Search

Background: Online mental health communities (OMHCs) are an effective and accessible channel to give and receive social support for individuals with mental and emotional issues. However, a key challenge on these platforms is finding suitable partners to interact with given that mechanisms to match users are currently underdeveloped or highly naive., Objective: In this study, we collaborated with one of the world's largest OMHCs; our contribution is to show the application of agent-based modeling for the design of online community matching algorithms. We developed an agent-based simulation framework and showcased how it can uncover trade-offs in different matching algorithms between people seeking support and volunteer counselors., Methods: We used a comprehensive data set spanning January 2020 to April 2022 to create a simulation framework based on agent-based modeling that replicates the current matching mechanisms of our research site. After validating the accuracy of this simulated replication, we used this simulation framework as a "sandbox" to test different matching algorithms based on the deferred acceptance algorithm. We compared trade-offs among these different matching algorithms based on various metrics of interest, such as chat ratings and matching success rates., Results: Our study suggests that various tensions emerge through different algorithmic choices for these communities. For example, our simulation uncovered that increased waiting time for support seekers was an inherent consequence on these sites when intelligent matching was used to find more suitable matches. Our simulation also verified some intuitive effects, such as that the greatest number of support seeker-counselor matches occurred using a "first come, first served" protocol, whereas relatively fewer matches occurred using a "last come, first served" protocol. We also discuss practical findings regarding matching for vulnerable versus overall populations. Results by demographic group revealed disparities-underaged and gender minority groups had lower average chat ratings and higher blocking rates on the site when compared to their majority counterparts, indicating the potential benefits of algorithmically matching them. We found that some protocols, such as a "filter"-based approach that matched vulnerable support seekers only with a counselor of their same demographic, led to improvements for these groups but resulted in lower satisfaction (-12%) among the overall population. However, this trade-off between minority and majority groups was not observed when using "topic" as a matching criterion. Topic-based matching actually outperformed the filter-based protocol among underaged people and led to significant improvements over the status quo among all minority and majority groups-specifically, a 6% average chat rating improvement and a decrease in blocking incidents from 5.86% to 4.26%., Conclusions: Agent-based modeling can reveal significant design considerations in the OMHC context, including trade-offs in various outcome metrics and the potential benefits of algorithmic matching for marginalized communities., (©Yuhan Liu, Anna Fang, Glen Moriarty, Cristopher Firman, Robert E Kraut, Haiyi Zhu. Originally published in JMIR Formative Research (https://formative.jmir.org), 01.10.2024.)

Objective: To observe the effect of nurse-patient co-management mode on preventing venous thromboembolism (VTE) in lung cancer patients with carboplatin and gemcitabine chemotherapy after peripheral venipuncture central venous catheterization (PICC)., Methods: 100 patients with lung cancer admitted to the 2nd Affiliated Hospital of Hainan Medical University from April 2020 to April 2022 were selected. All patients received a combination chemotherapy of carboplatin and gemcitabine and PICC catheterization. The patients were divided into an observation group and a control group by 1:1 simple random method, with 50 cases in each group. Patients in the control group were given routine nursing for lung cancer, and patients in the observation group were treated with nurse-patient co-management mode, and nursing intervention lasted for 2 months. General Comfort Questionnaire, self-management ability, quality of life, Self-care ability Scale, self-rating Anxiety Scale (SAS), and self-rating depression Scale were compared before and after intervention between the two groups. The recovery of immune ability indices (CD3+, CD3+CD4+, CD3+CD8+, CD3+CD4+/CD3+CD8+) in 2 groups were detected. Complications after PICC catheterization were recorded in the two groups., Results: After nursing, self-rating depression Scale and self-rating Anxiety Scale scores in both groups were significantly decreased, which were lower in the observation group than the control group (P < .001). After nursing, scores of self-concept, self-responsibility, self-care skills, and health knowledge level were significantly increased in both groups, which were higher in the observation group than control group (P < .001). After nursing, scores on the General Comfort Questionnaire, self-management scale, and quality of life were increased in both groups, which were higher in the observation group than control group (P < .0501). After nursing care, the immune competence indices of both patients increased significantly, and the immune indexes of CD3+, CD3+CD4+, and CD3+ CD4+/CD3+CD8+ in the observation group were significantly higher than those in the control group (P < .05). The total incidence of complications in the observation group was significantly lower than that in the control group (8.00% vs. 26.00%, P < .001), and the incidence of venous thromboembolism was significantly lower than that in the control group (2.00% vs. 14.00%, P < .001)., Conclusion: The nurse-patient co-management model has shown to be effective in reducing the incidence of venous thromboembolism in patients who have undergone PICC catheterization while receiving carboplatin and gemcitabine chemotherapy. This model also helps patients improve their self-care and self-management abilities, alleviates adverse psychological effects, and contributes to the recovery of their immune system.