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  1. Article: Prediction of Physical Activity Patterns in Older Patients Rehabilitating After Hip Fracture Surgery: Exploratory Study.

    van Dartel, Dieuwke / Wang, Ying / Hegeman, Johannes H / Vollenbroek-Hutten, Miriam M R

    JMIR rehabilitation and assistive technologies

    2023  Volume 10, Page(s) e45307

    Abstract: Background: Building up physical activity is a highly important aspect in an older patient's rehabilitation process after hip fracture surgery. The patterns of physical activity during rehabilitation are associated with the duration of rehabilitation ... ...

    Abstract Background: Building up physical activity is a highly important aspect in an older patient's rehabilitation process after hip fracture surgery. The patterns of physical activity during rehabilitation are associated with the duration of rehabilitation stay. Predicting physical activity patterns early in the rehabilitation phase can provide patients and health care professionals an early indication of the duration of rehabilitation stay as well as insight into the degree of patients' recovery for timely adaptive interventions.
    Objective: This study aims to explore the early prediction of physical activity patterns in older patients rehabilitating after hip fracture surgery at a skilled nursing home.
    Methods: The physical activity of patients aged ≥70 years with surgically treated hip fracture was continuously monitored using an accelerometer during rehabilitation at a skilled nursing home. Physical activity patterns were described in our previous study, and the 2 most common patterns were used in this study for pattern prediction: the upward linear pattern (n=15) and the S-shape pattern (n=23). Features from the intensity of physical activity were calculated for time windows with different window sizes of the first 5, 6, 7, and 8 days to assess the early rehabilitation moment in which the patterns could be predicted most accurately. Those features were statistical features, amplitude features, and morphological features. Furthermore, the Barthel Index, Fracture Mobility Score, Functional Ambulation Categories, and the Montreal Cognitive Assessment score were used as clinical features. With the correlation-based feature selection method, relevant features were selected that were highly correlated with the physical activity patterns and uncorrelated with other features. Multiple classifiers were used: decision trees, discriminant analysis, logistic regression, support vector machines, nearest neighbors, and ensemble classifiers. The performance of the prediction models was assessed by calculating precision, recall, and F
    Results: The amplitude feature describing the overall intensity of physical activity on the first day of rehabilitation and the morphological features describing the shape of the patterns were selected as relevant features for all time windows. Relevant features extracted from the first 7 days with a cosine k-nearest neighbor model reached the highest overall prediction performance (micro F
    Conclusions: Continuous monitoring of the physical activity of older patients in the first week of hip fracture rehabilitation results in an early physical activity pattern prediction. In the future, continuous physical activity monitoring can offer the possibility to predict the duration of rehabilitation stay, assess the recovery progress during hip fracture rehabilitation, and benefit health care organizations, health care professionals, and patients themselves.
    Language English
    Publishing date 2023-11-30
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2798120-4
    ISSN 2369-2529
    ISSN 2369-2529
    DOI 10.2196/45307
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Patterns of physical activity over time in older patients rehabilitating after hip fracture surgery: a preliminary observational study.

    van Dartel, Dieuwke / Wang, Ying / Hegeman, Johannes H / Vermeer, Marloes / Vollenbroek-Hutten, Miriam M R

    BMC geriatrics

    2023  Volume 23, Issue 1, Page(s) 373

    Abstract: Background: To investigate patterns of continuously monitored physical activity in older patients rehabilitating after hip fracture surgery and the association with patient characteristics.: Methods: Physical activity of surgically treated hip ... ...

