Health Journey Research Articles

Collaboration Challenges and Technology Opportunities at the Intersection of Perinatal and Mental Health Journeys

Collaborative Care Programs (CCPs) integrate mental health services into primary care settings to help patients access much needed treatment. Technologies could increase the effectiveness of CCPs, but we know little about what collaboration challenges technologies must address in this complex clinical setting. To investigate these challenges and technology opportunities, we conducted interviews and contextual inquiries with 30 patients and providers in an obstetric CCP. Using the Parallel Journeys Framework as a lens, we uncover new collaboration challenges (e.g., weighing risks and benefits of treatment, conflicting opinions and ambiguous responsibilities) at the intersection of patients' obstetric and psychosocial care journeys. We discuss new CSCW implications and technology opportunities, such as the importance of addressing support gaps in cyclical experiences, and the need to resolve provider conflicts to refocus on patient needs. These contributions inform how technologies can support patient engagement and collaboration with providers to access and receive treatment, as well as improve health outcomes.

"It Depends on the Situation": How Hearing-Specific Contexts Affect the Way Adults With Hearing Loss Report Their Personal Attributes.

This study examined how adults with untreated hearing loss respond to surveys about their self-efficacy, personality traits, and affective states when assessed "in general" and in listening-related contexts. We also explored the associations between hearing aid self-efficacy (HASE) and listening-related personality traits and affective states. Sixty-two adults with self-reported hearing difficulties and no experience with hearing aids (HAs) participated in this descriptive study. Participants self-reported their self-efficacy, personality, and affective states in general and in listening-related contexts. Paired t tests and repeated measures with Holm-Šídák corrections were performed to explore differences between reports of patient traits in different contexts. Multiple regression analyses were conducted to explore significant associations. On average, there were no significant differences between general and listening-related self-efficacy or personality traits. However, our participants indicated significantly more negative affective states in listening-related situations compared to in general. There was a small positive association between HASE and reported affective states in "General" and "Listening at Home" contexts. This study confirms that context-specific measures are not required to accurately assess self-efficacy and personality traits in the initial stages of the hearing health journey. However, reported affective states were listening dependent for this sample. Although reported affective states were related to HASE, context-dependent measures did not provide additional insight into participants' self-efficacy for successful HA use. This suggests that rehabilitation protocols designed to promote HASE and positive affect in general and listening-related situations could facilitate HA success.

Cough Characteristics and Healthcare Journeys of Chronic Cough Patients in Community-Based Populations in South Korea and Taiwan

PurposeThis study aimed to understand the cough characteristics and health journeys among community-based chronic cough (CC) patients, and their characteristics associated with healthcare visits.MethodsA population-based cross-sectional study was conducted in 2020, using the South Korea and Taiwan National Health and Wellness Survey (NHWS) and CC surveys. Patients with current CC were defined by daily coughing for > 8 weeks in the past 12 months and currently coughing at the time of survey. The survey items pertained to CC patients’ treatment journey and cough characteristics.ResultsPatients with current CC in South Korea and Taiwan, respectively, had cough duration for 3.45 ± 5.13 years and 5.75 ± 7.28 years and cough severity visual analogue scale (VAS) scores of 4.50 ± 2.15 and 4.46 ± 1.92 out of 0–10 scale, with 70.3% and 57.9% having spoken with a physician about cough. Compared to CC patients who had not visited healthcare professionals for cough, those who visited reported more severe cough (VAS: 3.89 ± 1.71 vs. 4.6 ± 2.02; p = 0.009), worse cough-specific quality of life (Leicester Cough Questionnaire: 16.20 ± 3.23 vs.13.45 ± 2.68, p < 0.001), greater symptom severity (Hull Airway Reflux Questionnaire: 16.73 ± 15.16 vs. 24.57 ± 13.38; p < 0.001), and more urinary incontinence (13.6 vs. 26.5%, p = 0.027). More than 50% of patients perceived cough medication(s) as not or a little useful and 25% felt their physicians did not well understand how CC impacts their life.ConclusionCough is frequently severe and persistent among community-based CC patients. They experience several issues in their health journey, including treatment ineffectiveness and physician’s understanding. Further efforts are warranted to reduce CC burden in the community.

Linking Heart Health and Mental Wellbeing: Centering Indigenous Perspectives from across Canada.

