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1.
Res Nurs Health ; 44(5): 822-832, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34402080

RESUMO

Over a decade following the nationwide push to implement electronic health records (EHRs), the focus has shifted to addressing the cognitive burden associated with their use. Most research and discourse about the EHR's impact on clinicians' cognitive work has focused on physicians rather than on nursing-specific issues. Labor and delivery nurses may encounter unique challenges when using EHRs because they also interact with an electronic fetal monitoring system, continuously managing and synthesizing both maternal and fetal data. This grounded theory study explored labor and delivery nurses' perceptions of the EHR's impact on their cognitive work. Data were individual interviews and participant observations with twenty-one nurses from two labor and delivery units in the western U.S. and were analyzed using dimensional analysis. Nurses managed the tension between caring and charting using various strategies to integrate the EHR into their dynamic, high-acuity, specialty practice environment while using EHRs that were not designed for perinatal patients. Use of the EHR and associated technologies disrupted nurses' ability to locate and synthesize information, maintain an overview of the patient's status, and connect with patients and families. Individual-, group-, and environmental-level factors facilitated or constrained nurses' integration of the EHR. These findings represent critical safety failures requiring comprehensive changes to EHR designs and better processes for responding to end-user experiences. More research is needed to develop EHRs that support the dynamic and relationship-based nature of nurses' work and to align with specialty practice environments.


Assuntos
Atitude Frente aos Computadores , Parto Obstétrico/psicologia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Cuidados de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Enfermagem Obstétrica/estatística & dados numéricos , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Gravidez , Estados Unidos
2.
Lancet Digit Health ; 3(9): e599-e611, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34446266

RESUMO

Artificial intelligence (AI) promises to change health care, with some studies showing proof of concept of a provider-level performance in various medical specialties. However, there are many barriers to implementing AI, including patient acceptance and understanding of AI. Patients' attitudes toward AI are not well understood. We systematically reviewed the literature on patient and general public attitudes toward clinical AI (either hypothetical or realised), including quantitative, qualitative, and mixed methods original research articles. We searched biomedical and computational databases from Jan 1, 2000, to Sept 28, 2020, and screened 2590 articles, 23 of which met our inclusion criteria. Studies were heterogeneous regarding the study population, study design, and the field and type of AI under study. Six (26%) studies assessed currently available or soon-to-be available AI tools, whereas 17 (74%) assessed hypothetical or broadly defined AI. The quality of the methods of these studies was mixed, with a frequent issue of selection bias. Overall, patients and the general public conveyed positive attitudes toward AI but had many reservations and preferred human supervision. We summarise our findings in six themes: AI concept, AI acceptability, AI relationship with humans, AI development and implementation, AI strengths and benefits, and AI weaknesses and risks. We suggest guidance for future studies, with the goal of supporting the safe, equitable, and patient-centred implementation of clinical AI.


Assuntos
Inteligência Artificial , Atitude Frente aos Computadores , Atitude Frente a Saúde , Pacientes/psicologia , Opinião Pública , Humanos
3.
Artigo em Inglês | MEDLINE | ID: mdl-34073786

RESUMO

The fourth industrial revolution has produced new information technology (IT) that is widely used in the healthcare industry. Although the nature of the institution affects IT adoption, the Technology Acceptance Model (TAM), a dominant theory, has dismissed its role and influence. Our research investigates how institutions influence the adoption of new IT by using the Institution-based Technology Acceptance Model (ITAM). We conducted an empirical test by using survey data collected from 300 employees in the public sector. Structural equation modeling was applied to test the proposed hypotheses. The results showed the total effect of institutions on the intention to use new IT is positive and significant. Second, IT adoption is not only affected by external institutions but also by type of institution; the external institution takes a greater role in inducing perceived usefulness, perceived ease of use, and intention to use than does the internal. Third, perceived ease of use and perceived usefulness play mediating roles between institution and IT adoption. Fourth, an alternative expanded model to which more individual and organizational factors were added confirmed the results of the base model. We concluded that institutions have a strong impact on the level of intention for IT use through perceived ease of use and perceived usefulness.