    Abstract Background: To investigate patterns of continuously monitored physical activity in older patients rehabilitating after hip fracture surgery and the association with patient characteristics.
    Methods: Physical activity of surgically treated hip fracture patients aged 70 years or older, who were rehabilitating at a skilled nursing home, was continuously monitored using a tri-axial accelerometer. The intensity of physical activity per day was calculated from the accelerometer signals to describe the daily physical activity levels of the enrolled patients. The patterns of three different aspects of physical activity were investigated: overall physical activity, overall variability, and day-to-day variability. Two experts in the geriatric rehabilitation field helped identifying unique physical activity patterns for each aspect based on visual analysis. Eighteen healthcare professionals independently classified each patient in one of the predefined patterns for each aspect. Differences between physical activity patterns and patient characteristics were assessed using a Kruskal-Wallis or Fisher's Exact Test.
    Results: Physical activity data from 66 older patients were used in this preliminary study. A total of six unique patterns were identified for overall physical activity and overall variability, and five unique patterns for the day-to-day variability. The most common pattern found for the overall physical activity and day-to-day variability had a S-shape, which first slowly increased, then steeply increased, and subsequently flattened (n = 23, 34.8%). A N-shape pattern was found the most common pattern for overall variability, which first slowly increased, then steeply increased, then decreased and lastly increased (n = 14, 21.2%). The functionality at admission to rehabilitation, measured with the Barthel Index, and the duration of rehabilitation stay differed between the patterns of physical activity.
    Conclusions: Multiple patterns of physical activity among older patients during hip fracture rehabilitation were found in this preliminary study. The functionality at admission to rehabilitation and the duration of rehabilitation stay were associated with the different patterns found in this study. Results of this study highlight the importance of personalized hip fracture treatment.
    MeSH term(s) Humans ; Aged ; Length of Stay ; Treatment Outcome ; Hip Fractures/surgery ; Hip Fractures/rehabilitation ; Hospitalization ; Exercise
    Language English
    Publishing date 2023-06-16
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-023-04054-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: What web-based intervention for chronic cancer-related fatigue works best for whom? Explorative moderation analyses of a randomized controlled trial.

    Schellekens, Melanie P J / Bruggeman-Everts, Fieke Z / Wolvers, Marije D J / Vollenbroek-Hutten, Miriam M R / van der Lee, Marije L

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

    2022  Volume 30, Issue 10, Page(s) 7885–7892

    Abstract: Purpose: Approximately 25% of cancer patients suffer from chronic cancer-related fatigue (CCRF), which is a complex, multifactorial condition. While there are evidence-based interventions, it remains unclear what treatment works best for the individual ... ...

    Abstract Purpose: Approximately 25% of cancer patients suffer from chronic cancer-related fatigue (CCRF), which is a complex, multifactorial condition. While there are evidence-based interventions, it remains unclear what treatment works best for the individual patient. This study explored whether baseline characteristics moderated the effect of web-based mindfulness-based cognitive therapy (eMBCT) versus ambulant activity feedback (AAF) and a psycho-education control group (PE) on fatigue in patients suffering from CCRF.
    Methods: In a randomized controlled trial, participant suffering from CCRF participated in either eMBCT, AAF, or PE. Complete data of the treatment-adherent sample (≥ 6 sessions) was used to explore whether sociodemographic, clinical, and psychological characteristics at baseline moderated the intervention effect on fatigue severity at 6 months.
    Results: A trend showed that baseline fatigue severity and fatigue catastrophizing moderated the intervention effect. That is, at low levels of fatigue severity and catastrophizing, patients benefited more from AAF than from eMBCT and at high levels of fatigue severity and catastrophizing, patients benefited more from eMBCT than from PE.
    Conclusions: This study found some preliminary evidence on what treatment works best for the individual suffering from CCRF. These findings emphasize the potential gain in effectiveness of personalizing treatment. An alternative approach that might help us further in answering the question "what treatment works best for whom?" is discussed.
    MeSH term(s) Cognitive Behavioral Therapy ; Fatigue/etiology ; Fatigue/psychology ; Fatigue/therapy ; Humans ; Internet-Based Intervention ; Mindfulness ; Neoplasms/therapy ; Treatment Outcome
    Language English
    Publishing date 2022-06-21
    Publishing country Germany
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1134446-5
    ISSN 1433-7339 ; 0941-4355
    ISSN (online) 1433-7339
    ISSN 0941-4355
    DOI 10.1007/s00520-022-07223-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Mobile App for Monitoring 3-Month Postoperative Functional Outcome After Hip Fracture: Usability Study.

