Department of Cardiology, Peking University First Hospital, Beijing, China.
Health Systems, Philips Research China, Shanghai, China.
JMIR Mhealth Uhealth. 2019 Feb 4;7(2):e10117. doi: 10.2196/10117.
Mobile health (mHealth)-a method of assisting long-term care in patients with chronic cardiovascular diseases (CVDs)-is gaining popularity in China, mainly owing to the large number of patients and limited clinical resources. Patients of different ages have varying needs for CVD management. However, evidence regarding how age influences Chinese CVD patients' use and perceptions of mHealth is limited.
This study aimed to explore age-related differences among Chinese patients with CVD regarding their use and perceptions of mHealth and to determine the factors that influence this population's willingness to use mHealth technologies.
We conducted a cross-sectional study of patients with chronic CVDs in a tertiary hospital in Beijing using a new questionnaire designed by the investigators. Participants were sourced using nonproportional quota-sampling methods, being recruited consecutively in each sampling category (age 18-49, 50-64, 65-74, and ≥75 years, with at least 25 men and 25 women in each age group). The survey consisted of 5 parts, including sociodemographic profile and medical history; current disease management situation; self-evaluation of disease management; current usage of mobile and internet technology (IT); and willingness to use an mHealth solution to perform disease self-management. Responses were compared among the 4 age groups as well as between patients who were willing to use mHealth solutions and those who were not. Multivariate logistic regression model was used to identify predictors of willingness to use mHealth for self-management.
Overall, 231 patients (124 men) completed the questionnaire; of these, 53 were aged 18-49 years, 66 were aged 50-64 years, 54 were aged 65-74 years, and 58 were aged ≥75 years. Patients in the older cohorts visited hospitals more often than did those in the younger cohorts (P<.001), and they also showed lower technology skills regarding the use of mobile or internet devices (P<.001) and searched for health-related information on the internet less often (P<.001). In addition, 68.0% (157/231) of the patients showed interest in using mHealth solution to manage their disease; of these, 40.8% (64/157) were aged 65 years. Patients who were more willing to use mHealth solution to manage their diseases were younger (P<.001), more educated (P<.001), still working (P=.001), possessed higher skill regarding mobile or internet device use (P<.001), and more frequently searched for health information on the internet (P<.001). Finally, multivariate logistic regression showed that IT skill was the single indicator (P=.003) of willingness to use mHealth, not age.
Although age is associated with the use of mobile or internet devices, the sole indicator of mHealth use for self-management was participants' IT skills. Education regarding the use of mobile devices and development of easy-to-use software might improve the acceptance of mHealth solutions among older patient populations.
移动医疗(mHealth)——一种辅助慢性心血管疾病(CVD)患者长期护理的方法——在中国越来越受欢迎,主要是因为患者数量众多,而临床资源有限。不同年龄的患者对 CVD 管理有不同的需求。然而,关于年龄如何影响中国 CVD 患者对 mHealth 的使用和认知的证据有限。
本研究旨在探讨不同年龄段的中国 CVD 患者在使用和认知 mHealth 方面的差异,并确定影响该人群使用 mHealth 技术意愿的因素。
我们在北京的一家三级医院对慢性 CVD 患者进行了一项横断面研究,使用了由研究人员设计的新问卷。参与者采用非比例配额抽样方法,在每个抽样类别中连续招募(年龄 18-49 岁、50-64 岁、65-74 岁和≥75 岁,每个年龄组至少有 25 名男性和 25 名女性)。该调查由 5 部分组成,包括社会人口统计学特征和病史;当前疾病管理状况;疾病自我管理自评;移动和互联网技术(IT)的当前使用情况;以及使用 mHealth 解决方案进行疾病自我管理的意愿。比较了 4 个年龄组之间以及愿意和不愿意使用 mHealth 解决方案的患者之间的反应。使用多变量逻辑回归模型确定愿意使用 mHealth 进行自我管理的预测因素。
共有 231 名患者(124 名男性)完成了问卷;其中,53 名年龄在 18-49 岁之间,66 名年龄在 50-64 岁之间,54 名年龄在 65-74 岁之间,58 名年龄在≥75 岁之间。较年长队列的患者比年轻队列的患者更频繁地去医院就诊(P<.001),并且他们在使用移动或互联网设备方面的技术技能也较低(P<.001),在互联网上搜索健康相关信息的频率也较低(P<.001)。此外,68.0%(157/231)的患者表示有兴趣使用 mHealth 解决方案来管理他们的疾病;其中,40.8%(64/157)的患者年龄65 岁。更愿意使用 mHealth 解决方案来管理疾病的患者更年轻(P<.001),受教育程度更高(P<.001),仍在工作(P=.001),在移动或互联网设备使用方面的技能更高(P<.001),并且更频繁地在互联网上搜索健康信息(P<.001)。最后,多变量逻辑回归显示,信息技术技能(P=.003)是使用 mHealth 进行自我管理的唯一指标,而不是年龄。
尽管年龄与移动或互联网设备的使用有关,但 mHealth 自我管理的唯一指标是参与者的 IT 技能。关于移动设备使用的教育和开发易于使用的软件可能会提高老年患者群体对 mHealth 解决方案的接受度。