Assuntos
Atitude Frente aos Computadores , Tecnologia , Computadores , Humanos , Informática , Intenção
4.
Aust N Z J Public Health ; 45(4): 344-347, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33970555

RESUMO

OBJECTIVE: We report a survey in regional Queensland to understand the reasons for suboptimal uptake of the COVIDSafe app. METHODS: A short five-minute electronic survey disseminated to healthcare professionals, mining groups and school communities in the Central Queensland region. Free text responses and their topics were modelled using natural language processing and a latent Dirichlet model. RESULTS: We received a total of 723 responses; of these, 69% had downloaded the app and 31% had not. The respondents' reasons for not downloading the app were grouped under four topics: lack of perceived risk of COVID-19/lack of perceived need and privacy issues; phone-related issues; tracking and misuse of data; and trust, security and credibility. Among the 472 people who downloaded the app and provided text amenable to text mining, the two topics most commonly listed were: to assist with contact tracing; and to return to normal. CONCLUSIONS: This survey of a regional population found that lack of perceived need, concerns around privacy and technical difficulties were the major barriers to users downloading the application. Implications for public health: Health promotion campaigns aimed at increasing the uptake of the COVIDSafe app should focus on promoting how the app will assist with contact tracing to help return to 'normal'. Additionally, health promotors should address the app's impacts on privacy, people's lack of perceived need for the app and technical barriers.


Assuntos
Atitude Frente aos Computadores , COVID-19/prevenção & controle , Confidencialidade/psicologia , Confiabilidade dos Dados , Aplicativos Móveis/estatística & dados numéricos , Medicina Preventiva/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Queensland , Fatores de Risco , SARS-CoV-2 , Inquéritos e Questionários
5.
Urol Int ; 105(7-8): 650-656, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33951666

RESUMO

BACKGROUND: There are limited data on the use and concern of telemedicine among German urologists, and thus, there are no established guidelines for telemedical diagnosis, treatment, and prevention of urological indications. METHODS: An anonymized survey was conducted among German private practice urologists during the 2019 coronavirus disease (COVID-19) pandemic. The χ2 test, Mann-Whitney U-test, and Kruskal-Wallis test were used for statistical analysis. RESULTS: 257 urologists were included in the final analysis. Thirty-five (14.0%) of urologists had used telemedicine as part of their consultation, and 221 (86.0%) had not used telemedicine. There was no difference between telemedicine adoption rates between rural and urban settings. Telemedicine users were significantly more satisfied with the information they had received regarding telemedicine issues. Users saw the greatest barrier to telemedicine that patients do not take up the offer of telemedicine. Nonusers were most concerned with unclear indications for telemedicine followed by lesser reimbursements during telemedicine than in-person visitations. Users were significantly more likely to use telemedicine beyond the COVID-19 pandemic. Urologists, who wanted to use the service in the future, wanted an active support by the German society of urology and guidelines for telemedicine. Last, users and nonusers preferred telemedicine for non-acute chronic diseases and follow-up visitations. CONCLUSION: Despite the COVID-19 pandemic, telemedicine remains a rarely used service among German private practice urologists. Ultimately, to overcome the current challenges, urologists require an active support for the service through the German Society of Urology and telemedical guidelines.


Assuntos
COVID-19 , Padrões de Prática Médica/tendências , Prática Privada/tendências , Telemedicina/tendências , Doenças Urológicas/terapia , Urologistas/tendências , Urologia/tendências , Adulto , Idoso , Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Alemanha , Pesquisas sobre Serviços de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Doenças Urológicas/diagnóstico
6.
ESMO Open ; 6(2): 100104, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33838532

RESUMO

BACKGROUND: The COVID-19 pandemic has impacted all aspects of modern-day oncology, including how stakeholders communicate through social media. We surveyed oncology stakeholders in order to assess their attitudes pertaining to social media and how it has been affected during the pandemic. MATERIALS AND METHODS: A 40-item survey was distributed to stakeholders from 8 July to 22 July 2020 and was promoted through the European Society for Medical Oncology (ESMO) and the OncoAlert Network. RESULTS: One thousand and seventy-six physicians and stakeholders took part in the survey. In total, 57.3% of respondents were medical oncologists, 50.6% aged <40 years, 50.8% of female gender and mostly practicing in Europe (51.5%). More than 90% of respondents considered social media a useful tool for distributing scientific information and for education. Most used social media to stay up to date on cancer care in general (62.5%) and cancer care during COVID-19 (61%) given the constant flow of information. Respondents also used social media to interact with other oncologists (78.8%) and with patients (34.4%). Overall, 61.1% of respondents were satisfied with the role that social media was playing during the COVID-19 pandemic. On the other hand, 41.1% of respondents reported trouble in discriminating between credible and less credible information and 30% stated social networks were a source of stress. For this reason, one-third of respondents reduced its use during the COVID-19 pandemic. Regarding meeting attendance, a total of 59.1% of responding physicians preferred in-person meetings to virtual ones, and 51.8% agreed that virtual meetings and social distancing could hamper effective collaboration. CONCLUSION: Social media has a useful role in supporting cancer care and professional engagement in oncology. Although one-third of respondents reported reduced use of social media due to stress during the COVID-19 pandemic, the majority found social media useful to keep up to date and were satisfied with the role social media was playing during the pandemic.


