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Historically, in-person contact between patients and nurses in home-based care has been pivotal in palliative care and hospice care. The provision of home-based palliative care services could be challenged by the projected increase in patients who need palliative care and by the expected shortage of nurses. Digital health services could constitute one measure for delivering high-quality palliative care, enabling patients to stay home. Nurses often follow up these patients remotely. Because digital health services are increasingly implemented in home-based palliative care, it is imperative that nurses consider the ethical concerns regarding such service delivery. Neglecting ethical concerns could result in unintended consequences for patients and nurses and inhibit care delivery. The aim of this article was to explore ethical concerns of digital health services in home-based palliative care through the lens of the 4 biomedical principles: autonomy, beneficence, nonmaleficence, and justice. This study utilized a bottom-up methodology conducting a subanalysis of the results of 2 previous reviews. [ABSTRACT FROM AUTHOR]

Background: Globally, clinical hypothyroidism affects an estimated 0.5 to 5% of the population, while subclinical hypothyroidism affects 5-20%. Limited data is available on the prevalence of thyroid disease within the Mexican population. The objective of this study was to describe the characteristics of people screened for hypothyroidism in Mexico during 2022 using the Zulewski scale. Methods: A cross-sectional analysis was conducted using data obtained from a digital survey administered by an e-Health platform. This study included participants of all genders, aged 18 years and older (n = 31,449). Descriptive statistics (frequencies and percentages) were sued to describe the data. Differences between groups were assessed through the chi-square or Fischer's exact test. Information gathered was subjected to hierarchical segmentation analysis to explore trends and patterns. Statistical significance was set as <0.05. Results: Among the participants, 87.7% were women, and 80% fell within the age group 18 and 44 years. According to the Zulewski scale, 27% of the participants had a low risk of hypothyroidism, 37.4% were classified as having an intermediate risk, and 35.6% were at a high risk. In people at high risk of hypothyroidism, the most common symptom was constipation (29.2%) whereas the most common sign was decreased speed of movement (26.2%). Inquiry of slow movements, dry skin, and facial edema allowed the identification of 90.2% of participants at high risk of hypothyroidism. Conclusions: In Mexico, a significant portion of the population is at an intermediate or high risk of hypothyroidism, requiring confirmatory diagnostic tests. [ABSTRACT FROM AUTHOR]

Internet of Things aims to simplify and automate complicated tasks by using sensors and other inputs for collecting huge amounts of data, processing them in the cloud and on the edge networks, and allowing decision making toward further interactions via actuators and other outputs. As connected IoT devices rank in billions, semantic interoperability remains one of the permanent challenges, where ontologies can provide a great contribution. The main goal of this paper is to analyze the state of research on semantic interoperability in well-being, aging, and health IoT services by using ontologies. This was achieved by analyzing the following research questions: "Which IoT ontologies have been used to implement well-being, aging and health services?" and "What is the dominant approach to achieve semantic interoperability of IoT solutions for well-being, aging and health?' We conducted a scoping literature review of research papers from 2013 to 2024 by applying the PRISMA-ScR meta-analysis methodology with a custom-built software tool for an exhaustive search through the following digital libraries: IEEE Xplore, PubMed, MDPI, Elsevier ScienceDirect, and Springer Nature Link. By thoroughly analyzing 30 studies from an initial pool of more than 80,000 studies, we conclude that IoT ontologies for well-being, aging, and health services increasingly adopt Semantic Web of Things standards to achieve semantic interoperability by integrating heterogeneous data through unified semantic models. Emerging approaches, like semantic communication, Large Language Models Edge Intelligence, and sustainability-driven IoT analytics, can further enhance service efficiency and promote a holistic "One Well-Being, Aging, and Health" framework. [ABSTRACT FROM AUTHOR]

Background: Effective public health surveillance is essential for policymaking and resource allocation. The World Health Organization (WHO) supports the integration of mobile technologies to create mobile Oral (m-Oral) Health surveillance systems to enhance disease monitoring. The effectiveness and sustainability of electronic health information initiatives depend on users' acceptance of new technologies. This research assessed dentists' acceptance of electronic oral health surveillance systems (EOHSS) and related factors, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Materials and methods: A cross-sectional study included 1470 Egyptian dentists in an online survey from November 2023 to May 2024. The dentists were recruited from the five administrative regions in Egypt using convenience and snowball sampling. Participants responded to a questionnaire that was based on the UTAUT model. Structural equation model (SEM) was used for data analysis. Results: 83.4% of dentists intended to use EOHSS. Performance expectancy (PE) (ß = 0.240, 95% CI: 0.182, 0.295), training adequacy (TA) (ß = 0.232, 95% CI: 0.165, 0.291), and effort expectancy (EE) (ß = 0.231, 95% CI: 0.169, 0.289) had the greatest influence on behavioral intention (BI). In contrast, anxiety towards electronic systems (ANX) (ß = -0.140, 95% CI: -0.187, -0.095) had a significant negative effect on BI. Effort Expectancy (EE) had a significantly stronger positive impact on BI of females than males. Moreover, EE had a significantly stronger impact on BI of dentists older than 40 years old than those who were younger than 30 years old. Conclusions: Egyptian dentists' intentions to use the EOHSS were influenced by PE, TA, and EE. However, anxiety related to technology may limit its adoption. EE had a greater positive impact on BI in females and in older dentists. [ABSTRACT FROM AUTHOR]

