Background To support the self-management of heart failure, a team of hospital clinicians, patients, and family caregivers have co-designed the consumer mobile health app, Care4myHeart . Objective This research aimed to determine patient experiences of using the app to self-manage heart failure. Methods Patients with heart failure used the app for 14 days on their own smart device in a home setting, following which a mixed-methods evaluation was performed. Eight patients were recruited, of whom six completed the Mobile Application Rating Scale and attended an interview. Results The overall app quality score was “acceptable” with 3.53 of 5 points, with the aesthetics (3.83/5) and information (3.78/5) subscales scoring the highest. The lowest mean score was in the app-specific subscale representing the perceived impact on health behavior change (2.53/5). Frequently used features were weight and fluid restriction tracking, with graphical representation of data particularly beneficial for improved self-awareness and ongoing learning. The use of technology for self-management will fundamentally differ from current practices and require a change in daily routines. However, app use was correlated with potential utility for daily management of illness with benefits of accurate recording and review of personal health data and as a communication tool for doctors to assist with care planning, as all medical information is available in one place. Technical considerations included participants’ attitudes toward technology, functionality and data entry issues, and relatively minor suggested changes. Conclusions The findings from this usability study suggest that a significant barrier to adoption is the lack of integration of technology into everyday life in the context of already established disease self-management routines. Future studies should explore the barriers to adoption and sustainability of consumer mobile health interventions for chronic conditions, particularly whether introducing such apps is more beneficial at the commencement of a self-management regimen.

Therapeutic interpersonal relationships are the primary component of all health care interactions that facilitate the development of positive clinician–patient experiences. Therapeutic interpersonal relationships have the capacity to transform and enrich the patients’ experiences. Consequently, with an increasing necessity to focus on patient-centered care, it is imperative for health care professionals to therapeutically engage with patients to improve health-related outcomes. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases of peer-reviewed research, limited to the English language with search terms developed to reflect therapeutic interpersonal relationships between health care professionals and patients in the acute care setting. This study found that therapeutic listening, responding to patient emotions and unmet needs, and patient centeredness were key characteristics of strategies for improving therapeutic interpersonal relationships.

BackgroundEffective nurse–patient communication is important in improving quality of health care. However, there are several barriers to nurse–patient communication in Saudi Arabia. This is attributed to the increasing number of non-Saudi expatriate nurses providing health care to patients. In particular, there are differences in culture, religion and language among non-Saudi nurses and patients. This integrative review aims to identify and synthesize quantitative and qualitative evidence on the current practice in nurse–patient communication in Saudi Arabia and its effect on service users’ quality of care, safety and satisfaction.MethodsAn integrative review based on Whittemore and Knafl’s approach (Whittemore and Knafl, J Adv Nurs 52:546–553, 2005) was used to conduct the review. Peer-reviewed articles containing any of a series of specific key terms were identified from sources such as CINAHL, EMBASE, Medline, PubMed and PsychINFO. The review included studies that focused on nurse–patient communication issues, communication barriers, and cultural and language issues. The search was limited to papers about the Saudi Arabian health system published in English and Arabic languages between 2000 and 2018. A data extraction form was developed to extract information from included articles.ResultsTwenty papers were included in the review (Table 1). Ten papers employed quantitative methods, eight papers used qualitative methods and two used mixed methods. The review revealed two major themes: ‘current communication practices’ and ‘the effect of communication on patients’. Some of the communication practices rely on non-verbal methods due to a lack of a common language, which often results in the meaning of the communication being misinterpreted. Many non-Saudi nurses have limited knowledge about Saudi culture and experience difficulty in understanding, and in some cases respecting, the cultural and religious practices of patients. Further, limited nurse–patient communication impacts negatively on the nurse–patient relationship, which can affect patient safety and lead to poor patient satisfaction.ConclusionsCurrent nurse–patient communication practices do not meet the needs of Saudi patients due to cultural, religious and language differences between nurses and patients. The barriers to effective nurse–patient communication adversely effects patient safety and patient satisfaction. Further research from the perspective of the patient and family is needed.

The intervention resulted in a 19% overall improvement in prophylaxis rates, which is a significant achievement for any behavioural change intervention. There is, however, still a significant discrepancy between surgical and medical patient prophylaxis rates, which clearly warrants further attention.

The adverse physical impacts of childhood obesity are increasingly being recognized. The objective of this study is to examine relationships between physical function and adiposity in youth. An umbrella review searched seven databases from inception to May 2019 for systematic reviews examining associations between adiposity and physical function in 0-20-year-olds. Findings were synthesized using the International Classification of Functioning, Disability and Health Framework and NHMRC FORM. Seventeen of 21 systematic reviews reported impairments to body function, including cardiorespiratory fitness (CRF), muscle function, balance/coordination, gait biomechanics, pain and injury. Six reviews reported activity restrictions in motor skills, running speed/agility and functional mobility, and two found inverse associations between adiposity and physical health-related quality of life (p-HRQOL). Some causal relationships indicated that adiposity inversely predicted p-HRQOL/CRF and CRF/muscle function inversely predicted adiposity. Assessments of physical function were heterogeneous and impacts on participation in life situations meaningful to the individual were largely unknown. Substantial evidence associates childhood overweight/obesity with reduced physical function. Associations were mainly cross-sectional, with causative evidence for some outcomes. Comprehensive physical function assessments by qualified health professionals are needed, along with targeted interventions to address deficits. Research should further examine causality of relationships, underlying mechanisms and participation challenges in real-life contexts.