Department of Infectious Disease, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St,, GRJ-5, Boston, MA 02114, USA.
BMC Med Inform Decis Mak. 2012 Jun 21;12:56. doi: 10.1186/1472-6947-12-56.
Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region.
We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to notify patients of abnormal test results.
Participants had a median of 38 years, were 56% female, and were residents of a large catchment area throughout southwestern Uganda. All participants expressed interest in a service to receive information about laboratory results by cell phone text message, stating benefits of increased awareness of their health and decreased transportation costs. Ninety percent reported that they would not be concerned for unintended disclosure. A minority additionally expressed concerns about difficulty interpreting messages, discouragement upon learning bad news, and technical issues. Though all respondents expressed interest in password protection of messages, there was also a strong desire for direct messages to limit misinterpretation of information.
Cell phone text messaging for communication of abnormal laboratory results is highly acceptable in this cohort of HIV-infected patients in rural Uganda. The feasibility of text messaging, including an optimal balance between privacy and comprehension, should be further studied.
在拥有广阔服务区域的资源有限环境中，医患沟通是一个重大挑战。尽管过去十年间非洲的手机用户数量增长了 20 倍，但人们对该地区手机在卫生信息传播方面的可接受性、对信息披露和保密性的看法，以及对手机通讯的偏好知之甚少。
我们对乌干达姆巴拉拉的免疫抑制综合征诊所的 50 名患者进行了结构化访谈，以评估四个与健康相关的沟通领域：a）手机使用习惯和读写能力，b）对实验室结果沟通的偏好，c）隐私和保密性，以及 d）对通过短信通知患者异常检测结果的可接受性和偏好。
参与者的中位数年龄为 38 岁，56%为女性，居住在乌干达西南部的一个大服务区域。所有参与者都表示有兴趣通过手机短信接收实验室结果信息的服务，并表示这将提高对自身健康的认识和降低交通成本。90%的人表示不会担心信息意外泄露。少数人还表示担心难以理解信息、得知坏消息时感到沮丧，以及存在技术问题。尽管所有受访者都对信息进行密码保护表示感兴趣，但他们也强烈希望通过直接发送短信来限制信息的误解。
在乌干达农村的这一艾滋病毒感染患者群体中，通过手机短信发送异常实验室结果的通讯方式非常受欢迎。应进一步研究短信通讯的可行性，包括在隐私和理解之间取得最佳平衡。
