ORCID Profile
0000-0002-6410-7064
Current Organisation
Deakin University
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Publisher: JMIR Publications Inc.
Date: 02-11-2022
DOI: 10.2196/36773
Abstract: The management of heart failure is complex. Innovative solutions are required to support health care providers and people with heart failure with decision-making and self-care behaviors. In recent years, more sophisticated technologies have enabled new health care models, such as smart health ecosystems. Smart health ecosystems use data collection, intelligent data processing, and communication to support the diagnosis, management, and primary and secondary prevention of chronic conditions. Currently, there is little information on the characteristics of smart health ecosystems for people with heart failure. We aimed to identify and describe the characteristics of smart health ecosystems that support heart failure self-care. We conducted a scoping review using the Joanna Briggs Institute methodology. The MEDLINE, Embase, CINAHL, PsycINFO, IEEE Xplore, and ACM Digital Library databases were searched from January 2008 to September 2021. The search strategy focused on identifying articles describing smart health ecosystems that support heart failure self-care. A total of 2 reviewers screened the articles and extracted relevant data from the included full texts. After removing duplicates, 1543 articles were screened, and 34 articles representing 13 interventions were included in this review. To support self-care, the interventions used sensors and questionnaires to collect data and used tailoring methods to provide personalized support. The interventions used a total of 34 behavior change techniques, which were facilitated by a combination of 8 features for people with heart failure: automated feedback, monitoring (integrated and manual input), presentation of data, education, reminders, communication with a health care provider, and psychological support. Furthermore, features to support health care providers included data presentation, alarms, alerts, communication tools, remote care plan modification, and health record integration. This scoping review identified that there are few reports of smart health ecosystems that support heart failure self-care, and those that have been reported do not provide comprehensive support across all domains of self-care. This review describes the technical and behavioral components of the identified interventions, providing information that can be used as a starting point for designing and testing future smart health ecosystems.
Publisher: JMIR Publications Inc.
Date: 25-06-2022
Abstract: eart failure (HF) is a common chronic condition that affects over 26 million people worldwide. It is a progressive and debilitating disease with a broad symptom profile, intermittently marked by periods of acute decompensation. People with HF generally do not self-manage their condition well (eg, monitoring symptoms, taking medications regularly, physical activity, etc). A better understanding of self-care activities and what factors may indicate deterioration is warranted. he aim of this study was to determine the feasibility and acceptability of using wearable cameras to assess self-care activities in people with HF. The study objectives were to (1) explore whether changes in self-care activities could be identified prior to hospitalization and (2) determine the acceptability of wearable cameras to people with HF. total of 30 people recently diagnosed with HF wore a camera for a maximum of 30 days the camera took a photo every 30 seconds in the forward-facing direction. At the end of the study, all 30 participants were presented with 8 statements of acceptability, scored on a 5-point Likert scale. To determine whether camera images could identify changes in self-care activities and lifestyle risk factors before hospitalization, we analyzed images from participants (n=8) who were hospitalized during the 30-day study period. Images from the period immediately prior to hospitalization and a comparison were selected for each participant. Images were manually coded according to 9 different event categories relating to self-care and lifestyle risk factors, and events were compared between the 2 periods. he participants reported high acceptability for wearing the cameras, as most strongly agreed or agreed that they were comfortable to wear (28/30, 93%) and easy to use (30/30, 100%). The results of the camera image analysis showed that participants undertook fewer activities of daily living ( i P /i =.008) and were more sedentary ( i P /i =.02) prior to being hospitalized, compared to a period nonadjacent to hospitalization. dults with HF were accepting of using a wearable camera for periods within a 30-day time frame. Wearable cameras were a feasible approach for providing data on selected self-care activities and lifestyle risk factors for HF and offer the potential to be a valuable tool for improving our understanding of self-care.