Background: Electronic health (e-Health) interventions may increase effectiveness and address limitations of conventional in-person childhood obesity treatment programs. This study evaluates the effectiveness of a 10-week e-Health (web-based) healthy lifestyle program for school-aged children with overweight/obesity. Methods: In this randomised control trial (RCT), families with children aged 7–13 years with overweight/obesity (body mass index, BMI ≥ 85th percentile), living in Victoria, Australia, were recruited. Families were randomised to intervention or waitlist control and received the 10-week web-based program. The primary outcome was the change in children's BMI z-score over 10 weeks. Other outcomes included change in children's waist circumference, dietary intake, physical activity, and quality of life over 10 weeks. Results: Of 148 children (125 families) recruited, 102 children (85 families) completed the RCT. A significant decrease in children's BMI z-scores was observed in the intervention compared to the control group over 10 weeks (mean difference 0.11; 95% CI, 0.02–0.20). The web-based program was also effective in improving children's quality of life and lifestyle behaviour changes over 10 weeks. In the intervention group, there was a significant increase in children's quality of life scores (intervention versus control: median change (IQR) = 11 (3, 17) versus 1 (-3, 7); p = 0.034), overall diet quality scores (6 (2, 10) versus 2 (-3, 5); p < 0.001), and daily physical activity levels (5.2 (-2.6, 12.8) versus − 0.2 (-8.2, 4.5); p = 0.022) compared to the control group. Conclusions: A web-based healthy lifestyle program effectively improved short-term health-related outcomes in children with overweight/obesity. Further research is needed to identify determinants of program effectiveness, evaluate sustained effects, and equitably tailor childhood obesity e-Health interventions to diverse populations. Trial registration: This study was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12621001762842) on November 11, 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383053. [ABSTRACT FROM AUTHOR]

Usability of home use medical devices is complex, multidimensional and multifactorial. The design of such devices must accommodate a range of users, including patients, caregivers, and hospital staff, as well as the potential impact of human-human interaction through the device. In this study, we analyse the impact of the hospital context on the usability of a medical device used for post-ambulatory monitoring. We enrolled 28 patients and 20 student physicians in an ambulatory surgery system simulation. After the simulation, we conducted both focus groups and interviews to gather both quantitative and qualitative data to measure the usability of the medical device. The results show that exchanges during the consultation with the anaesthetist have a definite impact on the device's usability by modifying the user's perceived risk. Even if the device is intuitive to use, its usability is dependent on the context of use and the projection of the users. [ABSTRACT FROM AUTHOR]

Today, social and healthcare systems at a global level are facing constant challenges dictated by an increasing mismatch between the demand for care services and the supply of human and economic resources. Such a situation has been exacerbated in the past two years by the Covid-19 pandemic. This has led to an increase in the leverage of digitalisation, which has proved to be a crucial tool for the development and application of new organisational models at both hospital and territorial levels, thus addressing the various criticalities already present in the system. In this sense, the Virtual Hospital has emerged as a potential model for increasing effectiveness and efficiency in delivering sociomedical services. Starting from these premises, an EFTE (estimate, feedback, talk, estimate) approach was used to acquire an expert consensus within a multidisciplinary panel of academics and healthcare managers of the Veneto Region in Italy. This article reports the expert opinion on the possible application of the Virtual Hospital model in the national context, starting from the existing international evidence and good practices, highlighting the potential advantages and barriers to its implementation. Furthermore, the article analyses the most relevant areas of investment for the development of intangible assets and the acquisition of tangible assets necessary for its implementation. [ABSTRACT FROM AUTHOR]

