Internet-based Support System Research Articles

A systematic diagnostic evaluation combined with an internet-based self-management support system for patients with asthma or COPD.

IntroductionAn (inter)national systematic approach for patients with asthma COPD referred to secondary care is lacking. Therefore, a novel systematic approach was designed and tested in clinical practice.MethodsThis was a retrospective observational study of data from the electronic record system of the Leiden University Medical Center. Asthma and COPD patients were included if they were evaluated with a novel systematic approach or if they had a new record for asthma or COPD and received usual care. The novel systematic approach consisted of a predefined diagnostic evaluation combined with an optional internet-based self-management support system. Diagnostic tests, final diagnosis, lifestyle advices, symptoms and individual care plans in the electronic records, number of patients referred back to primary care, and time to referral back to primary care were compared between the systematic approach and usual care groups using t-tests and chi-squared tests.ResultsA total of 125 patients were included, of which 22 (21.4%) were evaluated with the systematic approach. Mean (±SD) age was 48.8 (±18.4) years and 59.2% were women. Mean (±SD) number of diagnostic tests was higher in the systematic approach group compared with the usual care group (7.6±1.0 vs 5.5±1.8, P<0.001). Similarly, in the systematic approach group, more lifestyle advices (81.8% vs 29.1%), symptom scores (95.5% vs 21.4%), and individual care plans (50.0% vs 7.8%) were electronically recorded (P<0.001), and more patients were referred back to primary care (81.8% vs 56.3%, P=0.03). There were no differences in the final diagnoses and time to referral back.ConclusionOur study suggested that not all tests that were included in the systematic approach are regularly needed in the diagnostic work-up. In addition, a designated systematic approach stimulates physicians to record lifestyle advices, symptoms, and individual care plans. Thus, this approach could increase the number of patients referred back to primary care.

"인터넷 기반 영어 말하기 수행평가 지원 시스템 고등학교 적용 사례 연구"

This study aims to develop an Internet-based English speaking performance assessment support system (ESPASS) and to apply ESPASS into high schools in order to investigate its applicability and usefulness. Eleven high schools participated in an application of ESPASS during one semester. Four best practices in the use of ESPASS from the four schools were selected and presented at an English speaking performance assessment workshop for English teachers. A post workshop survey on its utility and applicability was conducted with 80 English teachers who attended the workshop. The results indicated that the teachers and the students were satisfied with its convenience and usefulness. Especially, the teachers expressed high satisfaction with ESPASS. Based upon the findings, pedagogical implications and policy suggestions were addressed for expanding ESPASS into more high schools.

Conventional Cognitive Behavioral Therapy Facilitated by an Internet-Based Support System: Feasibility Study at a Psychiatric Outpatient Clinic

BackgroundCognitive behavioral therapies have been shown to be effective for a variety of psychiatric and somatic disorders, but some obstacles can be noted in regular psychiatric care; for example, low adherence to treatment protocols may undermine effects. Treatments delivered via the Internet have shown promising results, and it is an open question if the blend of Internet-delivered and conventional face-to-face cognitive behavioral therapies may help to overcome some of the barriers of evidence-based treatments in psychiatric care.ObjectiveWe evaluated the feasibility of an Internet-based support system at an outpatient psychiatric clinic in Sweden. For instance, the support system made it possible to send messages and share information between the therapist and the patient before and after therapy sessions at the clinic.MethodsNine clinical psychologists participated and 33 patients were enrolled in the current study. We evaluated the usability and technology acceptance after 12 weeks of access. Moreover, clinical data on common psychiatric symptoms were assessed before and after the presentation of the support system.ResultsIn line with our previous study in a university setting, the Internet-based support system has the potential to be feasible also when delivered in a regular psychiatric setting. Notably, some components in the system were less frequently used. We also found that patients improved on common outcome measures for depressive and anxious symptoms (effect sizes, as determined by Cohen d, ranged from 0.20-0.69).ConclusionsThis study adds to the literature suggesting that modern information technology could be aligned with conventional face-to-face services.

