乌干达一家心脏护理中心心力衰竭患者和临床医生的生活体验和技术素养。
Lived Experiences and Technological Literacy of Heart Failure Patients and Clinicians at a Cardiac Care Centre in Uganda.
机构信息
Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, CA.
Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, CA.
出版信息
Ann Glob Health. 2020 Jul 28;86(1):85. doi: 10.5334/aogh.2905.
BACKGROUND
Digital health could serve as a low-cost means of enabling better self-care in patients living with heart failure (HF) in resource-limited settings such as Uganda. However, digital health interventions previously deployed in such settings have been unsuccessful due to a lack of local patient and clinician engagement in the design process.
OBJECTIVE
To engage Ugandan HF patients and clinicians regarding their experiences with HF management and technology, so as to inform the future design of a digital health intervention for HF patients in Uganda.
METHODS
The study employed a convergent parallel mixed-methods design. Data collection was completed at the Uganda Heart Institute in Kampala, Uganda. Data were ascertained through a patient survey and semi-structured interviews completed with HF patients, caregivers, physicians, and nurses. A conventional content analysis approach was used to qualitatively examine interview transcripts.
FINDINGS
Survey data were collected from 101 HF patients (62 female/39 male, aged 54.2 ± 17.5 years). Nearly half (48%) disagreed that they knew what to do in response to changes in their HF symptoms. Almost all patients (98%) had access to a mobile device. Many patients (63%) identified as comfortable in using mobile money - a local set of services that use Unstructured Supplementary Service Data (USSD). Interviews were completed with 19 HF patients, three caregivers, seven physicians, and three nurses. Qualitative analysis revealed four clusters of themes: overdependence of patients on the clinic, inconvenience associated with attending the clinic, inconsistent patient self-care behaviours at home, and technological abilities that favoured USSD-based services.
CONCLUSIONS
Ugandan HF patients possess unmet information needs that leave them ill-equipped to care for themselves. Future digital health interventions for this population should empower patients with HF-specific information and reassurance in their self-care abilities. Based on patient preferences, such systems should harness USSD technology with which most patients are already comfortable.
背景
在乌干达等资源有限的环境中，数字健康可以作为一种低成本的手段，帮助心力衰竭（HF）患者更好地进行自我护理。然而，由于缺乏当地患者和临床医生在设计过程中的参与，之前在这些环境中部署的数字健康干预措施都没有成功。
目的
让乌干达 HF 患者和临床医生参与进来，了解他们在 HF 管理和技术方面的经验，以便为乌干达 HF 患者的数字健康干预措施的未来设计提供信息。
方法
该研究采用了收敛平行混合方法设计。数据收集在乌干达坎帕拉的乌干达心脏研究所进行。通过 HF 患者、护理人员、医生和护士完成的患者调查和半结构化访谈来获取数据。采用传统的内容分析方法对访谈记录进行定性分析。
发现
从 101 名 HF 患者（62 名女性/39 名男性，年龄 54.2±17.5 岁）中收集了调查数据。近一半（48%）的患者不同意他们知道如何应对 HF 症状的变化。几乎所有的患者（98%）都可以使用移动设备。许多患者（63%）表示他们对使用移动货币感到舒适-这是一种使用非结构化补充服务数据（USSD）的本地服务。与 19 名 HF 患者、3 名护理人员、7 名医生和 3 名护士进行了访谈。定性分析揭示了四个主题集群：患者过度依赖诊所、就诊不便、患者在家自我护理行为不一致以及有利于 USSD 服务的技术能力。
结论
乌干达 HF 患者存在未满足的信息需求，这使他们无法很好地照顾自己。未来针对这一人群的数字健康干预措施应该赋予 HF 患者特定的信息，并增强他们自我护理能力的信心。根据患者的偏好，这些系统应该利用大多数患者已经熟悉的 USSD 技术。
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