Indigenous peoples have thrived since time immemorial across North America; however, over the past three to four generations there has been a marked increase in health disparities amongst Indigenous peoples versus the general population. Heart disease and mental health issues have been well documented and appear to be interrelated within Indigenous peoples across Canada. However, Western medicine has yet to clearly identify the reasons for the increased prevalence of heart disease and mental health issues and their relationship. In this narrative review, we discuss how Indigenous perspectives of health and wholistic wellness may provide greater insight into the connection between heart disease and mental wellbeing within Indigenous peoples and communities across Canada. We argue that colonization (and its institutions, such as the Indian Residential School system) and a failure to include or acknowledge traditional Indigenous health and wellness practices and beliefs within Western medicine have accelerated these health disparities within Indigenous peoples. We summarize some of the many Indigenous cultural perspectives and wholistic approaches to heart health and mental wellbeing. Lastly, we provide recommendations that support and wholistic perspective and Indigenous peoples on their journey of heart health and mental wellbeing.

Enablers and barriers to prevent weight-regain post bariatric surgery – A qualitative enquiry

BackgroundWeight-regain is commonly experienced after bariatric surgery. This qualitative enquiry aimed to explore participants' self-reported enablers and barriers to prevent future weight-regain post-surgery. MethodsEligible adults were recruited at 12-months post-bariatric-surgery at Counties Manukau, Auckland. Participants were invited to attend data collection at their 18-month group nutrition-education session, and to participate in a focus group at 21-months post-surgery. Thematic analysis was used to evaluate patient experiences. ResultsParticipants (n = 28) were mostly female (73.2 %), New Zealand European (41.5 %), and had gastric sleeve surgery (92.3 %). Five key themes emerged from the analysis: A Life Changing Health Journey - participants experienced a decrease in obesity-related comorbidities and a subsequent decrease in medications. Weight change and food intolerances impacted quality of life. Challenge of managing a New Healthy Lifestyle - financial stress, buying healthier foods and social events were new challenges, often centred on food. Changing Eating Behavior - all participants struggled managing eating behaviors. Mindset Changes - post-surgery most participants had a positive mindset, increased confidence, and feelings of happiness. However, many struggled with mindset around weight and food. A need for On-going Support - most felt under-supported and expressed a need for longer, specific follow-up care. ConclusionPost-surgery group education sessions provided participants with increased support from both health professionals and peers on the same journey, to overcome struggles such as binge eating or identifying new coping strategies. Findings provide important insights into the challenges patients with bariatric surgery face and key learnings to develop specific supports for future care practices.

To Hell and Back: A Performer's mental health journey during the COVID-19 pandemic.

WHAT IS KNOWN ON THE SUBJECT?: The COVID-19 pandemic has induced a considerable amount of mental health difficulties, ranging from anxiety and depression to psychosis. As services struggle to cope with the demand for support, the effect of such psychological challenges on quality of life remains a major concern. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Since the beginning of the COVID-19 pandemic, a vast amount of research has focused on the physical consequences of the virus. Gradually, studies on the mental health effects related to the pandemic started to emerge, as it became clear that mental health difficulties were as present and as concerning as the physical ones. Whilst such studies commonly explore the prevalence and nature of the presenting mental health challenges, the publication of personal mental health experiences linked to the ongoing situation is lacking. Introducing the human element in literature is an important means of raising awareness on the mental health difficulties that can be triggered by the pandemic. Using public figures such as the individual in this paper is additionally powerful due to the role model effect. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The paper highlights the need for enhanced awareness and monitoring of mental health especially by health professionals who therefore need to receive adequate mental health training. Furthermore, mental health awareness efforts need to be considered as being a part of the role of the psychiatric and mental health nurse who is at a prime position to educate, monitor and support those receiving care.

