Boodoo Chris, Perry Julie Ann, Hunter Paul John, Duta Dragos Ioan, Newhook Samuel Carl Paul, Leung General, Cross Karen
Department of Medical Imaging, St Michael's Hospital, Toronto, ON, Canada.
Keenan Research Centre for Biomedical Science, St Michael's Hospital, Toronto, ON, Canada.
JMIR Diabetes. 2017 Sep 15;2(2):e22. doi: 10.2196/diabetes.8505.
People with diabetes are at risk for diabetic foot ulcers (DFUs), which can lead to limb loss and a significant decrease in quality of life. Evidence suggests that mHealth can be an effective tool in diabetes self-management. mHealth presents an opportunity for the prevention and monitoring of DFUs. However, there is a paucity of research that explores its effectiveness in the DFU patient population, as well as the views and attitudes of these patients toward technology and mHealth.
This study aimed to explore the views, attitudes, and experiences of a diabetic patient population with or at risk of DFUs regarding technology, mHealth, and the diabetic foot.
We used a qualitative research approach using in-depth interviews with 8 patients with DFUs. Questions were structured around experience with technology, current health practices related to diabetic foot care, and thoughts on using an mHealth device that prevents and monitors DFUs. We transcribed and thematically analyzed all interviews.
All patients had positive responses for an mHealth intervention aimed at preventing and monitoring DFUs. We found 4 themes in the data: diversity in use of technology, feet-checking habits, 2-way communication with health care professionals (HCPs), and functionality. There were varying levels of familiarity with and dependence on technology within this patient population. These relationships correlated with distinct generations found in North America, including baby boomers and Generation X. Furthermore, we found that most patients performed daily feet checks to monitor any changes in health. However, some did not perform feet checks prior to the development of a DFU. Patients expressed interest in 2-way communication with HCPs that would allow for easier appointment scheduling, sharing of medical data, decreased number of visits, and use of alerts for when medical attention is required. Patients also identified conditions of functionality for the mHealth intervention. These included consideration of debilitating complications because of diabetes, such as retinopathy and decreased mobility; ease of use of the intervention; and implementation of virtual communities to support continued use of the intervention.
Our patient population expressed an interest in mHealth for preventing and monitoring DFUs, although some participants were not frequent users of technology. mHealth continues to show potential in improving patient outcomes, and this study provides a foundation for designing interventions specific to a DFU population. Further research is needed to confirm these findings.
糖尿病患者有患糖尿病足溃疡（DFU）的风险，这可能导致肢体丧失并显著降低生活质量。有证据表明，移动健康（mHealth）可以成为糖尿病自我管理的有效工具。移动健康为预防和监测糖尿病足溃疡提供了机会。然而，很少有研究探讨其在糖尿病足溃疡患者群体中的有效性，以及这些患者对技术和移动健康的看法和态度。
本研究旨在探讨患有糖尿病足溃疡或有患糖尿病足溃疡风险的糖尿病患者群体对技术、移动健康和糖尿病足的看法、态度及体验。
我们采用定性研究方法，对8名糖尿病足溃疡患者进行了深入访谈。问题围绕技术使用经验、当前与糖尿病足护理相关的健康实践，以及对使用预防和监测糖尿病足溃疡的移动健康设备的想法展开。我们对所有访谈进行了转录和主题分析。
所有患者对旨在预防和监测糖尿病足溃疡的移动健康干预措施都给予了积极回应。我们在数据中发现了4个主题：技术使用的多样性、足部检查习惯、与医护人员的双向沟通以及功能。该患者群体对技术的熟悉程度和依赖程度各不相同。这些关系与北美发现的不同代际相关，包括婴儿潮一代和X一代。此外，我们发现大多数患者每天都会进行足部检查以监测健康状况的任何变化。然而，一些患者在糖尿病足溃疡发生之前并未进行足部检查。患者对与医护人员的双向沟通表示感兴趣，这将使预约安排更容易、医疗数据共享更便捷、就诊次数减少，并在需要医疗关注时使用警报功能。患者还确定了移动健康干预措施的功能条件。这些条件包括考虑糖尿病导致的使人衰弱的并发症，如视网膜病变和行动能力下降；干预措施的易用性；以及实施虚拟社区以支持干预措施的持续使用。
我们的患者群体对用于预防和监测糖尿病足溃疡的移动健康表示感兴趣，尽管一些参与者并非频繁使用技术。移动健康在改善患者预后方面继续显示出潜力，本研究为设计针对糖尿病足溃疡患者群体的干预措施提供了基础。需要进一步的研究来证实这些发现。
