Pritzker School of Medicine, University of Chicago, Chicago, Ill.
Department of Medicine, University of Chicago, Chicago, Ill.
J Allergy Clin Immunol Pract. 2017 Nov-Dec;5(6):1728-1736. doi: 10.1016/j.jaip.2017.04.032. Epub 2017 Jun 7.
Most hospitalized patients with asthma or chronic obstructive pulmonary disease misuse respiratory inhalers. An in-person educational strategy, teach-to-goal (TTG), improves inpatients' inhaler technique.
To develop an effective, portable education intervention that remains accessible to hospitalized patients postdischarge for reinforcement of proper inhaler technique.
A mixed methods approach at an urban academic hospital was used to iteratively develop, modify, and test a virtual teach-to-goal (V-TTG) educational intervention using patient end-user feedback. A survey examined access and willingness to use technology for self-management education. Focus groups evaluated patients' feedback on access, functionality, and quality of V-TTG.
Forty-eight participants completed the survey, with most reporting having Internet access; 77% used the Internet at home and 82% used the Internet at least once every few weeks. More than 80% reported that they were somewhat or very likely to use V-TTG to gain skills to improve their health. Most participants reported smartphone access (73%); half owned laptop computers (52%). Participants with asthma versus chronic obstructive pulmonary disease were more likely to own a smartphone, have a data plan, and have daily Internet use (P < .05). Nine focus groups (n = 25) identified themes for each domain: access-platform and delivery, Internet access, and technological literacy; functionality-usefulness, content, and teaching strategy; and quality-clarity, ease of use, length, and likability.
V-TTG is a promising educational tool for improving patients' inhaler technique, iteratively developed and refined with patient input. Patients in our urban, academic hospital overwhelmingly reported access to platforms and willingness to use V-TTG for health education.
大多数患有哮喘或慢性阻塞性肺疾病的住院患者错误地使用呼吸吸入器。面对面的教育策略，即目标导向教学（TTG），可以改善住院患者的吸入器技术。
开发一种有效、便携的教育干预措施，以便在出院后仍能为住院患者提供正确的吸入器技术强化教育。
采用混合方法，在一家城市学术医院对一种虚拟目标导向教学（V-TTG）教育干预措施进行迭代开发、修改和测试，使用患者最终用户的反馈。一项调查考察了患者对使用技术进行自我管理教育的可及性和意愿。焦点小组评估了患者对 V-TTG 的可及性、功能和质量的反馈。
48 名参与者完成了调查，大多数报告有互联网接入；77%的人在家中使用互联网，82%的人至少每隔几周使用一次互联网。超过 80%的人报告说他们有可能或非常有可能使用 V-TTG 来获得改善健康的技能。大多数参与者报告说他们有智能手机（73%）；一半人拥有笔记本电脑（52%）。与慢性阻塞性肺疾病患者相比，哮喘患者更有可能拥有智能手机、数据计划和每天使用互联网（P<.05）。9 个焦点小组（n=25）确定了每个域的主题：可及性平台和交付、互联网接入和技术素养；功能实用性、内容和教学策略；以及质量清晰度、易用性、长度和吸引力。
V-TTG 是一种很有前途的教育工具，可以改善患者的吸入器技术，通过患者的反馈进行迭代开发和改进。我们城市学术医院的患者压倒性地报告了他们有使用平台的途径，并且愿意使用 V-TTG 进行健康教育。
