BACKGROUND Although mobile health application (mHealth app) programs have effectively promoted di... more BACKGROUND Although mobile health application (mHealth app) programs have effectively promoted disease self-management behaviors in the last decade, usage rates have tended to fall over time. OBJECTIVE We used a case management approach led by a nurse and supported by a health-social partnership team with the aim of sustaining app usage among community-dwelling older adults and evaluated the outcome differences (i.e, self-efficacy, levels of depression, and total health service usages) between those who continued to use the app. METHODS This was a 3-arm randomized controlled trial. A total of 221 older adults with hypertension, diabetes, or chronic pain were randomized into 3 groups: mHealth (n=71), mHealth with interactivity (mHealth+I; n=74), and the control (n=76). The mHealth application was given to the mHealth and mHealth+I groups. The mHealth+I group also received 8 proactive calls in 3 months from a nurse to encourage use of the app. The control group received no interventions. Data were collected at preintervention (T1), postintervention (T2), and at 3 months’ postintervention (T3) to ascertain the sustained effect. RESULTS A total of 37.8% of mHealth+I and 18.3% of mHealth group participants continued using the mHealth app at least twice per week until the end of the sixth month. The difference in app usage across the 2 groups between T2 and T3 was significant (χ21=6.81, P=.009). Improvements in self-efficacy (β=4.30, 95% CI 0.25-8.35, P=.04) and depression levels (β=–1.98, 95% CI –3.78 to –0.19, P=.03) from T1 to T3 were observed in the mHealth group participants who continued using the app. Although self-efficacy and depression scores improved from T1 to T2 in the mHealth+I group, the mean values decreased at T3. Health service usage decreased for all groups from T1 to T2 (β=–1.38, 95% CI –1.98 to –0.78, P<.001), with a marginal increase at T3. CONCLUSIONS The relatively low rates of mHealth app usage at follow-up are comparable to those reported in the literature. More work is needed to merge the technology-driven and in-person aspects of mHealth. CLINICALTRIAL ClinicalTrials.gov NCT03878212; https://clinicaltrials.gov/ct2/show/NCT03878212 INTERNATIONAL REGISTERED REPORT RR2-10.1159/000509129
IntroductionPost‐burn scarring is often cosmetically unappealing and create discomfort. This make... more IntroductionPost‐burn scarring is often cosmetically unappealing and create discomfort. This makes it crucial to understand the experience of individuals living with scars which can offer insights into their recovery. This review sought to develop an in‐depth understanding of living with post‐burn scars.DesignA systematic review and meta‐ethnography approach were employed. We utilized an interpretive approach to inductively generate codes. These codes were examined iteratively using a constant comparison strategy following which they were re‐interpreted to formulate themes which formed the basis of undertaking a narrative synthesis.ResultsTwenty‐five studies were retained. The analytical process yielded two themes: emergence of a new identity and living with the redefined self. The experience of living with scars is entwined with the initial trauma as the scars served as a permanent reminder of the injury. Emergence of a new identity involved a process of meaning making, mourning the loss of the old self, confronting the new self, reconciling the remains of the old self with the new, rebuilding a new identity, and navigating through functional restrictions. These processes were particularly challenging for persons involved in self‐immolation. Positive coping and changing one's perspective emerged as strategies to facilitate living with the redefined self.ConclusionLiving with scars is a challenging process which is more difficult for persons whose injuries are due to self‐immolation (act of burning oneself). The findings highlight a latent yet ongoing process towards subjective recovery. Clinicians need to be aware of the processes and incorporate these into rehabilitation programmes.Clinical relevanceBurn survivors need ongoing professional support to adjust to and live with the scars. Victims of self‐immolation should be considered for early psychosocial support.
