Jackson Belinda D, Con Danny, De Cruz Peter
Department of Gastroenterology, The Austin Hospital, Melbourne, Victoria, Australia.
Department of Medicine, Austin Academic Centre, The University of Melbourne, Melbourne, Victoria, Australia.
Intern Med J. 2018 Jun;48(6):674-681. doi: 10.1111/imj.13677.
Electronic health (eHealth) decision support tools have the potential to: facilitate inflammatory bowel disease (IBD) self-management, reduce health care utilisation and alleviate the pressure on overburdened outpatient clinics. The purpose of this study was to explore the perspectives of key stakeholders on the potential use of a decision support tool for IBD patients.
A qualitative study using focus group methodology was conducted at a tertiary IBD centre in Melbourne, Australia in February 2015. Key stakeholders, including physicians, nurses and patients, were included in the study. Two independent reviewers undertook inductive coding and generated themes.
In total, 31 participants were included in the study (including 16 males; 11 physicians; 6 nurses). An eHealth decision support tool was thought to be beneficial to facilitate IBD self-management. Four themes emerged: (i) Framework for the decision support tool - the tool should be an adjunct to current models of care and facilitate shared decision-making and patient engagement; (ii) Target population - stable patients with mild to moderate disease; (iii) Functionalities of the intervention - a web-based platform encompassing patient-reported outcomes, objective markers of disease and clinical algorithms based on international guidelines; and (iv) Design and Implementation - patients should be involved in the design.
eHealth interventions are thought to be an important strategy to facilitate self-management for patients with IBD. A multi-stage iterative approach should be adopted in the design and implementation process of eHealth interventions. Patient perspectives need to be sought prior to and throughout the development of an eHealth decision support tools for IBD.
电子健康(eHealth)决策支持工具具有以下潜力:促进炎症性肠病(IBD)的自我管理,减少医疗保健的使用,并减轻负担过重的门诊诊所的压力。本研究的目的是探讨关键利益相关者对IBD患者使用决策支持工具的潜在看法。
2015年2月在澳大利亚墨尔本的一家三级IBD中心采用焦点小组方法进行了一项定性研究。研究纳入了包括医生、护士和患者在内的关键利益相关者。两名独立评审员进行归纳编码并生成主题。
共有31名参与者纳入研究(包括16名男性;11名医生;6名护士)。电子健康决策支持工具被认为有利于促进IBD的自我管理。出现了四个主题:(i)决策支持工具的框架——该工具应作为当前护理模式的辅助手段,并促进共同决策和患者参与;(ii)目标人群——病情轻度至中度的稳定患者;(iii)干预措施的功能——一个基于网络的平台,包括患者报告的结果、疾病的客观指标以及基于国际指南的临床算法;(iv)设计与实施——患者应参与设计。
电子健康干预被认为是促进IBD患者自我管理的重要策略。在电子健康干预的设计和实施过程中应采用多阶段迭代方法。在为IBD开发电子健康决策支持工具之前及整个过程中,都需要征求患者的意见。