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移动心理健康:移动健康应用在进食障碍患者中的用户体验。

Mobile Health Adoption in Mental Health: User Experience of a Mobile Health App for Patients With an Eating Disorder.

机构信息

Department of Information and Communication Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.

Open Evidence Research, Barcelona, Spain.

出版信息

JMIR Mhealth Uhealth. 2019 May 31;7(6):e12920. doi: 10.2196/12920.


DOI:10.2196/12920
PMID:31199329
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6592393/
Abstract

BACKGROUND: Despite the worldwide growth in mobile health (mHealth) tools and the possible benefits for both patients and health care providers, the overall adoption levels of mHealth tools by health professionals remain relatively low. OBJECTIVE: This study aimed (1) to investigate attitudes of health care providers and mHealth experts toward mHealth tools in the health context in general, and this study aimed (2) to test the acceptability and feasibility of a specific mHealth tool for patients with an eating disorder (ED), called TCApp, among patients and ED specialists. METHODS: To this purpose, we conducted an explorative qualitative study with 4 in-depth group discussions with several groups of stakeholders: our first focus group was conducted with 11 experts on mHealth from the Catalan Association of Health Entities; the second focus group included 10 health care professionals from the Spanish College of Doctors of Barcelona; the third focus group involved 9 patients with an ED who had used the TCApp over a 12-week period, and the fourth and last focus group involved 8 ED specialists who had monitored such ED patients on the Web. RESULTS: The focus groups showed that health care providers and mHealth experts reported barriers for mHealth adoption more often than facilitators, indicating that mHealth techniques are difficult to obtain and use. Most barriers were attributed to external factors relating to the human or organizational environment (ie, lack of time because of workload, lack of direct interest on a legislative or political level) rather than being attributed to internal factors relating to individual obstacles. The results of the mHealth intervention study indicate that the TCApp was considered as easy to use and useful, although patients and the ED specialists monitoring them on the Web reported different adoption problems, such as the inability to personalize the app, a lack of motivational and interactive components, or difficulties in adhering to the study protocol. CONCLUSIONS: In general, this paper indicates that both health professionals and patients foresee difficulties that need to be addressed before comprehensive adoption and usage of mHealth techniques can be effectively implemented. Such findings are in line with previous studies, suggesting that although they acknowledge their possible benefits and cost-effectiveness, health care providers are quite resistant and conservative about integrating mHealth technologies in their daily practice.

摘要

背景:尽管移动医疗(mHealth)工具在全球范围内不断增长,并且可能对患者和医疗保健提供者都有好处,但医疗保健专业人员对 mHealth 工具的总体采用水平仍然相对较低。

目的:本研究旨在(1)调查医疗保健提供者和 mHealth 专家对一般健康背景下的 mHealth 工具的态度,本研究旨在(2)测试一种名为 TCApp 的特定 mHealth 工具在饮食障碍(ED)患者中的可接受性和可行性,该工具专门针对 ED 患者。

方法:为此,我们进行了一项探索性定性研究,共进行了 4 次深入的小组讨论,涉及多个利益相关者群体:我们的第一个焦点小组由来自加泰罗尼亚健康实体协会的 11 名 mHealth 专家组成;第二个焦点小组包括来自巴塞罗那西班牙医生学院的 10 名医疗保健专业人员;第三个焦点小组涉及 9 名在 12 周内使用过 TCApp 的 ED 患者,第四个也是最后一个焦点小组涉及 8 名在网上监测此类 ED 患者的 ED 专家。

结果:焦点小组表明,医疗保健提供者和 mHealth 专家报告的 mHealth 采用障碍多于促进因素,这表明 mHealth 技术难以获取和使用。大多数障碍归因于外部因素,与人为或组织环境有关(即,由于工作量大而缺乏时间,在立法或政治层面缺乏直接利益),而不是归因于与个人障碍有关的内部因素。mHealth 干预研究的结果表明,TCApp 被认为易于使用且有用,尽管患者和在网上监测他们的 ED 专家报告了不同的采用问题,例如无法个性化应用程序、缺乏激励和互动组件,或难以遵守研究协议。

结论:总的来说,本文表明,医疗保健专业人员和患者都预见到了在全面采用和使用 mHealth 技术之前需要解决的困难。这些发现与之前的研究一致,表明尽管他们承认 mHealth 技术可能带来好处并且具有成本效益,但医疗保健提供者对将 mHealth 技术整合到他们的日常实践中相当抵制和保守。

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本文引用的文献

[1]
The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review.

J Cancer Surviv. 2019-1-11

[2]
Use of eHealth and mHealth technology by persons with multiple sclerosis.

Mult Scler Relat Disord. 2018-10-2

[3]
Patient Experiences Using a Self-Monitoring App in Eating Disorder Treatment: Qualitative Study.

JMIR Mhealth Uhealth. 2018-6-22

[4]
A systematic review of mHealth interventions for the support of eating disorders.

Eur Eat Disord Rev. 2018-6-21

[5]
Cost-effectiveness of the mobile application TCApp combined with face-to-face CBT treatment compared to face-to-face CBT treatment alone for patients with an eating disorder: study protocol of a multi-centre randomised controlled trial.

BMC Psychiatry. 2018-5-2

[6]
"I would love to have online support but I don't trust it": Positive and negative views of technology from the perspective of those with eating disorders in Canada.

Health Soc Care Community. 2018-7

[7]
The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science.

Lancet Psychiatry. 2018-3

[8]
Clinicians' perspective on an app for patient self-monitoring in eating disorder treatment.

Int J Eat Disord. 2018-2-22

[9]
Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review.

J Med Internet Res. 2017-9-15

[10]
The Model for Assessment of Telemedicine (MAST): A scoping review of empirical studies.

J Telemed Telecare. 2017-7-31

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