    Geerds, Merle A J / Nijmeijer, Wieke S / Hegeman, J H / Vollenbroek-Hutten, Miriam M R

    JMIR human factors

    2020  Volume 7, Issue 3, Page(s) e16989

    Abstract: Background: As a result of an aging population, there has been an increasing incidence of hip fractures worldwide. In the Netherlands, in order to improve the quality of care for elderly patients with hip fractures, the multidisciplinary Centre for ... ...

    Abstract Background: As a result of an aging population, there has been an increasing incidence of hip fractures worldwide. In the Netherlands, in order to improve the quality of care for elderly patients with hip fractures, the multidisciplinary Centre for Geriatric Traumatology was established in 2008 at the Department of Trauma Surgery at Ziekenhuisgroep Twente hospital (located in Almelo and Hengelo in the Netherlands).
    Objective: Though the Dutch Hip Fracture audit is used to monitor the quality of care for patients with fractures of the hip, only 30.7% of patients complete registration in the 3-month follow-up period. Mobile apps offer an opportunity for improvement in this area. The aim of this study was to investigate the usability and acceptance of a mobile app for gathering indicators of quality of care in a 3-month follow-up period after postoperative treatment of hip fracture.
    Methods: From July 2017 to December 2017, patients who underwent surgical treatment for hip fracture were recruited. Patients and caregivers, who were collectively considered the participant cohort, were asked to download the app and answer a questionnaire. Participants were divided into two groups-those who downloaded the app and those who did not download the app. A telephone interview that was based upon the Unified Theory of Acceptance and Use of Technology was conducted with a subset of participants from each group (1:1 ratio). This study was designated as not being subject to the Dutch Medical Research Involving Human Subjects Act according to the appropriate medical research ethics committees.
    Results: Of the patients and caregivers who participated, 26.4% (29/110) downloaded the app, whereas 73.6% (81/110) did not. Telephone interviews with the subset of participants (n=24 per group) revealed that 54.0% (13/24) of the group of participants who did not download the app had forgotten the study. Among the group who downloaded the app, 95.8% (23/24) had the intention of completing the questionnaire, but only 4.2% (1/24) did so. The reasons for not completing the questionnaire included technical problems, cognitive disorders, or patient dependency on caregivers. Most participants in the group who downloaded the app self-reported a high level of expertise in using a smartphone (22/24, 91.7%), and sufficient facilitating conditions for using a smartphone were self-reported in both groups (downloaded the app: 23/24, 95.8%; did not download the app: 21/24, 87.5%), suggesting that these factors were not barriers to completion.
    Conclusions: Despite self-reported intention to use the app, smartphone expertise, and sufficient facilitating conditions for smartphone use, implementation of the mobile app was infeasible for daily practice. This was due to a combination of technical problems, factors related to the implementation process, and the population of interest having cognitive disorders or a dependency on caregivers for mobile technology.
    Language English
    Publishing date 2020-09-14
    Publishing country Canada
    Document type Journal Article
    ISSN 2292-9495
    ISSN (online) 2292-9495
    DOI 10.2196/16989
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Embodiment of Wearable Technology: Qualitative Longitudinal Study.

    Nelson, Elizabeth C / Sools, Anneke M / Vollenbroek-Hutten, Miriam M R / Verhagen, Tibert / Noordzij, Matthijs L

    JMIR mHealth and uHealth

    2020  Volume 8, Issue 11, Page(s) e16973

    Abstract: Background: Current technology innovations, such as wearables, have caused surprising reactions and feelings of deep connection to devices. Some researchers are calling mobile and wearable technologies cognitive prostheses, which are intrinsically ... ...

