老年冠心病居家护理服务mHealth管理程序的构建及应用:一项随机对照研究

在过去二十余年,冠状动脉粥样硬化性心脏病(简称“冠心病”)是威胁我国居民健康的主要慢性疾病,给家庭及社会造成了沉重的负担。冠心病作为与生活方式高度相关的终身性疾病[1],长期有效地健康管理在疾病预防及控制中起到重要作用。

置入PICC并带管出院癌症患者基于mHealth技术延续护理的效果观察

目的 探讨基于mHealth技术的延续护理在置入PICC癌症患者中的应用效果。方法 采取便利抽样法,2020年2月—2021年3月选取山西省某三级甲等医院置入PICC并带管出院的癌症患者110例为研究对象,按入院时间分为对照组和观察组各55例。对照组给予常规延续护理,观察组在对照组基础上,给予基于m Health技术的延续护理。观察比较2组患者干预后PICC相关并发症发生率、患者导管维护依从性、PICC自我管理能力、PICC专项护理服务满意度。结果 干预3个月末观察组PICC相关并发症发生率、因导管维护花费的时间和费用低于对照组(P<0.01);导管维护依从性、PICC自我管理能力、PICC专项服务满意度高于对照组(P<0.05)。结论 基于mHealth技术的延续护理可为置入PICC并带管出院的癌症患者提供及时安全、连续的居家护理,降低导管相关并发症,提升患者自我管理能力,提高患者PICC专项护理服务满意度,值得借鉴使用。

mHealth中可追踪多授权机构基于属性的访问控制方案

移动健康护理作为一种新兴的技术给个人健康档案的分享提供了极大的便利,也给其隐私带来了极大的风险。基于属性的加密体制能够对加密数据实现细粒度的访问控制,有效地保护了个人健康档案的隐私。然而,目前基于属性的访问控制方案要么缺乏有效的恶意用户追踪机制,要么只支持单个授权机构。针对该问题,提出了一个移动健康护理环境下适应性安全的可追踪多授权机构基于属性的访问控制方案,该方案在合数群上构造,支持任意单调的线性秘密共享机制的访问策略,基于子群判定假设证明了该方案在标准模型下是适应性安全的,基于k-SDH假设证明了该方案的可追踪性,性能分析表明了该方案的实用性。

mHealth和eHealth在中医诊断、非药物疗法及传统功法中推广应用探讨

随着5G通讯技术的发展和人民防病诊疗方式需求的增加,mHealth和eHealth技术逐渐参与现代诊疗及运动健康,但在中医诊疗中运用较少。本文主要探讨mHealth和eHealth技术在中医诊断、非药物疗法和传统功法中的运用。基于mHealth和eHealth技术发展并完善中医体系,大力推进健康医疗大数据应用,是未来中医诊疗的趋势。同时,新的诊疗模式将发挥中医科技创新和信息化支撑作用,形成具有中国特色、促进全民健康的体系。

An mHealth intervention to improve medication adherence among patients with coronary heart disease in China: Development of an intervention

Objectives:With this study,we aimed to develop a mobile technology(mHealth)intervention to improve medication adherence among patients with coronary heart disease(CHD).Methods:The study was conducted in two phases with CHD patients from a Cardiology Department of a hospital located in China.Each phase was independent from the other.Phase 1 tested the integration of the two apps-"WeChat"and"BB Reminder"-as an mHealth intervention.All participants received the same educational materials via WeChat every two days.Participants in the experimental group received a reminder from BB Reminder for every dose of their medications.The duration of Phase 1 was 30 days for each participant.Phase 2 refined the intervention,in which educational materials were sent every five days rather than every two days,and medication-taking reminders were sent daily rather than every dose.Results:In Phase 1,an mHealth intervention was developed by integrating two mobile apps.In Phase 2,medication adherence increased at 30-day follow-up in both groups compared to baseline.At the 30-day follow-up,the mean of the decrease in medication non-adherence score in the experimental group(M=1.35,SD=2.18,n=36)was more than the decrease in control group(M=0.69,SD=1.58,n=36),which means the medication adherence improved more in the experimental group.Conclusion:The feasibility of using mHealth to remind CHD patients to take their medications is high.

以针灸治疗管理夜尿症为例探讨mHealth在中医临床中的运用

目前,针灸与人工智能学科交叉要求不断提高,借助当前人工智能科技开展针灸研究,是时代的要求。本文从移动健康(Mobile Health,mHealth)的睡眠监测技术、四诊部分采集、红外功能镜头、智能针灸机器人等探讨针灸管理夜尿症的方法,并对当前存在的问题及未来研究趋势进行探讨和展望。认为中医针灸治疗联合mHealth技术治疗常见病智能化、信息化、护理、跟踪治疗是未来中医针灸治疗和科研的新模式,通过mHealth构建中医针灸诊疗数据和共享数据库,可为针灸临床指南、共识等提供依据。

