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2.
Neurol Sci ; 42(4): 1247-1251, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33459891

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has dramatically stressed the health care system and has provoked changes in population use of digital technologies. Digital divide is any uneven distribution in Information and Communications Technologies between people. AIMS: The purpose of this work was to describe the digital divide of a population of patients with dementia contacted by telemedicine during Italian lockdown for COVID-19 pandemic. METHOD: One hundred eight patients with cognitive impairment were contacted by video call to perform a telemedicine neurological evaluation. Information on patients and caregivers attending the televisit were recorded. RESULTS: Seventy-four patients connected with neurologist (successful televisit, 68.5%) and 34 patients were not able to perform televisit and were contacted by phone (failed televisit, 31.5%). No significant differences were observed among the two groups concerning age, gender, and education, but the prevalence of successful televisit was higher in the presence of younger caregivers: televisits performed in the presence of subjects of younger generation (sons and grandsons) had a successful rate higher (86% successful, 14% failed) than the group without younger generation caregiver (49% successful, 51% failed). This difference is mainly due to the ability of technological use among younger people. DISCUSSION: The most impacting factors on digital divide in our population are the social support networks and the experience with the technology: the presence of a digital native caregiver. The COVID-19 pandemic is unmasking an emerging form of technology-related social inequalities: political and community interventions are needed to support the most socially vulnerable population and prevent social health inequalities.


Assuntos
Cuidadores/estatística & dados numéricos , Demência/terapia , Exclusão Digital , Pandemias , Telemedicina/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cuidadores/psicologia , Escolaridade , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Neurologistas , Prevalência , Quarentena , Fatores Sexuais , Adulto Jovem
3.
Lima; Perú. Ministerio de Salud; 20201100. 59 p. ilus, graf.
Monografia em Espanhol | LILACS, MINSAPERÚ | ID: biblio-1122243

RESUMO

El documento técnico aborda los principales temas de: visión de la agenda digital del Sector Salud 2025-2030; visión de la salud digital al 2030; objetivos específicos y estrategias: fortalecer el ecosistema de salud digital y su gobernanza, desplegar a nivel nacional la historia clínica electrónica y la telesalud, mejorar a confiabilidad y disponibilidad de la información para su uso en el análisis y la toma de decisiones.


Assuntos
Saúde , Telemedicina , Acesso à Informação , Política de Inovação e Desenvolvimento , Tecnologia da Informação , Registros Eletrônicos de Saúde , Políticas , Exclusão Digital , Desenvolvimento Sustentável , Estratégias de eSaúde , Governo Eletrônico , Objetivos
4.
BMC Med Educ ; 20(1): 377, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33092586

RESUMO

BACKGROUND: The coronavirus pandemic has exerted significant impacts on primary care, causing rapid digital transformation, exacerbating social isolation, and disrupting medical student and General Practice [GP] trainee education. Here we report on a medical student telephone initiative set-up by a final year GP trainee (the equivalent of a family medicine resident), which aimed to support patients at high risk and vulnerable to the Coronavirus Disease of 2019 [Covid-19]. In addition, it was hoped the project would mitigate a digital divide, enable proactive anticipatory planning, and provide an active learning environment to compensate for the pandemic's impact on medical education. METHODS: Thirty-three medical students conducted daily telephone conversations with high risk and vulnerable patients as specified by the initial NHSE published lists. They confirmed public health messages, offered details for voluntary support groups, established need for medication delivery, explored levels of digital connectivity, and prompted discussions around end-of-life choices. Students had access to online reflective resources and daily remote debriefing sessions with the GP trainee. A convergent mixed-methods evaluation was subsequently undertaken, using quantitative process and descriptive data and individual qualitative interviews were conducted according to a maximal variation sampling strategy with students, General Practitioners [GPs], and the GP trainee. Inductive thematic analysis was then applied with cross-validation, respondent validation, and rich evidential illustration aiding integrity. RESULTS: Ninety-seven 'high risk' and 781 'vulnerable' calls were made. Individuals were generally aware of public heath information, but some struggled to interpret and apply it within their own lives. Therefore respondents felt students provided additional practical and psychological benefits, particularly with regard to strengthening the links with the community voluntary groups. The project was widely liked by students who reported high levels of skill development and widened awareness, particularly valuing the active learning environment and reflective feedback sessions. CONCLUSION: This study demonstrates utilization of medical students as wider assets within the primary health care team, with an initiative that enables support for vulnerable patients whilst promoting active medical education. Ongoing integration of students within 'normal' primary health care roles, such as chronic disease or mental health reviews, could provide similar opportunities for supported active and reflective learning.