    Abstract Background: Current technology innovations, such as wearables, have caused surprising reactions and feelings of deep connection to devices. Some researchers are calling mobile and wearable technologies cognitive prostheses, which are intrinsically connected to individuals as if they are part of the body, similar to a physical prosthesis. Additionally, while several studies have been performed on the phenomenology of receiving and wearing a physical prosthesis, it is unknown whether similar subjective experiences arise with technology.
    Objective: In one of the first qualitative studies to track wearables in a longitudinal investigation, we explore whether a wearable can be embodied similar to a physical prosthesis. We hoped to gain insights and compare the phases of embodiment (ie, initial adjustment to the prosthesis) and the psychological responses (ie, accept the prosthesis as part of their body) between wearables and limb prostheses. This approach allowed us to find out whether this pattern was part of a cyclical (ie, period of different usage intensity) or asymptotic (ie, abandonment of the technology) pattern.
    Methods: We adapted a limb prosthesis methodological framework to be applied to wearables and conducted semistructured interviews over a span of several months to assess if, how, and to what extent individuals come to embody wearables similar to prosthetic devices. Twelve individuals wore fitness trackers for 9 months, during which time interviews were conducted in the following three phases: after 3 months, after 6 months, and at the end of the study after 9 months. A deductive thematic analysis based on Murray's work was combined with an inductive approach in which new themes were discovered.
    Results: Overall, the individuals experienced technology embodiment similar to limb embodiment in terms of adjustment, wearability, awareness, and body extension. Furthermore, we discovered two additional themes of engagement/reengagement and comparison to another device or person. Interestingly, many participants experienced a rarely reported phenomenon in longitudinal studies where the feedback from the device was counterintuitive to their own beliefs. This created a blurring of self-perception and a dilemma of "whom" to believe, the machine or one's self.
    Conclusions: There are many similarities between the embodiment of a limb prosthesis and a wearable. The large overlap between limb and wearable embodiment would suggest that insights from physical prostheses can be applied to wearables and vice versa. This is especially interesting as we are seeing the traditionally "dumb" body prosthesis becoming smarter and thus a natural merging of technology and body. Future longitudinal studies could focus on the dilemma people might experience of whether to believe the information of the device over their own thoughts and feelings. These studies might take into account constructs, such as technology reliance, autonomy, and levels of self-awareness.
    MeSH term(s) Fitness Trackers ; Humans ; Longitudinal Studies ; Qualitative Research ; Wearable Electronic Devices
    Language English
    Publishing date 2020-11-03
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2719220-9
    ISSN 2291-5222 ; 2291-5222
    ISSN (online) 2291-5222
    ISSN 2291-5222
    DOI 10.2196/16973
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Development of machine learning models to predict cancer-related fatigue in Dutch breast cancer survivors up to 15 years after diagnosis.

    Beenhakker, Lian / Wijlens, Kim A E / Witteveen, Annemieke / Heins, Marianne / Korevaar, Joke C / de Ligt, Kelly M / Bode, Christina / Vollenbroek-Hutten, Miriam M R / Siesling, Sabine

    Journal of cancer survivorship : research and practice

    2023  

    Abstract: Purpose: To prevent (chronic) cancer-related fatigue (CRF) after breast cancer, it is important to identify survivors at risk on time. In literature, factors related to CRF are identified, but not often linked to individual risks. Therefore, our aim was ...