Assuntos
COVID-19 , Oncologistas , Mídias Sociais , Adulto , Idoso , Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Feminino , Humanos , Disseminação de Informação , Masculino , Oncologia/educação , Pessoa de Meia-Idade , Oncologistas/psicologia , Rede Social , Estresse Psicológico , Inquéritos e Questionários , Telemedicina
7.
J Am Med Inform Assoc ; 28(5): 915-922, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33712828

RESUMO

OBJECTIVE: Few studies examine physicians' use of different features of health information technology (HIT) in relation to their psychological empowerment and stress, especially in China, where many hospitals are being pushed to share digitized medical information. Further, there are mixed findings about the impact of HIT on stress, with some studies suggesting that HIT increases stress and others suggesting no effect. Hence, there is a need for a nuanced view of HITs to incorporate different features, regions, and outcomes. This work seeks to extend the existing body of knowledge on HIT by assessing the effects of basic (data-related) and advanced (clinical) HIT features on physician empowerment, stress, and ultimately, job satisfaction in Chinese hospitals. MATERIALS AND METHODS: We surveyed 367 physicians at 5 class 3 hospitals (ie, regional hospitals that provide specialist medical and healthcare services and carry out high levels of teaching and scientific research tasks) in 5 provinces in China. We specified and estimated a structural equation model using partial least squares. RESULTS: Physicians who used advanced features experienced improvement in all dimensions of physician empowerment and significant reduction in stress. Physicians who used basic technology, however, experienced improvement in fewer dimensions of physician empowerment and no significant change in stress. Except for efficacy, all dimensions of physician empowerment and stress predicted job satisfaction. CONCLUSIONS: Healthcare professionals should assess the purpose of HIT features and expect different effects on intermediate and ultimate outcomes. The nuanced view of HIT features and processes leading to outcomes sheds light on their differential effects and resolves inconsistencies in prior findings on HIT effects.


Assuntos
Atitude do Pessoal de Saúde , Informática Médica , Corpo Clínico Hospitalar , Adulto , Idoso , Atitude Frente aos Computadores , China , Empoderamento , Feminino , Humanos , Satisfação no Emprego , Masculino , Corpo Clínico Hospitalar/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
8.
Nurs Forum ; 56(3): 612-618, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33728660

RESUMO

BACKGROUND: The emergence of the COVID-19 pandemic resulted in a sudden transition to remote learning. These circumstances presented many challenges for higher education faculty and students around the world but especially for nursing education programs which are traditionally conducted in a face-to-face learning environment that includes hands-on experiential learning. METHODS: Guided by Meleis' Transition Theory, a qualitative descriptive design was utilized to explore prelicensure nursing students' experiences of the transition to remote learning during the Spring 2020 semester. Participants were recruited from one baccalaureate program in the Pacific Northwestern United States. Interviews were conducted and transcribed using a web conferencing platform. Data were analyzed using Colaizzi's phenomenological reduction. RESULTS: Eleven students participated. Interviews revealed four overarching themes: technological challenges, academic relationship changes, role stress and strain, and resilience. CONCLUSION: The sudden transition to remote learning resulted in a number of challenges for nursing students. Despite these challenges, students demonstrated a remarkable sense of resilience and perseverance. Faculty have an opportunity to address student stressors and design remote courses in such a way to facilitate student engagement and community building.


