使用移动医疗技术系统测试心力衰竭自我护理中患者观点的理论

Theory Testing of Patient Perspectives Using a Mobile Health Technology System in Heart Failure Self-care.

机构信息

Ewa Hägglund, RN, PhD Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. Anna Strömberg, RN, PhD Professor, Division of Nursing Science, Department of Medical and Health Sciences and Department of Cardiology, Linköping University, Sweden. Inger Hagerman MD, PhD Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. Patrik Lyngå, RN, PhD Karolinska Institutet, Department of Clinical Science and Education and Department of Cardiology, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.

出版信息

J Cardiovasc Nurs. 2019 Nov/Dec;34(6):448-453. doi: 10.1097/JCN.0000000000000595.

DOI:10.1097/JCN.0000000000000595

PMID:31365443

Abstract

BACKGROUND

There is an increasing interest in mobile health (mHealth), the use of mobile devices for supporting self-care in persons with heart failure. However, an established theoretical framework to explain, predict, and understand the phenomena of mHealth to support self-care is lacking.

OBJECTIVE

The aim of this study was to deductively test if the situation-specific theory of heart failure self-care could be applied in the context of persons with heart failure using an mHealth system with a tablet computer connected to a weighing scale to support their self-care. We wanted to test whether the 3 phases of the self-care process (ie, self-care maintenance, symptom perception, and self-care management) could be validated in the experiences of persons with heart failure using an mHealth tool.

METHODS

A qualitative study design was used with semistructured interviews. Data were analyzed deductively using content analysis and coded according to a structured matrix into 1 of the 3 predefined categories: self-care maintenance, symptom perception, or self-care management RESULTS:: Seventeen persons with heart failure, with mean age of 75 years, participated. The mHealth system was found to be feasible, influencing adherence and providing support for maintaining self-care as well as influencing both physical and psychological symptom perception.In persons with heart failure, the mHealth tool experience influenced the development and use of skills and fostered independence in self-care management. An interaction with healthcare professionals was sometimes needed in combination with the mHealth tool.

CONCLUSIONS

The findings confirmed that "the situation-specific theory of heart failure self-care" could be applied in this context.

摘要

背景

移动医疗（mHealth）越来越受到关注，它使用移动设备来支持心力衰竭患者的自我护理。然而，目前缺乏一个既定的理论框架来解释、预测和理解 mHealth 支持自我护理的现象。

目的

本研究旨在通过使用连接到体重秤的平板电脑的 mHealth 系统来检验心力衰竭自我护理的特定情境理论是否可应用于心力衰竭患者的情境中，以支持他们的自我护理。我们想测试该 mHealth 工具是否可以验证心力衰竭患者自我护理过程的 3 个阶段（即自我护理维持、症状感知和自我护理管理）的经验。

方法

本研究采用定性研究设计，进行半结构式访谈。使用内容分析法进行演绎分析，根据一个结构化矩阵将数据编码为 3 个预定义类别之一：自我护理维持、症状感知或自我护理管理。

结果

17 名心力衰竭患者参与了本研究，平均年龄为 75 岁。研究发现，mHealth 系统是可行的，它可以影响坚持自我护理的意愿，并提供支持，还可以影响身体和心理症状的感知。在心力衰竭患者中，mHealth 工具的体验影响了技能的发展和使用，促进了自我护理管理的独立性。有时需要与医疗保健专业人员进行交互，结合使用 mHealth 工具。