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了解用户对基于互联网的耳鸣自我管理干预措施的反应和互动:混合方法评估

Understanding User Reactions and Interactions With an Internet-Based Intervention for Tinnitus Self-Management: Mixed-Methods Evaluation.

作者信息

Greenwell Kate, Sereda Magdalena, Coulson Neil S, Hoare Derek J

机构信息

Centre for Clinical and Community Applications of Health Psychology, University of Southampton, United Kingdom.

National Institute for Health Research Nottingham Biomedical Research Centre, Hearing Sciences Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom.

出版信息

Am J Audiol. 2019 Sep 13;28(3):697-713. doi: 10.1044/2019_AJA-18-0171. Epub 2019 Sep 4.

Abstract

Purpose Internet-based interventions have the potential to reduce the disparity in access to psychological therapy that people with tinnitus currently experience. One example is the Tinnitus E-Programme, which, although freely available online, has not yet been formally evaluated. The purpose of this study was to evaluate past, current, and new users' reactions and interactions with the Tinnitus E-Programme. Method Study 1 used an online survey to gather past and current users' reactions to, and interactions with, the intervention ( = 27). Study 2 used interviews and a relaxation log to assess how new users implemented the skills they learned into their everyday lives ( = 13). Results Generally, users expressed positive views on the intervention content and design features. Users particularly valued the education about tinnitus and its management and the relaxation skills training, and use of these components was high. In contrast, user reactions to self-monitoring tools, an online support forum, and therapist support were mixed, and use was lower. Implementation was limited by instances of poor usability and accessibility, user engagement, and adherence to relaxation goals. Users' perceptions of the intervention's credibility and relevance and beliefs regarding a negative impact on their tinnitus influenced engagement. Users in both studies identified several benefits gained, including functional and emotional management, self-efficacy for managing and coping with tinnitus, understanding tinnitus and its management, social support, and acceptance of tinnitus. Conclusion Findings suggest that the intervention was acceptable to its target group but also highlighted some areas for improvement. These findings will be used to inform further optimization work.

摘要

目的 基于互联网的干预措施有可能减少耳鸣患者目前在获得心理治疗方面存在的差距。一个例子是耳鸣电子项目,该项目虽然可在网上免费获取,但尚未经过正式评估。本研究的目的是评估过去、现在和新用户对耳鸣电子项目的反应及互动情况。方法 研究1采用在线调查收集过去和现在用户对该干预措施的反应及互动情况(n = 27)。研究2采用访谈和放松日志来评估新用户如何将所学技能应用到日常生活中(n = 13)。结果 总体而言,用户对干预内容和设计特点表达了积极看法。用户尤其重视有关耳鸣及其管理的教育以及放松技能培训,并且这些内容的使用率很高。相比之下,用户对自我监测工具、在线支持论坛和治疗师支持的反应不一且使用率较低。实施受到可用性和可及性差、用户参与度以及对放松目标的坚持等情况的限制。用户对干预措施的可信度和相关性的认知以及对耳鸣负面影响的信念影响了参与度。两项研究中的用户都指出获得了一些益处,包括功能和情绪管理、管理和应对耳鸣的自我效能感、对耳鸣及其管理的理解、社会支持以及对耳鸣的接纳。结论 研究结果表明该干预措施对其目标群体是可接受的,但也突出了一些需要改进的方面。这些研究结果将用于为进一步的优化工作提供信息。

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