    Abstract Purpose: To prevent (chronic) cancer-related fatigue (CRF) after breast cancer, it is important to identify survivors at risk on time. In literature, factors related to CRF are identified, but not often linked to individual risks. Therefore, our aim was to predict individual risks for developing CRF.
    Methods: Two pre-existing datasets were used. The Nivel-Primary Care Database and the Netherlands Cancer Registry (NCR) formed the Primary Secondary Cancer Care Registry (PSCCR). NCR data with Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship (PROFILES) data resulted in the PSCCR-PROFILES dataset. Predictors were patient, tumor and treatment characteristics, and pre-diagnosis health. Fatigue was GP-reported (PSCCR) or patient-reported (PSCCR-PROFILES). Machine learning models were developed, and performances compared using the C-statistic.
    Results: In PSCCR, 2224/12813 (17%) experienced fatigue up to 7.6 ± 4.4 years after diagnosis. In PSCCR-PROFILES, 254 (65%) of 390 patients reported fatigue 3.4 ± 1.4 years after diagnosis. For both, models predicted fatigue poorly with best C-statistics of 0.561 ± 0.006 (PSCCR) and 0.669 ± 0.040 (PSCCR-PROFILES).
    Conclusion: Fatigue (GP-reported or patient-reported) could not be predicted accurately using available data of the PSCCR and PSCCR-PROFILES datasets.
    Implications for cancer survivors: CRF is a common but underreported problem after breast cancer. We aimed to develop a model that could identify individuals with a high risk of developing CRF, ideally to help them prevent (chronic) CRF. As our models had poor predictive abilities, they cannot be used for this purpose yet. Adding patient-reported data as predictor could lead to improved results. Until then, awareness for CRF stays crucial.
    Language English
    Publishing date 2023-12-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2388888-X
    ISSN 1932-2267 ; 1932-2259
    ISSN (online) 1932-2267
    ISSN 1932-2259
    DOI 10.1007/s11764-023-01491-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: A Digital Lifestyle Coach (E-Supporter 1.0) to Support People With Type 2 Diabetes: Participatory Development Study.

    Hietbrink, Eclaire A G / Middelweerd, Anouk / van Empelen, Pepijn / Preuhs, Katharina / Konijnendijk, Annemieke A J / Oude Nijeweme-d'Hollosy, Wendy / Schrijver, Laura K / Laverman, Gozewijn D / Vollenbroek-Hutten, Miriam M R

    JMIR human factors

    2023  Volume 10, Page(s) e40017

    Abstract: Background: A healthy lifestyle, including regular physical activity and a healthy diet, is becoming increasingly important in the treatment of chronic diseases. eHealth interventions that incorporate behavior change techniques (BCTs) and dynamic ... ...

    Abstract Background: A healthy lifestyle, including regular physical activity and a healthy diet, is becoming increasingly important in the treatment of chronic diseases. eHealth interventions that incorporate behavior change techniques (BCTs) and dynamic tailoring strategies could effectively support a healthy lifestyle. E-Supporter 1.0 is an eCoach designed to support physical activity and a healthy diet in people with type 2 diabetes (T2D).
    Objective: This paper aimed to describe the systematic development of E-Supporter 1.0.
    Methods: Our systematic design process consisted of 3 phases. The definition phase included the selection of the target group and formulation of intervention objectives, and the identification of behavioral determinants based on which BCTs were selected to apply in the intervention. In the development phase, intervention content was developed by specifying tailoring variables, intervention options, and decision rules. In the last phase, E-Supporter 1.0 integrated in the Diameter app was evaluated using a usability test in 9 people with T2D to assess intervention usage and acceptability.
    Results: The main intervention objectives were to stimulate light to moderate-vigorous physical activities or adherence to the Dutch dietary guidelines in people with T2D. The selection of behavioral determinants was informed by the health action process approach and theories explaining behavior maintenance. BCTs were included to address relevant behavioral determinants (eg, action control, self-efficacy, and coping planning). Development of the intervention resulted in 3 types of intervention options, consisting of motivational messages, behavioral feedback, and tailor-made supportive exercises. On the basis of IF-THEN rules, intervention options could be tailored to, among others, type of behavioral goal and (barriers to) goal achievement. Data on these variables could be collected using app data, activity tracker data, and daily ecological momentary assessments. Usability testing revealed that user experiences were predominantly positive, despite some problems in the fixed delivery of content.
    Conclusions: The systematic development approach resulted in a theory-based and dynamically tailored eCoach. Future work should focus on expanding intervention content to other chronic diseases and lifestyle behaviors, enhancing the degree of tailoring and evaluating intervention effects on acceptability, use, and cost-effectiveness.
    Language English
    Publishing date 2023-01-12
    Publishing country Canada
    Document type Journal Article
    ISSN 2292-9495
    ISSN (online) 2292-9495
    DOI 10.2196/40017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Early Warning Scores to Support Continuous Wireless Vital Sign Monitoring for Complication Prediction in Patients on Surgical Wards: Retrospective Observational Study.

