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Artykuły w czasopismach na temat "Ethnicity – Health aspects – Great Britain"
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Pearson, Geoffrey, i Kamlesh Patel. "Drugs, Deprivation, and Ethnicity: Outreach among Asian Drug Users in a Northern English City". Journal of Drug Issues 28, nr 1 (styczeń 1998): 199–224. http://dx.doi.org/10.1177/002204269802800112.
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One consistent theme within public debates on the problem of drug misuse is its association with minority ethnic groups (Pearson 1995b). It is, nevertheless, a peculiar feature of the British drug scene that members of black and other minority groups have been significantly underrepresented among known populations of problem drug users. This despite the fact that there has been clear evidence since the early 1980s of a concentration of the most serious drug-related problems in areas of high unemployment and social deprivation, and that ethnic minorities in Britain experience a high degree of social exclusion in terms of poverty, housing deprivation, educational disadvantage, and discrimination in the labor force (Jones 1996). It is entirely possible, of course, that drug users from Britain's black communities are more likely to remain unknown to service agencies—reflecting other aspects of disadvantage in access to health care (Awiah et al. 1992). In what continues to be a rapidly changing drug scene in Britain, this paper sets out to review this perplexing area of drugs, deprivation, and ethnic minority status, while also presenting evidence in Part II from an outreach project among Asian drug injectors in the city of Bradford in the north of England.
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Marques, Iuri, Sarah Caroline Willis, Ellen Ingrid Schafheutle i Karen Hassell. "Development of an instrument to measure organisational culture in community pharmacies in Great Britain". Journal of Health Organization and Management 32, nr 2 (9.04.2018): 176–89. http://dx.doi.org/10.1108/jhom-06-2017-0131.
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Purpose Organisational culture (OC) shapes individuals’ perceptions and experiences of work. However, no instrument capable of measuring specific aspects of OC in community pharmacy exists. The purpose of this paper is to report the development and validation of an instrument to measure OC in community pharmacy in Great Britain (GB), and conduct a preliminary analysis of data collected using it. Design/methodology/approach Instrument development comprised three stages: Stage I: 12 qualitative interviews and relevant literature informed instrument design; Stage II: 30 cognitive interviews assessed content validity; and Stage III: a cross-sectional survey mailed to 1,000 community pharmacists in GB, with factor analysis for instrument validation. Statistical analysis investigated how community pharmacists perceived OC in their place of work. Findings Factor analysis produced an instrument containing 60 items across five OC dimensions – business and work configuration, social relationships, personal and professional development, skills utilisation, and environment and structures. Internal reliability for the dimensions was high (0.84 to 0.95); item-total correlations were adequate (r=0.46 to r=0.76). Based on 209 responses, analysis suggests different OCs in community pharmacy, with some community pharmacists viewing the environment in which they worked as having a higher frequency of aspects related to patient contact and safety than others. Since these aspects are important for providing high healthcare standards, it is likely that differences in OC may be linked to different healthcare outcomes. Originality/value This newly developed and validated instrument to measure OC in community pharmacy can be used to benchmark existing OC across different pharmacies and design interventions for triggering change to improve outcomes for community pharmacists and patients.
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Jeder, Daniela. "Pedagogy of diversity in teacher training". Journal of Education, Society & Multiculturalism 3, nr 2 (1.12.2022): 236–43. http://dx.doi.org/10.2478/jesm-2022-0029.
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Abstract The present work outlines a series of arguments that support the need for awareness and involvement of teacher trainers in the development of competences for diversity from the stage of initial training. The work also proposes an analysis of knowledge, skills, attitudes of a cognitive, social, emotional nature, self-knowledge capacities, ethical values, etc. as structured ensembles that can be dynamically trained for the purpose of training and developing the competences for diversity of teachers. A sequential presentation of the Professional Standards for teachers from Romania, Great Britain, Australia and France from the perspective of diversity and inclusion offers some benchmarks for an educational practice that promotes equal opportunities for education and development of all children, regardless of differences in the socio-economic status, language, culture/personality, race/ethnicity, religion, abilities or disabilities, learning styles, aspects of personality etc. that differentiate them.