AimTo identify and classify the transitional and aftercare needs of persons hospitalised with and... more AimTo identify and classify the transitional and aftercare needs of persons hospitalised with and recovering from COVID‐19.BackgroundSeveral studies exist that describe the patient needs at the acute phase of COVID‐19. The transitional and aftercare needs that emerge during recovery, however, remain vague.MethodsA scoping review was conducted and reported according to the PRISMA extension guidelines for scoping reviews (PRISMA‐ScR). Primary studies were identified from database search. Narrative synthesis was undertaken, with the Omaha System as a framework.ResultsForty studies were included. Persons recovering from the infection may have several needs in all domains of the Omaha System. Although the severity and persistence of the needs may be unrelated to the severity of the initial infection, they may vary based on factors such as age and pre‐morbid factors.ConclusionRecovering from COVID‐19 is associated with varied biopsychosocial‐environmental needs which can adversely affect the quality‐of‐life experience. The review findings represent an inventory of needs that can guide the development of multi‐disciplinary post‐acute or aftercare programmes.Relevance to Clinical PracticeRecovering from COVID‐19 can be a protracted process requiring ongoing professional support after discharge. Policies are required to support the development and implementation of post‐acute programmes of care. Comprehensive transitional and aftercare rehabilitative programmes are needed to support the recovery process.
International journal for human caring, Nov 1, 2017
Care provision to severely burned patients is a challenging task that has the potential of puttin... more Care provision to severely burned patients is a challenging task that has the potential of putting aside other spheres of the patient and placing emphasis on the physical injury. Thus, Watson’s Theory of Human Caring was applied to a burned patient. Though his stay was short, it offered an opportunity to assess the applicability of Watson’s theory to end of life care. The theory proved useful to end of life care in the unit but it was identified that the current nursing care strategies will have to change to the primary nursing approach to enable a continuity of this application.
International journal for human caring, Mar 1, 2017
Abstract Care provision to severely burned patients is a challenging task that has the potential ... more Abstract Care provision to severely burned patients is a challenging task that has the potential of putting aside other spheres of the patient and placing emphasis on the physical injury. Thus, Watson's Theory of Human Caring was applied to a burned patient. Though his stay was short, it offered an opportunity to assess the applicability of Watson's theory to end of life care. The theory proved useful to end of life care in the unit but it was identified that the current nursing care strategies will have to change to the primary nursing approach to enable a continuity of this application.
Objective The ongoing pandemic has accentuated the use of telecare services; however, only limite... more Objective The ongoing pandemic has accentuated the use of telecare services; however, only limited progress has been made in understanding the barriers and facilitators to using these services. In order to move towards sustaining such essential services, the present study aimed to ascertain the experiences of stroke survivors and healthcare providers regarding the utilization of a post-stroke telecare service in Hong Kong. Methods Interpretive description was employed for this study. Semi-structured discussions and interviews were undertaken with nine stroke survivors and four stroke nurses who delivered the telecare services. The principles of thematic analysis were inductively followed to analyse the data. The Standards for Reporting Qualitative Research checklist was used to guide the reporting of the data. Results Three themes emerged: (a) pre-existing post-discharge service pathways; (b) push factors/facilitators for telecare usage; and (c) barriers to telecare usage. Overall, the telecare service was considered a significant alternative and one that complements conventional face-to-face follow-ups. Stroke survivors were motivated to use the service because it was convenient and flexible. However, significant barriers exist, including technical issues and a lack of guidelines and training opportunities for healthcare providers. Conclusions Although telecare is still evolving, several factors drive stroke survivors to use the service. Attention needs to be paid to the emerging barriers to improve long-term usage of the service. Clear guidelines are needed to underpin the development and implementation of telecare services.
Background Despite emerging evidence on the effectiveness of eHealth interventions in improving c... more Background Despite emerging evidence on the effectiveness of eHealth interventions in improving cardiovascular health, little is known about the perception of use and efficacy of these interventions and real-world application. Objective We sought to develop an in-depth understanding of the perceptions of eHealth interventions in improving cardiovascular health. Methods This is a systematic review and meta-synthesis of qualitative studies. A comprehensive search of multiple databases and a manual search of the references list were conducted. Meta-synthesis of qualitative data was performed to review and interpret the findings. The study report followed the ENTREQ checklist. Results Four themes emerged regarding perceptions of eHealth interventions: preferred eHealth intervention design features, enabling healthcare professionals' support, eHealth engagement for health benefits, and barriers to eHealth engagement. Intervention design features should integrate motivational elements...
