捕捉青少年慢性疼痛的日常疾病体验：移动医疗介导的症状跟踪。
Capturing Daily Disease Experiences of Adolescents With Chronic Pain: mHealth-Mediated Symptom Tracking.
机构信息
iOUCH Pain Lab, Department of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
Centre for Global eHealth Innovation, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
出版信息
JMIR Mhealth Uhealth. 2019 Jan 17;7(1):e11838. doi: 10.2196/11838.
BACKGROUND
Chronic pain is a common problem in adolescents that can negatively impact all aspects of their health-related quality of life. The developmental period of adolescence represents a critical window of opportunity to optimize and solidify positive health behaviors and minimize future pain-related disability and impaired work productivity. This research focuses on the development and evaluation of a smartphone-based pain self-management app for adolescents with chronic pain.
OBJECTIVE
The objectives of this study were to characterize (1) the feasibility of deploying a mobile health (mHealth) app (iCanCope) to the personal smartphones of adolescent research participants; (2) adherence to daily symptom tracking over 55 consecutive days; (3) participant interaction with their symptom history; and (4) daily pain-related experiences of adolescents with chronic pain.
METHODS
We recruited adolescents aged 15-18 years from 3 Canadian pediatric tertiary care chronic pain clinics. Participants received standardized instructions to download the iCanCope app and use it once a day for 55 days. Detailed app analytics were captured at the user level. Adherence was operationally defined as per the relative proportion of completed symptom reports. Linear mixed models were used to examine the trajectories of daily symptom reporting.
RESULTS
We recruited 60 participants between March 2017 and April 2018. The mean age of the participants was 16.4 (SD 0.9) years, and 88% (53/60) of them were female. The app was deployed to 98% (59/60) devices. Among the 59 participants, adherence was as follows: low (4, 7%), low-moderate (14, 24%), high-moderate (16, 27%), and high (25, 42%). Most (49/59, 83%) participants chose to view their historical symptom trends. Participants reported pain intensity and pain-related symptoms of moderate severity, and these ratings tended to be stable over time.
CONCLUSIONS
This study indicates that (1) the iCanCope app can be deployed to adolescents' personal smartphones with high feasibility; (2) adolescents demonstrated moderate-to-high adherence over 55 days; (3) most participants chose to view their symptom history; and (4) adolescents with chronic pain experience stable symptomology of moderate severity.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02601755; https://clinicaltrials.gov/ct2/show/NCT02601755 (Archived by WebCite at http://www.webcitation.org/74F4SLnmc).
背景
慢性疼痛是青少年中常见的问题，会对他们健康相关生活质量的各个方面产生负面影响。青少年的发展时期是优化和巩固积极健康行为、最大限度减少未来与疼痛相关的残疾和工作生产力下降的关键机会窗口。本研究专注于为患有慢性疼痛的青少年开发和评估基于智能手机的疼痛自我管理应用程序。
目的
本研究的目的是描述（1）将移动健康（mHealth）应用程序（iCanCope）部署到青少年研究参与者的个人智能手机上的可行性；（2）连续 55 天坚持每天进行症状跟踪；（3）参与者与其症状史的互动；以及（4）患有慢性疼痛的青少年的日常疼痛相关体验。
方法
我们从加拿大 3 家儿科三级慢性疼痛诊所招募了 15-18 岁的青少年参与者。参与者接受了下载 iCanCope 应用程序并每天使用 55 天的标准化指导。在用户级别捕获了详细的应用程序分析。坚持被定义为完成症状报告的相对比例。使用线性混合模型来检查每日症状报告的轨迹。
结果
我们于 2017 年 3 月至 2018 年 4 月期间招募了 60 名参与者。参与者的平均年龄为 16.4（SD 0.9）岁，其中 88%（53/60）为女性。该应用程序已部署到 98%（59/60）的设备上。在 59 名参与者中，坚持情况如下：低（4 人，7%）、低-中（14 人，24%）、中-高（16 人，27%）和高（25 人，42%）。大多数（49/59，83%）参与者选择查看其历史症状趋势。参与者报告了中度严重的疼痛强度和与疼痛相关的症状，这些评分随时间趋于稳定。
结论
本研究表明：（1）iCanCope 应用程序可以高度可行地部署到青少年的个人智能手机上；（2）青少年在 55 天内表现出中-高坚持度；（3）大多数参与者选择查看他们的症状史；以及（4）患有慢性疼痛的青少年经历了中度严重程度的稳定症状。
试验注册
ClinicalTrials.gov NCT02601755；https://clinicaltrials.gov/ct2/show/NCT02601755（由 WebCite 存档；http://www.webcitation.org/74F4SLnmc）。
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