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Sarwar, Fareeha, i Abid Ghafoor Chaudhry. "Ethnicity, Ethnic Food and Diabetes Mellitus Type II". Global Anthropological Studies Review IV, nr II (30.12.2021): 42–51. http://dx.doi.org/10.31703/gasr.2021(iv-ii).05.
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The topic of discussion mainly belongs to the field of medical anthropology. Medical anthropology is linked to applied anthropology and involves the study of biological and cultural aspects of human beings for the explanation of the impact of culture on human health and as well as on diseases.The environment had a great impact on human health. There are many environmental factors that can bring changes in the health of a person like pollution as water pollution air pollution and some the lifestyle factors like physical activities due to the excessive use of TV or mobile phones etc. Descriptive methodology has been used for the collection of data including methods of an in-depth interview.it is concluded that bringing good or positive changes in lifestyle and having good and unpolluted environment can bring good changes in health and keep away a person from chronic diseases like diabetes type-II.
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Viziriakina, O. "The need to train competent specialists in the field of health care with experience in some aspects of international models". Health-saving technologies, rehabilitation and physical therapy 3, nr 1 (10.10.2022): 15–18. http://dx.doi.org/10.58962/hstrpt.2022.3.1.15-18.
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The article examines the experience of the health care system, in particular medical rehabilitation: Germany, the Netherlands, Great Britain, which work with the application of the international Classification of Functioning. The measures and principles of the organization of the rehabilitation process as medical care are presented, which indicates the need to use new forms and approaches in the professional education of relevant specialists.
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Price, David P. T. "Contemporary Transplantation Initiatives: Where's the Harm in Them?" Journal of Law, Medicine & Ethics 24, nr 2 (1996): 139–49. http://dx.doi.org/10.1111/j.1748-720x.1996.tb01846.x.
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Two contemporary strategies in cadaver organ transplantation, both with the potential to affect significantly expanding organ transplant waiting list sizes, have evolved: elective ventilation (EV) and use of nonheart-beating donors (NHBDs). Both are undergoing a period of critical review. It is not clear how widely EV is practiced around the world. In Great Britain, the Royal Devon and Exeter Hospital was the first hospital to develop an EV protocol (the Exeter Protocol), in 1988, after which other British hospitals followed suit. In the 1980s, new NHBD protocols of two distinct types were implemented worldwide, although both rely on death confirmed by traditional cardiopulmonary criteria. The first type involves the removal of organs immediately after death, the preeminent example being the University of Pittsburgh Medical Center Protocol (the Pittsburgh Protocol). The second involves the perfusion and cooling of kidneys immediately following death and subsequent organ removal. Protocols of this type have sprung up in Holland, Great Britain (for example, at Leicester General Hospital), Italy, France, Spain, Japan, and the United States (for example, the Regional Organ Bank of Illinois).
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Shah, A., N. Diggens, C. Stiller, S. Richards, M. C. G. Stevens i M. F. G. Murphy. "Recruitment of childhood leukaemia patients to clinical trials in Great Britain during 1980-2007: variation by birth weight, congenital malformation, socioeconomic status and ethnicity". Archives of Disease in Childhood 99, nr 5 (10.03.2014): 407–12. http://dx.doi.org/10.1136/archdischild-2012-303268.
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Weed, Matthew. "Discourse on Embryo Science and Human Cloning in the United States and Great Britain: 1984–2002". Journal of Law, Medicine & Ethics 33, nr 4 (2005): 802–10. http://dx.doi.org/10.1111/j.1748-720x.2005.tb00546.x.
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There is a stark difference between American and British policy on embryo science and research cloning. The following survey of the discourse offered both in support of and in opposition to research cloning and embryo science in the United States and Great Britain will show that the same arguments were made in both countries. The fact that similar ethical argumentation occurred in environments where different policy was set is an indicator that current frames for ethical discourse on embryonic stem cell research and human cloning do not effectively capture the debate in the form that politicians and possible consumers of services to be derived from embryo science face.The ethics surrounding embryo research and human cloning have been presented from virtually every possible viewpoint in all forms of medium. It is impossible to reprise every argument made on embryo science and research cloning; therefore, this survey will focus on some of the arguments made during the time leading up to the enactment of Great Britain's Human Fertilisation and Embryology Act of 1990 and the Human Fertilisation and Embryology regulations added to it in 2001.
