Aref-Adib Golnar, McCloud Tayla, Ross Jamie, O'Hanlon Puffin, Appleton Victoria, Rowe Sarah, Murray Elizabeth, Johnson Sonia, Lobban Fiona
Division of Psychiatry, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, St Pancras Hospital, London, UK.
Division of Psychiatry, University College London, London, UK.
Lancet Psychiatry. 2019 Mar;6(3):257-266. doi: 10.1016/S2215-0366(18)30302-X. Epub 2018 Dec 3.
Digital health interventions present an important opportunity to improve health care for people with psychosis or bipolar disorder, but despite their potential, integrating and implementing them into clinical settings has been difficult worldwide. This Review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder. We searched seven databases and synthesised data from 26 studies using the Consolidated Framework for Implementation Research. Attitudes and beliefs about interventions were crucial factors for both staff and service users, with negative attitudes and scepticism resulting in a lack of motivation to engage with interventions or complete them. The complexity of the interventions was a barrier for people with psychiatric symptoms, low premorbid intelligence quotient, or minimal information technology skills. The accessibility and adaptability of interventions were key facilitators, but insufficient resources, finances, and staff time were barriers to implementation. Interventions need to be user friendly and adaptable to the needs and capabilities of people with psychosis or bipolar disorder, and the staff who support their implementation. Service users and staff should cofacilitate the process of developing and implementing the interventions.
数字健康干预为改善精神病或双相情感障碍患者的医疗保健提供了一个重要机会，但尽管其具有潜力，在全球范围内将其整合并应用于临床环境却一直困难重重。本综述旨在确定影响针对精神病或双相情感障碍患者实施数字健康干预的因素。我们检索了七个数据库，并使用实施研究综合框架对26项研究的数据进行了综合分析。对于工作人员和服务使用者而言，对干预措施的态度和信念都是关键因素，负面态度和怀疑导致缺乏参与或完成干预措施的动力。干预措施的复杂性对有精神症状、病前智商较低或信息技术技能有限的人来说是一个障碍。干预措施的可及性和适应性是关键的促进因素，但资源、资金和工作人员时间不足是实施的障碍。干预措施需要对用户友好，并能适应精神病或双相情感障碍患者及其支持实施的工作人员的需求和能力。服务使用者和工作人员应共同推动干预措施的开发和实施过程。
