Abstract
The World Health Organization described mHealth as the integration between traditional healthcare assistance and Internet Communication Technologies (ICTs) and devices. mHealth applications are developed by the joined contributions of healthcare researchers and informatic engineers. In pediatric healthcare, these apps can be used to foster the child's distraction through play, but also for psychoeducational and support purposes, according to gamification principles. A growing body of scientific studies points out that mHealth provides fruitful support in surgical practices with pediatric patients and in children's pain management. Research stresses out the core challenge of this field of investigation: the difficulty to develop engaging mHealth applications for pediatric patients that must be, at the same time, effective. In order to deepen the knowledge about pediatric mHealth, the chapter offers a review of N=11 mHealth applications, describing their main features, aims, and scientific outcomes.
Top1. Introduction
1.1 A Biopsychosocial Model of Healthcare
From the Seventies, healthcare underwent impressive changes, especially regarding the relationship between healthcare professionals (e.g., physicians, pediatricians, nurses, etc.) and their patients. Such change is bonded with the rise of Engel’s (1978) biopsychosocial model that extended the conception of health and illness beyond physical processes: indeed, social, and psychological factors became recognized as important as biological variables in determining the outcomes of patients’ cure. In other words, Engel’s model stimulated healthcare professionals to envision their patients as unique and complex individuals, who are the result of a multidimensional interaction of emotional, cognitive, experiential, and cultural factors (Melchert, 2020). Who the patient is? What does she/he believe and understand about her/his condition? How does she/he feel towards the diagnosis and the treatment? How much she/he is willing and capable to cooperate with the cure? These questions became crucial in healthcare, alongside a major involvement of patients in the process of treatment, based on interaction and communication between the physician and the person.
Communicating with the patient, monitoring her/his perceptions, involving, and, if possible, making her/him responsible for her/his health when she/he exits the medical setting, are the keys for the therapeutic alliance. Last decades studies highlighted the correlation between therapeutic alliance (Rauch & Muriel, 2004; Spinetta et al., 2002), with patients’ adherence to medical treatment (Jones et al., 2004): the more a patient is involved in a relationship of trust and exchange with the healthcare professional, the more she/he will be willing and able to follow the cure protocol. Moreover, it has been demonstrated that those healthcare professionals who are able to effectively communicate and have better relational skills are likely to foster patients’ proactive coping strategies and to diminish their resistance toward treatment, the hospitalization duration, and the frequency of relapse (Howick et al., 2018).
Key Terms in this Chapter
Gamification: Gamification is a strategy used to improve systems and motivate users by using playing experience elements. It implies the application of game-design aspects and dynamics in non-game contexts such as learning, physical exercise, organizational productivity, etc.
Therapeutic Alliance: Therapeutic alliance is a feature of the relationship between the patient and the healthcare professional, which should be characterized by trust and high-quality communication. The term is driven from psychotherapy, but it should be applied to all the interactions between a healthcare professional and a patient.
Pediatric Patient: A pediatric patient is an individual target of healthcare services who is minor to 15 years old (in some countries 21). Pediatric patients are: neonates (0-28 days of life), infants (28 days -12 months), toddlers (1-3 years), preschoolers (3-5 years), school aged children (6-10 years), adolescents (11-16 years).
MHealth: mHealth means “mobile health” and refers to medicine and health practices through mobile devices such as mobile phones, personal digital assistants (PDAs), smart-watches, and tablets. mHealth emerged from eHealth that uses information communication technology (ICT) to provide patients with health services and information via personal computer.
Power Imbalance: Pediatric patients are likely to perceive a power-imbalance when hospitalized. In fact, all the previous conquests in terms of autonomy need to be sacrificed in the process of the cure where every decision is taken by adults (e.g., parents and healthcare professionals). Such unpleasant feeling represents a source of distress for the child and should be counteracted by adequately engaging her/him in the treatment.