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Leavey, Gerard, Michael King, Eleanor Cole, Amanda Hoar i Eric Johnson-Sabine. "First-onset psychotic illness: Patients'and relatives' satisfaction with services". British Journal of Psychiatry 170, nr 1 (styczeń 1997): 53–57. http://dx.doi.org/10.1192/bjp.170.1.53.
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BackgroundDespite the growth in patient satisfaction studies, scant attention has been paid to the satisfaction of patients with a first episode of psychotic illness soon after presentation to services. We were particularly interested in any ethnic differences in satisfaction at this seminal stage in patient care.MethodUsing multi-item questionnaire, face-to-face interviews were conducted with patients and relatives 12 months after first contact with psychiatric services. Relatives were also questioned on support and advice issues related to after-care.ResultsMost patients and relatives were generally satisfied with the treatment, and with the ‘humane’ qualities of psychiatric staff, but were less satisfied with the ‘hotel’ aspects of hospital care. Patients, and particularly relatives, were most concerned about levels of information and advice received. Relatives were dissatisfied with after-care. There were no significant differences between Black and other patients, but some differences between their relatives. Patients born abroad were significantly more satisfied than those born in Britain, irrespective of ethnicity. Compulsory detention under the Mental Health Act was also significant in determining low satisfaction for patients and especially for their relatives.ConclusionsFor improved care in the community patients and their relatives need to be seen as partners in care rather than as passive recipients. The issue of information-giving by psychiatric services demands serious attention. Black patients and their relatives were not especially likely to be dissatisfied.
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Paykel, E. S., Deborah Hart i R. G. Priest. "Changes in public attitudes to depression during the Defeat Depression Campaign". British Journal of Psychiatry 173, nr 6 (grudzień 1998): 519–22. http://dx.doi.org/10.1192/bjp.173.6.519.
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BackgroundAims of the Defeat Depression Campaign between 1991 and 1996 included the reduction of stigma associated with depression, education of the public about the disorder and its treatment and encouragement of earlier treatment-seeking. Newspaper and magazine articles, radio and television programmes and other media activities were employed.MethodSurveys of public attitudes were conducted by MORI in late 1991, early 1995 and mid-1997. Each covered approximately 2000 subjects, sampled to be representative of the population of Great Britain. Structured interviews covered views on depression, treatment and general practitioners (GPs).ResultsThere were significant positive changes regarding attitudes to depression, reported experience of it, attitudes to antidepressants, and less consistently, to treatment from GPs. Changes were of the order of 5–10%. Throughout, attitudes to depression and to treatment by counselling were very favourable, whereas antidepressants were regarded as addictive and less effective.ConclusionsPositive attitude change was achieved during the Campaign, although there is still room for improvement in some aspects.
Rozprawy doktorskie na temat "Ethnicity – Health aspects – Great Britain"
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Liu, Lixun. "Exploring ethnic inequalities in cardiovascular disease using Hospital Episode Statistics". Thesis, St Andrews, 2009. http://hdl.handle.net/10023/819.
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Diaz, Martinez Elisa. "Does social class explain health inequalities? : a study of Great Britain and Spain". Thesis, University of Oxford, 2004. http://ora.ox.ac.uk/objects/uuid:ca53a88e-0459-47d0-b13a-2525745d0d6a.
