Patient co-design of digital health storytelling tools for multimorbidity: A phenomenological study.

BACKGROUND: Interest in both narrative medicine and electronic health records has increased over the past 30 years. However, electronic health records are mainly written by and for clinicians, and the patient narrative and voice are not incorporated. Recent studies within the United Kingdom have indicated that there is a need to incorporate patient stories into health records, to improve quality and continuity of care. This is particularly important when treating people with multiple long-term health conditions (multimorbidity), whose health stories can be particularly complex. OBJECTIVE: To understand the goals and requirements of people with multimorbidity for digital health storytelling tools. METHODS: The methodology uses narrative within a phenomenological approach to inform a process of co-design. RESULTS: The findings indicate that people living with multimorbidity would use health storytelling tools to understand and reflect on their journeys, convey their experiences to others and advocate for themselves against scepticism. CONCLUSION: Outputs from the project give insight into the lived experience of multimorbidity, as well as understanding the goals of people living with multimorbidity for using health storytelling tools as part of treatment and self-management. Future research could explore other areas such as collaborative health storytelling or the technical implementation of tools. PATIENT OR PUBLIC CONTRIBUTION: Five adults with multiple long-term conditions participated in the project, and research was carried out in three stages. First, semistructured interviews were used to understand each participant's health story. Second, each participant worked with the researcher to co-design a visual representation of their story. Finally, digital prototypes based on their health story were reviewed with each of the participants.

Evaluation and treatment of childhood physical abuse and neglect: a review.

According to 2010 CDC estimates, 1 in 5 US children have experienced maltreatment. Risk factors for child maltreatment include child characteristics such as non-compliance and diagnostic conditions that increase caregiver burden. Parent characteristic risk factors include parental mental illness and low social support. New developments in radiologic evaluation of child maltreatment will be reviewed. New findings in evidence based psychotherapies for childhood maltreatment will be discussed. A review of the role of pharmacotherapy in child maltreatment cases will also be presented. New evidence from prevention models targeting young mothers and families are also reviewed.

Treatment of childhood sexual abuse: an updated review.

Childhood sexual abuse (CSA) involves multiple complex factors that make the evaluation of therapeutic interventions especially complicated. PTSD prevalence rates of CSA are approximately 37 % -53 %. Several other psychiatric sequelae of CSA exist. CSA appears to disrupt brain and body physiology. One co-located service delivery model reported a 52 % linkage rate of CSA survivors with mental health treatment. This article reviews current literature on the treatment of CSA, including psychosocial interventions, pharmacotherapy, and early preventative interventions. It also provides an update on the short- and long-term sequelae of CSA and implications for future research directions. A literature search of papers published in the last 3 years was conducted using the keywords treatment, sexual abuse, childhood, epigenetics, resilience and review, and searching the following databases: PsycInfo, PubMed, Substance Abuse and Mental Health Services Administration, and Centers for Disease Control.