Nurses’ experiences of the use of an Internet-based support system for adolescents with depressive disorders

ABSTRACTBackground: Internet-based applications are potentially useful and effective interventions to reach and support adolescents with mental health problems. Adolescents’ commitment to the use of a new Internet-based intervention is closely related to the support they receive from healthcare professionals. This study describes nurses’ experiences of the use of an Internet-based support system for adolescents with depressive disorders. Method: Qualitative descriptive study design including individual interviews with nine nurses at two psychiatric outpatient clinics. The Technology Acceptance Model (TAM) was used as the theoretical background of the study. Results: Nurses described several benefits of using the Internet-based support system in the care of adolescents with depressive disorders if the nurses integrate it into daily nursing practices. As perceived disadvantages the nurses thought that an adolescent’s mental status might be a barrier to working with the support system. Perceived enablers could be organizational support, nurses’ attitudes, and technology-related factors. Nurses’ attitudes were identified as a barrier to supporting adolescents’ use of the Internet-based support system. Conclusion: The findings suggest that the implementation plan and support from the organization, including that from nurse managers, are crucial in the process of implementing a technology-based support system.

Internet-based support system and rehabilitation of drug users under maintenance treatment.

Internet-based support system and rehabilitation of drug users under maintenance treatment.

The initial evaluation of an Internet-based support system for audiologists and first-time hearing aid clients

ObjectivesAudiologists provide professional contact and support between appointments to clients with hearing impairment using telephone and e-mail, but more advanced and flexible technological platforms are also possible. The present study aimed to evaluate the clinical application of an Internet-based support system for audiologists and their first-time hearing aid clients. DesignAn Internet-based support system developed by Månsson et al. (2013) for psychologists and their clients was adapted for audiologic purposes. Three audiologic clinics in Sweden tested the support system with their clients. Study sampleTwenty-three clients managed by four audiologists used and evaluated the support system. In addition, five of the clients and all four audiologists were interviewed and their responses were analyzed using content analysis. ResultsThe clients and the audiologists reported positive experiences and overall satisfaction but audiologists reported that the support system did not address the needs of all clients. More positive experiences and greater satisfaction with the support system were associated with reductions on self-reported consequences of hearing loss and positive hearing aids outcomes. ConclusionsAn Internet-based support system can be used in audiologic rehabilitation. Both audiologists and clients recognized the system's potential value to offer an online support to the provision of audiologic services.

The Process of Developing an Internet-Based Support System for Audiologists and First-Time Hearing Aid Clients.

In audiologic practice, complementary information sources and access to the clinician between appointments improve information retention and facilitate adjustment behaviors. An Internet-based support system is a novel way to support information sharing and clinician access. This research forum article describes the process of developing an Internet-based support system for audiologists and their first-time hearing aid clients. The iterative development process, including revisions by 4 research audiologists and 4 clinical audiologists, is described. The final system is exemplified. An Internet-based support system was successfully developed for audiologic practice.

Development and Initial Evaluation of an Internet-Based Support System for Face-to-Face Cognitive Behavior Therapy: A Proof of Concept Study

BackgroundEvidence-based psychological treatments, such as cognitive behavior therapy (CBT), have been found to be effective in treating several anxiety and mood disorders. Nevertheless, issues regarding adherence are common, such as poor patient compliance on homework assignments and therapists’ drifting from strictly evidence-based CBT. The development of Internet-delivered CBT (ICBT) has been intensive in the past decade and results show that guided ICBT can be as effective as face-to-face CBT but also indicate a need to integrate the two forms of CBT delivery.ObjectiveIn this study, we developed and tested a new treatment format in which ICBT and face-to-face therapy were blended. We designed a support system accessible via the Internet (using a computer or an Apple iPad) for patients and therapists delivering CBT face-to-face. The support system included basic CBT components and a library of interventions gathered from existing ICBT manuals.MethodsThe study involved 15 patients with mild to moderate anxiety or depression (or both). Eight therapists conducted the treatments. All participants were interviewed after the nine-week intervention. Further, patients provided self-reports on clinical measures pre- and post-trial, as well as at a 12-month follow-up.ResultsA reduction was found in symptom scores across all measures. The reliable change index ranged from 60% to 87% for depression and anxiety. Large effect sizes (Cohen’s d) ranging from 1.62 (CI 95% 0.59-2.66) to 2.43 (CI 95% 1.12-3.74) were found. There were no missing data and no treatment dropouts. In addition, the results had been maintained at the 12-month follow-up. Qualitative interviews revealed that the users perceived the support system as beneficial.ConclusionsThe results suggest that modern information technology can effectively blend with face-to-face treatments and be used to facilitate communication and structure in therapy, thus reducing therapist drift.