Human-centered integrated care pathways for co-creating a digital, user-centric health information solution

PurposeA broader challenge of co-creating digital solutions with patients addresses the question how to apply an open-access digital platform with trusted digital health information as a measure to transform the way patients access and understand health information. It further addresses use this for adherence to treatment, risk minimization and quality of life throughout the integrated patient journey. The aim of this paper is to demonstrate the early steps in towards progress to co-creating the digital solution.Design/methodology/approachTo coordinate the co-creation process, the authors established a multiphased plan to deep-dive into user needs and behaviors across patient journeys, to identify nuances and highlight important patterns in stakeholder and end-user segment at various stages in the patient's journey.FindingsA set of tools was designed to serve as a human-centered compass throughout the lifecycle of the project. Those tools include shared objects; personas, user journeys, a set of performance indicators with related requirements – all those tools being consistently refined in ongoing co-creation workshops with members of the cross-functional stakeholder groups.Originality/valueIn this study, a multidisciplinary, public-private partnership looked at integrated digital tool to improve access, understanding and adherence to treatment for diverse groups of patients across all stages of their health journeys in a number of countries including European Union (EU) and United States of America (USA). As a result of this work, the authors attempt to increase the possibility that the improved availability and understanding of health information from trusted sources translates to higher levels of adherence to treatment, safer use of medication (pharmacovigilance), better health outcomes and quality of life integrated in the patient's journey.

Born again: Narrating the mental health journeys of religious exiters

AbstractReligious exit–also known as disaffiliation, deconversion, or apostasy–from religion is a growing phenomenon in the United States with significant individual and social consequences. In this review, I consult existing literature to clarify the relationship between the process of religious exit and the mental health of exiters. I organize this literature using Ebaugh’s (1988) role‐exit model to frame exiting religion as a multi‐stage process of role‐identity disruption, exit, anomie, and reestablishment, each of which are characterized by changes in mental health. The literature suggests that, beginning with tension between a religious system and the individual, exiters undergo a psychologically and emotionally fraught process of role‐identity transformation typified by a sequence of pre‐exit strains, a turning point at which exit occurs, immediate psychological and social aftermath, and a subsequent lifetime process of reconstruction. Using evidence from exiters' narratives, I argue that the conflict inherent in the process of religious exit catalyzes psychological distress, but that exit provides a mechanism for role‐identity reset that relieves many of the negative mental health effects associated with religious strain.

Data-driven intelligent decision for multimedia medical management

Since medical diagnosis runs through the whole journey of human health, the traditional medical diagnosis methods cannot ensure the diagnosis accurate due to the interference of multiple external factors. In response, this paper proposes a multimedia medical management method supported by the data-driven intelligent decision (MMD-DI). This method can be used to predict the survival time of cancer patients under the help of gradient boosting decision tree (GBDT) and hybrid neural network model. First, the feature factors were scanned to match the conditions by GBDT, according to the set value domain; Then the factors were inputted into the neural network. The hybrid neural network was employed to predict the survival time of cancer patients, and it was constructed by combining the convolutional neural network (CNN) and the long short-term memory (LSTM) model. Finally, the stability of the proposed MMD-DI was analyzed, and performance was compared with a series of commonly exploited baseline methods: the mean of cross-validated RMSE (Root Mean Squared Error) evaluation results is 0.183, the mean of cross-validated MAE (Mean Absolute Error) evaluation results is 0.147, the two indicators are both much lower than the commonly exploited baseline methods. A series of experiments proved that MMD-DI has excellent performance and can be used in the multimedia medical management systems.

Promoting extreme fitness regimes through the communicative affordances of reality makeover television: a multimodal critical discourse analysis

ABSTRACT Taking off from the theory of social semiotics and using the methods of multimodal critical discourse analysis, this paper demonstrates how the communicative affordances of a Swedish reality makeover show, The Great Health Journey, are used to promote discourses normalizing extreme fitness ideals. It is a show that reduces health to body fitness and supports a particular health consciousness gaining prominence today, an ideology here depicted as fitnessism. Progressing the ideas put forward by Crawford with the notion of healthism, fitnessism accentuates the careful submission to strict fitness-related regimes as crucial for a healthy lifestyle. It turns the very fit body into a sign of good morals, indicating the values of self-discipline, self-control, and willpower, personal characteristics seen as crucial in the neoliberal era. But the healthiness of this fitness ideal can be questioned. Rather than serving the interest of public health, fitnessism seems to mainly encourage “aesthetic labour” and support commercial interests to exploit body dissatisfaction.