Background: Pregnancy is a special time for women that involves substantial emotional, physical, social, and family changes, which can lead to physical and psychological harm. The rapid development of e‐health has provided a favourable platform for managing health‐related outcomes in pregnant women, and nurses are the professional group that is most likely to provide e‐health services. Nurse‐led e‐health interventions have attracted increasing attention, but their effects are uncertain. Objective: To identify the effectiveness of nurse‐led e‐health interventions in improving health‐related outcomes in pregnant women. Design: A systematic review. Data Sources: The PubMed, PsycINFO, EMBASE, CINAHL, ProQuest, MEDLINE, Scopus, Web of Science and Cochrane Library databases were searched from inception to March 2023. Methods: Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias tool was used for quality assessment. The findings of this review are presented using a narrative synthesis. Results: This review included 14 studies involving 2016 participants. Three out of five studies reported that nurse‐led e‐health interventions significantly reduced depressive symptoms. Four studies reported significant improvements in stress and self‐efficacy after the intervention. Two studies reported significant improvements in anxiety symptoms, self‐management ability, and quality of life after the intervention. One study showed that weight gain and physical activity significantly improved after the intervention. Due to the heterogeneity in the included studies, no meta‐analysis was conducted. Conclusions: Nurse‐led e‐health interventions may be beneficial for improving anxiety symptoms, depressive symptoms, stress, self‐efficacy, weight gain, self‐management ability, physical activity, and quality of life in pregnant women. Relevance to Clinical Practice: Nurse‐led e‐health interventions could provide individualised, economic, interactive, and convenient nursing modes for pregnant women. Rigorous and high‐quality evidence confirming the long‐term effects of these interventions on pregnant women is necessary. No Patient or Public Contribution: The patients had no direct involvement in the present study. Registration Number: PROSPERO registration ID: CRD42023401973 [ABSTRACT FROM AUTHOR]

Aims: Diabetes distress is common among people with type 1 diabetes (T1D), negatively affecting quality of life, self management, and diabetes outcomes. E‐health‐based interventions could be an effective and low‐cost way to improve the psychological care for people with T1D experiencing diabetes distress. The MyREMEDY study aims to test the effectiveness of the online unguided self‐help intervention MyDiaMate in decreasing diabetes distress in adults with T1D. MyDiaMate is based on Cognitive Behavioural Therapy and consists of eight modules, each focusing on a different aspect of living with T1D that is often experienced as burdensome (e.g. hypoglycaemia, fatigue). Methods: The effectiveness of MyDiaMate will be tested through a randomised‐controlled trial across four European countries (the Netherlands, Germany, Spain and the United Kingdom). Six hundred and sixty adults (N = 165 per country) with T1D will be recruited and randomised with a balance of 2:1 into the intervention and care as usual groups. Intervention group members receive access to MyDiaMate for 6 months, care as usual group members receive access after 3 months for 3 months. Participants fill in questionnaires at 0 (baseline), 3 (effectiveness) and 6 months (follow‐up). Primary outcome is diabetes distress at 3 months. Secondary outcomes are emotional well‐being, psychological self‐efficacy in relation to diabetes, social engagement, fatigue, and glycaemic outcomes. Moreover, logdata of MyDiaMate use is passively collected. Linear mixed model analyses will be used to test the effectiveness of MyDiaMate along with identifying which user subgroup benefits most from MyDiaMate use. Trial Registration: Clinicaltrials.gov NCT06308549. [ABSTRACT FROM AUTHOR]

Objectives To assess a remote physiotherapist (PT) counselling intervention using self-monitoring tools for improving self-management ability, physical activity participation and health outcomes in people with rheumatoid arthritis (RA). Methods Eligible participants were randomly assigned to receive group education, a Fitbit®, a self-monitoring app, and PT counselling phone calls (Immediate Group). The Delayed Group received a monthly e-newsletter until week 26, and then the intervention. The primary outcome was Patient Activation Measure (PAM-13). Participants were assessed at baseline, 27 weeks (the primary end point) and 53 weeks. Secondary outcomes included disease activity, pain, fatigue, depression, sitting/walking habits, daily physical activity time and daily awake sedentary time. Generalized Linear Mixed-effect Models (GLMMs) were used to assess the effect of the intervention on the change of each outcome measure from the initiation to 27 weeks after the intervention. Results Analysis included 131 participants (91.6% women; 80.2% completed during the COVID-19 pandemic). The mean change of PAM-13 at 27 weeks was 4.6 (Standard Deviation [SD] = 14.7) in the Immediate Group vs −1.6 (SD = 12.5) in the Delayed Group. The mean change in Delayed Group at 53 weeks (after the 26-week intervention) was 3.6 (SD = 14.6). Overall, the intervention improved PAM-13 at 27 weeks post-intervention from the GLMM analysis (adjusted coefficient: 5.3; 95% CI: 2.0, 8.7; P   ≤  0.001). Favourable intervention effects were also found in disease activity, fatigue, depression and self-reported walking habit. Conclusion Remote counselling paired with self-monitoring tools improved self-management ability in people with RA. Findings of secondary outcomes indicate that the intervention had a positive effect on symptom management. [ABSTRACT FROM AUTHOR]