A burn has been described as a family injury warranting the delivery of family-centered care (FCC... more A burn has been described as a family injury warranting the delivery of family-centered care (FCC) across the continuum of burns management. This assertion notwithstanding, only limited progress has been made to develop and implement FCC interventions in the burn unit. As a starting point, this study sought to formulate a tentative framework to underpin FCC in burn care. A multi-method design comprising an umbrella review and the secondary data analysis of qualitative datasets was employed. Following these, the findings were merged and aligned to the Universal Model of FCC to formulate the burn-specific FCC framework. For the umbrella review, four review articles met the criteria for inclusion. Following a data synthesis of the review findings and their integration with the qualitative dataset, four meta-themes that encapsulate the shared needs/concerns of family members of both pediatric and adult burn survivors emerged: (1) psychosocial concerns, (2) issues relating to role change...
Despite the notable benefits of palliative care (PC) for patients with chronic diseases, its deli... more Despite the notable benefits of palliative care (PC) for patients with chronic diseases, its delivery to people with cardiac problems, particularly in the Middle East region (EMR), remains a critical issue. There is a scarcity of research assessing nursing staff’s needs and knowledge in providing PC to cardiac patients in the EMR. This study aimed to assess the level of knowledge and needs of PC among nurses towards the provision of PC in intensive coronary care units (ICCUs) in the Gaza Strip, Palestine. It also identified the barriers to the provision of PC services in ICCUs in the Gaza Strip. A hospital-based descriptive quantitative cross-sectional design was adopted to collect data from 85 nurses working in ICCUs at four main hospitals in the Gaza Strip. Knowledge about PC was collected using a developed questionnaire based on the Palliative Care Quiz Nursing Scale (PCQN) and Palliative Care Knowledge Test (PCKT). PC training needs and barriers were assessed using the PC Needs ...
BACKGROUND Although mobile health application (mHealth app) programs have effectively promoted di... more BACKGROUND Although mobile health application (mHealth app) programs have effectively promoted disease self-management behaviors in the last decade, usage rates have tended to fall over time. OBJECTIVE We used a case management approach led by a nurse and supported by a health-social partnership team with the aim of sustaining app usage among community-dwelling older adults and evaluated the outcome differences (i.e, self-efficacy, levels of depression, and total health service usages) between those who continued to use the app. METHODS This was a 3-arm randomized controlled trial. A total of 221 older adults with hypertension, diabetes, or chronic pain were randomized into 3 groups: mHealth (n=71), mHealth with interactivity (mHealth+I; n=74), and the control (n=76). The mHealth application was given to the mHealth and mHealth+I groups. The mHealth+I group also received 8 proactive calls in 3 months from a nurse to encourage use of the app. The control group received no interventions. Data were collected at preintervention (T1), postintervention (T2), and at 3 months’ postintervention (T3) to ascertain the sustained effect. RESULTS A total of 37.8% of mHealth+I and 18.3% of mHealth group participants continued using the mHealth app at least twice per week until the end of the sixth month. The difference in app usage across the 2 groups between T2 and T3 was significant (χ21=6.81, P=.009). Improvements in self-efficacy (β=4.30, 95% CI 0.25-8.35, P=.04) and depression levels (β=–1.98, 95% CI –3.78 to –0.19, P=.03) from T1 to T3 were observed in the mHealth group participants who continued using the app. Although self-efficacy and depression scores improved from T1 to T2 in the mHealth+I group, the mean values decreased at T3. Health service usage decreased for all groups from T1 to T2 (β=–1.38, 95% CI –1.98 to –0.78, P<.001), with a marginal increase at T3. CONCLUSIONS The relatively low rates of mHealth app usage at follow-up are comparable to those reported in the literature. More work is needed to merge the technology-driven and in-person aspects of mHealth. CLINICALTRIAL ClinicalTrials.gov NCT03878212; https://clinicaltrials.gov/ct2/show/NCT03878212 INTERNATIONAL REGISTERED REPORT RR2-10.1159/000509129