Assuntos
Adaptação Psicológica , Atitude Frente aos Computadores , COVID-19/psicologia , Educação à Distância/organização & administração , Bacharelado em Enfermagem/organização & administração , Estresse Psicológico , Estudantes de Enfermagem/psicologia , Adulto , Feminino , Humanos , Masculino , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Adulto Jovem
9.
BMJ Health Care Inform ; 28(1)2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33753326

RESUMO

INTRODUCTION: Telehealth became the most practical option for general practice consultations in Aotearoa New Zealand (NZ) as a result of the national lockdowns in response to the COVID-19 pandemic. What is the consumer experience of access to telehealth and how do consumers and providers perceive this mode of care delivery going forward? METHODS AND ANALYSIS: A national survey of general practice consumers and providers who used telehealth services since the national lockdowns in 2020 will be distributed. It is based on the Unified Theory of Acceptance and Use of Technology framework of technology acceptance and the access to care framework. The data will be statistically analysed to create a foundation for in-depth research on the use of telehealth services in NZ general practice services, with a specific focus on consumer experiences and health outcomes. ETHICS AND DISSEMINATION: Ethics approval was granted by the Auckland Health Research Ethics Committee on 13/11/2020, reference AH2539. The survey will be disseminated online.


Assuntos
COVID-19/epidemiologia , Medicina Geral/organização & administração , Telemedicina/organização & administração , Atitude Frente aos Computadores , Humanos , Nova Zelândia/epidemiologia , Pandemias , Estudos Prospectivos , Projetos de Pesquisa , SARS-CoV-2 , Inquéritos e Questionários , Telefone , Comunicação por Videoconferência
11.
Curationis ; 44(1): e1-e7, 2021 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-33764129

RESUMO

BACKGROUND: The real-world problems and ever-changing challenges currently confronting the future of nursing education and healthcare require a problem-based learning approach using simulation strategy. This is exacerbated by the increasing burden of diseases such as tuberculosis, human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) and more recently the coronavirus disease 2019 (COVID-19) pandemic, as well as advancing technology and changing regulations and policies. Problem-based learning is a student-centred learning strategy, where students are presented with situations drawn from practice, which can be used to bridge the theory-practice gap. OBJECTIVES: To explore the perceptions and views of healthcare educators on how problem-based learning can be facilitated through simulation. METHOD: A qualitative, exploratory, descriptive and contextual research design was used. Thirteen educators from the Faculty of Health Sciences of the University of Johannesburg, with 5 years' teaching experience, were purposively selected from the Dean's office, the Nursing Department, emergency medical care and the departments of podiatry, somatology and radiography. The participants were selected based on their extensive knowledge of problem-based learning and the use of simulation. Data were collected through in-depth, individual, semi-structured interviews. Thematic analysis provided six themes and 13 related sub-themes. The article focuses on the perceptions and views of educators regarding problem-based learning through simulation. RESULTS: Problem-based learning through simulation allows students to work together in teams, which demonstrates a new modus operandi and renders a holistic approach to patient care. CONCLUSION: Problem-based learning through simulation should be utilised to encourage reflective knowledge exchange. Students from various departments can learn about new innovations, creativity and develop critical thinking when solving complex health-related problems.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Instrução por Computador/métodos , Educação em Enfermagem/métodos , Docentes de Enfermagem/psicologia , Aprendizagem Baseada em Problemas/métodos , Adulto , Currículo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
12.
J Am Med Inform Assoc ; 28(4): 824-831, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33575787

RESUMO

OBJECTIVES: The purpose of the study was to determine if association exists between evidence-based provider training and clinician proficiency in electronic health record (EHR) use and if so, which EHR use metrics and vendor-defined indices exhibited association. MATERIALS AND METHODS: We studied ambulatory clinicians' EHR use data published in the Epic Systems Signal report to assess proficiency between training participants (n = 133) and nonparticipants (n = 14). Data were collected in May 2019 and November 2019 on nonsurgeon clinicians from 6 primary care, 7 urgent care, and 27 specialty care clinics. EHR use training occurred from August 5 to August 15, 2019, prior to EHR upgrade and organizational instance alignment. Analytics performed were descriptive statistics, paired t-tests, multivariate correlations, and hierarchal multiple regression. RESULTS: For number of appointments per 30-day reporting period, trained clinicians sustained an average increase of 16 appointments (P < .05), whereas nontrained clinicians incurred a decrease of 8 appointments. Only the trained clinician group achieved postevent improvement in the vendor-defined Proficiency score with an effect size characterized as moderate to large (dCohen = 0.625). DISCUSSION: Controversies exist on the return of investment from formal EHR training for clinician users. Previously published literature has mostly focused on qualitative data indicators of EHR training success. The findings of our EHR use training study identified EHR use metrics and vendor-defined indices with the capacity for translation into productivity and generated revenue measurements. CONCLUSIONS: One EHR use metric and 1 vendor-defined index indicated improved proficiency among trained clinicians.