BACKGROUND: Numerous preventive measures and regulations including electronic health (e-health) services were implemented during the coronavirus pandemic. Despite their importance, very little is known about their use. Therefore, the aim of this study was to determine the use of e-health application by healthcare providers (HCPs), and assess their awareness, perceptions, and practices of such services. MATERIALS AND METHODS: A cross-sectional study was conducted during July to September 2024 using online self-administered questionnaires. Participants were selected using convenient sampling technique supplemented by snowball sampling. The calculated sample size was 218 participants. Data was collected through an online pretested English-language questionnaire. SPSS version 26 was used to analyze data; Chi-square test was used to examine the associations between HCPs' responses regarding perceived benefits, risks, and needs related to e-health tools. RESULTS: Of the 471 survey participants who started filling out the survey, 64% (n=300) reported using e-health services since coronavirus disease and were included in the final analysis. Female HCPs used e-health applications twice as often as males, and a decline in e-health use was seen with increasing age of participants. Most common purpose for using e-health services were treatment (61%), consultations (60%), and follow up with patient (54%). The most used e-health tools were telephones or cell phones (69.0%) and WhatsApp applications (64.0%) followed by Zoom application (50.0%) and Sehhaty application. Technical problems such as poor internet connection and automatic updates of applications were reported by more than half of the users (52%). Participants reported perceived risks regarding privacy and data protection, and clinical risks associated with using e-health tools. CONCLUSION: HCPs' positive experiences with e-health services in Saudi Arabia, valued for their cost-effectiveness and efficiency. However, patient misinterpretation, privacy risks, and clinical errors persist. Growing demand underscores the need for more explicit e-health regulations and broader professional involvement to enhance e-health service. [ABSTRACT FROM AUTHOR]

Purpose: Ambient-assisted living (AAL) is one solution to the challenges of healthcare systems in an aging population. Using the "ecosystem adoption of practices over time" (EAPT) as a theoretical lens, this study explores and describes three elements of AAL adoption: (1) the AAL practices in which the technology is embedded (i.e. object of adoption), (2) the older adult's adoption ecosystem (i.e. subject of adoption) and (3) the change of adoption practices over time (i.e. temporality of adoption). Design/methodology/approach: Qualitative interviews with three actor groups in the ecosystem: clients, relatives and home nurses. Findings: The study identifies six categories of AAL practices. Clients, relatives and nurses interact and integrate their resources in carrying out these practices. Some of the practices have developed, or are expected to develop, over time. Originality/value: The study applies a novel theoretical perspective on how AAL technology is embedded in practices performed by different actors in the adoption ecosystem. This broadens the conceptualization of what is being adopted compared to traditional adoption research. [ABSTRACT FROM AUTHOR]

"Medical deserts" are areas with low healthcare service levels, challenging the access, quality, and sustainability of care. This qualitative narrative review examines how artificial intelligence (AI), particularly large language models (LLMs), can address these challenges by integrating with e-Health and the Internet of Medical Things to enhance services in under-resourced areas. It explores AI-driven telehealth platforms that overcome language and cultural barriers, increasing accessibility. The utility of LLMs in providing diagnostic assistance where specialist deficits exist is highlighted, demonstrating AI's role in supplementing medical expertise and improving outcomes. Additionally, the development of AI chatbots offers preliminary medical advice, serving as initial contact points in remote areas. The review also discusses AI's role in enhancing medical education and training, supporting the professional development of healthcare workers in these regions. It assesses AI's strategic use in data analysis for effective resource allocation, identifying healthcare provision gaps. AI, especially LLMs, is seen as a promising solution for bridging healthcare gaps in "medical deserts," improving service accessibility, quality, and distribution. However, continued research and development are essential to fully realize AI's potential in addressing the challenges of medical deserts. [ABSTRACT FROM AUTHOR]