Assuntos
Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Estudantes de Medicina , Exclusão Digital , Educação Médica/métodos , Humanos , Entrevistas como Assunto , Pandemias , Educação de Pacientes como Assunto , Telefone , Assistência Terminal , Reino Unido , Populações Vulneráveis
6.
Rev. adm. pública (Online) ; 54(4): 650-662, jul.-ago. 2020. graf
Artigo em Português | LILACS | ID: biblio-1136968

RESUMO

Resumo A pandemia da COVID-19, por demandar isolamento social, impõe aproximação e coordenação de esforços de entes públicos e privados por intermédio da Internet e dos serviços digitais. O artigo analisa o uso e a operacionalização do ciberespaço pela Administração Pública no combate ao SARS-CoV-2 e apresenta um diagnóstico das vulnerabilidades e desafios referentes a essa crescente operacionalização. A administração pública passou a operacionalizar o ciberespaço com mais afinco a partir da década de 1990, com o e-government. Estratégias de coordenação (inter)governamental impostas pela atual conjuntura seriam impossíveis sem a intensificação da operacionalização do ciberespaço pelo aparato administrativo público, que transpõe para o domínio digital práticas e ações pouco usuais ou mesmo inéditas. Dada sua artificialidade, o ciberespaço só pode ser operacionalizado por detentores de meios para tal. A "democratização" cibernética esbarra na exclusão digital. O atual isolamento social evidencia desafios técnicos e socioeconômicos decorrentes da transposição do aparato de administração pública para o ciberespaço.


Resumen Por exigir aislamiento social, la pandemia de COVID-19 impone la aproximación y coordinación de esfuerzos de las entidades públicas y privadas por medio de Internet y de los servicios digitales. El artículo analiza el uso y operacional actual del ciberespacio por parte de la Administración Pública en la lucha contra el virus SARS-CoV-2 y presenta un diagnóstico de las vulnerabilidades y desafíos relacionados con esta creciente utilización operacional. La administración pública comenzó a usar el ciberespacio con mayor ahínco desde la década de 1990, momento en que surgió el e-government. Las estrategias de coordinación (inter)gubernamental impuestas por la situación actual serían imposibles sin la intensificación de la utilización operacional del ciberespacio por parte del aparato administrativo público, que transpone al dominio digital prácticas y acciones poco usuales o inéditas. Dada su artificialidad, el ciberespacio solo puede ser operado por quienes tienen los medios para hacerlo. La "democratización" cibernética choca con la exclusión digital. El aislamiento social actual destaca los desafíos técnicos y socioeconómicos derivados de la transposición del aparato de la administración pública al ciberespacio.


Abstract The COVID-19 pandemic, while demanding social distancing, imposes approximation and coordination of efforts by public and private entities through the Internet and digital services. This article analyzes the use and operationalization of cyberspace by the public administration in the fight against SARS-CoV-2. It presents a diagnosis of the vulnerabilities and challenges related to this growing operationalization. The public administration began to operationalize cyberspace more vigorously from the 1990s, with e-government. Inter-governmental and governmental coordination strategies imposed by the current situation would be impossible without the intensification of the operationalization of cyberspace by the public administration apparatus, which transposes unusual and even unprecedented practices and actions to the digital domain. Given its artificiality, cyberspace can only be operated by those with the means to do so. Cyber-democratization comes up against the digital divide. The current need for social distancing highlights technical and socio-economic challenges arising from the transposition of the public administration apparatus into cyberspace.


Assuntos
Humanos , Masculino , Feminino , Administração Pública , Infecções por Coronavirus , Internet , Vulnerabilidade Social , Exclusão Digital , Governo Eletrônico
9.
Cuad. Hosp. Clín ; 61(1): [15], jul. 2020.
Artigo em Espanhol | LILACS, LIBOCS | ID: biblio-1118974

RESUMO

El objetivo del presente trabajo es describir las estrategias educativas y su integración con las tecnologías digitales para el fortalecimiento del proceso enseñanza aprendizaje de docentes y estudiantes. Se abordan diferentes investigaciones, enfoques y conceptualizaciones desarrollados por otras investigaciones; además, se describen las estrategias de enseñanza pre-instruccionales, co-instruccionales y postinstruccionales entre las cuales resaltan los objetivos, organizadores previos, mapas mentales y conceptuales, ilustraciones, analogías y otros; por otra parte, se enfoca en las estrategias que el estudiante emplea en su formación académica como ser el ensayo, elaboración, organización, comprensión, apoyo y aprendizaje significativo. Por otro lado, se destaca las nuevas tecnologías digitales, los recursos de Internet orientadas a la educación y las miradas concernientes a reducir la brecha digital en el contexto educativo. Por último, se enfatiza en la integración de las estrategias educativas y las nuevas tecnologías de información y comunicación disponibles, y como éstas conllevan a la apertura de nuevos escenarios activos de interrelación e interacción entre docentes y estudiantes.


