Division of Clinical Psychology, School of Psychological Sciences, the University of Manchester, Oxford Road, Manchester, United Kingdom.
BMC Psychiatry. 2013 Jan 23;13:34. doi: 10.1186/1471-244X-13-34.
Over the past decade policy makers have emphasised the importance of healthcare technology in the management of long-term conditions. Mobile-phone based assessment may be one method of facilitating clinically- and cost-effective intervention, and increasing the autonomy and independence of service users. Recently, text-message and smartphone interfaces have been developed for the real-time assessment of symptoms in individuals with schizophrenia. Little is currently understood about patients' perceptions of these systems, and how they might be implemented into their everyday routine and clinical care.
24 community based individuals with non-affective psychosis completed a randomised repeated-measure cross-over design study, where they filled in self-report questions about their symptoms via text-messages on their own phone, or via a purpose designed software application for Android smartphones, for six days. Qualitative interviews were conducted in order to explore participants' perceptions and experiences of the devices, and thematic analysis was used to analyse the data.
Three themes emerged from the data: i) the appeal of usability and familiarity, ii) acceptability, validity and integration into domestic routines, and iii) perceived impact on clinical care. Although participants generally found the technology non-stigmatising and well integrated into their everyday activities, the repetitiveness of the questions was identified as a likely barrier to long-term adoption. Potential benefits to the quality of care received were seen in terms of assisting clinicians, faster and more efficient data exchange, and aiding patient-clinician communication. However, patients often failed to see the relevance of the systems to their personal situations, and emphasised the threat to the person centred element of their care.
The feedback presented in this paper suggests that patients are conscious of the benefits that mobile-phone based assessment could bring to clinical care, and that the technology can be successfully integrated into everyday routine. However, it also suggests that it is important to demonstrate to patients the personal, as well as theoretical, benefits of the technology. In the future it will be important to establish whether clinical practitioners are able to use this technology as part of a personalised mental health regime.
在过去的十年中，政策制定者强调了医疗技术在管理长期疾病方面的重要性。基于移动电话的评估可能是促进临床和成本效益干预以及提高服务用户自主性和独立性的一种方法。最近，已经开发出用于实时评估精神分裂症个体症状的短信和智能手机接口。目前，人们对这些系统的患者感知知之甚少，也不知道如何将这些系统融入他们的日常生活和临床护理中。
24 名社区非情感性精神病患者完成了一项随机重复测量交叉设计研究，他们通过自己的手机短信或专为 Android 智能手机设计的应用软件，在六天内填写关于自己症状的自我报告问题。进行了定性访谈，以探索参与者对这些设备的看法和经验，并用主题分析对数据进行了分析。
从数据中出现了三个主题：i）可用性和熟悉性的吸引力，ii）可接受性、有效性和融入家庭日常生活，以及 iii）对临床护理的感知影响。尽管参与者普遍认为该技术没有污名化，并且很好地融入了他们的日常生活，但问题的重复性被认为是长期采用的一个潜在障碍。认为该技术可能会提高护理质量，例如帮助临床医生、更快、更有效地进行数据交换以及帮助患者与临床医生沟通。然而，患者往往没有看到该系统与他们个人情况的相关性，并强调对以人为中心的护理元素的威胁。
本文提出的反馈表明，患者意识到基于移动电话的评估可以为临床护理带来的好处，并且该技术可以成功地融入日常生活。然而，这也表明向患者展示技术的个人和理论上的好处非常重要。未来，重要的是要确定临床医生是否能够将这种技术作为个性化心理健康治疗方案的一部分。
