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  1 / 1919 MEDLINE  
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[PMID]:28125699
[Au] Autor:Mugo PM; Micheni M; Shangala J; Hussein MH; Graham SM; Rinke de Wit TF; Sanders EJ
[Ad] Endereço:Kemri-Wellcome Trust Research Programme, Kilifi, Kenya.
[Ti] Título:Uptake and Acceptability of Oral HIV Self-Testing among Community Pharmacy Clients in Kenya: A Feasibility Study.
[So] Source:PLoS One;12(1):e0170868, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: While HIV testing and counselling is a key entry point for treatment as prevention, over half of HIV-infected adults in Kenya are unaware they are infected. Offering HIV self-testing (HST) at community pharmacies may enhance detection of undiagnosed infections. We assessed the feasibility of pharmacy-based HST in Coastal Kenya. METHODS: Staff at five pharmacies, supported by on-site research assistants, recruited adult clients (≥18 years) seeking services indicative of HIV risk. Participants were offered oral HST kits (OraQuick®) at US$1 per test. Within one week of buying a test, participants were contacted for post-test data collection and counselling. The primary outcome was test uptake, defined as the proportion of invited clients who bought tests. Views of participating pharmacy staff were solicited in feedback sessions during and after the study. RESULTS: Between November 2015 and April 2016, 463 clients were invited to participate; 174 (38%) were enrolled; and 161 (35% [95% Confidence Interval (CI) 31-39%]) bought a test. Uptake was higher among clients seeking HIV testing compared to those seeking other services (84% vs. 11%, adjusted risk ratio 6.9 [95% CI 4.9-9.8]). Only 4% of non-testers (11/302) stated inability to pay as the reason they did not take up the test. All but one tester reported the process was easy (29%) or very easy (70%). Demand for HST kits persisted after the study and participating service providers expressed interest in continuing to offer the service. CONCLUSIONS: Pharmacy HST is feasible in Kenya and may be in high demand. The uptake pattern observed suggests that a client-initiated approach is more feasible compared to pharmacy-initiated testing. Price is unlikely to be a barrier if set at about US$1 per test. Further implementation research is required to assess uptake, yield, and linkage to care on a larger scale.
[Mh] Termos MeSH primário: Testes Diagnósticos de Rotina/utilização
Infecções por HIV/diagnóstico
Assistência Farmacêutica/utilização
Farmácias/utilização
Autocuidado/utilização
[Mh] Termos MeSH secundário: Adolescente
Adulto
Aconselhamento/estatística & dados numéricos
Estudos de Viabilidade
Feminino
Seres Humanos
Quênia
Masculino
Programas de Rastreamento
Assistência Individualizada de Saúde/provisão & distribuição
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170810
[Lr] Data última revisão:
170810
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170127
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0170868