Assuntos
Alfabetização Digital , Registros Eletrônicos de Saúde , Informática Médica/educação , Instituições de Assistência Ambulatorial , Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Prática Clínica Baseada em Evidências , Humanos , Profissionais de Enfermagem , Assistentes Médicos , Médicos , Competência Profissional , Análise de Regressão , Washington
13.
J Psycholinguist Res ; 50(4): 883-900, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33398606

RESUMO

The study uses technology acceptance model (TAM) to gain insights into user reactions to the technology adopted for language learning. The study aims to analyze the correlation between the variables of TAM on using Zoom application in language learning, in addition to examining how gender and experience influence the use of technology. The participants of this study comprise of 75 undergraduate English-as-Foreign-Language learners who have studied for their courses online during the COVID-19 pandemic. The results of the study reveal a strong positive correlation between the actual use of Zoom and the students' attitudes and behavioral intention. In addition, there is a positive correlation between computer self-efficacy and other variables (i.e. PU, actual use, PEU, attitude and behavioral intention). Further, while the results reveal that there is no correlation between the gender and any variables of the model, it has been found that experience is positively correlated with the variables of TAM.


Assuntos
Atitude Frente aos Computadores , Educação à Distância , Idioma , Modelos Educacionais , Estudantes/psicologia , Tecnologia , Adulto , COVID-19 , Feminino , Humanos , Intenção , Masculino , Autoeficácia , Inquéritos e Questionários , Adulto Jovem
15.
BMC Musculoskelet Disord ; 22(1): 18, 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33402136

RESUMO

BACKGROUND: Like with all cancers, multidisciplinary team (MDT) meetings are the norm in bone and soft tissue tumour (BST) management too. Problem in attendance of specialists due to geographical location is the one of the key barriers to effective functioning of MDTs. To overcome this problem, virtual MDTs involving videoconferencing or telemedicine have been proposed, but however this has been seldom used and tested. The COVID-19 pandemic forced the implementation of virtual MDTs in the Oxford sarcoma service in order to maintain normal service provision. We conducted a survey among the participants to evaluate its efficacy. METHODS: An online questionnaire comprising of 24 questions organised into 4 sections was circulated among all participants of the MDT after completion of 8 virtual MDTs. Opinions were sought comparing virtual MDTs to the conventional face-to-face MDTs on various aspects. A total of 36 responses were received and were evaluated. RESULTS: 72.8% were satisfied with the depth of discussion in virtual MDTs and 83.3% felt that the decision-making in diagnosis had not changed following the switch from face-to-face MDTs. About 86% reported to have all essential patient data was available to make decisions and 88.9% were satisfied with the time for discussion of patient issues over virtual platform. Three-fourths of the participants were satisfied (36.1% - highly satisfied; 38.9% - moderately satisfied) with virtual MDTs and 55.6% of them were happy to attend MDTs only by the virtual platform in the future. Regarding future, 77.8% of the participants opined that virtual MDTs would be the future of cancer care and an overwhelming majority (91.7%) felt that the present exercise would serve as a precursor to global MDTs involving specialists from abroad in the future. CONCLUSION: Our study shows that the forced switch to virtual MDTs in sarcoma care following the unprecedented COVID-19 pandemic to be a viable and effective alternative to conventional face-to-face MDTs. With effective and efficient software in place, virtual MDTs would also facilitate in forming extended MDTs in seeking opinions on complex cases from specialists abroad and can expand cancer care globally.