Background: High-risk pregnancies, characterized by underlying health issues or unusual circumstances, pose increased risks to both maternal and neonatal health during pregnancy and childbirth. Global guidelines emphasize the importance of early identification, monitoring, and intervention to mitigate these risks. Method: We decided to design and implement a telemonitoring system for remotely monitoring and managing pregnancies in women with conditions such as hypertension, diabetes, or high-risk pregnancy. When a high-risk pregnant mom is discharged from the hospital, the Healthcare Center or Integrated Healthcare Services Center in her area is immediately notified via SMS to ensure her condition is monitored remotely. In addition to sending notifications, the patient's medical record, post-discharge care recommendations, drug prescription, re-visit time, and contact details are also sent to them via the application. The high-risk pregnant mom is followed up and all her information is recorded in the application for further use. To evaluate the usability of the proposed telemonitoring system, we conducted a laboratory study involving 92 participants, including pregnant mothers' care experts at hospitals, healthcare center experts, midwives at integrated healthcare services centers, and midwifery department experts with varying levels of digital skills. Participants performed activities related to the application's services, while their satisfaction was measured using the QUIS 7.0 questionnaires covering multiple aspects of usability, including user interface, system capabilities, and online help, with ratings on a Likert scale. Result: The usability evaluation revealed that the average satisfaction score across all usability dimensions was above 8, demonstrating a satisfactory level of system usage from all user perspectives. Additionally, the close alignment of mean and median scores, along with standard deviations below 1 for several dimensions, indicated consistent positive feedback among users. Conclusion: Our telemonitoring system demonstrates promise for enhancing the management of high-risk pregnancies, facilitating better health outcomes for mothers and infants through effective remote monitoring and support. The usability test results underscore the platform's effectiveness and user satisfaction, contributing valuable insights for future improvements in high-risk pregnancy care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: During the severe acute respiratory syndrome coronavirus 2 pandemic, could be observed an established use of online information in the field of coronavirus disease worldwide. As a systematic review study, the present investigation aimed to evaluate related studies about digital health/e-health literacy among university students in the coronavirus disease 2019 era. METHODS: Three electronic bibliographic databases (PubMed/Medline, Scopus, and Google Scholar) were searched from 2020 until June 2022, and articles were screened according to pre-established inclusion criteria. RESULTS: Fifteen studies were included in this systematic review study. All of the studies were cross-sectional in design, and in total, 45,255 students were evaluated. The majority of studies report health literacy scores among university students that are lower compared to reference samples. Students' health literacy is influenced by different variables (age, gender, socioeconomic background, sources of online information, well-being, and satisfaction with data). CONCLUSION: Digital health literacy (DHL) shapes health behaviors and actions. To enhance DHL, multidisciplinary teams from diverse fields can design curricula suitable for students. The internet's role in DHL is crucial, but it can also spread misleading content. Therefore, professionals should provide clear, evidence-based information and encourage critical data evaluation. Future studies should use robust sampling methods, consider students with limited internet access, and address the unique needs of specific populations, such as those with disabilities and low socioeconomic status. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionTechnological advancement has added new dimensions to the communication between physicians and their patients in healthcare settings worldwide. This study aimed to measure patients’ views about physicians’ interpersonal communication during telemedicine consultations by cultural adaptation and validation of the communication assessment tool (CAT) in Bangladesh.A cross-sectional phone survey was conducted among 400 patients who received healthcare services from a telemedicine centre in Bangladesh. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the dimensionality of the CAT-Bangla scale. The goodness of fit of the CFA was assessed using the comparative fit index (CFI), Tucker–Lewis index (TLI), Chi-square values, root-mean-square error of approximation (RMSEA) and standardized root mean squared residual (SRMR). The internal consistency reliability of the CAT-Bangla scale was assessed using Cronbach's alpha.Factor analysis findings suggest that the CAT-Bangla scale is unidimensional with good internal consistency (Cronbach's α = 0.876). The individual item analysis findings suggest that most of the patients felt that the physicians treated them with respect (81% rated ‘excellent’) and allowed them to talk without interruption (73.5% rated ‘excellent’). Overall, the level of satisfaction among patients regarding physicians’ communication skills was high with a mean score of 4.36 (SD = 0.30) across all the 14 items. However, the patients were not satisfied with the amount of time that physicians spent with them as none of them reported ‘excellent’ in that domain.The CAT-Bangla scale is feasible, valid, and internally consistent for measuring physicians’ communication skills in the telemedicine environment. This study can contribute to policymakers regarding the integration of learning communication skills of future physicians to competently deliver healthcare in the telemedicine environment. It would also help to understand various aspects of doctor-patient communication in a telemedicine context. [ABSTRACT FROM AUTHOR]

Purpose: To explore health literacy (HL) among parents of children with Hirschsprung disease (HD). Methods: Norwegian-speaking parents of children under 16 who underwent HD surgery at a tertiary center were surveyed using the Health Literacy Questionnaire-Parent, electronic Health Literacy Scale, General Self-efficacy Scale, and a study-specific questionnaire. Demographics were collected and ethical approval was obtained. Results: Among 132 parents (77 mothers) of 91 children (median age 8 years), high HL scores appeared in the domains "understanding health information" and "active engagement", with lower scores in "provider support", "health information appraisal", and "social support". Higher HL correlated with parents aged over 40 and higher education. Lower scores were seen with non-exclusive Norwegian use at home and not living with the child's other parent. High electronic HL scores were common (mean 3.6, maximum score 5). 69% had high self-efficacy scores (score > 2, maximum score 4). Self-efficacy correlated strongly with higher HL scores. Conclusion: Parents of children with HD feel healthcare providers lack understanding of their child's challenges, experience limited social support and struggle with interpreting health information. We suggest targeted HL interventions for young, lower-educated, non-cohabitating parents and those not primarily speaking the official language at home. [ABSTRACT FROM AUTHOR]