  2 / 1919 MEDLINE  
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[PMID]:28099965
[Au] Autor:Pigini L; Bovi G; Panzarino C; Gower V; Ferratini M; Andreoni G; Sassi R; Rivolta MW; Ferrarin M
[Ad] Endereço:IRCCS Fondazione Don Carlo Gnocchi Onlus, Milan, Italy.
[Ti] Título:Pilot Test of a New Personal Health System Integrating Environmental and Wearable Sensors for Telemonitoring and Care of Elderly People at Home (SMARTA Project).
[So] Source:Gerontology;63(3):281-286, 2017.
[Is] ISSN:1423-0003
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The increase in life expectancy is accompanied by a growing number of elderly subjects affected by chronic comorbidities, a health issue which also implies important socioeconomic consequences. Shifting from hospital or community dwelling care towards a home personalized healthcare paradigm would promote active aging with a better quality of life, along with a reduction in healthcare-related costs. OBJECTIVE: The aim of the SMARTA project was to develop and test an innovative personal health system integrating standard sensors as well as innovative wearable and environmental sensors to allow home telemonitoring of vital parameters and detection of anomalies in daily activities, thus supporting active aging through remote healthcare. METHODS: A first phase of the project consisted in the definition of the health and environmental parameters to be monitored (electrocardiography and actigraphy, blood pressure and oxygen saturation, weight, ear temperature, glycemia, home interaction monitoring - water tap, refrigerator, and dishwasher), the feedbacks for the clinicians, and the reminders for the patients. It was followed by a technical feasibility analysis leading to an iterative process of prototype development, sensor integration, and testing. Once the prototype had reached an advanced stage of development, a group of 32 volunteers - including 15 healthy adult subjects, 13 elderly people with cardiac diseases, and 4 clinical operators - was recruited to test the system in a real home setting, in order to evaluate both technical reliability and user perception of the system in terms of effectiveness, usability, acceptance, and attractiveness. RESULTS: The testing in a real home setting showed a good perception of the SMARTA system and its functionalities both by the patients and by the clinicians, who appreciated the user interface and the clinical governance system. The moderate system reliability of 65-70% evidenced some technical issues, mainly related to sensor integration, while the patient's user interface showed excellent reliability (100%). CONCLUSIONS: Both elderly people and clinical operators considered the SMARTA system a promising and attractive tool for improving patients' healthcare while reducing related costs and preserving quality of life. However, the moderate reliability of the system should prompt further technical developments in terms of sensor integration and usability of the clinical operator's user interface.
[Mh] Termos MeSH primário: Serviços de Assistência Domiciliar
Telemedicina/instrumentação
[Mh] Termos MeSH secundário: Idoso
Sistemas de Computação
Seres Humanos
Itália
Monitorização Fisiológica/instrumentação
Aceitação pelo Paciente de Cuidados de Saúde
Assistência Individualizada de Saúde
Projetos Piloto
Telemetria/instrumentação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170119
[St] Status:MEDLINE
[do] DOI:10.1159/000455168


  3 / 1919 MEDLINE  
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[PMID]:28027366
[Au] Autor:Dieleman JL; Baral R; Birger M; Bui AL; Bulchis A; Chapin A; Hamavid H; Horst C; Johnson EK; Joseph J; Lavado R; Lomsadze L; Reynolds A; Squires E; Campbell M; DeCenso B; Dicker D; Flaxman AD; Gabert R; Highfill T; Naghavi M; Nightingale N; Templin T; Tobias MI; Vos T; Murray CJ
[Ad] Endereço:Institute for Health Metrics and Evaluation, Seattle, Washington.
[Ti] Título:US Spending on Personal Health Care and Public Health, 1996-2013.
[So] Source:JAMA;316(24):2627-2646, 2016 12 27.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time. Objective: To systematically and comprehensively estimate US spending on personal health care and public health, according to condition, age and sex group, and type of care. Design and Setting: Government budgets, insurance claims, facility surveys, household surveys, and official US records from 1996 through 2013 were collected and combined. In total, 183 sources of data were used to estimate spending for 155 conditions (including cancer, which was disaggregated into 29 conditions). For each record, spending was extracted, along with the age and sex of the patient, and the type of care. Spending was adjusted to reflect the health condition treated, rather than the primary diagnosis. Exposures: Encounter with US health care system. Main Outcomes and Measures: National spending estimates stratified by condition, age and sex group, and type of care. Results: From 1996 through 2013, $30.1 trillion of personal health care spending was disaggregated by 155 conditions, age and sex group, and type of care. Among these 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion (uncertainty interval [UI], $96.7 billion-$106.5 billion) in spending, including 57.6% (UI, 53.8%-62.1%) spent on pharmaceuticals and 23.5% (UI, 21.7%-25.7%) spent on ambulatory care. Ischemic heart disease accounted for the second-highest amount of health care spending in 2013, with estimated spending of $88.1 billion (UI, $82.7 billion-$92.9 billion), and low back and neck pain accounted for the third-highest amount, with estimated health care spending of $87.6 billion (UI, $67.5 billion-$94.1 billion). The conditions with the highest spending levels varied by age, sex, type of care, and year. Personal health care spending increased for 143 of the 155 conditions from 1996 through 2013. Spending on low back and neck pain and on diabetes increased the most over the 18 years, by an estimated $57.2 billion (UI, $47.4 billion-$64.4 billion) and $64.4 billion (UI, $57.8 billion-$70.7 billion), respectively. From 1996 through 2013, spending on emergency care and retail pharmaceuticals increased at the fastest rates (6.4% [UI, 6.4%-6.4%] and 5.6% [UI, 5.6%-5.6%] annual growth rate, respectively), which were higher than annual rates for spending on inpatient care (2.8% [UI, 2.8%-2.8%] and nursing facility care (2.5% [UI, 2.5%-2.5%]). Conclusions and Relevance: Modeled estimates of US spending on personal health care and public health showed substantial increases from 1996 through 2013; with spending on diabetes, ischemic heart disease, and low back and neck pain accounting for the highest amounts of spending by disease category. The rate of change in annual spending varied considerably among different conditions and types of care. This information may have implications for efforts to control US health care spending.
[Mh] Termos MeSH primário: Doença/economia
Custos de Cuidados de Saúde
Gastos em Saúde
Assistência Individualizada de Saúde/economia
Saúde Pública/economia
[Mh] Termos MeSH secundário: Distribuição por Idade
Fatores Etários
Doença/classificação
Custos de Medicamentos/estatística & dados numéricos
Custos de Medicamentos/tendências
Governo Federal
Custos de Cuidados de Saúde/estatística & dados numéricos
Custos de Cuidados de Saúde/tendências
Gastos em Saúde/estatística & dados numéricos
Gastos em Saúde/tendências
Seres Humanos
Classificação Internacional de Doenças
Assistência Individualizada de Saúde/estatística & dados numéricos
Assistência Individualizada de Saúde/tendências
Saúde Pública/estatística & dados numéricos
Saúde Pública/tendências
Distribuição por Sexo
Fatores Sexuais
Estados Unidos
Ferimentos e Lesões/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161228
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2016.16885