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The main research questions examined in this thesis concern the extent to which social class influence individuals' health, and how and whether individuals' occupation, education and lifestyles mediate between class and health. The conclusions drawn from the analysis of these empirical questions cast further light on the widening health inequalities seen in developed societies in recent decades. In particular, this research suggests that, employment conditions as well as educational levels are variables that need to be taken into account when planning policies aimed at tackling differences in health outcomes. Lifestyle variables, on the other hand, would appear to be almost irrelevant when explaining why the members of the more privileged social classes not only live longer than those in other classes, but also enjoy significantly better health over the course of their lives. In trying to understand the association between class and health, I define a theoretical framework that specifies the mechanisms through which class is linked to health. Social structure influences health by distributing certain factors such as material resources or some health-related behaviour that ultimately result in individuals having different living conditions. Educational attainment also affects the way these resources are employed and, therefore, lifestyles. A fundamental element of a social class is occupation: individuals' employment and working conditions also affect their health. Furthermore, the nature of a social structure has an effect on health at the aggregate level of analysis since social policies are partly the result of the structure of class interests. Four mechanisms are specified in order to systematically test this theoretical framework. Mechanisms (2) and (3), those that relate class and health through education and lifestyle lie at the heart of the empirical analysis. This analysis employs individual-level data drawn from health surveys carried out during the first half of the 1990s in the two countries selected for the analysis, United Kingdom and Spain. These countries are treated as contexts in which to test the theoretical explanation. The main results of the analysis reveal the importance of social class in determining health outcomes. Indeed, individuals from different classes enjoy distinct degrees of health. Specifically, individuals in the most privileged class categories have persistently better health than those in the other class categories. Differences exist in terms of both objective and subjective or self-perceived health. Moving on from observation to explanation, the analysis suggests that the distribution of certain resources across classes accounts for some of the variance in health outcomes. Hence, education is identified as a significant variable to comprehend part of the health inequalities in developed societies. Lifestyle, on the other hand, does not appear relevant in accounting for health outcomes. The small differences found between the United Kingdom and Spain in the mechanisms that link class and health suggest that the process through which class affects health is essentially similar in developed societies.
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Murphy, Richard. "Health professionals and ethnic Pakistanis in Britain : risk, thalassaemia and audit culture". Thesis, University of St Andrews, 2005. http://hdl.handle.net/10023/2802.
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The central theme or 'red-thread' that I consider in this thesis is the concept of risk as it is perceived by and affects the two sides of the medical encounter -in this instance ethnic Pakistanis and Health Professionals- in Britain. Each side very often perceives risk quite distinctively, relating to the balance between the spiritual and temporal realms. This is particularly germane in matters to do with possible congenital defects within the prenatal realm for the ethnic Pakistani, and predominantly Muslim, side of this encounter. Thus one of the factors considered in this thesis is how senses of Islam impact upon the two sides. By ethnic Pakistanis Islam is seen as central to all life decisions, whilst Health Professionals view Islam with some considerable trepidation, little understanding it or its centrality to the former's decision-making processes. This is particularly significant with regard to attitudes to health and health care. In the initial stages of the project I had thought first cousin marriage (FCM), seen by ethnic Pakistanis as desirable and by Health Professionals as putting ethnic Pakistanis at-risk to be central to the argument, but concluded that concerns around FCM were a 'red herring', merely a trope for the tensions between the two sides -at once both British and at-risk from audit culture. Although no longer central, FCM remains a viable touchstone in consideration of the two sides' perceptions of genetic risk. In this thesis the medical encounter between ethnic Pakistanis and Health Professionals is performed within the realm of the so called New Genetics. Here the respective understandings of the New Genetics are informed by the enculturation processes that shape the two sides' world view. Furthermore, I will agree with Lord Robert Winston's and others' concern that any attempt to eradicate an adaptive genetic mutation, in this instance, thalassaemia, from the gene pool is not only undesirable in the short term, but also that such eradications may have an adverse, and far reaching, effect on whole population groups in the future. The main thrust of my argument is that audit culture not only compounds risk for both sides, but also perpetuates institutional racism within the National Health Service (NHS), by promulgating what I have called the language myth. That is to say that much institutional racism is the unwanted by-product of the NHS's attempts to become more patient centred and its continuing efforts to develop systems of best practice. This professionalisation process within the NHS can be seen to impact most strongly in relation to communication -particularly the claimed language barrier between the two sides. This 'barrier' has worrying policy implications for any meaningful communication between the two sides, notably relating to obtaining informed consent from ethnic Pakistani patients -with a resultant increase in risk for the two sides and clear economic consequences for the NHS.
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Honey, Stephanie Ann. "Participation by proxy : how bilingual support workers aid the participation of minority ethnic users in the North West region of the National Health Service". Thesis, University of Manchester, 2001. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.673818.
