Cyberchondria in First Year Medical Students of Yogyakarta

Abstract

Cyberchondria is a relatively new term addressing health anxiety associated with online information. Research data is scarce, as most instruments measuring anxiety do not consider online behavior an important factor. Medical students are arguably assumed to have frequent health anxieties, i.e. “medical student syndrome.” Moreover, they are exposed to large amounts of information. We aimed to measure the level of cyberchondria severity of first-year medical students. First-year medical students of the regular program at Universitas Gadjah Mada completed self-reported instruments (the Cyberchondria Severity Scale (CSS) and the Beck Anxiety Inventory (BAI)). Cut off was determined using ROC analysis to find the best score that corresponded to BAI cut off of 16. Data were analyzed using chi square and t-tests to analyze any differences between gender. Respondents were 162 students, 54 males and 108 females, with mean age 18.18-year-old ± 0.696. Based on ROC analysis, cut off of 75.5 corresponded with BAI score of 16. Mean CSS score was 70.73 ± 16.292. There was no significant difference of CSS scores between genders. Based on the analysis of individual items, compared to male students, female students more frequently searched for physical symptoms on the Internet, and afterwards, consulted the results with a General Practitioner (GP), discussed with a GP, or went to other specialists; and thus, more frequently required reassurance after online search. In contrast, male students more frequently had difficulty relaxing after searching online for physical symptoms. We concluded that there was no difference of overall cyberchondria severity score, but there were slight but significant differences of online behavior between genders.     

An adaptive case management system to support integrated care services: Lessons learned from the NEXES project

BackgroundExtensive deployment and sustainability of integrated care services (ICS) constitute an unmet need to reduce the burden of chronic conditions. The European Union project NEXES (2008–2013) assessed the deployment of four ICS encompassing the spectrum of severity of chronic patients.ObjectiveThe current study aims to (i) describe the open source Adaptive Case Management (ACM) system (Linkcare®) developed to support the deployment of ICS at the level of healthcare district; (ii) to evaluate its performance; and, (iii) to identify key challenges for regional deployment of ICS.MethodsWe first defined a conceptual model for ICS management and execution composed of five main stages. We then specified an associated logical model considering the dynamic runtime of ACM. Finally, we implemented the four ICS as a physical model with an ICS editor to allow professionals (case managers) to play active roles in adapting the system to their needs. Instances of ICS were then run in Linkcare®. Four ICS provided a framework for evaluating the system: Wellness and Rehabilitation (W&R) (number of patients enrolled in the study (n) = 173); Enhanced Care (EC) in frail chronic patients to prevent hospital admissions, (n = 848); Home Hospitalization and Early Discharge (HH/ED) (n = 2314); and, Support to remote diagnosis (Support) (n = 7793). The method for assessment of telemedicine applications (MAST) was used for iterative evaluation.ResultsLinkcare® supports ACM with shared-care plans across healthcare tiers and offers integration with provider-specific electronic health records. Linkcare® successfully contributed to the deployment of the four ICS: W&R facilitated long-term sustainability of training effects (p < 0.01) and active life style (p < 0.03); EC showed significant positive outcomes (p < 0.05); HH/ED reduced on average 5 in-hospital days per patient with a 30-d re-admission rate of 10%; and, Support, enhanced community-based quality forced spirometry testing (p < 0.01). Key challenges for regional deployment of personalized care were identified.ConclusionsLinkcare® provided the required functionalities to support integrated care adopting an ACM model, and it showed adaptive potential for its implementation in different health scenarios. The research generated strategies that contributed to face the challenges of the transition toward personalized medicine for chronic patients.     