  4 / 1919 MEDLINE  
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[PMID]:27332197
[Au] Autor:Kim KK; Bell JF; Bold R; Davis A; Ngo V; Reed SC; Joseph JG
[Ad] Endereço:Betty Irene Moore School of Nursing, University of California Davis, United States.
[Ti] Título:A Personal Health Network for Chemotherapy Care Coordination: Evaluation of Usability Among Patients.
[So] Source:Stud Health Technol Inform;225:232-6, 2016.
[Is] ISSN:0926-9630
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Cancer is a top concern globally. Cancer care suffers from lack of coordination, silos of information, and high cost. Interest is emerging in person-centered technology to assist with coordination to address these challenges. This study evaluates the usability of the "personal health network" (PHN), a novel solution leveraging social networking and mobile technologies, among individuals undergoing chemotherapy and receiving care coordination. Early results from interviews of 12 participants in a randomized pragmatic trial suggest that they feel more connected to the healthcare team using the PHN, find value in access to the patient education library, and are better equipped to organize the many activities that occur during chemotherapy. Improvements are needed in navigation, connectivity, and integration with electronic health records. Findings contribute to improvements in the PHN and informs a roadmap for potentially greater impact in technology-enabled cancer care coordination.
[Mh] Termos MeSH primário: Neoplasias/tratamento farmacológico
Satisfação do Paciente/estatística & dados numéricos
Assistência Centrada no Paciente/utilização
Assistência Individualizada de Saúde/utilização
Apoio Social
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Continuidade da Assistência ao Paciente/estatística & dados numéricos
Monitoramento de Medicamentos/psicologia
Monitoramento de Medicamentos/utilização
Seres Humanos
Meia-Idade
Determinação de Necessidades de Cuidados de Saúde
Neoplasias/psicologia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:160623
[St] Status:MEDLINE


  5 / 1919 MEDLINE  
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[PMID]:27244284
[Au] Autor:Rudling K
[Ti] Título:[In Process Citation].
[Ti] Título:Personer med hjärnskada missgynnas vid tillämpning av LSS..
[So] Source:Lakartidningen;113, 2016 May 27.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Mh] Termos MeSH primário: Lesões Encefálicas
Pessoas com Deficiência/legislação & jurisprudência
Assistência Individualizada de Saúde/legislação & jurisprudência
[Mh] Termos MeSH secundário: Atividades Cotidianas
Transtornos Cognitivos
Seres Humanos
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170510
[Lr] Data última revisão:
170510
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160601
[St] Status:MEDLINE


