Constantinescu Gabriela, Rieger Jana, Mummery Kerry, Hodgetts William
Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada.
Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
Am J Speech Lang Pathol. 2017 Nov 8;26(4):1296-1303. doi: 10.1044/2017_AJSLP-17-0040.
Delivery of swallowing therapy is faced with challenges regarding access to in-clinic services and adherence to prescribed home programs. Mobile health (mHealth) technologies are being developed at a rapid pace to address these difficulties. Whereas some benefits to using these modern tools for therapy are obvious (e.g., electronic reminders), other advantages are not as well understood. One example is the potential for mHealth devices and apps to enhance adherence to treatment regimens.
This article introduces a number of psychological concepts that relate to adherence and that can be leveraged by mHealth. Elements that contribute to flow (optimal experience) during an activity and those that reinforce grit (perseverance to achieve a long-term goal) can be used to engage patients in their own rehabilitation.
The experience of flow can be targeted by presenting the rehabilitation exercise as an optimally challenging game, one that offers a match between challenge and ability. Grit can be supported by reinforcing routine and by varying the therapy experience using different games.
A combination of hardware and software design approaches have the potential to transform uninteresting and repetitive activities, such as those that make up swallowing therapy regimens, into engaging ones. The field of gamification, however, is still developing, and gamified mHealth apps will need to withstand scientific testing of their claims and demonstrate effectiveness in all phases of outcome research.
吞咽治疗的实施面临着门诊服务获取和家庭规定治疗方案依从性方面的挑战。移动健康（mHealth）技术正在迅速发展以应对这些困难。虽然使用这些现代工具进行治疗的一些益处很明显（例如电子提醒），但其他优势尚未得到很好的理解。一个例子是移动健康设备和应用程序增强治疗方案依从性的潜力。
本文介绍了一些与依从性相关的心理学概念，移动健康可以利用这些概念。在一项活动中有助于产生心流（最佳体验）的要素以及强化毅力（为实现长期目标而坚持不懈）的要素，可用于促使患者参与自身康复。
通过将康复锻炼呈现为具有最佳挑战性的游戏，即提供挑战与能力相匹配的游戏，可以针对心流体验。通过强化日常训练以及使用不同游戏改变治疗体验，可以支持毅力。
硬件和软件设计方法的结合有可能将诸如构成吞咽治疗方案的那些无趣且重复的活动转变为引人入胜的活动。然而，游戏化领域仍在发展，游戏化的移动健康应用程序需要经受对其宣称内容的科学测试，并在成果研究的各个阶段证明其有效性。