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Wickramasinghe, Kremlin. "Quantifying the impact of policies addressing sustainable and healthy diets". Thesis, University of Oxford, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.711872.
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Mahoney, Lucy. "Investigating the interactions of travel behaviour and wellbeing : mixed-methods case study of Penarth and Cardiff, Wales". Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:10c62f3c-fb19-4381-89b4-b9bd4334629a.
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Transport systems are essential to trade, globalisation, communication and other forms of interaction between people and societies (Banister, 2013). Yet they can also have negative impacts including decreased quality of life or health impacts arising from pollutants, environmental damage including climate change and a range of wider socio-economic effects (Glanz et al., 1990). Given that most car journeys are short however (57% of UK trips are under five miles), there is particular potential for active travel (i.e. walking and cycling) to both reduce the environmental externalities of modern transport systems and stimulate improved quality of life and societal wellbeing (Banister, 2013; Martin et al., 2014). Unfortunately, there is a paucity of robust evidence that examines how infrastructural interventions (i.e. those aimed at making the physical environment more conducive to active travel) actually impact on active travel levels in specific communities. In addition, there is very limited evidence of the wider effects that such interventions have on wellbeing and levels of happiness overtime. This thesis details mixed-method research undertaken in Cardiff, UK, during 2011/2012, which examined the impacts of a new piece of infrastructure - the Pont-y-Werin walking and cycling bridge - on the local community's levels of active travel and subjective wellbeing. It provides insights into the nature of constraints preventing travel behaviour change from taking place, and - through the use of the novel, 'Day Reconstruction Method' - into the consequences that different modes of travel can have for travel and wellbeing, including on moment-to-moment moods and emotions. Overall by contextualising and measuring and evaluating wellbeing, the research suggests that people experience less pleasant emotions during travel than when undertaking everyday activities, and also that for certain modes there is a decrease in happiness before and after travel compared to everyday activities. Additionally greater monitoring, evaluation and promotion of combined hard and soft measures - focusing on travel behaviour change - is needed alongside providing travellers with accessible information on the wellbeing impacts of different modes (Elvik, 2009).
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McCulloch, Steven P. "The British animal health and welfare policy process : accounting for the interests of sentient species". Thesis, Royal Veterinary College (University of London), 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.701663.
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Ozgur, Polat Pelin. "Testing the effectiveness of gain- and loss-framed physical activity messages in relation to stress management : a cross-cultural study". Thesis, University of St Andrews, 2018. http://hdl.handle.net/10023/14270.
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The current PhD thesis aimed to cross-culturally investigate the effectiveness of gain- and loss-framed physical activity messages among the university students in Turkey and the UK. This study sought to test the impact of the physical activity messages focusing on stress-related effects on physical activity intentions, attitudes and behaviours of the target group. The messages were developed based on the findings of a series of preliminary studies targeting to determine the characteristics and needs of the target groups, and identify the barriers to engage in physical activity. Two quasi-experimental studies were conducted with 309 university students from the two countries (200 participants from Turkey and 109 participants from the UK) to test the effects of framed messages on intentions and attitudes towards physical activity, and physical activity behaviour change in two weeks after message exposure. Results showed that immediate effects of both gain- and loss-framed messages on physical activity intentions and attitudes were significant in Turkey and the UK. However, these effects could not be maintained in the two weeks following the message exposure. Moreover, the loss-framed message led to a message reactance in the UK, and physical activity intensity of the participants in the loss-framed group were significantly decreased compared to their baseline physical activity levels. The present study was the first message framing study comparing Turkey and the UK in terms of the impact of gain- and loss-framed framed physical activity messages. Therefore, this study contributes to the literature through providing evidence on the effects of message framing interventions which are developed and implemented in different cultures. Recommendations for future message framing research include measuring physical activity behaviour through objective methods, and examining the impact of the tailored messages through using different dissemination methods in larger samples.
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Lemar, Susan. "Control, compulsion and controversy: venereal diseases in Adelaide and Edinburgh 1910-1947". Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phl548.pdf.