A Review of the Role of Essential Ayurvedic Management in Covid Pandemics

At the end of 2019, China exploded COVID-19 and mushroomed rapidly throughout every nation. Due to the information received by the media, this message has spread somewhere in the minds of the people. Covid-19 is a complicated, difficult to treat, or horrifying disease. Although the severity of symptoms and the lethality of the virus directly causing the disease cannot be ruled out or ignored, but somewhere, the negligence of the imbalance in the nature of the basic elements of the body is the reason for the fatality of this disease. According to Aacharya Charak, "there can be hundreds of alternatives for the pathogen of any disease," but "this body is the only option for pathogens to cause hundreds of diseases." Which is why this should be the major focus for treatment in any stream of medical science and Ayurveda is a science of 'ayu', meaning harmony of health and life or journey of healthy life. This reveals that there is a high opportunity to evaluate the range of relevant drugs available in the Ayurvedic that may be employed more rationally to complement each stage of the disease. The Ayurvedic literature provides no explicit mention of this illness but according to the similarity of symptoms despite the occurrence of diseases, there is a special outbreak of Vata and Kapha. This disease can be reconciled in Janpadudhwansh janya diseases, Visham jwara and Vatshleshmic jwara.

The Transformative Journey of Transplantation.

The Transformative Journey of Transplantation Valen Keefer The moisture from the ocean floated effortlessly through the air as it glided over the rocky cliff. The steady stream of mist covered my face and frizzy hair with beaded water droplets. I had been sitting on a bench alone for hours admiring the Northern California coast at a magnificent overlook featuring a bird’s-eye view of the endless sea and campground I called home for the past month. The stunning mountain landscape behind me, the soothing colors of the coastal shrubbery, and the smell of eucalyptus made for a trifecta of surreal beauty. The ocean disappeared from my view and I became engulfed in the precipitation and felt like I was suspended in a cloud. I was soaking in every moment as it was the last day of my solo RV trip. The fog slowly separated and exposed bits and pieces of the ocean again and then a breathtaking rainbow came into sight. Each end appeared to be touching either side of the campground like it was giving it a hug. I was eye-level with the center and highest point of the rainbow, arching above our home on wheels. I stood on the bench with my arms wide open, embracing nature and the gift of life in all its glory. This moment would not have possessed such deep meaning if it wasn’t for the journey that came before it—the transformative journey of transplantation. Some may think of transplantation as a singular event when in reality, it’s a lifelong journey that can start with a diagnosis many years prior. My transplant journey began when I was diagnosed with polycystic kidney disease (PKD) at 10-years-old. Being diagnosed with a hereditary disease that has deeply impacted multiple generations of our family and with no known treatment or cure was a lot to carry as a child. My youth was full of love from my parents and filled with illness and the limitations and long-term impacts of growing up with multiple chronic illnesses. My education on PKD was the brutal real-life experiences of enduring it firsthand—with no support groups, resources, or internet to seek answers. I always felt different during a time when you’d do anything to fit in. I couldn’t play sports and had to sit on the sidelines in gym class. I was often in the nurse’s office, hospital, or recovering from a surgery. I hid my scars and unattractive body while changing in gym class. Friendships were really hard. Relationships were even harder. Growing up with chronic illnesses takes away from the fun of dreaming. It’s like that bright future full of endless possibilities is blocked by a huge mountain you know you have to summit first with no supplies, no friends, and no paved path to follow. Complications from PKD followed me from high school right into college, when I spent almost a year in the hospital. Both of my kidneys were removed, I was on dialysis, had pancreatitis, received over 70 blood transfusions, survived an internal bleed, and was in dire need of a lifesaving kidney transplant. At 19-years-old, I was too sick to be placed on the transplant waiting list, but needed a kidney to survive. My parents were living at the Ronald McDonald House, wondering if they would be the next ones to lose their teenage daughter. A close family friend forever changed our lives when she restored my health by selflessly donating her kidney to me. While it was an arduous path to transplantation, in some ways, the journey was just beginning. Fifteen years following my kidney transplant and summiting what I thought was going to be the most challenging mountain of my health journey, I found myself back on death’s doorstep with another battle ahead. I was in need of a second miracle, this time a lifesaving liver transplant. It was PKD again. The bile ducts in my liver were so gnarly that they looked like limbs of an oak tree rather than the desired smooth straw-like appearance. Their malformations led to chronic liver infections and multiple sepsis...

