Hallberg Inger, Ranerup Agneta, Bengtsson Ulrika, Kjellgren Karin
Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Patient Prefer Adherence. 2018 Mar 28;12:467-476. doi: 10.2147/PPA.S157658. eCollection 2018.
A well-controlled blood pressure (BP) reduces cardiovascular complications. Patient participation in care using technology may improve the current situation of only 13.8% of adults diagnosed with hypertension worldwide having their BP under control.
The objective of this study was to explore patients' and professionals' experiences of and expectations for an interactive mobile phone-based system to support self-management of hypertension.
The self-management system consists of: 1) a mobile phone platform for self-reports, motivational messages and reminders; 2) a device for measuring BP and 3) graphical feedback of self-reports. Patients diagnosed with high BP (n=20) and their treating professionals (n=7) participated in semi-structured interviews, after 8 weeks use of the system in clinical practice. Data were analyzed thematically.
The self-reporting of BP, symptoms, medication use, medication side effects, lifestyle and well-being was perceived to offer insight into how daily life activities influenced BP and helped motivate a healthy lifestyle. Taking increased responsibility as a patient, by understanding factors affecting one's well-being, was reported as an enabling factor for a more effective care. Based on the experiences, some challenges were mentioned: for adoption of the system into clinical practice, professionals' educational role should be extended and there should be a reorganization of care to fully benefit from technology. The patients and professionals gave examples of further improvements to the system, for example, related to the visualization of graphs from self-reports and an integration of the system into the general technical infrastructure. These challenges are important on the path to accomplishing adoption.
The potential of a more autonomous, knowledgeable and active patient, through use of the interactive mobile system would improve outcomes of hypertension treatment, which has been desired for decades. Documentation and visualization of patients' self-reports and the possibilities to communicate these with professionals may be a significant resource for person-centered care.
血压得到良好控制可降低心血管并发症。利用技术让患者参与护理，可能改善全球仅13.8%被诊断为高血压的成年人血压得到控制的现状。
本研究的目的是探讨患者和专业人员对基于手机的交互式系统支持高血压自我管理的体验和期望。
自我管理系统包括：1）用于自我报告、激励信息和提醒的手机平台；2）测量血压的设备；3）自我报告的图形反馈。在临床实践中使用该系统8周后，20名被诊断为高血压的患者及其治疗专业人员（7名）参与了半结构化访谈。对数据进行了主题分析。
血压、症状、用药情况、药物副作用、生活方式和幸福感的自我报告被认为有助于深入了解日常生活活动如何影响血压，并有助于激发健康的生活方式。据报告，通过了解影响自身幸福感的因素，患者承担更多责任是实现更有效护理的一个促成因素。基于这些经验，提到了一些挑战：为将该系统应用于临床实践，应扩大专业人员的教育作用，并应重新组织护理以充分利用技术。患者和专业人员给出了该系统进一步改进的示例，例如，与自我报告图形的可视化以及将该系统集成到一般技术基础设施中有关。这些挑战在实现采用的道路上很重要。
通过使用交互式移动系统，培养更自主、知识更丰富和更积极的患者的潜力将改善高血压治疗效果，这是几十年来一直期望的。患者自我报告的记录和可视化以及与专业人员交流这些报告的可能性可能是以人为本护理的重要资源。
