den Bakker Chantal M, Schaafsma Frederieke G, van der Meij Eva, Meijerink Wilhelmus Jhj, van den Heuvel Baukje, Baan Astrid H, Davids Paul Hp, Scholten Petrus C, van der Meij Suzan, van Baal W Marchien, van Dalsen Annette D, Lips Daniel J, van der Steeg Jan Willem, Leclercq Wouter Kg, Geomini Peggy Maj, Consten Esther Cj, Schraffordt Koops Steven E, de Castro Steve Mm, van Kesteren Paul Jm, Cense Huib A, Stockmann Hein Bac, Ten Cate A Dorien, Bonjer Hendrik J, Huirne Judith Af, Anema Johannes R
Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands.
Department of Surgery, VU University Medical Center, Amsterdam, Netherlands.
J Med Internet Res. 2019 Feb 6;21(2):e9938. doi: 10.2196/jmir.9938.
Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention ("ikherstel" intervention or "I recover" intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures.
This study aimed to further develop the "ikherstel" eHealth intervention using Intervention Mapping (IM) to fit a broader patient population.
The IM protocol was used to guide further development of the "ikherstel" intervention. First, patients' needs were identified using (1) the information of a process evaluation of the earlier performed "ikherstel" study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed.
The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as "achieving earlier recovery including return to normal activities and work." The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands.
The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed.
Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686.
患者出院后通常得不到指导和监测术后恢复及活动恢复情况的支持。因此，开发了一种围手术期电子健康（eHealth）干预措施（“ikherstel”干预或“我康复”干预），以增强妇科患者围手术期的能力。对于将接受各种普通外科和妇科手术的患者而言，这种电子健康干预措施需要进一步完善。
本研究旨在使用干预映射（IM）进一步完善“ikherstel”电子健康干预措施，以适用于更广泛的患者群体。
采用IM方案指导“ikherstel”干预措施的进一步完善。首先，通过以下方式确定患者需求：（1）对早期进行的“ikherstel”研究的过程评估信息；（2）文献综述；（3）一项调查研究；（4）利益相关者之间的焦点小组讨论（FGD）。其次，确定项目成果和变革目标。第三，为干预项目选择行为改变理论和实用工具。最后，制定实施和评估计划。
将用于腹部普通外科和妇科手术康复患者的电子健康干预工具的成果重新定义为“实现更早康复，包括恢复正常活动和工作”。态度-社会影响-自我效能模型被用作理论框架，将个人和外部决定因素转化为个人行为的变革目标。在IM方案的准备步骤中，通过需求评估和使用理论框架收集的知识产生了更多工具。进一步完善的电子健康干预措施将纳入一个移动应用程序、一个活动追踪器和一次电子咨询（eConsult）。该干预措施将在荷兰11家参与医院的18个科室进行的多中心、单盲随机对照试验中进行评估。
该干预措施扩展至接受普通外科手术的患者以及有恶性指征的患者。开发了新的干预工具，如移动应用程序、活动追踪器和电子咨询。
荷兰试验注册中心NTR5686；http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686 。