Improved remote mental health illness assessment and detection using facial emotion detection and speech emotion detection

The use of Artificial Intelligence in the healthcare sector has been recently observed. Projects are being made that integrate AI and therapeutic sessions[1]. A new area of study evolved where doctors, along with technicians, collaborate to create projects which will help give the old school therapy an advanced technical form. This study uses the original therapy techniques for mental health assessment and integrates it with machine learning models for facial emotion recognition and speech pattern recognition to get a better understanding of a patient’s mental health condition and help them deal with it. This project assists the patient in the diagnosis of 11 different mental health conditions where the patient’s emotional state is taken into consideration while diagnosis. Patients’ social interactions are also being checked and analyzed regularly. This project calculates a verdict which declares whether the patient suffers from the diagnosed illness or whether they should retake the tests. In addition, the project maintains records of the patient's emotional and mental health journey.

"I Wanted to See How Bad it Was": Online Self-screening as a Critical Transition Point Among Young Adults with Common Mental Health Conditions.

Young adults have high rates of mental health conditions, yet they are the age group least likely to seek traditional treatment. They do, however, seek information about their mental health online, including by filling out online mental health screeners. To better understand online self-screening, and its role in help-seeking, we conducted focus groups with 50 young adults who voluntarily completed a mental health screener hosted on an advocacy website. We explored (1) catalysts for taking the screener, (2) anticipated outcomes, (3) reactions to the results, and (4) desired next steps. For many participants, the screener results validated their lived experiences of symptoms, but they were nevertheless unsure how to use the information to improve their mental health moving forward. Our findings suggest that online screeners can serve as a transition point in young people's mental health journeys. We discuss design implications for online screeners, post-screener feedback, and digital interventions broadly.

Do you have any questions? An analysis of question asking patterns in surgical outpatient consultations.

BackgroundPatient centred communication ensures patients are well informed and educated, which is vital to providing the best care possible. By asking questions, patients can better understand their disease and make informed decisions regarding their health journey. We aimed to investigate factors that affect question asking behaviours in surgical outpatient consultations and to determine the typical question‐asking by doctors, patients, and their companions.MethodsThis is an observational cross‐sectional study, where 182 video recordings of surgical consultations in the surgical outpatient setting at The Queen Elizabeth Hospital, Adelaide, South Australia were reviewed.ResultsA total of 3472 questions were asked. Most questions were asked by the surgeon, followed by the patient, and if present, their companion. Pre‐surgical consultations resulted in the most questions asked by the patients, compared to post‐surgical or follow‐up consultations. When companions were present, patients asked more questions in consultants regarding malignant conditions. Interruptions increased the number of questions asked by the patient and their companion. Questions were commonly asked to clarify information given by the surgeon and often regarded the cause of the illness and the timing of the next step in disease management.ConclusionPatients are generally interested in their health and ask questions during consultations. Companions have a positive effect on patient question asking behaviour and their presence in surgical consultations should be encouraged. Surgeons should develop strategies to encourage question asking and could review their own behaviours via surgical coaching and video review.

Toward Zero Harm: Mackenzie Health's Journey Toward Becoming a High Reliability Organization and Eliminating Avoidable Harm.

In response to an organizational survey revealing low safety culture scores, we implemented a "zero harm" approach to eliminate preventable harm across a wide variety of clinical areas. We aimed to achieve this objective within 3 years. We developed a 5-part strategy for cultural and process redesign that included (1) engaging leadership; (2) developing an organization-specific patient safety framework; (3) monitoring specific quality aims based on high-risk, high-volume, high-cost, and problem-prone areas; (4) standardizing a 3-part review process that includes a root cause analysis for moderate and critical patient safety incidents; and (5) communicating progress to staff in real time via unit-specific electronic dashboards. In less than 1 year, we increased patient safety incident reporting by 37% while simultaneously decreasing falls with injury by 39%, pressure injury rates by 37%, and central line-associated blood stream infections by 34%. We also improved medication reconciliation rate by 3.3% and decreased our irretrievable specimen rate to 0. Finally, we noted increased awareness around patient safety within clinical teams, with open discussions about patient safety becoming a routine part of patient care. This study describes an initiative that sought to introduce system-wide changes to practice and patient safety culture in a rapid time frame. Results suggest that our 5-step approach to transformation may confer substantial gains in patient safety for peer institutions. Next steps include continuing to expand and monitor quality aims as we progress through our journey to eliminating preventable patient harm in our healthcare system.

