Introduction

Many people suffer from mental illnesses and biological disorders that need daily observations to keep the problem from becoming worse. Mental disorders such as bipolar disorder (also known as manic depression) can be very dangerous. People who suffer from bipolar disease go through episodes of mood swings, from severe mania and depression. The bipolar disorder can be so severe that it can lead to the patient committing suicide.

"Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide (Jamison 6)."

Bipolar patients usually meet a psychologist to discuss their recent mood and living style. Patients are required to answer questions about their mood, amount of sleep, type of food and drink consumed, and medication taken. However, having the questions asked on a daily basis would aid in the doctor's analysis and treatments because the patients' activities change daily. A person could show severe symptoms any given day and by answering the questions, the patient could realize that their symptoms are dangerous and will contact their doctor. There is no cure for bi-polar disorder, but if properly managed, the symptoms can be controlled.

A urological disorder such as urinary incontinence is a problem for over 35% of the elderly and is more prevalent in women over men (Wilson). People who suffer from urinary incontinence have difficulty controlling their bladder and have frequent accidents. There are different causes of urinary incontinence from an infection, medication, weakening of the bladder muscle, and many more. In order to properly diagnose urinary incontinence, patients are required to keep a daily journal of what fluids they consume, their urination activity, any accidents that occur, and what activity caused the urination. The daily diary is necessary because the pattern and causes of urination can indicate what type of urinary incontinence the patient is suffering. There are four types of urinary incontinence. One type of urinary incontinence is stress incontinence, which occurs when urine leaks during exercise, sneezing, coughing, or anything that puts pressure on the bladder. A second type of urinary incontinence is urge incontinence, which is identified by not being able to hold urine long enough to get to the toilet. It is common with people who have diabetes, stroke, Alzheimer's, Parkinson's, or multiple sclerosis. The third type of urinary incontinence is overflow incontinence, which is diagnosed when small amounts of urine leak from a full bladder. This type of incontinence is commonly caused by diabetes and spinal cord injuries. A fourth type of incontinence is functional incontinence. People who have functional incontinence have normal bladder control but have difficulty getting to the bathroom in time because they have difficulty moving due to surgery or arthritis, etc. It is important to diagnose urinary incontinence because it is "not just a medical problem. It is a problem that also affects their emotional, psychological, and social well-being. Many people are afraid to participate in normal daily activities that might take them too far from a toilet (AFUD)." Fortunately, unlike bi-polar disorder, most forms of urinary incontinence can be treated, but some are permanent.

After diagnosing what type of urinary incontinence the patient is suffering, the patient is often given another diary to aid in their treatment. This diary is called a voiding diary. It is very similar to the bladder diary, but instead of focusing on what caused the incontinence, voiding diary focuses on finding patterns about fluid intake. This will help the patient understand what events could trigger an incontinent episode. Voiding diaries also help determine the patient’s bladder current capacity and the daily input and output of fluids. Patients use the voiding diaries to see their improvements during their treatment. Voiding diaries also help patients understand how much they can drink before having an urge to urinate.

Both the bladder and voiding diaries are very simple interfaces. Therefore, the commercial viability of a stand alone diary is not applicable. Many medical companies that offer drugs to treat urinary incontinence have free diaries available from their web site or from the patient’s Gynecologist. A diary for urinary incontinence is necessary for diagnosing the type of incontinence and is a beneficial product to use in conjunction with another program.

DailyLog PHR is intended for people who use CapMed's PHR software and have an illness that requires a daily journal, such as bi-polar disorder or urinary incontinence. Other diary products for bipolar disorder that are similar to DailyLog PHR are a book that tells people how to record their daily moods and experiences, guides to creating hard-copy mood charts, and software to chart patient moods. Other products for urinary incontinence diary are the free diaries available on the internet that the patient can print or received from the patient’s gynecologist. There was a clinical trial in 2003 about the viability of an electronic portable bladder diary.

The book that teaches people how to detect symptoms of bi-polar symptoms by recording their daily moods and experiences is called A Mood Journal by Derek Wood. The book is intended for people with bi-polar disorder, depression, or anyone who would like to track their emotions on a regular basis. The daily recording allows the patient to see trends in their daily moods by viewing them in a chart. This allows the patient to notice when they usually have symptoms of bipolar disorder and the patient will have time to take steps to reduce the severity of the mania or depression cycle and possibly avoid the cycle. The book has a three part system to create the necessary data to represent trends in the user's bipolar cycles. The three parts includes rating their symptoms, keeping track of their sleeping patterns and keeping a daily journal. A Mood Journal is a good way of finding trends for people suffering from bipolar, but requires the user to read through a book and learn how to create the charts necessary to understand their moods. Also, the user of the book has to manually write data using the three part system to figure out the pattern of their moods. This could cause frustration for the user and give up trying to understand their emotions. It would be beneficial if there was software to do the calculation.

A non-profit company called ChronoRecord Association develops software that automates the process of creating mood charts. Instead of manually creating the charts, ChronoRecord takes the daily record of moods, sleep, medication, and events that occur and creates a mood chart. It also creates "descriptive longitudinal displays and statistical analyses" of the patient's moods (ChronoRecord). The software was based upon a ChronoSheet, developed in the 1970's, which taught bipolar patients how to create mood charts manually. Patients have to input their data into a computer daily and the software will track their progress. This product is beneficial for users with urinary incontinence because the patient only has to enter data about their moods, sleep, medication, and events and the software will create the mood chart on its own. However, this is where the functionality ends. There is a mood chart, but what if the patient wanted to know about their sleep pattern over the past month? ChronoRecord does not support such functionality. However, it is free and available for download from their web site.

There are no commercial products available for daily journaling of patients with urinary incontinence. This is due to the availability of free journals at a Gynecologist's office, creating your own diary, or printing one from the web. There is a bladder diary available to print out from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) web site. This diary is very similar to the one given to patients from a Gynecologist where patients input data about what they drink during the day, when and how much they urinated, if they had any accidental leaking of fluids, and what were they doing when they needed to urinate. There was also a clinical trial in 2003 of a portable electronic daily diary, which showed that the results of using the electronic device were about the same as the paper journal. However, the portable electronic journal allows real-time data input, which prevents patients from forgetting to record incontinent episodes. Also, the clinical trial showed that the electronic device allows quick analysis of the results. The results do not have to be analyzed by hand or inputted into a computer. The portable device is not in production, but could be used for sufferers of urinary incontinence and increase the accuracy of journal entry and analysis. The trial also shows that users are not afraid to use an electronic device over the standard hard-copy journal and would be willing to use DailyLog PHR.

 

NIDDK: example of a bladder diary


 

 

DailyLog PHR will be used in conjunction with CapMed's Personal Health Record (PHR) software. A journal feature in the PHR will be an effective way for doctor's to keep track of a patient's symptoms and aid in the doctor's diagnosis and treatment. Many users of CapMed's PHR could suffer from bi-polar or urinary incontinence and will benefit from this feature. DailyLog PHR does everything that the mood charting book and software and urinary incontinent diaries do, but has more functionality to aid the physician and patient.