Fledderus Martine, Schreurs Karlein Mg, Bohlmeijer Ernst T, Vollenbroek-Hutten Miriam Mr
Roessingh Research and Development, Enschede, Netherlands.
JMIR Hum Factors. 2015 Jan 5;2(1):e1. doi: 10.2196/humanfactors.3302.
A significant number of chronic pain patients experience a decline in therapeutic effects after rehabilitation. As face-to-face contacts with health care professionals are not always feasible after treatment, new, innovative, fully automated relapse-prevention programs are highly needed.
In this study an online, automated relapse-prevention program based on acceptance and commitment therapy (ACT)-both as a website and as a mobile app-was developed and evaluated. At each step of the development, end users (ie, chronic pain patients) were consulted in order to fully address their needs.
In a step-by-step process, a contextual inquiry, requirement specification, and design were executed with chronic pain patients by conducting, respectively, a focus group (n=10), interviews with rapid prototyping (n=28), and a user- and expert-based usability evaluation (n=14). Furthermore, a pilot evaluation was conducted with 14 chronic pain or fatigue patients who had received the online relapse-prevention program following a multidisciplinary ACT treatment. They were interviewed about their usage and the usefulness of the program in supporting them to maintain changed behaviors and prevent relapses in avoidance and pain control behaviors.
The three stages provided information about the expected needs of end users, comments about the usefulness of the proposed features, and feedback about the design and usability of the program. This resulted in a fully operational, online relapse-prevention program. Results from the pilot evaluation showed that 9 patients used the online program after treatment, 5 of whom indicated that the program supported them after treatment. Of all the patients, 4 of them indicated that the program did not support them because they wanted more social interaction with other users.
This study showed that an innovative, automated, online program that is user friendly can be developed by involving the end users in each step. The program was evaluated positively by some participants. The evaluation showed that the online relapse-prevention program has the potential to support chronic pain patients in maintaining their changed behaviors and preventing relapses in avoidance and pain control behaviors.
Nederlands Trial Register (NTR) Number: NTR4177; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4177 (Archived by WebCite at http://www.webcitation.org/6Ur6EFD1D).
相当数量的慢性疼痛患者在康复后治疗效果会下降。由于治疗后与医护人员进行面对面接触并不总是可行的，因此迫切需要全新的、创新的、全自动的预防复发项目。
在本研究中，开发并评估了一个基于接受与承诺疗法（ACT）的在线全自动预防复发项目，该项目同时有网站版和移动应用程序版。在开发的每个阶段，都咨询了最终用户（即慢性疼痛患者），以充分满足他们的需求。
通过分别开展焦点小组（n = 10）、快速原型访谈（n = 28）以及基于用户和专家的可用性评估（n = 14），与慢性疼痛患者逐步进行情境调查、需求规格说明和设计。此外，对14名在接受多学科ACT治疗后使用了在线预防复发项目的慢性疼痛或疲劳患者进行了试点评估。就他们对该项目的使用情况以及该项目在支持他们维持行为改变、预防回避行为和疼痛控制行为复发方面的有用性对他们进行了访谈。
这三个阶段提供了有关最终用户预期需求的信息、对所提议功能有用性的评论以及有关该项目设计和可用性的反馈。这促成了一个全面运行的在线预防复发项目。试点评估结果显示，9名患者在治疗后使用了该在线项目，其中5名表示该项目在治疗后对他们有帮助。在所有患者中，4名表示该项目对他们没有帮助，因为他们希望与其他用户有更多的社交互动。
本研究表明，通过让最终用户参与每个步骤，可以开发出一个创新的、自动化的、用户友好的在线项目。一些参与者对该项目给予了积极评价。评估表明，在线预防复发项目有潜力支持慢性疼痛患者维持他们的行为改变，并预防回避行为和疼痛控制行为的复发。
荷兰试验注册中心（NTR）编号：NTR4177；http://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 4177（由WebCite存档于http://www.webcitation.org/6Ur6EFD1D）