My mental health journey from a nurse perspective

Sarah Jane Palmer discusses her mental health experiences and what she thinks could be done to improve the patient pathway to recovery

Preservice Teachers’ Mental Health: Using Student Voice to Inform Pedagogical, Programmatic, and Curricular Change

ABSTRACT The purpose of the study is to analyze the role preservice teachers’ mental health plays in their development during teacher preparation programs and the role of teacher preparation programs in preservice teachers’ mental health journeys. Using an ethic of care theoretical approach, a within-method triangulation designwas utilized with interviews, focus groups, and surveys in a qualitative study with 33 participants in order to more fully understand student participant perspectives. The major findings included the need to better normalize mental healthcare, the demand preservice teachers face preparing for a helping profession, and the importance of providing an environment in which care and self-care can be better developed.

A Randomized Trial of 21 Days of Loving Kindness Meditation for Stress Reduction and Emotional Well-being Within an Online Health Community for Patients, Family, and Friends Experiencing a Cancer Health Journey.

Objectives: CaringBridge (CB) is an online health community for people undergoing challenging health journeys. Loving Kindness Meditation (LKM) is a systemized mind-body approach developed to increase loving acceptance and has previously been reported to increase resilience in the face of adversity. Materials and Methods: Results of a randomized controlled trial of immediate compared with deferred 21-day LKM intervention in an online community are reported. The deferred group received LKM intervention after a waiting period of 3 weeks. Inclusion criteria were >18 years old, ability to understand English, willingness to participate in a mind-body practice, and use of CB for a cancer journey. Change in perceived stress, self-compassion, social connectedness and assurance, and compassionate love scales from baseline to 21 days was assessed. Results: Of the 979 participants included in the study, 649 (66%) provided 3-week follow-up data and 330 (49%) self-reported engaging in the LKM practice 5 or more days/week. Participants in the immediate LKM group reported medium effect size improvement in stress (0.4), self-compassion (0.5), and social connectedness (0.4) compared with the deferred LKM group. Changes in perceived stress and self-compassion were larger in magnitude and increased with more frequent engagement in LKM. Conclusions: The immediate LKM group showed improvements in stress, self-compassion, and social connectedness compared with the deferred control group. Differential study retention rates by treatment arm and self-reported engagement in LKM subject the results to selection bias. Future research of similar interventions within online health communities might pay greater attention to promoting intervention adherence and engaging a more diverse economic and racial/ethnic population. ClinicalTrials.gov (NCT05002842).

Congregations as Health Connectors – Addressing Health and Social Needs of Neighbors Through Conversations, Not Surveys

Background and Hypothesis: Social determinants of health (SDOH) directly affect health outcomes and indirectly limit access to resources needed to maintain individual health. In an effort to address the negative impacts of SDOH on the urban communities of Indianapolis, four congregations have employed Site Connectors to directly form relationships with neighbors, learn about their health journey, and connect them to resources addressing expressed needs. It is our hypothesis that through research of similar models and discussion with community partners, an optimized model for fostering relationships and assessing the health and social needs of neighbors can be developed for use by the Site Connectors.&#x0D; Project Methods: A search was performed for examples of health and social needs assessments utilized by established care providers, and thirteen were identified. The items within these assessments were then organized into six groups based on SDOH topic (ie. Housing, Transportation, etc.). Additionally, six interviews with community partners performing similar work were conducted utilizing a fixed set of questions.&#x0D; Results: It was determined that the best format for our assessment would not be a survey, as in the example assessments, but rather a visual aid resembling a concept map. This model lends itself more to the nature of relationship-building by guiding Connector-Neighbor conversations rather than dictating them, with three starter questions at the center and six offshoots covering each of the SDOH topics. A post-encounter checklist was also developed for Connectors to retroactively record priority items from their conversations.&#x0D; Potential Impact: It is yet to be determined whether our model will be useful in practice, as the Connectors begin their work in August. However, it is our hope that we have developed a novel format for assessing needs that more holistically addresses the impacts of SDOH through respecting the vulnerability and energy required for relationship-building.