    van Rossum, Mathilde C / Bekhuis, Robin E M / Wang, Ying / Hegeman, Johannes H / Folbert, Ellis C / Vollenbroek-Hutten, Miriam M R / Kalkman, Cornelis J / Kouwenhoven, Ewout A / Hermens, Hermie J

    JMIR perioperative medicine

    2023  Volume 6, Page(s) e44483

    Abstract: Background: Wireless vital sign sensors are increasingly being used to monitor patients on surgical wards. Although early warning scores (EWSs) are the current standard for the identification of patient deterioration in a ward setting, their usefulness ... ...

    Abstract Background: Wireless vital sign sensors are increasingly being used to monitor patients on surgical wards. Although early warning scores (EWSs) are the current standard for the identification of patient deterioration in a ward setting, their usefulness for continuous monitoring is unknown.
    Objective: This study aimed to explore the usability and predictive value of high-rate EWSs obtained from continuous vital sign recordings for early identification of postoperative complications and compares the performance of a sensor-based EWS alarm system with manual intermittent EWS measurements and threshold alarms applied to individual vital sign recordings (single-parameter alarms).
    Methods: Continuous vital sign measurements (heart rate, respiratory rate, blood oxygen saturation, and axillary temperature) collected with wireless sensors in patients on surgical wards were used for retrospective simulation of EWSs (sensor EWSs) for different time windows (1-240 min), adopting criteria similar to EWSs based on manual vital signs measurements (nurse EWSs). Hourly sensor EWS measurements were compared between patients with (event group: 14/46, 30%) and without (control group: 32/46, 70%) postoperative complications. In addition, alarms were simulated for the sensor EWSs using a range of alarm thresholds (1-9) and compared with alarms based on nurse EWSs and single-parameter alarms. Alarm performance was evaluated using the sensitivity to predict complications within 24 hours, daily alarm rate, and false discovery rate (FDR).
    Results: The hourly sensor EWSs of the event group (median 3.4, IQR 3.1-4.1) was significantly higher (P<.004) compared with the control group (median 2.8, IQR 2.4-3.2). The alarm sensitivity of the hourly sensor EWSs was the highest (80%-67%) for thresholds of 3 to 5, which was associated with alarm rates of 2 (FDR=85%) to 1.2 (FDR=83%) alarms per patient per day respectively. The sensitivity of sensor EWS-based alarms was higher than that of nurse EWS-based alarms (maximum=40%) but lower than that of single-parameter alarms (87%) for all thresholds. In contrast, the (false) alarm rates of sensor EWS-based alarms were higher than that of nurse EWS-based alarms (maximum=0.6 alarm/patient/d; FDR=80%) but lower than that of single-parameter alarms (2 alarms/patient/d; FDR=84%) for most thresholds. Alarm rates for sensor EWSs increased for shorter time windows, reaching 70 alarms per patient per day when calculated every minute.
    Conclusions: EWSs obtained using wireless vital sign sensors may contribute to the early recognition of postoperative complications in a ward setting, with higher alarm sensitivity compared with manual EWS measurements. Although hourly sensor EWSs provide fewer alarms compared with single-parameter alarms, high false alarm rates can be expected when calculated over shorter time spans. Further studies are recommended to optimize care escalation criteria for continuous monitoring of vital signs in a ward setting and to evaluate the effects on patient outcomes.
    Language English
    Publishing date 2023-08-30
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-9128
    ISSN (online) 2561-9128
    DOI 10.2196/44483
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A Digital Coach (E-Supporter 1.0) to Support Physical Activity and a Healthy Diet in People With Type 2 Diabetes: Acceptability and Limited Efficacy Testing.