Introduction: The transactional model of e-health literacy addresses not only the skills needed for handling online health-related information but also the capacity to communicate regarding health issues on the Internet. It also emphasizes a critical component of e-health literacy: enabling appraisal and selection of information adequate to individual needs. Our study aimed to culturally adapt the instrument assessingTransactional e-Health Literacy (TeHL) and examine the association between TeHL and the use of e-health services by Polish adult Internet users. Methods: The analysis was conducted on data from an online survey among 1,661 respondents. After cultural adaptation and piloting of the Polish version of the instrument measuring TeHL, exploratory and confirmatory factor analyses were performed on two samples obtained by random splitting of the original data set. The roles of TeHL categories in the use of several types of e-health services were assessed with multivariable logistic regression models. Results: We have found that the four-factor model of the Polish version of the TeHL instrument, consisting of 17 items, obtained after excluding item 13, shows the best fit to the measurement data (NFI = 0.950, RFI 0.938, TLI = 0.951, CFI = 0.960, GFI = 0.932, RMSEA = 0.066). Regression modeling revealed that Functional e-health literacy is a significant positive predictor of the use of remote physician advice, the Internet Patient Account Portal, portals providing general health-related information, and websites allowing for checking laboratory test results. Communicative eHL was significantly negatively related to the use of general health-related information portals and positively related to the use of portals offering paid medical advice. Critical e-health literacy was a significant negative predictor of the use of remote physician advice and the laboratory test results websites but a positive predictor of using portals offering paid medical advice and websites offering easy access to e-prescriptions. Finally, Translational e-health literacy was significantly positively associated with the use of the Internet Patient Account Portal, general health-related information portals, and laboratory test results websites. Discussion: Polish version of the instrument assessing TeHL is a tool of confirmed validity that can be used for e-health research in Poland. The relationships between four types of TeHL and the use of concrete e-health solutions show a complex pattern requiring further evaluation. [ABSTRACT FROM AUTHOR]

Background: Information and communication technology (ICT) provides one solution to meet increasing demands for occupational therapy for older adults. Aims/Objectives: To examine if and how municipality-based occupational therapists (OTs) include ICT in their work, and which factors are associated with use of occupational therapy at a distance. Material and Methods: Survey study including 167 OTs. Data were presented descriptively. Associations were analysed by Chi2 test and logistic regression models. Results: Forty-eight percent of OTs used ICT once a month or more. OTs belief on possibilites to use ICT is associated with replacement of physical home visits. Managers expectations and support also seem to be important factors. Conclusion: ICT solutions are frequently used by OTs in home health care and can be considered complementing rather than replacing physical home visits. More knowledge is needed on when and how ICT solutions can be used by OTs and how factors that impact the use of ICT can be managed. [ABSTRACT FROM AUTHOR]

Background: Research is limited about how the introduction of new ways of delivering and conducting occupational therapy, in accordance with expected changes in health care, is experienced by occupational therapists (OTs). Aim: To explore how OTs experienced use of a new internet-based intervention, 'Strategies for Empowering activities in Everyday life' (SEE), focusing on supporting client resources to manage an active everyday life after stroke. Material and methods: A focus group study with periodical repeated discussion was designed. Four sessions during a period of 22 months were conducted with a total of four OTs. Result: Overall, the results reflected that the OTs experienced that the use of SEE for persons with stroke was a valuable complement to existing rehabilitation. The process of introducing SEE included a multifaceted transition involving context, intervention process and delivery that renewed occupational therapy. Conclusion: These results indicate how the use of new internet-based interventions such as SEE can influence and support renewal of occupational therapy that extends beyond the particular intervention. Continued research is needed to explore more aspects of SEE feasibility. [ABSTRACT FROM AUTHOR]

Background/Objective: Over the past two decades, the utilization of virtual care in rehabilitation has witnessed a significant surge; this is owing to the widespread availability of technological tools and the global impact of the COVID-19 pandemic. As a result, discussions surrounding the relevance and benefits of telerehabilitation have gained prominence among practitioners, who continually seek to enhance patient care while maintaining high standards of quality. Associated with these discussions are concerns over being able to provide care in an ethical way, as well as addressing equity issues that might be hindered or improved via telerehabilitation. To address the ethical and equity concerns around telerehabilitation, a series of five parallel rapid reviews of the scientific literature were conducted, focusing on different rehabilitation fields: physiotherapy and occupational therapy (1); speech therapy and audiology (2); psychology and neuropsychology (3); and in two age groups: older adults (4); and pediatrics and young adults (5). The objective of this series of rapid reviews is to evaluate the evidence presented regarding telerehabilitation; identifying and recommending best practices especially in the realm of ethics and equity. Methods: Medline; CINAHL; and EMBASE were searched between 2010 and 2023 for English or French-language reviews (2010–2020) and individual studies (2020–2023) pertaining to telerehabilitation and these fields of interest. Data were extracted following a standardized form focusing on: outcomes; findings; quality assessment/biases; limitations; and discussion of ethical and equity concerns. Results: The results are presented according to the most relevant themes, which include: findings; strengths; limitations; and ethical/equity considerations. Conclusions: This research presents a methodology rarely published before, on how to conduct multiple parallel rapid reviews on the theme of telerehabilitation, based on different rehabilitation fields and age groups. This research will shape future guidelines and standards in applying ethical and equity standards in telerehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Digital technology has become increasingly relevant in physiotherapy, but little is known about communication and interaction in video-based physiotherapy. Therefore, this study aimed to explore the experiences among patients and physiotherapists, of communication and interaction in digital, video-based physiotherapy. Methods: A qualitative interview study with a phenomenological approach was conducted. Participants were purposively recruited from primary health care clinics. Semi-structured, in-depth interviews were conducted with 10 physiotherapists and 6 patients. Interviews were recorded, transcribed, and analyzed using a phenomenological approach. Results: The analysis resulted in the overall theme Reaching for connection, which captured the central meaning of the participants' experiences. Four categories emerged from the analysis: 1) Closeness at a distance; 2) Overcoming limited bodily communication; 3) The technology as part of the meeting; and 4) Challenging the physical meeting as a norm. The results suggest that communication and interaction in digital settings differ from physical settings, but there is an ongoing adaptation process to this new paradigm. Conclusions: The results of this study show that video-based physiotherapy, while having several benefits according to both patients and physiotherapists, affects the communication in several ways. Physiotherapists need to acknowledge these limitations and seek strategies to adapt and to compensate for the reduced non-verbal elements and lack of touch. Attention to the physical room and shifting between positions (face/full figure) are suggested practical strategies, but also to practice awareness and embodied communication to improve receptivity in the interaction. [ABSTRACT FROM AUTHOR]

