Nelligan Rachel K, Hinman Rana S, Teo Pek Ling, Bennell Kim L
Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Parkville, Australia.
JMIR Rehabil Assist Technol. 2020 Nov 26;7(2):e18860. doi: 10.2196/18860.
BACKGROUND: Knee osteoarthritis (OA) is a highly prevalent and debilitating condition. Exercise is a recommended treatment because of its effectiveness at improving pain and function. However, exercise is underutilized in OA management. Difficulty accessing health care has been identified as a key barrier to exercise uptake. Innovative and scalable methods of delivering exercise treatments to people with knee OA are needed. We developed a self-directed eHealth intervention to enable and encourage exercise participation. The effectiveness of this intervention on pain and function in people with knee OA is being evaluated in a randomized clinical trial. OBJECTIVE: This study aimed to explore the attitudes and experiences of people with knee OA who accessed the self-directed eHealth intervention and the features perceived as useful to facilitate self-directed exercise. METHODS: This was a qualitative study embedded within a randomized controlled trial. Individual, semistructured phone interviews were conducted with 16 people with knee OA who had accessed a 24-week eHealth intervention (website and behavior change SMS program) designed to support exercise participation. Interviews were audiorecorded, transcribed verbatim, and thematically analyzed using an inductive approach. RESULTS: Five themes arose: (1) technology easy to use and follow (website ease of use, SMS ease of use), (2) facilitators to exercise participation (credible OA and exercise information, website features, prescribed exercises simple to do unsupervised, freedom to adapt the exercise to suit needs, influence of other health care experiences), (3) sense of support and accountability (SMS good reminder and prompt, accountable, SMS tone and automation could trigger negative emotions [eg, guilt or shame], inability to contact someone when needed), (4) positive outcomes (knee symptom improvements, confidence to self-manage, encouraged active living), (5) suggestions for real-world application (provided by a health professional preferred, should be provided at subsidized or low out-of-pocket cost). CONCLUSIONS: People with knee OA had mostly positive experiences with and attitudes towards the use of an eHealth intervention that supported exercise participation independent of a health professional. A human connection associated with the eHealth intervention appeared important.
背景：膝关节骨关节炎（OA）是一种高度普遍且使人衰弱的病症。运动因其在改善疼痛和功能方面的有效性而被推荐作为一种治疗方法。然而，在OA的管理中运动未得到充分利用。已确定获得医疗保健的困难是运动采用的一个关键障碍。需要创新且可扩展的方法来为膝关节OA患者提供运动治疗。我们开发了一种自我指导的电子健康干预措施，以促进和鼓励运动参与。这项干预措施对膝关节OA患者疼痛和功能的有效性正在一项随机临床试验中进行评估。 目的：本研究旨在探讨使用自我指导电子健康干预措施的膝关节OA患者的态度和体验，以及被认为有助于促进自我指导运动的特征。 方法：这是一项纳入随机对照试验的定性研究。对16名膝关节OA患者进行了个人半结构化电话访谈，这些患者使用了一项为期24周的电子健康干预措施（网站和行为改变短信程序），该措施旨在支持运动参与。访谈进行了录音，逐字转录，并采用归纳法进行主题分析。 结果：出现了五个主题：（1）技术易于使用和遵循（网站易用性、短信易用性），（2）运动参与的促进因素（可靠的OA和运动信息、网站功能、规定的运动在无监督情况下易于进行、可自由调整运动以满足需求、其他医疗保健经历的影响），（3）支持感和责任感（短信是很好的提醒和提示、有责任感、短信语气和自动化可能引发负面情绪[如内疚或羞耻]、需要时无法联系到某人），（4）积极结果（膝关节症状改善、自我管理的信心、鼓励积极生活），（5）实际应用的建议（由健康专业人员提供更佳，应以补贴或低自付费用提供）。 结论：膝关节OA患者对使用支持独立于健康专业人员的运动参与的电子健康干预措施大多有积极的体验和态度。与电子健康干预措施相关的人际联系似乎很重要。
JMIR Rehabil Assist Technol. 2020-11-26
Cochrane Database Syst Rev. 2018-4-17
J Med Internet Res. 2020-9-28
Arthritis Care Res (Hoboken). 2020-12
Osteoarthr Cartil Open. 2025-2-15
J Healthc Inform Res. 2024-11-29
Musculoskeletal Care. 2025-3
JMIR Mhealth Uhealth. 2024-8-14
JMIR Mhealth Uhealth. 2024-5-2
BMC Musculoskelet Disord. 2023-11-21
Osteoarthritis Cartilage. 2019-7-3
Cochrane Database Syst Rev. 2018-4-17
Zotero 插件