数字健康干预措施对 2 型糖尿病患者自我护理专业技能的影响、适应身份变化以及影响他人感知的定性研究。
Digital Health Interventions for People With Type 2 Diabetes to Develop Self-Care Expertise, Adapt to Identity Changes, and Influence Other's Perception: Qualitative Study.
机构信息
Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
School for Policy Studies, University of Bristol, Bristol, United Kingdom.
出版信息
J Med Internet Res. 2020 Dec 21;22(12):e21328. doi: 10.2196/21328.
BACKGROUND
A diagnosis of type 2 diabetes (T2D) results in widespread changes to a person's life and can be experienced as an assault on their sense of self. The resources available to an individual influence how the individual adapts to their diabetic identity and subsequently engages in self-care. Digital interventions can be viewed as a resource that people can draw on to adapt to the diagnosis. However, there is an indication that people from disadvantaged groups find digital health technologies more challenging to access and use, which may increase health inequalities.
OBJECTIVE
This study aims to gain insights into how and why people with T2D use digital self-care technology and how experiences vary between individuals and social groups.
METHODS
A purposive sample of people who had used a digital intervention to help them self-care for their T2D were recruited for the study. Semistructured interviews were conducted, and data were analyzed thematically.
RESULTS
A diverse sample of 21 participants were interviewed. Participants used digital interventions to help them to understand and feel more in control of their bodies. Digital interventions were used by participants to project their chosen identity to others. Participants selected technology that allowed them to confirm and enact their preferred positive identities, both by avoiding stigma and by becoming experts in their disease or treatment. Participants preferred using digital interventions that helped them conceal their diabetes, including by buying discrete blood glucose monitors. Some participants used technology to increase their sense of power in their interaction with clinicians, whereas others used technology to demonstrate their goodness.
CONCLUSIONS
The technology that people with T2D have access to shapes the way they are able to understand and control their bodies and support preferred social identities.
背景
2 型糖尿病（T2D）的诊断会给患者的生活带来广泛的变化，并可能使其自我意识受到冲击。个体所拥有的资源会影响其如何适应糖尿病患者的身份，继而进行自我护理。数字干预可以被视为个体适应诊断的一种资源。然而，有迹象表明，弱势群体的人发现数字健康技术更难以获取和使用，这可能会加剧健康不平等。
目的
本研究旨在深入了解 T2D 患者如何以及为何使用数字自我护理技术，以及个体之间和社会群体之间的体验有何不同。
方法
研究招募了曾使用数字干预措施来帮助他们自我护理 T2D 的患者作为研究对象。采用半结构式访谈的方式进行，并进行主题分析。
结果
共采访了 21 名具有不同背景的参与者。参与者使用数字干预措施来帮助他们了解和更好地控制自己的身体。参与者通过数字干预措施向他人展示他们选择的身份。参与者选择的技术允许他们确认和表现出自己喜欢的积极身份，既可以避免污名化，也可以成为疾病或治疗方面的专家。参与者更喜欢使用可以帮助他们隐瞒糖尿病的数字干预措施，包括购买不显眼的血糖仪。一些参与者使用技术来增强他们与临床医生互动时的力量感，而另一些参与者则使用技术来表现自己的善良。
结论
T2D 患者能够获得的技术塑造了他们理解和控制身体以及支持偏好的社会身份的方式。
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