Assuntos
Ensino , Exclusão Digital , Aprendizagem , Tecnologia , Comunicação , Internet , Tecnologia da Informação , Docentes
10.
Artigo em Inglês | MEDLINE | ID: mdl-32492861

RESUMO

In today's knowledge- and information-based society, information literacy and information utilization skills are indicators of one's competitiveness, and play a very important role in various fields (e.g., in one's career, hobbies, as well as in daily life). In particular, information literacy and information utilization skills in older people are becoming essential for them to lead affluent lives. Moreover, information and communication technology is essential form of technology that can allow the elderly to ask for help in cases of emergency, as well as in daily life. Meanwhile, according to a recent Korean national statistical index, the digital divide among older people is more serious than that of the general public. The purpose of this paper is to statistically show that the digital divide among older people is more serious than other information-weak groups, as well as the general public. In addition, the purpose of this study is to identify the priorities that affect the digital divide among the three elements of the digital divide (digital access, digital capacity, and digital utilization) for older people. Based on that, we propose a variety of ways to solve the digital divide for older people. This study is expected to be widely used in future research and policies as a basis for solving the digital divide among older people.


Assuntos
Exclusão Digital , Idoso , Comunicação , Humanos , República da Coreia
11.
J Med Internet Res ; 22(7): e20472, 2020 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-32568726

RESUMO

BACKGROUND: Public health surveillance experts are leveraging user-generated content on social media to track the spread and effects of COVID-19. However, racial and ethnic digital divides, which are disparities among people who have internet access and post on social media, can bias inferences. This bias is particularly problematic in the context of the COVID-19 pandemic because due to structural inequalities, members of racial and ethnic minority groups are disproportionately vulnerable to contracting the virus and to the deleterious economic and social effects from mitigation efforts. Further, important demographic intersections with race and ethnicity, such as gender and age, are rarely investigated in work characterizing social media users; however, they reflect additional axes of inequality shaping differential exposure to COVID-19 and its effects. OBJECTIVE: The aim of this study was to characterize how the race and ethnicity of US adults are associated with their odds of posting COVID-19 content on social media and how gender and age modify these odds. METHODS: We performed a secondary analysis of a survey conducted by the Pew Research Center from March 19 to 24, 2020, using a national probability sample (N=10,510). Respondents were recruited from an online panel, where panelists without an internet-enabled device were given one to keep at no cost. The binary dependent variable was responses to an item asking whether respondents "used social media to share or post information about the coronavirus." We used survey-weighted logistic regressions to estimate the odds of responding in the affirmative based on the race and ethnicity of respondents (white, black, Latino, other race/ethnicity), adjusted for covariates measuring sociodemographic background and COVID-19 experiences. We examined how gender (female, male) and age (18 to 30 years, 31 to 50 years, 51 to 64 years, and 65 years and older) intersected with race and ethnicity by estimating interactions. RESULTS: Respondents who identified as black (odds ratio [OR] 1.29, 95% CI 1.02-1.64; P=.03), Latino (OR 1.66, 95% CI 1.36-2.04; P<.001), or other races/ethnicities (OR 1.33, 95% CI 1.02-1.72; P=.03) had higher odds than respondents who identified as white of reporting that they posted COVID-19 content on social media. Women had higher odds of posting than men regardless of race and ethnicity (OR 1.58, 95% CI 1.39-1.80; P<.001). Among men, respondents who identified as black, Latino, or members of other races/ethnicities were significantly more likely to post than respondents who identified as white. Older adults (65 years or older) had significantly lower odds (OR 0.73, 95% CI 0.57-0.94; P=.01) of posting compared to younger adults (18-29 years), particularly among those identifying as other races/ethnicities. Latino respondents were the most likely to report posting across all age groups. CONCLUSIONS: In the United States, members of racial and ethnic minority groups are most likely to contribute to COVID-19 content on social media, particularly among groups traditionally less likely to use social media (older adults and men). The next step is to ensure that data collection procedures capture this diversity by encompassing a breadth of search criteria and social media platforms.


