van der Krieke Lian, Emerencia Ando C, Aiello Marco, Sytema Sjoerd
University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
J Med Internet Res. 2012 Feb 6;14(1):e24. doi: 10.2196/jmir.1921.
Routine Outcome Monitoring (ROM) is a systematic way of assessing service users' health conditions for the purpose of better aiding their care. ROM consists of various measures used to assess a service user's physical, psychological, and social condition. While ROM is becoming increasingly important in the mental health care sector, one of its weaknesses is that ROM is not always sufficiently service user-oriented. First, clinicians tend to concentrate on those ROM results that provide information about clinical symptoms and functioning, whereas it has been suggested that a service user-oriented approach needs to focus on personal recovery. Second, service users have limited access to ROM results and they are often not equipped to interpret them. These problems need to be addressed, as access to resources and the opportunity to share decision making has been indicated as a prerequisite for service users to become a more equal partner in communication with their clinicians. Furthermore, shared decision making has been shown to improve the therapeutic alliance and to lead to better care.
Our aim is to build a web-based support system which makes ROM results more accessible to service users and to provide them with more concrete and personalized information about their functioning (ie, symptoms, housing, social contacts) that they can use to discuss treatment options with their clinician. In this study, we will report on the usability of the web-based support system for service users with schizophrenia.
First, we developed a prototype of a web-based support system in a multidisciplinary project team, including end-users. We then conducted a usability study of the support system consisting of (1) a heuristic evaluation, (2) a qualitative evaluation and (3) a quantitative evaluation.
Fifteen service users with a schizophrenia diagnosis and four information and communication technology (ICT) experts participated in the study. The results show that people with a schizophrenia diagnosis were able to use the support system easily. Furthermore, the content of the advice generated by the support system was considered meaningful and supportive.
This study shows that the support system prototype has valuable potential to improve the ROM practice and it is worthwhile to further develop it into a more mature system. Furthermore, the results add to prior research into web applications for people with psychotic disorders, in that it shows that this group of end users can work with web-based and computer-based systems, despite the cognitive problems they experience.
常规结果监测（ROM）是一种系统的方式，用于评估服务使用者的健康状况，以便更好地辅助他们的护理。ROM 包括用于评估服务使用者身体、心理和社会状况的各种措施。虽然 ROM 在精神卫生保健领域变得越来越重要，但其弱点之一是 ROM 并不总是充分以服务使用者为导向。首先，临床医生倾向于关注那些提供有关临床症状和功能信息的 ROM 结果，而有人建议以服务使用者为导向的方法需要关注个人康复。其次，服务使用者获取 ROM 结果的机会有限，而且他们往往没有能力解读这些结果。这些问题需要得到解决，因为获取资源和共享决策的机会已被视为服务使用者在与临床医生沟通中成为更平等伙伴的先决条件。此外，共享决策已被证明可以改善治疗联盟并带来更好的护理。
我们的目标是构建一个基于网络的支持系统，使服务使用者更容易获取 ROM 结果，并为他们提供关于其功能（即症状、住房、社会交往）的更具体和个性化的信息，以便他们能够与临床医生讨论治疗方案。在本研究中，我们将报告该基于网络的支持系统对精神分裂症服务使用者的可用性。
首先，我们在一个包括最终用户的多学科项目团队中开发了一个基于网络的支持系统原型。然后，我们对该支持系统进行了可用性研究，包括（1）启发式评估、（2）定性评估和（3）定量评估。
15 名被诊断为精神分裂症的服务使用者和 4 名信息通信技术（ICT）专家参与了该研究。结果表明，被诊断为精神分裂症的人能够轻松使用该支持系统。此外，该支持系统生成的建议内容被认为是有意义和有帮助的。
本研究表明，该支持系统原型具有改善 ROM 实践的宝贵潜力，值得进一步将其开发成更成熟的系统。此外，这些结果补充了先前针对精神疾病患者网络应用的研究，因为它表明这一最终用户群体尽管存在认知问题，但仍可以使用基于网络和计算机的系统。