Developing an Internet-Based Support System for Adolescents with Depression

BackgroundDepression is the most common mental health problem among adolescents. Despite policy guidance and governmental support to develop usable mental health services, there is still a lack of easily accessible and modern interventions available for adolescents in Finland’s majority official language.ObjectiveOur objective was to develop a user-friendly and feasible Internet-based support system for adolescents with depression.MethodsThe Internet-based support system for adolescents with depression was developed. To create this new intervention, some examples of existing interventions were studied, the theoretical basis for the intervention was described, and the health needs of adolescents identified. As an outcome of the process, the results were combined and the content and delivery of a new intervention will be described here.ResultsSix individual weekly Internet-based support sessions were delivered by a tutor over a 6-week period of time and developed to form an intervention called Depis.Net. This was an Internet-based support system for adolescents with depression tailored to improve self-management skills and increase awareness of their own well-being and mental health. The intervention was accessible via an electronic platform, which was secured and password protected for users. The intervention on the Depis.Net website consisted of elements identifying adolescents’ needs, and offering self-monitoring, access to health information and self-reflective written exercises. An educated nurse tutor gave written feedback to each adolescent via the electronic platform.ConclusionsAn Internet-based support system for adolescents with depression was developed using a systematic approach with four steps. This was done to ensure that the intervention had a sound theoretical background and at the same time caters flexibly for the problems that adolescents commonly face in their daily lives. Its potential for adolescents visiting outpatient clinics will be evaluated in the next phase by means of a randomized controlled trial.

A Classification of Bargaining Steps and their Impact on Negotiation Outcomes

In this paper, we develop a typology of bargaining steps for multi-issue negotiations, which is derived from possible changes in single issues. By considering all combinations of such changes, we create a consistent classification of steps. This classification forms the basis of an empirical analysis of the impact of different types of bargaining steps on various outcome dimensions of negotiations. We perform an exploratory analysis based on an ex-post analysis of existing negotiation data, which was collected over several years using an Internet-based negotiation support system. Empirical results indicate a strong positive impact of log-rolling strategies and a negative impact of “hard” tactics like insistence on the chances of reaching an agreement. Contrary to expectations, hard tactics do not improve the efficiency of agreements.

Internet-based exercise intervention systems: Are more interactive designs better?

The benefits of Internet-based health promotion programmes are much discussed, yet the literature on their feasibility and utility is limited. Here, we evaluate an Internet-based exercise motivation and action support system (Test system), relative to a group receiving no intervention (Reference) and another receiving a less interactive version of the same system (Control). We report results from a 10-week pilot study with 75 participants aged 23–54 years. We found that, relative to the control system and reference group, the more interactive (test) system was more engaging (better user retention), created higher expectations for exercise, greater satisfaction with motivation and increased self-perception of fitness. Seven months after the intervention, participants who used the test system reported greater levels of increase in exercise than the control or reference groups. Our study adds to the growing body of evidence on the benefits of interactive systems and the role they could play in health promotion programmes. However, it should also be noted that not all Web-based systems offer the same level of advantage; careful design is crucial to ensure that key messages are clearly communicated to attentive users. Further research is required to identify the optimum interactive system design principles, across a range of user types.

Development of a Tailored, Internet-based Smoking Cessation Intervention for Adolescents

Computer-assisted interventions represent an innovative approach to adolescent smoking cessation that may offer advantages over traditional smoking interventions in their potential to provide adolescents with a variety of appropriate cessation-related activities, as well as interactive feedback tailored to their developmental, psychosocial, behavioral, and biological needs. As part of a larger project to evaluate the effectiveness of an Internet-based approach to smoking cessation among adolescents, this paper will describe the intervention development process. Stomp Out Smokes (S.O.S.), an Internet-based information and support system, was created to address the specific needs and experiences of adolescents who want to quit smoking. The development of S.O.S. involved an iterative process with five distinct yet often overlapping phases: Phase 1: review of the adolescent development, smoking cessation, and health literature; Phase 2: development and implementation of a needs assessment; Phase 3: construction of a site development strategy; Phase 4: development, review, and revision of content; and Phase 5: development of the website architecture and graphic design.