Assuntos
Betacoronavirus , Grupos de Populações Continentais/estatística & dados numéricos , Infecções por Coronavirus , Exclusão Digital , Grupos Étnicos/estatística & dados numéricos , Pandemias , Pneumonia Viral , Mídias Sociais/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Afro-Americanos/estatística & dados numéricos , Fatores Etários , Idoso , Infecções por Coronavirus/epidemiologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Razão de Chances , Pneumonia Viral/epidemiologia , Fatores Sexuais , Mídias Sociais/provisão & distribução , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
12.
PLoS One ; 15(5): e0231465, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32365123

RESUMO

Learning using the Internet or training through E-Learning is growing rapidly and is increasingly favored over the traditional methods of learning and teaching. This radical shift is directly linked to the revolution in digital computer technology. The revolution propelled by innovation in computer technology has widened the scope of E-Learning and teaching, whereby the process of exchanging information has been made simple, transparent, and effective. The E-Learning system depends on different success factors from diverse points of view such as system, support from the institution, instructor, and student. Thus, the effect of critical success factors (CSFs) on the E-Learning system must be critically analyzed to make it more effective and successful. This current paper employed the analytic hierarchy process (AHP) with group decision-making (GDM) and Fuzzy AHP (FAHP) to study the diversified factors from different dimensions of the web-based E-Learning system. The present paper quantified the CSFs along with its dimensions. Five different dimensions and 25 factors associated with the web-based E-Learning system were revealed through the literature review and were analyzed further. Furthermore, the influence of each factor was derived successfully. Knowing the impact of each E-Learning factor will help stakeholders to construct education policies, manage the E-Learning system, perform asset management, and keep pace with global changes in knowledge acquisition and management.


Assuntos
Sucesso Acadêmico , Instrução por Computador , Currículo/normas , Internet , Aprendizagem/fisiologia , Instrução por Computador/métodos , Instrução por Computador/normas , Instrução por Computador/provisão & distribução , Exclusão Digital/tendências , Lógica Fuzzy , Humanos , Ciência da Implementação , Internet/organização & administração , Internet/normas , Internet/provisão & distribução , Acesso à Internet/estatística & dados numéricos , Acesso à Internet/tendências , Conhecimento , Professores Escolares/organização & administração , Professores Escolares/normas , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Capacitação de Professores/métodos , Capacitação de Professores/organização & administração , Capacitação de Professores/normas
13.
Trends Cogn Sci ; 24(8): 583-584, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32451239

RESUMO

Cognitive scientists have ramped up online testing in response to the COVID-19 pandemic. Although research conducted online solves the problem of data collection, the paucity of internet access among low-income and minority communities may reduce the diversity of study samples, and thus have an impact on the generalizability of scientific findings.


Assuntos
Ciência Cognitiva , Infecções por Coronavirus/epidemiologia , Coleta de Dados/métodos , Exclusão Digital , Status Econômico , Grupos Étnicos , Acesso à Internet , Internet , Pneumonia Viral/epidemiologia , Betacoronavirus , Diversidade Cultural , Humanos , Pandemias , Seleção de Pacientes , Pesquisa , Estados Unidos/epidemiologia
14.
Eur Neuropsychopharmacol ; 35: 12-16, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32446705

RESUMO

The epidemic of the 2019 novel coronavirus SARS-CoV-2, causing the coronavirus disease 2019 (COVID-19) is a global public health emergency with multifaceted severe consequences for people's lives and their mental health. In this article, as members of the European College of Neuropsychopharmacology (ECNP) Resilience, we will discuss the urgent need for a focus on resilience during the current coronavirus pandemic. Resilience is pivotal to cope with stress and vital to stay in balance. We will discuss the importance of resilience at the individual and societal level, but also the implication for patients with a psychiatric condition and health care workers. We not only advocate for an increased focus on mental health during the coronavirus pandemic but also highlight the urgent need of augmenting our focus on resilience and on strategies to enhance it.


