Lawson Health Research Institute London, ON Canada ; Arthur Labatt Family School of Nursing Faculty of Health Sciences Western University London, ON Canada.
Lawson Health Research Institute London, ON Canada ; Arthur Labatt Family School of Nursing Faculty of Health Sciences Western University London, ON Canada ; School of Health Studies Faculty of Science Western University London, ON Canada.
JMIR Ment Health. 2015 Jan 21;2(1):e1. doi: 10.2196/mental.3926. eCollection 2015 Jan-Mar.
The use of innovative technologies in mental health care has the potential to improve system efficiency, enhance quality of care, and increase patient engagement. The Mental Health Engagement Network (MHEN) project developed, delivered, and evaluated an interactive Web-based personal health record, the Lawson SMART Record (LSR), to assist mental health clients in managing their care and connecting with their care providers. This paper presents a secondary analysis of data collected in the MHEN project regarding clients' perceptions of technology and the use of these technologies in their care.
We aimed to answer six questions: (1) What is the level of comfort with technology within a sample of individuals experiencing mood or psychotic disorders? (2) How easy to use and helpful are the MHEN technologies from the perspective of individuals experiencing a mental illness? (3) Are there differences in how helpful or useful individuals find the smartphone compared to the LSR? (4) Are there specific functions of MHEN technologies (eg, reminders for medications or appointments) that are more valued than others? (5) What are the other ways that individuals are using MHEN technologies in their daily lives? (6) How likely are individuals to be able to retain and maintain their smartphone?
Mental health clients aged 18-80 (N=400) and diagnosed with a mood or psychotic disorder were provided with a smartphone (iPhone 4S) and participating care providers (n=52) were provided with a tablet (iPad) in order to access and engage with the LSR. A delayed implementation design with mixed methods was used. Survey and interview data were collected over the course of 18 months through semistructured interviews conducted by experienced research assistants every 6 months post-implementation of the intervention. Paired t tests were used to determine differences between 6 and 12-month data for perceptions of the MHEN technologies. A paired t test was used to examine whether differences existed between perceptions of the smartphone and the LSR at 12 months post-implementation.
Due to dropout or loss of contact, 394 out of 400 individuals completed the study. At the end of the study, 52 devices were lost or unusable. Prior to the intervention, participants reported being comfortable using technology. Perceptions of the MHEN technologies and their functions were generally positive. Positive perceptions of the smartphone increased over time (P=.002), while positive perceptions of the LSR decreased over time (P<.001).
Quantitative and qualitative findings from this analysis demonstrated that these technologies positively impacted the lives of individuals experiencing severe mental illnesses and dispeled some of the myths regarding retention of technology among marginalized populations. This secondary analysis supported the acceptability of using mental health technologies within this population and provided considerations for future development.
ClinicalTrials.gov NCT01473550; http://clinicaltrials.gov/show/NCT01473550 (Archived by WebCite at http://www.webcitation.org/6SLNcoKb8).
在精神卫生保健中使用创新技术有可能提高系统效率、改善护理质量并增加患者的参与度。心理健康参与网络（MHEN）项目开发、提供并评估了一个交互式基于网络的个人健康记录，即 Lawson SMART 记录（LSR），以帮助精神卫生客户管理其护理并与护理提供者建立联系。本文介绍了 MHEN 项目中收集的关于客户对技术的看法以及这些技术在其护理中的使用情况的二次分析数据。
我们旨在回答六个问题：（1）在经历情绪或精神病障碍的个体样本中，对技术的舒适度水平如何？（2）从经历精神疾病的个体的角度来看，MHEN 技术的易用性和有用程度如何？（3）智能手机与 LSR 相比，个体发现哪个更有帮助或有用？（4）MHEN 技术的某些功能（例如，药物或预约提醒）是否比其他功能更有价值？（5）个体在日常生活中还以其他哪些方式使用 MHEN 技术？（6）个体保留和维持其智能手机的可能性有多大？
为了访问和参与 LSR，为年龄在 18-80 岁（N=400）且被诊断为情绪或精神病障碍的精神卫生客户提供了智能手机（iPhone 4S），并为参与的护理提供者（n=52）提供了平板电脑（iPad）。采用延迟实施设计和混合方法。通过经验丰富的研究助理每隔 6 个月进行一次半结构化访谈，在干预实施后 18 个月内收集调查和访谈数据。使用配对 t 检验确定干预后 6 个月和 12 个月的 MHEN 技术感知之间的差异。使用配对 t 检验检验在干预后 12 个月时智能手机和 LSR 的感知是否存在差异。
由于辍学或失去联系，400 名参与者中有 394 名完成了研究。研究结束时，有 52 个设备丢失或无法使用。在干预之前，参与者报告说他们使用技术感到舒适。对 MHEN 技术及其功能的看法普遍较为积极。对智能手机的积极看法随着时间的推移而增加（P=.002），而对 LSR 的积极看法随着时间的推移而减少（P<.001）。
这项分析的定量和定性结果表明，这些技术对经历严重精神疾病的个人的生活产生了积极影响，并消除了一些关于边缘化人群保留技术的神话。这项二次分析支持在该人群中使用心理健康技术的可接受性，并为未来的发展提供了考虑因素。
ClinicalTrials.gov NCT01473550；http://clinicaltrials.gov/show/NCT01473550（由 WebCite 存档；http://www.webcitation.org/6SLNcoKb8）。
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