Training English pronunciation for Japanese learners of English online

In this study, a compact but effective Internet-based support system was designed for Japanese English learners to improve their English pronunciation. The system provides several interactive methods for users not only to learn pronunciation from the sample data of native speakers, but also to discover and evaluate their own specific pronunciation problems, and then improve their pronunciation with the help of the system. The system is real-time, Internet-based, and the pinpoint feedback from the system after it ha analyzed the user’s input sounds, will appear in human teacher-like natural language, rather than impersonal scores or abstract bar graphs which appear in other systems. Our present system focuses on pronunciations that are often problematic for Japanese learners of English. During the process of designing the system, we embedded HMM/DMM speech recognition and speech.

Postponed or cancelled heart operations from the patient's perspective.

The aim was to describe postponements or complete cancellations of planned cardiac operations at a Swedish hospital during 1999 and the reception the patients received from the staff in connection with this, from the inpatient's perspective. A qualitative descriptive design inspired by content analysis was used. Data were collected through questionnaires distributed to all 74 patients who had their heart operation cancelled. During analysis of the questionnaires, five categories of answers emerged describing the patients' perception of: organization, medical aspects, information, waiting time and staff reception. Overall, the patients reacted negatively to the postponement/cancellation in the form of anxiety and disappointment and fear of being affected by cardiovascular problems, but were generally satisfied with reception received from hospital staff. A number of concerns were revealed, however, with possible practical implications for the health-care system. An understanding of the disappointment and anxiety felt by patients because of the postponement/cancellation of heart surgery can help medical staff to improve the situation. An intervention program is suggested that includes a pre-admission clinic, a change in the planning and waiting list system and support via follow-up telephone calls or internet-based support system.

Market Monitoring in Dynamic Supply Networks and Chains: an Internet-Based Support System for the Agri-Food Sector

Enterprises in dynamic supply networks and chains with changing business partnerships are involved in complex dependency structures and interrelationships. Consequently, awareness of developments in the competitive and market environment is of paramount importance for economic success. The research presented in this paper deals with the conception of Internet-based support systems which supply actors in dynamic supply networks and chains with individualised information about their competitive and market environment. The paper builds on the situation in the agri-food sector but the discussions of the theoretical background and the principal system design generally apply to dynamic network scenarios. The paper presents a conceptual approach for a market monitoring system, which integrates results of research from a variety of scientific fields, utilises focused rule-based expert knowledge, and implements research-supported automation potentials. The design allows for information quality, efficiency and economic feasibility. First empirical results from experimental studies support the concept. The paper concludes with the discussion of a research outline for further validation initiatives in experimental and sector environments.

The Community Tool Box: Using the Internet to Support the Work of Community Health and Development

SUMMARY Despite limited preparation through formal and non-formal education, local people throughout the world are engaged in the common work of building healthier communities. Some core competencies-including community assessment, planning, mobilization, and evaluation-are needed to address the variety of issues that matter to local communities. This report describes an Internet-based support system for community work known as the Community Tool Box (CTB) [http://ctb.lsi.ukans.edu/]. We examine the idea and origins of the CTB and its core content, access features, and applications. We review evidence for its use, implementation and dissemination strategies, and discuss core values that guide this internet-based work.

Use of a group support system for collaborative assessment

Assessment is one of the most important tasks in the whole teaching and learning process. It has major impacts on students' learning approaches and learning outcomes. This paper reports the use of an Internet-based Group Support System (GSS) for the collaborative assessment of student projects. An empirical study was conducted on a 2nd year undergraduate course of Distributed Information Systems. In the experiment, the students were randomly assigned to two groups: an experimental group (with GSS support) and a control group (face-to-face). The results of the empirical study indicate that students participated in the GSS-supported collaborative assessment have a significantly higher level of “deep approach” strategies to learning and better project grades than those in the face-to-face collaborative assessment group.