Assuntos
Neoplasias Ósseas/terapia , COVID-19 , Comunicação Interdisciplinar , Oncologia/organização & administração , Neoplasias Musculares/terapia , Equipe de Assistência ao Paciente/organização & administração , Sarcoma/terapia , Telemedicina/organização & administração , Comunicação por Videoconferência/organização & administração , Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Neoplasias Ósseas/diagnóstico , Tomada de Decisão Clínica , Prestação Integrada de Cuidados de Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Neoplasias Musculares/diagnóstico , Sarcoma/diagnóstico , Centros de Atenção Terciária
16.
J Nurs Adm ; 51(2): 60-62, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33449593

RESUMO

OBJECTIVE: The purpose of this study was to determine staff satisfaction and technology acceptance of continuous video monitoring (CVM) in comparison to sitters. BACKGROUND: Traditionally, sitters have been used to prevent falls in hospitals. Continuous video monitoring has emerged to reduce costs associated with sitters while maintaining safety. METHODS: A descriptive online survey using a modified version of the Technology Acceptance Model was used to gain insight on technology acceptance and satisfaction levels of clinical staff related to CVM. RESULTS: Only 12.73% found CVM to be as effective as sitters. Statistical significance was shown comparing sitters with CVM. A positive correlation was found with perceived ease of use and perceived usefulness of CVM. CONCLUSIONS: Understanding staff satisfaction and technology acceptance is imperative for nurse leaders and administration when implementing new technologies.


Assuntos
Acidentes por Quedas/prevenção & controle , Atitude do Pessoal de Saúde , Monitorização Fisiológica/enfermagem , Assistentes de Enfermagem/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Atitude Frente aos Computadores , Humanos , Pacientes Internados/estatística & dados numéricos , Gravação de Videoteipe/métodos
19.
Acad Med ; 96(1): 31-36, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32852320

RESUMO

Estimates in a 1989 study indicated that physicians in the United States were unable to reach a diagnosis that accounted for their patient's symptoms in up to 90% of outpatient patient encounters. Many proponents of artificial intelligence (AI) see the current process of moving from clinical data gathering to medical diagnosis as being limited by human analytic capability and expect AI to be a valuable tool to refine this process. The use of AI fundamentally calls into question the extent to which uncertainty in medical decision making is tolerated. Uncertainty is perceived by some as fundamentally undesirable and thus, for them, optimal decision making should be based on minimizing uncertainty. However, uncertainty cannot be reduced to zero; thus, relative uncertainty can be used as a metric to weigh the likelihood of various diagnoses being correct and the appropriateness of treatments. Here, the authors make the argument, using as examples the experiences of 2 AI systems, IBM Watson on Jeopardy and Watson for Oncology, that medical decision making based on relative uncertainty provides a better lens for understanding the application of AI to medicine than one that minimizes uncertainty. This approach to uncertainty has significant implications for how health care leaders consider the benefits and trade-offs of AI-assisted and AI-driven decision tools and ultimately integrate AI into medical practice.


Assuntos
Inteligência Artificial/normas , Tomada de Decisão Clínica/métodos , Tomada de Decisões Assistida por Computador , Diagnóstico por Computador/métodos , Diagnóstico por Computador/psicologia , Médicos/psicologia , Incerteza , Adulto , Atitude Frente aos Computadores , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
20.
J Appl Gerontol ; 40(1): 3-13, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32914668

RESUMO

The COVID-19 pandemic is associated with several short- and long-term negative impacts on the well-being of older adults. Physical distancing recommendations to reduce transmission of the SARS-CoV2-19 virus increase the risk of social isolation and loneliness, which are associated with negative outcomes including anxiety, depression, cognitive decline, and mortality. Taken together, social isolation and additional psychological impacts of the pandemic (e.g., worry, grief) underscore the importance of intervention efforts to older adults. This narrative review draws upon a wide range of evidence to provide a comprehensive overview of appropriate remotely-delivered interventions for older adults that target loneliness and psychological symptoms. These include interventions delivered by a range of individuals (i.e., community members to mental health professionals), and interventions that vary by implementation (e.g., self-guided therapy, remotely-delivered interventions via telephone or video call). Recommendations to overcome barriers to implementation and delivery are provided, with consideration given to the different living situations.


Assuntos
COVID-19/psicologia , Atenção à Saúde/métodos , Angústia Psicológica , Isolamento Social/psicologia , Telecomunicações , Idoso , Ansiedade/etiologia , Ansiedade/terapia , Moradias Assistidas , Atitude Frente aos Computadores , Terapia Cognitivo-Comportamental/métodos , Depressão/etiologia , Depressão/terapia , Humanos , Vida Independente , Solidão/psicologia , Casas de Saúde , Distanciamento Físico , Privacidade , SARS-CoV-2 , Mídias Sociais
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