YouTube as a source of medical information on the novel coronavirus 2019 disease (COVID-19) pandemic

ABSTRACT

Media coverage on coronavirus disease 2019 (COVID-19) has been extensive, yet large gaps remain in our understanding of the role of social media platforms during worldwide health crisis. The purpose of this study was to assess the most viewed YouTube videos on COVID-19 for medical content. We coded video characteristics, source, and medical content of the 113 most-widely viewed videos about COVID-19. Seventy-nine (69.9%) videos were classified as useful, and 10 (8.8%) videos were classified as misleading. Independent users were more likely to post misleading videos than useful videos (60.0% vs 21.5%, P?=?0.009). News agencies were more likely to post useful videos than misleading videos (72.2% vs 40.0%, P?=?0.039). Useful videos were more likely to present any information on prevalence or incidence (79.7% vs 20.0%, P?<?0.001), as well as information on outcomes or prognosis (84.8% vs 30.0%, P?<?0.001) compared to misleading videos. The World Health Organization contributed one useful video (1.3%), while no videos from the Center for Disease Control were included. Although YouTube generally is a useful source of medical information on the COVID-19 pandemic, increased efforts to disseminate accurate information from reputable sources is desired to help mitigate disease spread and decrease unnecessary panic in the general population.     

ROCCIPI技术框架下智慧医院建设的问题识别及分析

建设智慧医院旨在以患者为中心,通过智慧化途径向患者提供便捷化、个性化的医疗卫生服务,改善患者就医体验。文章采用ROCCIPI技术框架,就规则、机会、能力、交流、利益、过程和意识七个方面对我国医院智慧化建设进行深入分析,为现代化医院建设提供一定参考。     

Digital navigators to implement smartphone and digital tools in care

While smartphone apps and other digital health tools have the clear potential to increase both quality of and access to care, actual successful implementation remains limited. Challenges often encountered in seeking to use apps in care include selecting safe/effective tools, spending clinical time troubleshooting technology instead of discussing health matters, and lack of time to check and review constant streams of data these digital tools can produce. In this ‘From Research to Clinical Practice’ piece, we focus on how a new care team member, the digital navigator, can help overcome these barriers through conducting evidence-based app evaluation to help in selecting the right apps, troubleshooting technology outside of visits to improve the therapeutic alliance during, and finally summarizing digital data to facilitate clinical care that focus on actionable data.     

互联网+延续性康复护理对腰椎融合术后老年患者的效果

目的 探讨互联网+延续性康复护理与传统延续性康复护理对老年腰椎融合术后康复作用的效果。     

移动互联网环境下医疗服务质量评价方法的创新应用

目的在移动互联网环境下,建立医疗服务质量关键指标,对医疗服务质量评价方法进行创新。方法将患者就医过程中的每一项服务进行量化,建立SERVQUAL服务质量评价体系。结果借助移动互联网智能终端,构建医疗服务质量指标体系包括有形性、可靠性、响应性、保证性、关怀性、经济性和有效性等7个一级指标,25个二级指标。结论在移动互联网的环境下,为医患沟通搭建平台,及时进行医患互动,对医院的医疗服务质量进行客观评价。     

互联网药品交易服务状况调查分析

目的：对国内互联网药品交易服务状况进行调查分析,为运用现代手段创新药品交易服务模式提供参考。方法：通过CFDA网站,统计截至2017年上半年我国互联网药品交易服务的构成和分类情况;以获得A类资格证书的第三方交易服务平台为样本,逐家登陆平台网站,对其平台建设与服务方式、内容和网站质量进行评价分析。结果：调查结果显示,截至2017年6月底,全国取得互联网药品交易服务资格证书的共913家,是2014年的2.7倍;其中第三方交易服务平台40家（4.3%）,与2014年相比新增1.7倍;该类平台交易服务形式包括供采易-供应链B2B（复选率100%）、医药B2B （复选率100%）、B2C全渠道平台（复选率100%）、医药智能物流平台（复选率82.5%）、跨境商城（复选率80.0%）、O2O电商系统（复选率75.0%）等;平台在支付/配送、售后服务、交易监管等方面均有相应栏目支撑;平台登录便捷程度评价优秀的75.0%,信息更新频率评价优秀的60.0%。结论：调查分析结果说明,我国互联网药品交易服务发展较为迅速,服务形式、内容和网站质量整体趋好,但各省份间开展程度还存在较大的差异,需进行引导推进。