    Hietbrink, Eclaire A G / Oude Nijeweme-d'Hollosy, Wendy / Middelweerd, Anouk / Konijnendijk, Annemieke A J / Schrijver, Laura K / Ten Voorde, Anouk S / Fokkema, Elise M S / Laverman, Gozewijn D / Vollenbroek-Hutten, Miriam M R

    JMIR formative research

    2023  Volume 7, Page(s) e45294

    Abstract: Background: A healthy lifestyle, including regular physical activity and a healthy diet, is increasingly part of type 2 diabetes (T2D) management. As many people with T2D have difficulty living and maintaining a healthy lifestyle, there is a need for ... ...

    Abstract Background: A healthy lifestyle, including regular physical activity and a healthy diet, is increasingly part of type 2 diabetes (T2D) management. As many people with T2D have difficulty living and maintaining a healthy lifestyle, there is a need for effective interventions. eHealth interventions that incorporate behavior change theories and tailoring are considered effective tools for supporting a healthy lifestyle. The E-Supporter 1.0 digital coach contains eHealth content for app-based eHealth interventions and offers tailored coaching regarding physical activity and a healthy diet for people with T2D.
    Objective: This study aimed to assess the acceptability of E-Supporter 1.0 and explore its limited efficacy on physical activity, dietary behavior, the phase of behavior change, and self-efficacy levels.
    Methods: Over a span of 9 weeks, 20 individuals with T2D received daily motivational messages and weekly feedback derived from behavioral change theories and determinants through E-Supporter 1.0. The acceptability of the intervention was assessed using telephone-conducted, semistructured interviews. The interview transcripts were coded using inductive thematic analysis. The limited efficacy of E-Supporter 1.0 was explored using the Fitbit Charge 2 to monitor step count to assess physical activity and questionnaires to assess dietary behavior (using the Dutch Healthy Diet index), phase of behavior change (using the single-question Self-Assessment Scale Stages of Change), and self-efficacy levels (using the Exercise Self-Efficacy Scale).
    Results: In total, 5 main themes emerged from the interviews: perceptions regarding remote coaching, perceptions regarding the content, intervention intensity and duration, perceived effectiveness, and overall appreciation. The participants were predominantly positive about E-Supporter 1.0. Overall, they experienced E-Supporter 1.0 as a useful and easy-to-use intervention to support a better lifestyle. Participants expressed a preference for combining E-Supporter with face-to-face guidance from a health care professional. Many participants found the intensity and duration of the intervention to be acceptable, despite the coaching period appearing relatively short to facilitate long-term behavior maintenance. As expected, the degree of tailoring concerning the individual and external factors that influence a healthy lifestyle was perceived as limited. The limited efficacy testing showed a significant improvement in the daily step count (z=-2.040; P=.04) and self-efficacy levels (z=-1.997; P=.046) between baseline and postintervention. Diet was improved through better adherence to Dutch dietary guidelines. No significant improvement was found in the phase of behavior change (P=.17), as most participants were already in the maintenance phase at baseline.
    Conclusions: On the basis of this explorative feasibility study, we expect E-Supporter 1.0 to be an acceptable and potentially useful intervention to promote physical activity and a healthy diet in people with T2D. Additional work needs to be done to further tailor the E-Supporter content and evaluate its effects more extensively on lifestyle behaviors.
    Language English
    Publishing date 2023-07-28
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/45294
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: A holistic profile for cancer-related fatigue for women with breast cancer - a qualitative study.

    Wijlens, Kim A E / Beenhakker, Lian / Witteveen, Annemieke / Siemerink, Ester J M / Jansen, Liesbeth / Gernaat, Christine / Schellekens, Melanie P J / Siesling, Sabine / Vollenbroek-Hutten, Miriam M R / Bode, Christina

    Psychology & health

    2023  , Page(s) 1–25

    Abstract: Objective: ...

    Abstract Objective:
    Language English
    Publishing date 2023-12-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 625255-2
    ISSN 1476-8321 ; 0887-0446
    ISSN (online) 1476-8321
    ISSN 0887-0446
    DOI 10.1080/08870446.2023.2289457
    Database MEDical Literature Analysis and Retrieval System OnLINE

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