Publisher: Frontiers Media SA
Date: 29-06-2022
Abstract: Smart home systems could enhance clinical and self-management of chronic heart failure by supporting health monitoring and remote support, but evidence to guide the design of smart home system functionalities is lacking. To identify consensus-based recommendations for functions of a smart home system that could augment clinical and self-management for people living with chronic heart failure in the community. Healthcare professionals caring for people living with chronic heart failure participated in a two-round modified Delphi survey and a consensus workshop. Thirty survey items spanning eight chronic health failure categories were derived from international guidelines for the management of heart failure. In survey Round 1, participants rated the importance of all items using a 9-point Liket scale and suggested new functions to support people with chronic heart failure in their homes using a smart home system. The Likert scale scores ranged from 0 (not important) to 9 (very important) and scores were categorized into three groups: 1–3 = not important, 4–6 = important, and 7–9 = very important. Consensus agreement was defined a priori as ≥70% of respondents rating a score of ≥7 and ≤ 15% rating a score ≤ 3. In survey Round 2, panel members re-rated items where consensus was not reached, and rated the new items proposed in earlier round. Panel members were invited to an online consensus workshop to discuss items that had not reached consensus after Round 2 and agree on a set of recommendations for a smart home system. In Round 1, 15 experts agreed 24/30 items were “very important”, and suggested six new items. In Round 2, experts agreed 2/6 original items and 6/6 new items were “very important”. During the consensus workshop, experts endorsed 2/4 remaining items. Finally, the expert panel recommended 34 items as “very important” for a smart home system including, healthy eating, body weight and fluid intake, physical activity and sedentary behavior, heart failure symptoms, tobacco cessation and alcohol reduction, medication adherence, physiological monitoring, interaction with healthcare professionals, and mental health among others. A panel of healthcare professional experts recommended 34-item core functions in smart home systems designed to support people with chronic heart failure for self-management and clinical support. Results of this study will help researchers to co-design and protyping solutions with consumers and healthcare providers to achieve these core functions to improve self-management and clinical outcomes in people with chronic heart failure.
Publisher: Wiley
Date: 06-2018
DOI: 10.1111/APHW.12132
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1093/AJCN/NQY045
Publisher: Oxford University Press (OUP)
Date: 17-06-2022
Abstract: Wearable cameras offer an innovative way to discover new insights into the lived experience of people with cardiovascular conditions. Wearable cameras can be used alone or supplement more traditional research methods, such as interviews and participant observations. This paper provides an overview of the benefits of using wearable cameras for data collection and outlines some key considerations for researchers and clinicians interested in this method. We provide a case study describing a study design using wearable cameras and how the data were used.
Publisher: JMIR Publications Inc.
Date: 22-12-2017
DOI: 10.2196/MHEALTH.8791
Publisher: JMIR Publications Inc.
Date: 25-01-2022
Abstract: eople with heart failure are supported by healthcare providers who follow clinical guidelines, and they are also encouraged to participate in self-care behaviors. However, the management of heart failure is complex. Innovative solutions are required to support healthcare providers with decision-making and to support people with heart failure to sustain appropriate self-care behaviors. In recent years, more sophisticated technologies have emerged within healthcare practice. These technologies use data collection, intelligent data processing, and communication to enable new models of healthcare, such as smart health ecosystems, to assist diagnosis and treatment of conditions, support patients in managing a condition, and monitor patients to support disease prevention. Currently, there is little information about the behavioral and technical characteristics of smart health ecosystems for people with heart failure. e aimed to identify and describe the characteristics of smart health ecosystems that support self-care for people with heart failure. e conducted a scoping review using the Joanna Briggs Institute (JBI) methodology. Searches of MEDLINE, Embase, CINAHL, PsycINFO, IEEE Xplore, and ACM Digital Library databases were searched from January 2008 to September 2021. The search strategy focused on studies that described smart health ecosystems to support self-care among people with heart failure. Two reviewers screened studies at the title and abstract level, and full text then extracted relevant data from the included full texts. fter removing duplicates, 1543 articles were screened, and 34 articles were identified, representing 13 interventions. Articles represented study designs from different stages of the e-health development cycle conceptual and planning (n=6), development and usability (n=14), pilot/feasibility (n=2), effectiveness testing (n=9), implementation (n=1), all phases (n=2). They collected data from the end user with sensors and questionnaires and used tailoring to provide personalized support. Interventions supported heart failure self-care behaviors using 34 different behavior change techniques (BCTs), which were facilitated by a combination of 8 intervention features automated feedback, monitoring (integrated and manual input), presentation of data, education, reminders, communication with a healthcare provider and psychological support. Furthermore, features to support healthcare providers included the presentation of data, alarms, and alerts, communication with the end user, remote care plan modification, health record integration, and communication with other members of the care team. his scoping review identified that there are few reports of smart health ecosystems to support self-care among people with heart failure, and those that have been reported do not provide comprehensive support across all domains of self-care. Further research on implementation and effectiveness is required. This review outlines the behavioral and technical components of the identified interventions this information can be used as a starting point for designing and testing future smart health ecosystem interventions.