  6 / 1919 MEDLINE  
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[PMID]:26760957
[Au] Autor:Zhang W; Wang ML; Khalili S; Cranford SW
[Ad] Endereço:1 Laboratory for Nanotechnology In Civil Engineering (NICE), Northeastern University , Boston, Massachusetts.
[Ti] Título:Materiomics for Oral Disease Diagnostics and Personal Health Monitoring: Designer Biomaterials for the Next Generation Biomarkers.
[So] Source:OMICS;20(1):12-29, 2016 Jan.
[Is] ISSN:1557-8100
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We live in exciting times for a new generation of biomarkers being enabled by advances in the design and use of biomaterials for medical and clinical applications, from nano- to macro-materials, and protein to tissue. Key challenges arise, however, due to both scientific complexity and compatibility of the interface of biology and engineered materials. The linking of mechanisms across scales by using a materials science approach to provide structure-process-property relations characterizes the emerging field of 'materiomics,' which offers enormous promise to provide the hitherto missing tools for biomaterial development for clinical diagnostics and the next generation biomarker applications towards personal health monitoring. Put in other words, the emerging field of materiomics represents an essentially systematic approach to the investigation of biological material systems, integrating natural functions and processes with traditional materials science perspectives. Here we outline how materiomics provides a game-changing technology platform for disruptive innovation in biomaterial science to enable the design of tailored and functional biomaterials--particularly, the design and screening of DNA aptamers for targeting biomarkers related to oral diseases and oral health monitoring. Rigorous and complementary computational modeling and experimental techniques will provide an efficient means to develop new clinical technologies in silico, greatly accelerating the translation of materiomics-driven oral health diagnostics from concept to practice in the clinic.
[Mh] Termos MeSH primário: Materiais Biocompatíveis
Biomarcadores
Biologia Computacional
Diagnóstico Bucal/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Assistência Individualizada de Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biocompatible Materials); 0 (Biomarkers)
[Em] Mês de entrada:1610
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160114
[St] Status:MEDLINE
[do] DOI:10.1089/omi.2015.0144


  7 / 1919 MEDLINE  
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[PMID]:26505330
[Au] Autor:Teasdale CA; Alwar T; Chege D; Fayorsey R; Hawken MP; Abrams EJ
[Ad] Endereço:*ICAP-Columbia University, New York, NY †Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY ‡College of Physicians and Surgeons, Columbia University, New York, NY.
[Ti] Título:Impact of Youth and Adolescent Friendly Services on Retention of 10-24-Year-Olds in HIV Care and Treatment Programs in Nyanza, Kenya.
[So] Source:J Acquir Immune Defic Syndr;71(2):e56-9, 2016 Feb 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços de Saúde do Adolescente
Serviços de Saúde da Criança
Continuidade da Assistência ao Paciente
Infecções por HIV/terapia
Assistência Individualizada de Saúde
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Infecções por HIV/epidemiologia
Pesquisa sobre Serviços de Saúde
Seres Humanos
Incidência
Quênia/epidemiologia
Masculino
Aceitação pelo Paciente de Cuidados de Saúde
Adulto Jovem
[Pt] Tipo de publicação:LETTER; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Em] Mês de entrada:1606
[Cu] Atualização por classe:170611
[Lr] Data última revisão:
170611
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:151028
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000000877


  8 / 1919 MEDLINE  
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[PMID]:26373491
[Au] Autor:Duffin C
[Ti] Título:Who counts the cost of patients spending their own care budget?
[So] Source:Nurs Stand;30(3):12-3, 2015 Sep 16.
[Is] ISSN:2047-9018
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Custos de Cuidados de Saúde
Assistência Individualizada de Saúde/economia
Medicina Estatal
[Mh] Termos MeSH secundário: Orçamentos
Administração de Caso/organização & administração
Controle de Custos
Seres Humanos
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170206
[Lr] Data última revisão:
170206
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:150917
[St] Status:MEDLINE
[do] DOI:10.7748/ns.30.3.12.s14