Background: There is limited information about how on-line screening tools developed by integrated systems facilitated management of COVID-like illness patients. Methods: Using the Kaiser Permanente Northwest (KPNW) Electronic Health Record, we identified adult plan members who accessed online COVID-19 screening e-visits and enumerated their subsequent medical encounters, tests for SARS-CoV-2, and test outcomes. Results: Between May 2020 and December 2021, members completed 55,139 e-visits, with disproportionate representation among females (65% vs. 53% in the overall membership) and members aged <45 years (61% vs. 39%). Thirty percent of patients (16,953) were managed entirely through e-visits and 70% received subsequent in-person care. The percent of SARS-CoV-2 positive individuals was highest among the 1055 individuals triaged to inpatient care (17.9%), compared to 9.5% among those escalated to additional ambulatory care. Conclusions: The e-visit on-line screening tool helped KPNW assist thousands of patients with COVID-19 symptoms, avoid unnecessary in-person patient encounters, and preserved KPNW infection control and pandemic surge capacity. [ABSTRACT FROM AUTHOR]

This article aims to find the determinants that affect patient satisfaction regarding the Mawiidi public portal in Moroccan public hospitals and assess its outpatient online booking system effectiveness using a model that integrates the Technology Acceptance Model (TAM) with the Information Systems Success Model (ISSM) while adopting a quantitative research methodology. The analysis was conducted using 348 self-administered questionnaires to analyze eight key constructs, such as information quality, patient satisfaction, perceived ease of use, and privacy protection, among others. The results of PLS-SEM verified six out of eleven hypotheses tested, which reflected that information quality has a positive influence on perceived ease of use, which again enhances patient satisfaction. The major factors influencing the satisfaction and trust of patients in online appointment scheduling systems at public hospitals are highlighted. Indeed, privacy protection enhances patient satisfaction and trust. Service quality positively affects satisfaction but to a lesser degree. Website-related anxiety impacts perceived ease of use, although it has a limited influence on satisfaction. Such findings can inform suggestions for the managers of hospitals and portal designers to increase user satisfaction. This study uses a model from the TAM and ISSM frameworks, including cultural and socioeconomic aspects that apply to Morocco's healthcare context. [ABSTRACT FROM AUTHOR]

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Introduction: The perioperative journey is filled with anxiety for patients, often exacerbated by poor communication and inadequate understanding of pre-operative information. Ineffective perioperative practices can lead to adverse outcomes, including poor health outcomes, increased surgery cancellations, extended hospital stays and higher health care costs. Addressing patients' health literacy levels and learning preferences is crucial for developing effective educational resources. Discussion: This paper takes the stance that health literacy and learning needs are essential components of pre-operative assessment and workup. To achieve this, validated instruments and decision support tools must be integrated into the pre-operative workflow to assess and plan patientcentred pre-operative education. This paper proposes a digital tool to assess and measure health literacy and learning preferences, aiming to tailor educational interventions for surgical patients. By incorporating validated health literacy assessments alongside learning style questionnaires, clinicians can be provided with reputable recommendations for personalising patient education. Effective patient education, aligned with individual learning styles, enhances comprehension and engagement, ultimately allowing for improved surgical outcomes and reduced health care costs. Conclusion: Integrating digital tools for health literacy and learning style assessment in surgical education has the potential to significantly improve patient outcomes and optimise resource utilisation. This patient-centric approach ensures personalised, effective education thus enhancing patient care and potentially reducing overall health care costs. Policymakers and health care providers should invest in the potential of these types of digital tools to promote equitable and effective health care delivery. Further research is needed to explore the development of such tools and evaluate the long-term benefits and scalability of personalised education in diverse settings. [ABSTRACT FROM AUTHOR]