基于mHealth的老年高血压健康教育的定性定量研究

目的:探究老年高血压患者对移动医疗(mHealth)健康教育方式的态度,以期为提高老年高血压患者服药依从性提供建议和依据。方法:采用定性和定量相结合方法,对171名老年高血压患者开展服药现状及mHealth健康教育态度调查,对其中20名老年高血压患者开展定性访谈,探究mHealth健康教育态度。结果:定量结果显示只有17.6%的老年高血压患者服药依从性较好,82.4%的患者服药依从性较差;47.4%的患者表示愿意接收mHealth健康教育内容。定性结果显示大多数患者缺乏对高血压疾病的正确认识,尤其是农村患者;多数患者未能意识到服药的重要性;绝大多数患者对mHealth健康教育方式表达了积极态度,但是存在阻碍因素如视力变弱、文化水平不高等。结论:老年高血压患者服药依从性偏差,应采取相应的措施提高其服药依从性。基于mHealth的老年高血压健康教育模式是可以考虑实施的措施。

Nursing and mHealth

Innovations in mobile health(mHealth)technology offer applications to promote wellness management and health behavior change outside of formal clinical settings.Nurses can help to move mHealth into mainstream health care by understanding its potential to change the landscape of health intervention delivery,incorporating mHealth into patients'day to day preventive care strategies,and supporting the science of mHealth's effectiveness.

Risk Assessment Framework of mHealth System Vulnerabilities: A Multilayer Analysis of the Patient Hub

Although there have been remarkable technological developments in healthcare, the privacy and security of mobile health systems (mHealth) still raise many concerns with considerable consequences for patients using these technologies. For instance, potential security and privacy threats in wireless devices, such as Wi-Fi and Bluetooth connected to a patient hub at the application, middleware and sensory layers, may result in the disclosure of private and sensitive data. This paper explores the security and privacy of the patient hub, including patient applications and their connections to sensors and cloud technology. Addressing the privacy and security concerns of the patient hub called for a comprehensive risk assessment by using the OCTAVE risk assessment framework. Findings reveal that the highest risk concerned data exposure at the sensory layer. In spite of the countermeasures presented in this paper, most served as a means to identify risk early as opposed to mitigating them. The findings can serve to inform users of the potential vulnerabilities in the patient hub before they arise.

Bluetooth^TMEnabled Acceleration Tracking (BEAT) mHealth System: Validation and Proof of Concept for Real-Time Monitoring of Physical Activity

Physical activity is critical to improve the condition of patients with chronic leg and foot ulcers, especially those who are obese and experienced multiple co-morbid conditions. Unfortunately, these individuals are unable to engage in guideline based physical activity (PA) programs. A prototype of BluetoothTM enabled acceleration tracking (BEAT) mHealth system was developed and manufactured for remote monitoring and stimulation of adherence to PA in deconditioned patients. The system consists of a miniature accelerometer-based sensor, smartphone application, and a network service. Validation testing showed high reliability and reproducibility of the BEAT sensors. Pilot study with human subjects demonstrated high accuracy of the BEAT system in recognition of different exercises and calculating overall outcomes of PA. Taken together, these results indicate that BEAT system could become a valuable tool for realtime monitoring of PA in deconditioned patients.

Real-Time Communication Method for mHealth Base on Extended XMPP Protocol

Considering characteristic of mHealth communication and problems of existing methods, this paper presents a real-time communication method for mHealth based on extended XMPP protocol. The method can maintain the role status efficiently and reduce data latency during the communication process. Meanwhile, it can be extended flexibly to meet increasing communication demands of mHealth services. Furthermore, a system framework is presented to support telemonitoring scene. Finally, system implementation and feasibility tests verify the effectiveness of the method and framework.

Research Priorities for mHealth and Innovative Strategies in Sexual and Reproductive Health and Rights in the WHO Africa Region

Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.

移动健康技术在慢性病管理中应用进展的文献计量学分析

背景近年来移动健康技术在慢性病管理中的研究发展迅速,然而该领域的研究趋势、热点和前沿问题尚不清晰。目的对移动健康技术在慢性病管理中的应用和发展进行系统梳理,为未来开展相关研究提供借鉴。方法以Web of Science核心合集、PubMed为文献数据来源,于2022-10-18通过CiteSpace 6.1.R 3软件检索1997-2022年发表的相关文献,限制语种为英文,排除会议论文、会议摘要、在线发表、社论、信函、书籍章节、新闻等类型的文献。对纳入文献的国家(地区)、学科交叉和关键词进行分析,以掌握国际上相关研究的现状和热点,采用关键词聚类分析、关键词突发检测和时间轴视图综合分析移动健康技术在慢性病管理中的研究前沿和趋势。结果共纳入文献7622篇,文献发表量在2011年开始出现明显增长趋势,其中美国对文献数量的贡献最大,共有2645篇(34.70%)。论文刊发期刊主要集中在医学、心理学和健康学等领域。频次排在前5位的关键词分别为慢性病(711次)、护理(695次)、管理(544次)、干预(502次)、健康(448次)。共形成10个有意义的聚类,可归纳为研究工具、研究理论与方法、研究对象、研究因素4个维度。结合关键词突现和时间线视图来看,热点问题主要聚焦于远程医疗、远程护理及数字健康。结论国际上对移动健康技术在慢性病管理中应用的研究热度不减,研究领域已从医学转向健康学,研究重点是采用移动健康技术对慢性病进行干预,利用数字技术为慢性病提供远程健康综合服务。提示我国学者应重视移动健康和数字技术在慢性病管理中的应用,开展干预研究为慢性病患者寻找高质量健康服务,为慢性病服务与管理的高质量发展提供建议。

