This study describes a comparison between retrospective questions and daily diaries inquiring about positive and negative support in spousal interactions. The design was a multitrait-multimethod ...matrix with trait factors of positive and negative support, and method factors of retrospective questions and daily asked questions. Five questions were used for positive support and 2 questions were used for negative support. The data were multilevel, with daily measurement occasions nested within subjects. In addition, the data were ordered categorically. The negative support events proved to be so rare that the original 4-point response scale had to be dichotomized. The resulting model could be estimated using M plus, but the model and data complexities set some limits to the analysis. The results showed that at the subject level both positive and negative support could be assessed with sufficient reliability and validity. At the daily measurements level, positive support showed significant but low reliability and validity, but negative support could not be assessed reliably. It was concluded that at the daily level both positive and negative support should be viewed as transient events that do not indicate an underlying latent variable, but that could be modeled as a formative construct.
Purpose This study aimed to determine which methods of remote symptom assessment cancer outpatients would be comfortable using, including those involving information technology, and whether this ...varied with age and gender. Methods A questionnaire survey of 477 outpatients attending the Edinburgh Cancer Centre in Edinburgh, UK. Results Most patients reported that they would not feel comfortable using methods involvingtechnology such as a secure website, email, mobile phone text message, or a computer voice on the telephone but that they would be more comfortable using more traditional methods such as a paper questionnaire, speaking to a nurse on the telephone, or giving information in person. Conclusions The uptake of new, potentially cost-effective technology-based methods of monitoring patients' symptoms at home might be limited by patients' initial discomfort with the idea of using them. It will be important to develop methods of addressing this potential barrier (such as detailed explanation and supervised practice) if these methods are to be successfully implemented.
This study examined the effects of daily support exchanges in couples facing multiple sclerosis (MS). Two issues were examined: the imbalance between received and provided support, and the extent to ...which reciprocal exchanges of received and provided support are associated with end‐of‐day well‐being (positive and negative mood and self‐esteem). Guided by equity theory, we expected that one‐sided support provision or receipt would be harmful for well‐being for both patients and partners. We argued that these negative outcomes could be offset by reciprocating support, that is, when both partners receive and provide support. Sixty‐one patients and their partners filled out questionnaires on demographics and disease‐related characteristics and subsequently completed computerized daily diaries for 14 days. At the end of each day, both partners completed diaries on end‐of‐day mood, self‐esteem, received and provided emotional and instrumental support, and several control variables (daily hassles and MS‐related symptoms for patients). Reciprocity in instrumental support transactions was associated with higher levels of self‐esteem among both patients and partners. However, the other results all showed independent effects of support received and provided. Patients’ well‐being was related to providing emotional support and instrumental support, whereas partners’ well‐being was related to receiving emotional support from patients.
This study describes a comparison between retrospective questions and daily diaries inquiring about positive and negative support in spousal interactions. The design was a multitrait-multimethod ...matrix with trait factors of positive and negative support, and method factors of retrospective questions and daily asked questions. Five questions were used for positive support and 2 questions were used for negative support. The data were multilevel, with daily measurement occasions nested within subjects. In addition, the data were ordered categorically. The negative support events proved to be so rare that the original 4-point response scale had to be dichotomized. The resulting model could be estimated using M plus, but the model and data complexities set some limits to the analysis. The results showed that at the subject level both positive and negative support could be assessed with sufficient reliability and validity. At the daily measurements level, positive support showed significant but low reliability and validity, but negative support could not be assessed reliably. It was concluded that at the daily level both positive and negative support should be viewed as transient events that do not indicate an underlying latent variable, but that could be modeled as a formative construct.
There were two objectives of this research. First was to establish the utility of online digital assistance (ODA), a generic software-based method designed to support behavioral training (BT) in ...migraine. The second was to test whether ODA can produce additional effects in BT. Utility (feasibility and acceptability) was based on 44 patients with migraine who received ODA as an adjuvant to BT delivered to small groups by lay trainers with migraine at home. ODA tracking files were used to determine ODA feasibility. Acceptability was assessed by a structured interview. To examine ODA effects, 31 patients with migraine who received ODA during BT and at 6 months' follow-up were compared with a matched group of 31 participants who received BT only. Feasibility was established based on minimal technical problems, good compliance, and successful execution of ODA. Acceptability was confirmed by positive participant responses concerning usefulness, supportiveness, and low burden. Finally, ODA participants did not mark better improvements considering migraine attack frequency, internal control, and migraine-specific quality of life compared to those that underwent BT only. ODA is feasible, well-accepted, and perceived to support self-care in 44 patients with migraine. The method is currently designed for these patients, but it can be easily adapted for other health settings. Whether ODA can induce higher gains remains to be established.
This article examines self-directed approaches to the treatment of depression. It first considers some of the reasons why the uptake of mental health services by depressed people is low, despite the ...high prevalence of depressive disorders and the availability of evidence-based treatments. It then looks at the role of self-management in increasing access to evidence-based treatments for depression. It also defines what self-directed treatments are and goes on to discuss the different types of self-directed therapy, the common components of self-directed interventions for depression, Internet-based interventions for depression, and the advantages and disadvantages of self-directed interventions. Finally, it summarizes the findings from research on self-directed interventions for depression and suggests directions for future research and development in this area. Some titles of self-help books that can be used in self-directed interventions are presented.
While reinforcement learning (RL) has proven to be the approach of choice for tackling many complex problems, it remains challenging to develop and deploy RL agents in real-life scenarios ...successfully. This paper presents pH-RL (personalization in e-Health with RL) a general RL architecture for personalization to bring RL to health practice. pH-RL allows for various levels of personalization in health applications and allows for online and batch learning. Furthermore, we provide a general-purpose implementation framework that can be integrated with various healthcare applications. We describe a step-by-step guideline for the successful deployment of RL policies in a mobile application. We implemented our open-source RL architecture and integrated it with the MoodBuster mobile application for mental health to provide messages to increase daily adherence to the online therapeutic modules. We then performed a comprehensive study with human participants over a sustained period. Our experimental results show that the developed policies learn to select appropriate actions consistently using only a few days' worth of data. Furthermore, we empirically demonstrate the stability of the learned policies during the study.
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