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针对慢性病成年人使用智能手机药物提醒应用程序的培训影响:应用技术接受模型的试点研究

Implications for Training on Smartphone Medication Reminder App Use by Adults With Chronic Conditions: Pilot Study Applying the Technology Acceptance Model.

作者信息

Park Daniel Y, Goering Elizabeth M, Head Katharine J, Bartlett Ellis Rebecca J

机构信息

Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.

Indiana University School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.

出版信息

JMIR Form Res. 2017 Nov 10;1(1):e5. doi: 10.2196/formative.8027.

DOI:10.2196/formative.8027
PMID:30684397
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6334682/
Abstract

BACKGROUND

The majority of middle-aged to older patients with chronic conditions report forgetting to take medications as prescribed. The promotion of patients' smartphone medication reminder app (SMRA) use shows promise as a feasible and cost-effective way to support their medication adherence. Providing training on SMRA use, guided by the technology acceptance model (TAM), could be a promising intervention to promote patients' app use.

OBJECTIVE

The aim of this pilot study was to (1) assess the feasibility of an SMRA training session designed to increase patients' intention to use the app through targeting perceived usefulness of app, perceived ease of app use, and positive subjective norm regarding app use and (2) understand the ways to improve the design and implementation of the training session in a hospital setting.

METHODS

A two-group design was employed. A total of 11 patients older than 40 years (median=58, SD=9.55) and taking 3 or more prescribed medications took part in the study on one of two different dates as participants in either the training group (n=5) or nontraining group (n=6). The training group received an approximately 2-hour intervention training session designed to target TAM variables regarding one popular SMRA, the Medisafe app. The nontraining group received an approximately 2-hour control training session where the participants individually explored Medisafe app features. Each training session was concluded with a one-time survey and a one-time focus group.

RESULTS

Mann-Whitney U tests revealed that the level of perceived ease of use (P=.13) and the level of intention to use an SMRA (P=.33) were higher in the training group (median=7.00, median=6.67, respectively) than in the nontraining group (median=6.25, median=5.83). However, the level of perceived usefulness (U=4.50, Z=-1.99, P=.05) and the level of positive subjective norm (P=.25) were lower in the training group (median=6.50, median=4.29) than in the nontraining group (median=6.92, median=4.50). Focus groups revealed the following participants' perceptions of SMRA use in the real-world setting that the intervention training session would need to emphasize in targeting perceived usefulness and positive subjective norm: (1) the participants would find an SMRA to be useful if they thought the app could help address specific struggles in medication adherence in their lives and (2) the participants think that their family members (or health care providers) might view positively the participants' SMRA use in primary care settings (or during routine medical checkups).

CONCLUSIONS

Intervention training session, guided by TAM, appeared feasible in targeting patients' perceived ease of use and, thereby, increasing intention to use an SMRA. Emphasizing the real-world utility of SMRA, the training session could better target patients' perceived usefulness and positive subjective norm that are also important in increasing their intention to use the app.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a42/6334682/0e1f7efc458c/formative_v1i1e5_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a42/6334682/4a769714ed5a/formative_v1i1e5_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a42/6334682/9ec82a3c2e28/formative_v1i1e5_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a42/6334682/0e1f7efc458c/formative_v1i1e5_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a42/6334682/4a769714ed5a/formative_v1i1e5_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a42/6334682/9ec82a3c2e28/formative_v1i1e5_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a42/6334682/0e1f7efc458c/formative_v1i1e5_fig3.jpg
摘要

背景

大多数患有慢性病的中老年患者表示会忘记按规定服药。推广患者使用智能手机用药提醒应用程序(SMRA)有望成为一种可行且具成本效益的方式来支持他们坚持服药。以技术接受模型(TAM)为指导,提供关于SMRA使用的培训可能是促进患者应用该程序的一种有前景的干预措施。

目的

这项试点研究的目的是:(1)评估旨在通过针对应用程序的感知有用性、感知易用性以及关于应用程序使用的积极主观规范来提高患者使用该应用程序意愿的SMRA培训课程的可行性;(2)了解在医院环境中改进培训课程设计和实施的方法。

方法

采用两组设计。共有11名年龄超过40岁(中位数 = 58,标准差 = 9.55)且正在服用3种或更多处方药的患者在两个不同日期中的一天参与研究,分别作为培训组(n = 5)或非培训组(n = 6)的参与者。培训组接受了一次约2小时的干预培训课程,旨在针对一款流行的SMRA(Medisafe应用程序)的TAM变量。非培训组接受了一次约2小时的对照培训课程,参与者在其中单独探索Medisafe应用程序的功能。每次培训课程结束时都进行一次一次性调查和一次焦点小组讨论。

结果

曼 - 惠特尼U检验显示,培训组(中位数分别为7.00和6.67)的感知易用性水平(P = 0.13)和使用SMRA的意愿水平(P = 0.33)高于非培训组(中位数分别为6.25和5.83)。然而,培训组(中位数分别为6.50和4.29)的感知有用性水平(U = 4.50,Z = -1.99,P = 0.05)和积极主观规范水平(P = 0.25)低于非培训组(中位数分别为6.92和4.50)。焦点小组揭示了参与者对在现实环境中使用SMRA的以下看法,即干预培训课程在针对感知有用性和积极主观规范时需要强调:(1)如果参与者认为该应用程序可以帮助解决他们生活中服药依从性方面的特定困难,他们会发现SMRA很有用;(2)参与者认为他们的家庭成员(或医疗保健提供者)可能会积极看待他们在初级保健环境中(或在常规体检期间)使用SMRA。

结论

以TAM为指导的干预培训课程在针对患者的感知易用性方面似乎是可行的,从而增加了使用SMRA的意愿。通过强调SMRA在现实世界中的实用性,培训课程可以更好地针对患者的感知有用性和积极主观规范,这对于提高他们使用该应用程序的意愿也很重要。

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