Background and Aims: Adolescents face many barriers and challenges associated with sexual and reproductive health (SRH). These barriers can include limited access to youth‐friendly healthcare services, lack of information, and stigma. Digital health interventions has the capability to enhance clinical management. This study was performed to investigate the efficacy of digital health interventions used for adolescent's sexual health. Methods: This Umbrella Review has reviewed the search engines and databases of PubMed, Web of Science, Scopus, Chochrane Library, Google Scholar in English with the keywords organized into three broad categories: Sexual health and related issues, digital health interventions, and Adolescent, until December 3, 2023. The final analysis was based on a review of 23 full‐text articles. Results: The findings of the study clearly demonstrate the effectiveness of digital health interventions in enhancing sexual health outcomes among adolescents. The review identified several significant fields where digital health interventions have been effective, including promoting safer sexual practices, improving sexual health knowledge, and Minimizing high‐risk sexual behaviors among adolescents. The assessment also emphasized the potential of digital health interventions to reach a wide audience, particularly those who may not have access to traditional healthcare services. Conclusion: The findings of this research suggest that digital health interventions can be an effective way to promote safer sexual practices, improve sexual health knowledge, and reduce risky sexual behavior among adolescents. The quality of the evidence, however, varied across the studies assessed, highlighting the need for further rigorous study to demonstrate the efficacy of these interventions. Trial Registration: PROSPERO CRD42023488296; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023488296. [ABSTRACT FROM AUTHOR]

People worldwide suffer from bladder incontinence. For patients it is difficult to train the pelvic floor without a physiotherapist. The aim of this paper is to show how smart textiles can be applied in telemedicine. Textile electrodes and conductive paths are embroidered into underwear. The electromyography (EMG) signals of the pants are sent to an app. The app visualizes the data of the muscle activity. [ABSTRACT FROM AUTHOR]

Aim: To investigate the potential for using video as a method of documentation in physiotherapy for children and adolescents, and potential facilitators and barriers for use and implementation. Design: The study followed physiotherapists from six collaborating locations in private, municipal, and specialist healthcare services, from project start and early testing and over a period of three years, to gather the physiotherapists' experiences with the use of video over time. Material & Methods: The material includes semi-structured interviews, a survey, workshops, observations, minutes from meetings and follow-up conversations with physiotherapists and a supplier of software for video editing and storage. Data was analysed using thematic analysis. Findings: The physiotherapists found video to be a useful tool that supports their current practices by providing better documentation and an "extra set of eyes". Video allows for new practices, including opportunities for sharing videos with other health care professionals, parents and institutions. Several facilitators and barriers for use and implementation were identified, including challenges related to time consumption, privacy concerns, the need for training and technical support and accessible and relevant technology. Conclusion: There is great potential for the use of video in physiotherapy. Using video is in line with the need for better tools for documentation that physiotherapists experience. Yet, further adaptation is needed before implementation into clinical practice. Moreover, unclear data protection regulations create insecurity. As a result, using video becomes cumbersome and non-attractive, despite its potential. Key-words: physiotherapy, clinical documentation e-health, video, communication.

Abstract Background Effective public health surveillance is essential for policymaking and resource allocation. The World Health Organization (WHO) supports the integration of mobile technologies to create mobile Oral (m-Oral) Health surveillance systems to enhance disease monitoring. The effectiveness and sustainability of electronic health information initiatives depend on users’ acceptance of new technologies. This research assessed dentists’ acceptance of electronic oral health surveillance systems (EOHSS) and related factors, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Materials and methods A cross-sectional study included 1470 Egyptian dentists in an online survey from November 2023 to May 2024. The dentists were recruited from the five administrative regions in Egypt using convenience and snowball sampling. Participants responded to a questionnaire that was based on the UTAUT model. Structural equation model (SEM) was used for data analysis. Results 83.4% of dentists intended to use EOHSS. Performance expectancy (PE) (ß = 0.240, 95% CI: 0.182, 0.295), training adequacy (TA) (ß = 0.232, 95% CI: 0.165, 0.291), and effort expectancy (EE) (ß = 0.231, 95% CI: 0.169, 0.289) had the greatest influence on behavioral intention (BI). In contrast, anxiety towards electronic systems (ANX) (ß = -0.140, 95% CI: -0.187, -0.095) had a significant negative effect on BI. Effort Expectancy (EE) had a significantly stronger positive impact on BI of females than males. Moreover, EE had a significantly stronger impact on BI of dentists older than 40 years old than those who were younger than 30 years old. Conclusions Egyptian dentists’ intentions to use the EOHSS were influenced by PE, TA, and EE. However, anxiety related to technology may limit its adoption. EE had a greater positive impact on BI in females and in older dentists.