Assuntos
Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Transtornos Mentais/psicologia , Saúde Mental , Pneumonia Viral/psicologia , Resiliência Psicológica , Estresse Psicológico/psicologia , Infecções por Coronavirus/epidemiologia , Exclusão Digital , Europa (Continente)/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Solidão , Serviços de Saúde Mental , Pandemias , Pneumonia Viral/epidemiologia , Isolamento Social
15.
PLoS One ; 15(4): e0232032, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324786

RESUMO

The new technologies, the digitalisation of processes and automation of work will change the manner of doing business, working and living. The effects of digitalisation on the economy, society and quality of life imply significant challenges of the labour market. All the participants will be concerned: authorities, companies and ordinary people. The objective of this research is to analyse the perceptions of the EU citizens about digitalisation and to highlight the differences among specific socio-demographic groups. The analysis is grounded on a composite methodology, comprising several statistical and econometric methods that provide scientific support to achieved conclusions: statistical analysis (with the primary goal to shed light on the EU citizens' perceptions about their digital technology skills), TwoStep Cluster Analysis (TSCA) (with the purpose to identify the 'digital vulnerable groups' and then the 'digital vulnerable countries' in terms of the exposure to digital divide) and logistic regression (with the main aim to quantify the impact of the relevant factors on citizens' perceptions about digitalisation). We identified a group of respondents evaluating themselves as having meagre digital skills, very afraid that robots could steal their jobs and with low usage of the internet. They are elderly, with a low level of education, manual workers or not working, with a relatively low level of income and little Internet use. The originality of our approach is given by the fact that we focused on investigating if digital divide leads to the creation of vulnerable groups (citizens and/or countries) and if there are specific patterns in terms of the perception on being skilled in the use of digital technologies in daily life or at work and of the understanding that robots replace human on the labour market. We aim to find relevant factors for the labour market to assume targeted measures that should be taken for a better match of supply and demand on the labour market and for creating a smart labour market. It is highly needed to increase the people's confidence in their skills level and to make the most of digitalisation of the societies. The results show consistent patterns in term of socio-demographic characteristics and perception towards digitalisation. The latter will have a meaningful impact on the economy and the society in the European Union in the next period. That is why a positive attitude towards digitalisation is essential for transforming this relatively new challenge into an excellent opportunity for the future.


Assuntos
Alfabetização Digital/estatística & dados numéricos , Exclusão Digital , Emprego/psicologia , Percepção , Adolescente , Adulto , Fatores Etários , Idoso , União Europeia , Feminino , Humanos , Acesso à Internet/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
16.
J Med Internet Res ; 22(6): e14714, 2020 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-32343670

RESUMO

BACKGROUND: Disparities in access to specific technologies within gender groups have not been investigated. Slum settings provide an ideal population to investigate the contributing factors to these disparities. OBJECTIVE: This study aimed to examine gender differences in mobile phone ownership, internet access, and knowledge of SMS text messaging among males and females living in urban slum settings. METHODS: A convenience sampling approach was used in sample selection from 675 unnotified slums. A total of 38 slum sites were then selected across four geographic zones. Of these, 10% of the households in each slum site was selected from each zone. One household member was interviewed based on their availability and fulfillment of the eligibility criteria. Eligible individuals included those aged 18 years and above, residing in these slums, and who provided voluntary consent to participate in the study. Individuals with mental or physical challenges were excluded from the study. RESULTS: Our results showed that females were half as likely to own mobile phones compared with males (odds ratio [OR] 0.53, 95% CI 0.37-0.76), less likely to have internet access (OR 0.79, 95% CI 0.56-1.11), or know how to send text messages (OR 0.93, 95% CI 0.66-1.31). The predictors of mobile phone ownership, internet access, and text messaging between males and females included age, individual education, housing type, and the number of earning members in a household in the adjusted analysis. Among males, the number of earning members was a predictor of both mobile phone ownership and text messaging, whereas household education was a predictor of both internet access and text messaging. Age and individual education only predicted internet access, whereas housing type only predicted text messaging. Among females, household education was a predictor of all the technology outcomes. Age and type of toilet facility only predicted mobile phone ownership; housing type only predicted internet access whereas television ownership with satellite service and smoking behavior only predicted text messaging. CONCLUSIONS: Our study findings showing disparate access to technology within gender groups lend support for further research to examine the causal mechanisms promoting these differences to proffer significant solutions. Specifically, our study findings suggest that improving household education is crucial to address the disparate access and usage of mobile phones, the internet, and text messaging among women in slum settings. This suggestion is due to the consistency in household educational level as a predictor across all these technology indicators. In addition, the mechanisms by which the number of household earning members influences the disparate access to technology among men call for further exploration.


