Graduate School of Business Administration, Bar-Ilan University, Ramat Gan, Israel.
Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.
JMIR Mhealth Uhealth. 2019 Aug 27;7(8):e13892. doi: 10.2196/13892.
Medical emergencies such as anaphylaxis may require immediate use of emergency medication. Because of the low adherence of chronic patients (ie, carrying anti-anaphylactic medication) and the potentially long response time of emergency medical services (EMSs), alternative approaches to provide immediate first aid are required. A smartphone-based emergency response community (ERC) was established for patients with allergies to enable members to share their automatic adrenaline injector (AAI) with other patients who do not have their AAI at the onset of anaphylactic symptoms. The community is operated by a national EMS. In the first stage of the trial, children with food allergies and their parents were invited to join.
This study aimed to identify the factors that influence the willingness to join an ERC for a group of patients at risk of anaphylaxis.
The willingness to join an ERC was studied from different perspectives: the willingness of children with severe allergies to join an ERC, the willingness of their parents to join an ERC, the willingness of parents to enroll their children in an ERC, and the opinions of parents and children about the minimum age to join an ERC. Several types of independent variables were used: demographics, medical data, adherence, parenting style, and children's autonomy. A convenience sample of children and their parents who attended an annual meeting of a nonprofit organization for patients with food allergies was used.
A total of 96 questionnaires, 73 by parents and 23 by children, were collected. Response rates were approximately 95%. Adherence was high: 22 out of 23 children (96%) and 22 out of 52 parents (42%) had their AAI when asked. Willingness to join the community was high among parents (95%) and among children (78%). Willingness of parents to enroll their children was 49% (36/73). The minimum age to join an ERC was 12.27 years (SD 3.02) in the parents' opinion and 13.15 years (SD 3.44) in the children's opinion.
Parents' willingness to join an ERC was negatively correlated with parents' age, child's age, and parents' adherence. This can be explained by the free-rider effect: parents who carried an AAI for their young child, but had low adherence, wanted to join the ERC to get an additional layer of emergency response. Children's willingness to join the community was positively correlated with age and negatively correlated with the child's emotional autonomy. Parents' willingness to enroll their children in an ERC was positively correlated with child's age and negatively correlated with parents' adherence: again, this can be explained by the aforementioned free-rider effect. Parents' and children's opinions about the minimum age to join an ERC were negatively correlated with protective parenting style and positively correlated with monitoring parenting style.
过敏等医疗急症可能需要立即使用急救药物。由于慢性病患者(即携带抗过敏药物)的依从性较低,以及紧急医疗服务(EMS)的潜在响应时间较长,因此需要寻求替代方法来提供即时急救。建立了一个基于智能手机的急救响应社区(ERC),供过敏患者使用,使成员能够在出现过敏症状时与其他没有携带自动肾上腺素注射器(AAI)的患者共享他们的 AAI。该社区由国家 EMS 运营。在试验的第一阶段,邀请了患有食物过敏的儿童及其父母参加。
本研究旨在确定影响一群有过敏风险的患者加入 ERC 的意愿的因素。
从不同角度研究加入 ERC 的意愿:严重过敏儿童加入 ERC 的意愿、父母加入 ERC 的意愿、父母让孩子加入 ERC 的意愿,以及父母和孩子对加入 ERC 的最低年龄的意见。使用了几种类型的自变量:人口统计学、医疗数据、依从性、育儿方式和儿童的自主性。使用了参加非营利组织年度会议的儿童及其父母的便利样本,该组织专为食物过敏患者而设。
共收集了 96 份问卷,其中 73 份由父母填写,23 份由孩子填写。回应率约为 95%。依从性很高:23 名儿童中的 22 名(96%)和 52 名父母中的 22 名(42%)在被问到是否携带 AAI 时携带了 AAI。父母(95%)和孩子(78%)都有很高的加入社区的意愿。父母让孩子加入 ERC 的意愿为 49%(36/73)。父母认为加入 ERC 的最低年龄为 12.27 岁(SD 3.02),儿童认为加入 ERC 的最低年龄为 13.15 岁(SD 3.44)。
父母加入 ERC 的意愿与父母年龄、孩子年龄和父母依从性呈负相关。这可以用搭便车效应来解释:携带 AAI 为年幼孩子的父母,由于依从性较低,希望加入 ERC 以获得额外的应急响应层。孩子加入社区的意愿与年龄呈正相关,与孩子的情绪自主性呈负相关。父母让孩子加入 ERC 的意愿与孩子的年龄呈正相关,与父母的依从性呈负相关:这同样可以用前面提到的搭便车效应来解释。父母和孩子对加入 ERC 的最低年龄的意见与保护性育儿方式呈负相关,与监控性育儿方式呈正相关。