Walsh Deirdre Mj, Moran Kieran, Cornelissen Véronique, Buys Roselien, Cornelis Nils, Woods Catherine
Insight Centre for Data Analytics, Dublin City University, Dublin, Ireland.
School of Health and Human Performance, Dublin City University, Dublin, Ireland.
J Med Internet Res. 2018 May 8;20(5):e163. doi: 10.2196/jmir.9181.
Cardiovascular diseases are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation. Uptake of traditional cardiac rehabilitation remains suboptimal, as attendance at formal hospital-based cardiac rehabilitation programs is low, with community-based cardiac rehabilitation rates and individual long-term exercise maintenance even lower. Home-based cardiac rehabilitation programs have been shown to be equally effective in clinical and health-related quality of life outcomes and yet are not readily available.
Given the potential that home-based cardiac rehabilitation programs have, it is important to explore how to appropriately design any such intervention in conjunction with key stakeholders. The aim of this study was to engage with individuals with cardiovascular disease and other professionals within the health ecosystem to (1) understand the personal, social, and physical factors that inhibit or promote their capacity to engage with physical activity and (2) explore their technology competencies, needs, and wants in relation to an eHealth intervention.
Fifty-four semistructured interviews were conducted across two countries. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Barriers to the implementation of PATHway were also explored specifically in relation to physical capability and safety as well as technology readiness and further mapped onto the COM-B model for future intervention design.
Key recommendations included collection of patient data and use of measurements, harnessing hospital based social connections, and advice to utilize a patient-centered approach with personalization and tailoring to facilitate optimal engagement.
In summary, a multifaceted, personalizable intervention with an inclusively designed interface was deemed desirable for use among cardiovascular disease patients both by end users and key stakeholders. In-depth understanding of core needs of the population can aid intervention development and acceptability.
心血管疾病是全球过早死亡的主要原因。国际指南建议常规开展心脏康复的各个阶段。传统心脏康复的采用率仍不理想，因为参加正规医院心脏康复项目的人数较少，社区心脏康复率以及个人长期运动维持率更低。家庭心脏康复项目已被证明在临床和与健康相关的生活质量结果方面同样有效，但却难以获得。
鉴于家庭心脏康复项目的潜力，探索如何与关键利益相关者共同恰当地设计此类干预措施非常重要。本研究的目的是与心血管疾病患者及健康生态系统中的其他专业人员合作，(1) 了解抑制或促进他们参与体育活动能力的个人、社会和身体因素，以及 (2) 探索他们在电子健康干预方面的技术能力、需求和期望。
在两个国家进行了54次半结构化访谈。访谈进行录音、逐字转录，并采用主题分析法进行分析。还专门探讨了实施PATHway的障碍，涉及身体能力和安全性以及技术准备情况，并进一步映射到COM-B模型上，以用于未来的干预设计。
关键建议包括收集患者数据和使用测量方法、利用基于医院的社会联系，以及建议采用以患者为中心的方法并进行个性化定制，以促进最佳参与度。
总之，终端用户和关键利益相关者都认为一种多方面、可个性化定制且界面设计包容的干预措施适用于心血管疾病患者。深入了解人群的核心需求有助于干预措施的开发和可接受性。
