用于急性呼吸衰竭幸存者的行为激活和物理康复联合干预的移动应用程序原型的可用性和可接受性。

Usability and acceptability of a mobile application prototype for a combined behavioural activation and physical rehabilitation intervention in acute respiratory failure survivors.

机构信息

Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Department of Pediatrics, Hershey Medical Center, Hershey, PA, USA.

出版信息

Aust Crit Care. 2020 Nov;33(6):511-517. doi: 10.1016/j.aucc.2020.02.010. Epub 2020 Apr 25.

DOI:10.1016/j.aucc.2020.02.010

PMID:32340769

Abstract

BACKGROUND

Acute respiratory failure survivors experience depression symptoms and new impairments in physical function. Behavioural activation, an evidence-based nonpharmacological treatment for depression, combined with physical rehabilitation, is a promising intervention. Notably, mHealth applications (Apps) are potentially effective methods of delivering home-based interventions.

OBJECTIVES

The objective of this study was to evaluate the usability and acceptability of a prototype App to deliver a combined, home-based behavioural activation and rehabilitation intervention to acute respiratory failure survivors.

METHODS

A prospective user-preference study was conducted with acute respiratory failure survivors and self-designated care partners. Survivors were adults with at least mild depression symptoms before hospital discharge who received mechanical ventilation in the intensive care unit for ≥24 h. Survivors and care partners reviewed the App during a single in-person home visit and completed the System Usability Scale (range: 0-100; score >73 considered "good") and a semistructured interview.

RESULTS

Ten patient/care partner dyads completed study. The median [interquartile range] patient age was 50 [40-64] years, and 50% were female. The median System Usability Scale scores among patients and care partners were 76 [68-83] and 88 [75-94], respectively. Qualitative feedback supported usability and acceptability of the App, with three themes reported: (1) stigma associated with depression, (2) App as a motivator for recovery, and (3) App providing multidisciplinary support for survivor and care partner.

CONCLUSIONS

A mobile App prototype designed to deliver a combined behavioural activation and rehabilitation intervention was usable and acceptable to survivors of acute respiratory failure and their care partners. Given the reported stigma associated with depression, the self-directed App may be particularly valuable for motivation and multidisciplinary support.

摘要

背景

急性呼吸衰竭幸存者会出现抑郁症状和新的身体功能障碍。行为激活是一种针对抑郁的循证非药物治疗方法，结合身体康复，是一种很有前途的干预措施。值得注意的是，移动健康应用程序（Apps）是提供家庭干预的潜在有效方法。

目的

本研究旨在评估一种原型 App 用于向急性呼吸衰竭幸存者提供组合式家庭行为激活和康复干预的可用性和可接受性。

方法

采用前瞻性患者偏好研究，纳入急性呼吸衰竭幸存者和自我指定的护理伙伴。幸存者为在重症监护病房接受机械通气≥24 小时的至少有轻度抑郁症状的成年人。幸存者和护理伙伴在一次上门家庭访问期间查看了 App，并完成了系统可用性量表（范围：0-100；得分>73 被认为“良好”）和半结构化访谈。

结果

共有 10 对患者/护理伙伴完成了研究。患者的中位（四分位距）年龄为 50 [40-64] 岁，50%为女性。患者和护理伙伴的中位系统可用性量表得分分别为 76 [68-83] 和 88 [75-94]。定性反馈支持 App 的可用性和可接受性，报告了三个主题：（1）与抑郁相关的耻辱感，（2）App 作为康复的动力，（3）App 为幸存者和护理伙伴提供多学科支持。