Abstract—In prevention of chronic diseases, health
promotion and early interventions based on self-management
should be emphasized. Mental health problems and stress
cause a significant portion of healthcare costs, and also
complicate the management of other chronic conditions. In
addition to physical health, psychophysiological and social
wellbeing should be equally promoted. Thus, we have
previously designed and reported the P4Well or Pervasive
Personal and PsychoPhysiological management of WELLness
concept for working-age citizens. The concept supports the
stress and recovery management on a daily basis through
improved health management strategies, and combines
psychological methods with personal health technologies. In
this paper, we discuss the preliminary user study experiences
of ongoing evaluations with two different user groups
consisting of: 1) middle-aged men who are using the concept
for managing their mental wellbeing or mild depression; and
2) entrepreneurs who are using the concept for coping with
stress. Our results provide a preliminary assessment of the
role and importance of experts, technologies, and peer-support
in the concept.
I. INTRODUCTION
Health includes physical, psychological and social
components, which are highly interrelated. Mental health
problems are the most common reason for early retirement
in the OECD countries [1] and their economic costs to
society are enormous, equaling 3–4% of the gross national
product in the EU Member States [2]. Depression is the
most common mental health problem, but is under-
diagnosed and, especially, under-treated. Only one third of
people with depressive disorders receive mental health
treatment [3]. Due to the scale of the problem and lack of
trained psychotherapists, there is a huge challenge to
Manuscript received April 23, 2009. This work was supported by
Finnish Funding Agency for Technology and Innovation (Tekes).
The authors wish to thank the project partner companies: Nokia Corp.,
Suunto Ltd., Mawell Ltd., Firstbeat Technologies Ltd., Vivago Ltd., Varma,
Mehiläinen Ltd., Solaris, JTO School of Management, and Duodecim Medical
Publications Ltd. for their valuable contribution to the project.
Antti P. Happonen, Kirsikka Kaipainen, Antti Väätänen, Elina Mattila,
and Ilkka Korhonen are with VTT Technical Research Centre of Finland,
P.O.Box 1300, FI-33101 Tampere, Finland.
Marja-Liisa Kinnunen, Päivi Lappalainen, Henna Tuomela, and Raimo
Lappalainen are with University of Jyväskylä, Department of Psychology,
P.O. Box 35, FI-40014, University of Jyväskylä, Finland.
Tero Myllymäki and Heikki Rusko are with University of Jyväskylä,
Department of Biology of Physical Activity, P.O. Box 35 FI-40014,
Jyväskylä, Finland. (corresponding author Antti P. Happonen phone: 358 40
487 0166; e-mail: antti.happonen@vtt.fi).
provide recommended treatments to all in need. This can
only be achieved with methods which utilize scarce
therapist resources more efficiently, foster patient
empowerment in care and self-treatment, and make efficient
self-management tools available in large populations.
In a holistic approach of wellbeing, all inter-related key
aspects (physical, mental, and social) should be
acknowledged. Factors contributing to decrements in mental
health include stress and sleep problems. For example,
extended stress may lead to burnout and depression, and is a
risk factor for diseases such as hypertension and diabetes
[4]. The stressors can rarely be totally avoided, but stress
recovery methods can help people cope with stress [5]. An
important tool to protect people from health problems and
diseases is regular exercise, which can improve people’s
psychophysiological wellbeing [6].
Computer-aided Cognitive-Behaviour Therapy (CCBT)
programs delivered through the Internet have shown their
effectiveness for mental wellbeing problems [7]. The
National Institute for Health and Clinical Excellence
(NICE) of the UK recommends CCBT as a primary
intervention method for anxiety disorders, post-traumatic
stress disorder, and depression [8]. The reported CCBT
methods, however, do not fully exploit the available modern
mobile and ambient technologies, and mostly focus solely
on mental wellbeing and lack the holistic approach.
We have previously proposed a concept for working-age
citizens to empower their self-management of
psychophysiological wellbeing through management of
stress and recovery from stress [9]. Our P4Well concept
integrates several personal health technologies, including
web-based tools and software, wearable monitoring devices,
mobile phone with special software, and various analysis
methods to interpret the gathered and acquired data and to
provide feedback. These technologies are used along with
modern psychological mini-intervention methods, such as
CCBT, to help people manage stress, sleep and mental
problems by encouraging and helping them to adopt a
healthier lifestyle. The focus of the concept is on early
prevention of or intervention on mental and health
problems, based especially on assessing stress and recovery,
sleeping and exercise habits. The concept fosters self-
management but supports expert consultation through the
Internet, and aims to lower the barrier for seeking
information, help, and possible treatment [10]. The devices,
software, and psychophysiological theories and methods are
A Concept to Empower Self-Management of Psychophysiological
Wellbeing: Preliminary User Study Experiences
Antti P. Happonen, Kirsikka Kaipainen, Antti Väätänen, Marja-Liisa Kinnunen, Tero Myllymäki, Päivi
Lappalainen, Henna Tuomela, Heikki Rusko, Elina Mattila, Raimo Lappalainen, and Ilkka Korhonen
312
31st Annual International Conference of the IEEE EMBS
Minneapolis, Minnesota, USA, September 2-6, 2009
978-1-4244-3296-7/09/$25.00 ©2009 IEEE