associated with increased patient safety and cost containment may not be readily accessible for nursing administrators. The purpose of this study was to present the findings of a nursing informatics literature review and highlight those publications seen as most influential in the last year. In addition, we seek identify common topics and emerging themes in nursing informatics published research.
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