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Includes bibliographical references (leaves 280-305). Argues that despite the liberal use of social control theory in the literature on the social history of venereal diseases, rationale discourses do not necessarily lead to government intervention. Comparative analysis reveals that culturally similar locations can experience similar impulses and constraints to the development of social policy under differing constitutional arrangements.
Książki na temat "Ethnicity – Health aspects – Great Britain"
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Berridge, Virginia. Health and society in Britain since 1939. Cambridge, UK: Cambridge University Press, 1999.
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Ahmad, W. I. U. 1957-, red. "Race" and health in contemporary Britain. Buckingham: Open University Press, 1993.
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Redwood, John. In sickness and in health: Managing change in the NHS. London: Centre for Policy Studies, 1988.
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Steve, Taylor, i Field David 1942-, red. Sociology of health and health care. Wyd. 3. Oxford: Blackwell, 2003.
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Richard, Lawson. Bills of health. Oxford: Radcliffe Medical Press, 1997.
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Steve, Taylor, i Field David 1942-, red. Sociology of health and health care. Wyd. 2. Oxford: Blackwell Science, 1997.
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Great Britain. Committee on the Medical Effects of Air Pollutants., red. Handbook on air pollution and health. London: Stationery Office, 1997.
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Great Britain. Ad-Hoc Group on the Economic Appraisal of the Health Effects of Air Pollution., red. Economic appraisal of the health effects of air pollution. London: Stationery Office, 1999.
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1942-, Field David, Hockey Jennifer Lorna i Small Neil, red. Death, gender, and ethnicity. London: Routledge, 1997.
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Steve, Taylor, i Field David 1942-, red. Sociology of health and health care: An introduction for nurses. Oxford: Blackwell Scientific Publications, 1993.
Znajdź pełny tekst źródłaCzęści książek na temat "Ethnicity – Health aspects – Great Britain"
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Goldstein, Avram. "Three Lessons from Abroad". W Addiction, 273–92. Oxford University PressNew York, NY, 2001. http://dx.doi.org/10.1093/oso/9780195146639.003.0018.
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Abstract Drug addiction is unbounded by geography, form of government, politics, ethnicity, economic status, or degree of formal education. In other words, it is a problem of the human condition. Three European nations—Great Britain, the Netherlands, and Switzerlandst—and out as having special ways of dealing with some aspects of drug addiction. In particular, their governmental policies are based solidly on public-health considerations—on pragmatic attempts to reduce harm wherever possible, without the moralistic crusading that has typified our own “war on drugs.” This chapter explores the similarities and differences between their approaches and our own, with a view to seeing what we can learn from them.
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Mazur, Dennis J. "Medical-legal aspects of evidence-based choice and shared decision-making". W Shared Decision-Making in Health Care, 165–70. Oxford University PressOxford, 2009. http://dx.doi.org/10.1093/oso/9780199546275.003.0023.
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Abstract Evidence-based patient choice and shared decision-making may begin to have medical – legal consequences as they enter into the patient care arena. These two emerging contemporary approaches to information in patient care will have to face the long history of the judge-made law of consent and informed consent that has evolved in the high courts around the world. In this chapter, I will describe the different ways shared decision-making may be viewed medico – legally, using particular examples available from the courts of Great Britain, the United States, Canada, and Australia in relation to the patient – physician relationship and the duties of care and disclosure owed by physicians to their patients.
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Ezquerro, Arturo, i María Cañete. "Genesis and Development of Group-Analytic Therapy in Great Britain: Bion, Bowlby, Foulkes, and the Relevance of Group Attachment". W The Theory and Practice of Group Therapy [Working Title]. IntechOpen, 2023. http://dx.doi.org/10.5772/intechopen.111826.
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A succinct account of the genesis and development of the Tavistock and group-analytic models of group psychotherapy focuses on their creators, Bion and Foulkes, and on how their life circumstances and their interpersonal and group attachment histories shaped their thinking and perception of the group and its therapeutic potential. The methodology combines historical investigation and literature review with psychodynamic and group-analytic formulations; it also provides an attachment-based, critical analysis of both approaches, their similarities and differences, and their mutual influence. Likewise, the chapter investigates the evolution of the concept of group attachment, formulated by Bowlby in 1969, which has been largely overlooked in the specialist literature until the last two decades, despite the fact that group lives, as well as interpersonal and group attachment, have played a fundamental role in our survival as a species and in our well-being and healthy development as a person. The present research is also informed by anthropological, psychosocial, organisational, and cultural aspects of human growth. It concludes that group attachment is highly relevant to group psychotherapy and that studying its nature and therapeutic implications should be an integral part of the training of psychotherapists and other mental health professionals, particularly those working with groups.