IntroductionPost‐burn scarring is often cosmetically unappealing and create discomfort. This make... more IntroductionPost‐burn scarring is often cosmetically unappealing and create discomfort. This makes it crucial to understand the experience of individuals living with scars which can offer insights into their recovery. This review sought to develop an in‐depth understanding of living with post‐burn scars.DesignA systematic review and meta‐ethnography approach were employed. We utilized an interpretive approach to inductively generate codes. These codes were examined iteratively using a constant comparison strategy following which they were re‐interpreted to formulate themes which formed the basis of undertaking a narrative synthesis.ResultsTwenty‐five studies were retained. The analytical process yielded two themes: emergence of a new identity and living with the redefined self. The experience of living with scars is entwined with the initial trauma as the scars served as a permanent reminder of the injury. Emergence of a new identity involved a process of meaning making, mourning the loss of the old self, confronting the new self, reconciling the remains of the old self with the new, rebuilding a new identity, and navigating through functional restrictions. These processes were particularly challenging for persons involved in self‐immolation. Positive coping and changing one's perspective emerged as strategies to facilitate living with the redefined self.ConclusionLiving with scars is a challenging process which is more difficult for persons whose injuries are due to self‐immolation (act of burning oneself). The findings highlight a latent yet ongoing process towards subjective recovery. Clinicians need to be aware of the processes and incorporate these into rehabilitation programmes.Clinical relevanceBurn survivors need ongoing professional support to adjust to and live with the scars. Victims of self‐immolation should be considered for early psychosocial support.
AimTo identify and classify the transitional and aftercare needs of persons hospitalised with and... more AimTo identify and classify the transitional and aftercare needs of persons hospitalised with and recovering from COVID‐19.BackgroundSeveral studies exist that describe the patient needs at the acute phase of COVID‐19. The transitional and aftercare needs that emerge during recovery, however, remain vague.MethodsA scoping review was conducted and reported according to the PRISMA extension guidelines for scoping reviews (PRISMA‐ScR). Primary studies were identified from database search. Narrative synthesis was undertaken, with the Omaha System as a framework.ResultsForty studies were included. Persons recovering from the infection may have several needs in all domains of the Omaha System. Although the severity and persistence of the needs may be unrelated to the severity of the initial infection, they may vary based on factors such as age and pre‐morbid factors.ConclusionRecovering from COVID‐19 is associated with varied biopsychosocial‐environmental needs which can adversely affect the quality‐of‐life experience. The review findings represent an inventory of needs that can guide the development of multi‐disciplinary post‐acute or aftercare programmes.Relevance to Clinical PracticeRecovering from COVID‐19 can be a protracted process requiring ongoing professional support after discharge. Policies are required to support the development and implementation of post‐acute programmes of care. Comprehensive transitional and aftercare rehabilitative programmes are needed to support the recovery process.
International journal for human caring, Nov 1, 2017
Care provision to severely burned patients is a challenging task that has the potential of puttin... more Care provision to severely burned patients is a challenging task that has the potential of putting aside other spheres of the patient and placing emphasis on the physical injury. Thus, Watson’s Theory of Human Caring was applied to a burned patient. Though his stay was short, it offered an opportunity to assess the applicability of Watson’s theory to end of life care. The theory proved useful to end of life care in the unit but it was identified that the current nursing care strategies will have to change to the primary nursing approach to enable a continuity of this application.
International journal for human caring, Mar 1, 2017
Abstract Care provision to severely burned patients is a challenging task that has the potential ... more Abstract Care provision to severely burned patients is a challenging task that has the potential of putting aside other spheres of the patient and placing emphasis on the physical injury. Thus, Watson's Theory of Human Caring was applied to a burned patient. Though his stay was short, it offered an opportunity to assess the applicability of Watson's theory to end of life care. The theory proved useful to end of life care in the unit but it was identified that the current nursing care strategies will have to change to the primary nursing approach to enable a continuity of this application.