移动健康在老年人孤独感中应用的范围综述

目的 :对移动健康在老年人孤独感中的应用进行范围审查,探究移动健康的载体、内容及效果,为开展老年人孤独感的干预提供参考。方法 :以乔安娜布里格斯研究所(JBI)发布的范围综述指南为方法学框架,系统检索PubMed、Embase、CINAHL、WebofScience、TheCochraneLibrary、中国知网、万方数据库和中国生物医学数据库。检索时限为建库至2023年2月5日。由2名研究人员独立筛选并提取资料。结果 :共纳入18篇文献,移动健康在老年人孤独感中应用内容包括提供健康指导、改善社会支持、远程心理干预,学习操作移动设备。结局指标包括有效性和可行性。结论:移动健康在改善老年人孤独感中的应用是可行的,具有积极作用。未来可以借鉴和参考国外高质量研究,依托多学科合作,开发符合国内文化背景的移动健康平台,以改善老年人的孤独感。

老年用户使用移动医疗意愿的影响因素元分析

信息和通信技术进步为移动医疗的实施提供了便利,但老年人口移动医疗服务使用率偏低。文章针对移动医疗老年用户使用意愿影响因素实证研究之间结果不一致的问题,对相关文献进行综合梳理和再分析。基于近十年30篇移动医疗使用意愿相关实证研究文献,采用元分析方法,利用CMA软件检验变量关系异质性、文献发表偏倚并计算各变量关系的合并效果量,并以国家或地区的经济发展水平作为调节变量进行次群体分析。研究表明:老年用户使用移动医疗的行为意愿通常直接受到7个因素的影响:努力期望、绩效期望、态度、价值价格、感知信任、便利条件以及社会影响;其中,技术焦虑与努力期望高度负相关,努力期望正向影响绩效期望,绩效期望显著影响老年用户使用移动医疗态度,经济发展水平对相关变量关系的调节作用明显。

移动健康干预在慢性心力衰竭患者居家容量管理中的应用

目的探讨基于心力衰竭自我护理理论的移动健康干预在慢性心力衰竭患者居家容量管理中的应用效果。方法将264例经治疗出院的慢性心力衰竭稳定期患者随机分为对照组与试验组各132例,对照组实施常规随访管理,试验组在对照组基础上实施基于心力衰竭自我护理理论的移动健康干预。结果对照组120例、试验组123例完成研究,干预6个月后,试验组干体质量达标率优于对照组(P<0.05),两组患者自我管理能力时间效应、组间效应及交互效应差异有统计学意义(均P<0.05),试验组再入院率低于对照组(P<0.05)。结论基于心力衰竭自我护理理论的移动健康干预有利于提高慢性心力衰竭患者干体质量达标率和自我管理能力,降低再入院率。

国际游戏化移动医疗领域的研究进展与趋势--基于Web of Science数据库的可视化分析

目的:了解2013年—2022年国际游戏化移动医疗领域的发展现状与研究热点,以期为国内开展游戏化移动医疗研究提供参考。方法:系统检索2013年—2022年收录在Web of Science核心合集数据库的文献,运用CiteSpace(V.5.8.R3)对游戏化移动医疗领域的研究机构、来源期刊、学科主题、被引文献、关键词等进行可视化分析。结果:共纳入593篇文献,近10年来游戏化移动医疗领域相关发文量总体上逐年增加,发文量最多的期刊与机构分别是JMIR mHealth and uHealth和杜克大学;目前该领域的主要研究方向为慢性病管理、体育活动、营养、心理健康、依从性等,其中慢性病管理最为常见。结论:建议未来研究人员及时关注国际权威机构、期刊的研究成果,加强本领域多学科交叉及团队合作,开展高质量干预性研究,并尽快构建我国游戏化移动医疗评价体系。

游戏化设计在癌症病人智能运动管理项目中的应用研究进展

对游戏化设计的表现形式与作用机制、在癌症病人智能运动管理中的应用模式及效果进行综述,并根据现存问题提出建议,以期为未来的相关研究提供参考。

女性尿失禁病人自我管理移动医疗应用及研究进展

阐述移动医疗的基本概念,综述移动医疗在国内外女性尿失禁病人自我管理过程中的应用进展。提出移动医疗在功能个性化、对病人可持续性和数据安全性上仍需进一步改进。旨在探索出适合我国女性尿失禁人群的移动医疗自我管理方式,使我国女性尿失禁病人在自我管理能力和生活质量上有所提升。

移动医疗技术在居家心脏康复护理中的研究进展

就居家心脏康复护理的概念、移动医疗在居家心脏康复护理中的应用现状、发展趋势、面临的挑战等进行综述,以期为我国尚处于起步阶段的居家心脏康复护理实践提供参考。