  9 / 1919 MEDLINE  
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PubMed Central Texto completo
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[PMID]:25787179
[Au] Autor:Ross MW; Nyoni J; Larsson M; Mbwambo J; Agardh A; Kashiha J; McCurdy SA
[Ad] Endereço:Program in Human Sexuality, Department of Family Medicine, University of Minnesota, Minneapolis, MN, USA.
[Ti] Título:Health care in a homophobic climate: the SPEND model for providing sexual health services to men who have sex with men where their health and human rights are compromised.
[So] Source:Glob Health Action;8:26096, 2015.
[Is] ISSN:1654-9880
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We present a model for developing health services for men who have sex with men (MSM) in sub-Saharan Africa and other places where MSM are heavily stigmatized and marginalized. The processes of the SPEND model include Safe treatment for sexually transmissible infections (STIs) and HIV; Pharmacy sites for treatment of STIs in countries where pharmacies and drug stores are the source of medical advice and treatment; Education in sexual health issues for health professionals to reduce discrimination against MSM patients; Navigation for patients who have HIV and are rejected or discriminated against for treatment; and Discrimination reduction through educating potential leaders in tertiary education in issues of human sexuality. Supporting empirical evidence from qualitative and quantitative studies is summarized, and barriers to implementation are discussed. Health care for MSM is one of the casualties of anti-homosexual social and legal climates. There is no amnesty for MSM in health care settings, where the stigma and discrimination that they face in the rest of society is replicated. Such conditions, however, make it necessary to consider ways of providing access to health care for MSM, especially where rates of HIV and STIs in MSM populations are high, and stigma and discrimination encourages high proportions of MSM to marry. This in itself enhances the status of MSM as an important bridge population for STIs including HIV. Where anti-homosexual laws encourage, or are believed to encourage, the reporting of MSM to authorities, health care may be seen as an agent of authority rather than an agency for care.
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Infecções por HIV/prevenção & controle
Homofobia/estatística & dados numéricos
Homossexualidade Masculina/estatística & dados numéricos
Direitos Humanos
Modelos Organizacionais
Doenças Sexualmente Transmissíveis/prevenção & controle
[Mh] Termos MeSH secundário: África ao Sul do Saara
Infecções por HIV/diagnóstico
Infecções por HIV/epidemiologia
Infecções por HIV/terapia
Seres Humanos
Masculino
Assistência Individualizada de Saúde/organização & administração
Sexo Seguro/estatística & dados numéricos
Sexismo
Estigma Social
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1601
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150320
[St] Status:MEDLINE
[do] DOI:10.3402/gha.v8.26096


  10 / 1919 MEDLINE  
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[PMID]:25655783
[Au] Autor:Sun N; Rau PL
[Ad] Endereço:Institute of Human Factors and Ergonomics, Department of Industrial Engineering, Tsinghua University, Beijing 100084, China.
[Ti] Título:The acceptance of personal health devices among patients with chronic conditions.
[So] Source:Int J Med Inform;84(4):288-97, 2015 Apr.
[Is] ISSN:1872-8243
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Personal health devices (PHDs) are rapidly developing and getting smarter. But little is known about chronic patients' acceptance of such PHDs. OBJECTIVE: The objective of this study is to explore how chronic patients accept PHDs and what are the main factors that predict use intention of PHDs. The results will provide suggestions for the design of PHDs and e-health services. METHOD: A questionnaire survey was conducted to identify the main factors that affect chronic patients' acceptance of PHDs. Three hundred and forty-six valid responses from chronic patients were collected and the data were analyzed using exploratory factor analysis and regression analysis method. The questionnaire also included questions about respondents' experience of PHDs and preference of PHD functions. These questions help to understand lived experience of PHD users and to explain the factors that influence their use intention. RESULT: Five influencing factors that predict use intention of PHDs were identified: attitude toward technology, perceived usefulness, ease of learning and availability, social support, and perceived pressure. An acceptance model of PHDs was proposed based on these factors, and suggestions for PHD designers and e-health service designers were discussed. The exploration of PHD experience indicated that ease of learning and social norm significantly influenced PHD use intention, and many respondents expressed negative opinions on the accuracy, durability and maintenance service of PHDs. Besides, people generally expressed positive attitude toward future functions of a PHD.
[Mh] Termos MeSH primário: Atitude Frente aos Computadores
Doença Crônica/prevenção & controle
Monitorização Ambulatorial/instrumentação
Aceitação pelo Paciente de Cuidados de Saúde
Assistência Individualizada de Saúde/utilização
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1512
[Cu] Atualização por classe:150302
[Lr] Data última revisão:
150302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150207
[St] Status:MEDLINE



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