Assuntos
Exclusão Digital/tendências , Adolescente , Adulto , Estudos Transversais , Feminino , Identidade de Gênero , Humanos , Índia , Masculino , Áreas de Pobreza , Adulto Jovem
18.
JAAPA ; 33(5): 46-51, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32345948

RESUMO

Over the past 2 decades, personal digital devices have evolved to become portable, attractive, readily accessible, interactive, and ubiquitous. Although digital and social media have evidence-based benefits, including early learning, exposure to new ideas and knowledge, and increased opportunities for social contact and support, unsupervised and unchecked use of personal digital devices can have negative consequences for the physical and mental health of children in their formative years.The widespread use of portable digital devices has been accompanied by a concomitant rise in the prevalence of physical and mental health issues in children. Research suggests an association between these trends, which also may be considered from a public health perspective. Proposed interventions include the development and implementation of individual family media use plans for children of all ages.


Assuntos
Desenvolvimento do Adolescente , Desenvolvimento Infantil , Meios de Comunicação , Exclusão Digital , Internet , Saúde Mental , Psicologia do Adolescente , Psicologia da Criança , Mídias Sociais , Adolescente , Comportamento Aditivo , Criança , Pré-Escolar , Cyberbullying , Feminino , Humanos , Masculino
19.
Int J Public Health ; 65(3): 325-333, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32277246

RESUMO

OBJECTIVES: This study aimed to identify which are the socio-demographic factors that can describe health information users' profiles in Europe and assess which are the factors distinguishing users and non-users and their association with the use of health-related online information. METHODS: Data from the Flash Eurobarometer No. 404 (2014) was analysed through a multilevel logistic regression model and a propensity score matching. RESULTS: There were significant differences in the use of the Internet for health information according to gender, age, education, long-term illness and health-related knowledge. Thus, some digital divides persisted in the use of health information online. Results showed that a poor health status was associated with a higher use of the Internet for health purposes only for people having chronic conditions. CONCLUSIONS: Findings show a need to increase people's eHealth literacy, especially for males over 45 years old not suffering from a long-term illness. In order to limit the misuse of poor or untrustworthy health information that might contribute to higher health disparities, special interest should be focused on population socio-demographic characteristics.


Assuntos
Exclusão Digital , Letramento em Saúde/estatística & dados numéricos , Internet/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Europa (Continente) , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
20.
J Med Internet Res ; 22(2): e16286, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32044752

RESUMO

BACKGROUND: For stroke, traumatic brain injury (TBI), and other neurologic conditions associated with speech-language disorders, speech and language therapy is the standard of care for promoting recovery. However, barriers such as clinician time constraints and insurance reimbursement can inhibit a patient's ability to receive the support needed to optimize functional gain. Although digital rehabilitation has the potential to increase access to therapy by allowing patients to practice at home, the clinical and demographic characteristics that impact a patient's level of engagement with technology-based therapy are currently unknown. OBJECTIVE: This study aimed to evaluate whether the level of engagement with digital therapy differs by various patient characteristics, including age, gender, diagnosis, time from disease onset, and geographic location (urban vs rural). METHODS: Data for patients with stroke or TBI that initiated the use of Constant Therapy, a remotely delivered, cloud-based rehabilitation program for patients with speech-language disorders, were retrospectively analyzed. Only data from therapeutic sessions completed at home were included. The following three activity metrics were evaluated: (1) the number of active weeks of therapy, (2) the average number of active therapy days per week, and (3) the total number of therapeutic sessions completed during the first 20 weeks of program access. An active day or week was defined as having at least one completed therapeutic session. Separate multiple linear regression models were performed with each activity measure as the dependent variable and all available patient demographics as model covariates. RESULTS: Data for 2850 patients with stroke or TBI were analyzed, with the average patient completing 8.6 weeks of therapy at a frequency of 1.5 days per week. Contrary to known barriers to technological adoption, older patients were more active during their first 20 weeks of program access, with those aged 51 to 70 years completing 5.01 more sessions than patients aged 50 years or younger (P=.04). Similarly, patients living in a rural area, who face greater barriers to clinic access, were more digitally engaged than their urban counterparts, with rural patients completing 11.54 more (P=.001) sessions during their first 20 weeks of access, after controlling for other model covariates. CONCLUSIONS: An evaluation of real-world data demonstrated that patients with stroke and TBI use digital therapy frequently for cognitive and language rehabilitation at home. Usage was higher in areas with limited access to clinical services and was unaffected by typical barriers to technological adoption, such as age. These findings will help guide the direction of future research in digital rehabilitation therapy, including the impact of demographics on recovery outcomes and the design of large, randomized controlled trials.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Exclusão Digital/tendências , Reabilitação/métodos , Fonoterapia/métodos , Fala/fisiologia , Idoso , Estudos de Coortes , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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