Streszczenia konferencji na temat "Ethnicity – Health aspects – Great Britain"
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Sjölinder, Marie, Olov Ståhl, Elisabeth Rydwik i Simon Torikka. "Design of an mHealth application for optimizing preoperative physical function". W 10th International Conference on Human Interaction and Emerging Technologies (IHIET 2023). AHFE International, 2023. http://dx.doi.org/10.54941/ahfe1004083.
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Limited physical reserve capacity in older people might be a risk factor for further functional decline and complications after surgery (Griffiths et al., 2014). A shift in cancer care in Sweden toward standardized and enhanced care processes, has led to that time between diagnosis and surgery has been shortened. Therefore, it has become important to focus on the effects of a short exercise program with high intensity and frequency. Recent qualitative studies have shown that patients with cancer need personalized support to perform preoperative exercises and that they prefer to do it at home or close to home (Beck et al., 2020). It is also important with a design that is tailored to the patient's needs, and goal setting, performance feedback, self-monitoring and reminders are all known facilitators for motivation and adherence to physical activity interventions (Michie et al., 2011).Development of the application: In a previous study, physiotherapists visited patients in their homes and supported them in conduction physical exercises during their preoperative phase. In the next step we developed a digital application consisting of, among other things, exercises, support and motivational features.The detailed features of the application were defined together with users during a co-creation process in workshops. Two workshops were conducted together with five patients. During the first workshop the participants discussed experiences from the previous intervention, factors they deemed relevant for adhering to the protocol and motivational aspects. During the second workshop the participants gave input on features and functionalities. One workshop was held together with five physiotherapists. In these workshops, experiences with the previous intervention, support needed for the patients and functionalities and interface for remote support were discussed. Further meetings and workshops were also conducted iteratively during the development phase.Content and interaction with the application: The specific aim of the application is to support the creation and tailoring of exercise programs with high intensity and frequency. The application consists of two parts, one used by the physiotherapists and one used by the patients. Physiotherapists are able to create individual exercise programs by selecting exercises from an exercise library, and then choosing settings for the exercises (e.g., numbers of sets and repetitions) based on a patient's needs and abilities. New types of exercises can be created by the physiotherapist and added to the library. The application allows the physiotherapist to monitor the patient's progress (based on data reported by the patient) and the exercise program can be adjusted if needed. The application also provides support for conveying a sense of presence and encouragement to the patient by allowing physiotherapist to write comments and to give the patient ”likes” on reported exercises, which will then be visible in the patient's part.The patient part of the application allows patients to see which exercises they are supposed to do each day, and to report to which extent the exercises have been completed. During reporting, the application will ask the patient to input data about how and when the exercise was performed (e.g., number of sets and reps, time of day, etc), and how the patient experienced the effort. All reported data are automatically gathered in a training diary section of the application, giving the patient access to the whole training history for later inspection. Any comments or likes sent by the physiotherapist also appears in the diary. The application includes different features for supporting and increasing the motivation to conduct the exercises. For example, rewards in the form of medals are given based on how well the patient follows the exercise program. Also, information about why this kind of training is important for improving the recovery after the surgery is provided in a theory section, to further strengthen the motivation to follow the exercise program. In the workshops patients had expressed the importance of this kind of information since it will be a reminder of how they can contribute to the best outcome as possible.ReferencesGriffiths R et al. Peri-operative care of the elderly 2014 Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2014;69:81-98. Beck A et al. Investigating the experiences, thoughts, and feelings underlying and influencing prehabilitation among cancer patients: a qualitative perspective on the what, when, where, who, and why. Disabil Rehabil. 2020 May 13:1-8.Michie S et al. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health 2011;26:1479-98.