Publisher: Public Library of Science (PLoS)
Date: 08-09-2020
Publisher: JMIR Publications Inc.
Date: 17-02-2023
DOI: 10.2196/40536
Abstract: Heart failure (HF) is a common chronic condition that affects over 26 million people worldwide. It is a progressive and debilitating disease with a broad symptom profile, intermittently marked by periods of acute decompensation. People with HF generally do not self-manage their condition well (eg, monitoring symptoms, taking medications regularly, physical activity, etc). A better understanding of self-care activities and what factors may indicate deterioration is warranted. The aim of this study was to determine the feasibility and acceptability of using wearable cameras to assess self-care activities in people with HF. The study objectives were to (1) explore whether changes in self-care activities could be identified prior to hospitalization and (2) determine the acceptability of wearable cameras to people with HF. A total of 30 people recently diagnosed with HF wore a camera for a maximum of 30 days the camera took a photo every 30 seconds in the forward-facing direction. At the end of the study, all 30 participants were presented with 8 statements of acceptability, scored on a 5-point Likert scale. To determine whether camera images could identify changes in self-care activities and lifestyle risk factors before hospitalization, we analyzed images from participants (n=8) who were hospitalized during the 30-day study period. Images from the period immediately prior to hospitalization and a comparison were selected for each participant. Images were manually coded according to 9 different event categories relating to self-care and lifestyle risk factors, and events were compared between the 2 periods. The participants reported high acceptability for wearing the cameras, as most strongly agreed or agreed that they were comfortable to wear (28/30, 93%) and easy to use (30/30, 100%). The results of the camera image analysis showed that participants undertook fewer activities of daily living (P=.008) and were more sedentary (P=.02) prior to being hospitalized, compared to a period nonadjacent to hospitalization. Adults with HF were accepting of using a wearable camera for periods within a 30-day time frame. Wearable cameras were a feasible approach for providing data on selected self-care activities and lifestyle risk factors for HF and offer the potential to be a valuable tool for improving our understanding of self-care.
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/OPENHRT-2021-001949
Abstract: This review aimed to compare the relative effectiveness of different exercise-based cardiac rehabilitation (ExCR) delivery modes (centre-based, home-based, hybrid and technology-enabled ExCR) on key heart failure (HF) outcomes: exercise capacity, health-related quality of life (HRQoL), HF-related hospitalisation and HF-related mortality. Randomised controlled trials (RCTs) published through 20 June 2021 were identified from six databases, and reference lists of included studies. Risk of bias and certainty of evidence were evaluated using the Cochrane tool and Grading of Recommendations Assessment, Development and Evaluation, respectively. Bayesian network meta-analysis was performed using R. Continuous and binary outcomes are reported as mean differences (MD) and ORs, respectively, with 95% credible intervals (95% CrI). One-hundred and thirty-nine RCTs (n=18 670) were included in the analysis. Network meta-analysis demonstrated improvements in VO 2 peak following centre-based (MD (95% CrI)=3.10 (2.56 to 3.65) mL/kg/min), home-based (MD=2.69 (1.67 to 3.70) mL/kg/min) and technology-enabled ExCR (MD=1.76 (0.27 to 3.26) mL/kg/min). Similarly, 6 min walk distance was improved following hybrid (MD=84.78 (31.64 to 138.32) m), centre-based (MD=50.35 (30.15 to 70.56) m) and home-based ExCR (MD=36.77 (12.47 to 61.29) m). Incremental shuttle walk distance did not improve following any ExCR delivery modes. Minnesota living with HF questionnaire improved after centre-based (MD=−10.38 (−14.15 to –6.46)) and home-based ExCR (MD=−8.80 (−13.62 to –4.07)). Kansas City Cardiomyopathy Questionnaire was improved following home-based ExCR (MD=20.61 (4.61 to 36.47)), and Short Form Survey 36 mental component after centre-based ExCR (MD=3.64 (0.30 to 6.14)). HF-related hospitalisation and mortality risks reduced only after centre-based ExCR (OR=0.41 (0.17 to 0.76) and OR=0.42 (0.16 to 0.90), respectively). Mean age of study participants was only associated with changes in VO 2 peak. ExCR programmes have broader benefits for people with HF and since different delivery modes were comparably effective for improving exercise capacity and HRQoL, the selection of delivery modes should be tailored to in iduals’ preferences.
No related grants have been discovered for Rebecca Nourse.