Objective The ongoing pandemic has accentuated the use of telecare services; however, only limite... more Objective The ongoing pandemic has accentuated the use of telecare services; however, only limited progress has been made in understanding the barriers and facilitators to using these services. In order to move towards sustaining such essential services, the present study aimed to ascertain the experiences of stroke survivors and healthcare providers regarding the utilization of a post-stroke telecare service in Hong Kong. Methods Interpretive description was employed for this study. Semi-structured discussions and interviews were undertaken with nine stroke survivors and four stroke nurses who delivered the telecare services. The principles of thematic analysis were inductively followed to analyse the data. The Standards for Reporting Qualitative Research checklist was used to guide the reporting of the data. Results Three themes emerged: (a) pre-existing post-discharge service pathways; (b) push factors/facilitators for telecare usage; and (c) barriers to telecare usage. Overall, the telecare service was considered a significant alternative and one that complements conventional face-to-face follow-ups. Stroke survivors were motivated to use the service because it was convenient and flexible. However, significant barriers exist, including technical issues and a lack of guidelines and training opportunities for healthcare providers. Conclusions Although telecare is still evolving, several factors drive stroke survivors to use the service. Attention needs to be paid to the emerging barriers to improve long-term usage of the service. Clear guidelines are needed to underpin the development and implementation of telecare services.
Background Despite emerging evidence on the effectiveness of eHealth interventions in improving c... more Background Despite emerging evidence on the effectiveness of eHealth interventions in improving cardiovascular health, little is known about the perception of use and efficacy of these interventions and real-world application. Objective We sought to develop an in-depth understanding of the perceptions of eHealth interventions in improving cardiovascular health. Methods This is a systematic review and meta-synthesis of qualitative studies. A comprehensive search of multiple databases and a manual search of the references list were conducted. Meta-synthesis of qualitative data was performed to review and interpret the findings. The study report followed the ENTREQ checklist. Results Four themes emerged regarding perceptions of eHealth interventions: preferred eHealth intervention design features, enabling healthcare professionals' support, eHealth engagement for health benefits, and barriers to eHealth engagement. Intervention design features should integrate motivational elements...
A burn has been described as a family injury warranting the delivery of family-centered care (FCC... more A burn has been described as a family injury warranting the delivery of family-centered care (FCC) across the continuum of burns management. This assertion notwithstanding, only limited progress has been made to develop and implement FCC interventions in the burn unit. As a starting point, this study sought to formulate a tentative framework to underpin FCC in burn care. A multi-method design comprising an umbrella review and the secondary data analysis of qualitative datasets was employed. Following these, the findings were merged and aligned to the Universal Model of FCC to formulate the burn-specific FCC framework. For the umbrella review, four review articles met the criteria for inclusion. Following a data synthesis of the review findings and their integration with the qualitative dataset, four meta-themes that encapsulate the shared needs/concerns of family members of both pediatric and adult burn survivors emerged: (1) psychosocial concerns, (2) issues relating to role change...
Despite the notable benefits of palliative care (PC) for patients with chronic diseases, its deli... more Despite the notable benefits of palliative care (PC) for patients with chronic diseases, its delivery to people with cardiac problems, particularly in the Middle East region (EMR), remains a critical issue. There is a scarcity of research assessing nursing staff’s needs and knowledge in providing PC to cardiac patients in the EMR. This study aimed to assess the level of knowledge and needs of PC among nurses towards the provision of PC in intensive coronary care units (ICCUs) in the Gaza Strip, Palestine. It also identified the barriers to the provision of PC services in ICCUs in the Gaza Strip. A hospital-based descriptive quantitative cross-sectional design was adopted to collect data from 85 nurses working in ICCUs at four main hospitals in the Gaza Strip. Knowledge about PC was collected using a developed questionnaire based on the Palliative Care Quiz Nursing Scale (PCQN) and Palliative Care Knowledge Test (PCKT). PC training needs and barriers were assessed using the PC Needs ...
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Papers by Jonathan Bayuo