用户对双相情感障碍在线干预的体验：对设计和评估的重要启示。
Users' experiences of an online intervention for bipolar disorder: important lessons for design and evaluation.
机构信息
Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK.
出版信息
Evid Based Ment Health. 2017 Nov;20(4):133-139. doi: 10.1136/eb-2017-102754.
BACKGROUND
The evidence base for digital interventions for physical and mental health, including severe and enduring mental health difficulties, is increasing. In a feasibility trial, web-based Enhanced Relapse Prevention (ERPonline) for bipolar disorder demonstrated high recruitment and retention rates. Relative to participants in the waitlist control group, those who received ERPonline showed increased monitoring for early warning signs of relapse and had developed more positive illness models.
OBJECTIVE
To understand users' motivations and barriers for taking part in an online/telephone-based trial, and for engagement with ERPonline.
METHODS
Participants from the trial who had been allocated to receive ERPonline were purposively sampled to participate in telephone-based, in-depth qualitative interviews about their experiences. Interviews (n19) were analysed using framework analysis to identify themes relevant to study aims.
FINDINGS
Participants took part due to the convenient, flexible and rewarding aspects of the trial design, as well as a desire to improve the mental health of themselves and others. Barriers included extensive assessments, practical difficulties and mood. ERPonline was was generally considered to be accessible, relevant and straightforward, but there were individual preferences regarding design, content and who it was for. Several participants reported positive changes, but there was a sense that digital interventions should not replace routine care.
CONCLUSIONS
There are a number of barriers and facilitators to consider when evaluating and implementing digital interventions. Individual preferences and human contact were key factors for both trial design and engagement with an online intervention.
CLINICAL IMPLICATIONS
Digital interventions should be co-produced, personalised, interactive and embedded as one component in a broader package of care.
TRIAL REGISTRATION NUMBER
ISRCTN56908625; Post-results.
背景
数字干预措施在身体和心理健康方面的证据基础越来越多，包括严重和持久的心理健康问题。在一项可行性试验中，基于网络的增强型双相情感障碍复发预防（ERPonline）显示出高招募和保留率。与等待名单对照组的参与者相比，接受 ERPonline 的参与者对复发预警信号的监测增加了，并且对疾病模型的看法也更加积极。
目的
了解参与者参与在线/电话试验的动机和障碍，以及参与 ERPonline 的动机和障碍。
方法
从试验中分配接受 ERPonline 的参与者中进行有针对性的抽样，以参与有关其经验的电话深度定性访谈。使用框架分析对访谈（n=19）进行分析，以确定与研究目的相关的主题。
结果
参与者参与的原因是试验设计的方便、灵活和有益方面，以及改善自己和他人心理健康的愿望。障碍包括广泛的评估、实际困难和情绪。ERPonline 通常被认为是可访问的、相关的和简单的，但在设计、内容和适用对象方面存在个体偏好。一些参与者报告了积极的变化，但有一种感觉是，数字干预措施不应替代常规护理。
结论
在评估和实施数字干预措施时，需要考虑一些障碍和促进因素。个人偏好和人际接触是试验设计和参与在线干预的关键因素。
临床意义
数字干预措施应该共同制定、个性化、互动并作为更广泛护理方案的一部分嵌入。
试验注册号
ISRCTN56908625；后结果。
Zotero 插件