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高科技采纳的退伍军人的健康相关目标设定和实现。

Health-Related Goal Setting and Achievement Among Veterans with High Technology Adoption.

机构信息

eHealth Partnered Evaluation Initiative, VA Bedford Healthcare System, Bedford, MA, USA.

Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, Hines, IL, USA.

出版信息

J Gen Intern Med. 2021 Nov;36(11):3337-3345. doi: 10.1007/s11606-021-06779-5. Epub 2021 May 7.

Abstract

BACKGROUND

There is increasing recognition of the importance of supporting patients in their health-related goals. Patient-provider discussions and health-related mobile applications (apps) can support patients to pursue health goals; however, their impact on patient goal setting and achievement is not well understood.

OBJECTIVE

To examine the relationships between the following: (1) patient demographics, patient-provider discussions, and health-related goal setting and achievement, and (2) patient mobile health app use and goal achievement.

DESIGN

Cross-sectional survey.

PARTICIPANTS

Veterans who receive Veterans Health Administration (VA) healthcare and are users of VA patient-facing technology.

MAIN MEASURES

Veteran demographics, goal-related behaviors, and goal achievement.

METHODS

Veterans were invited to participate in a telephone survey. VA administrative data were linked to survey data for additional health and demographic information. Logistic regression models were run to identify factors that predict health-related goal setting and achievement.

KEY RESULTS

Among respondents (n=2552), 75% of patients indicated having set health goals in the preceding 6 months and approximately 42% reported achieving their goal. Men (vs. women) had lower odds of setting goals (OR: 0.71; CI95: 0.53-0.97), as did individuals with worse (vs. better) health (OR: 0.18; CI95: 0.04-0.88). Individuals with advanced education-some college/college degrees, and post-college degrees (vs. no college education)-demonstrated higher odds of setting goals (OR: 1.35; CI95: 1.01-1.79; OR: 1.71; CI95: 1.28-2.28, respectively). Those who reported having discussed their goals with their providers were more likely to set goals (OR: 3.60; CI95: 2.97-4.35). Patient mobile health app use was not statistically associated with goal achievement.

CONCLUSIONS

Efforts to further promote patient-led goal setting should leverage the influence of patient-provider conversations. Use of patient-facing technologies, specifically mobile health apps, may facilitate goal-oriented care, but further work is needed to examine the potential benefits of apps to support patient goals, particularly if providers discuss and endorse use of those apps with patients.

摘要

背景

越来越多的人认识到支持患者实现与健康相关目标的重要性。医患讨论和与健康相关的移动应用程序(apps)可以帮助患者追求健康目标;然而,它们对患者设定和实现目标的影响还不太清楚。

目的

探讨以下因素之间的关系:(1)患者人口统计学特征、医患讨论与健康相关目标设定和实现,以及(2)患者使用移动健康应用程序(apps)与目标实现之间的关系。

设计

横断面调查。

参与者

接受退伍军人事务部(VA)医疗保健服务且使用 VA 面向患者技术的退伍军人。

主要测量指标

退伍军人人口统计学特征、与目标相关的行为和目标实现情况。

方法

邀请退伍军人参加电话调查。退伍军人的 VA 管理数据与调查数据相关联,以获取额外的健康和人口统计学信息。使用逻辑回归模型确定预测与健康相关目标设定和实现的因素。

主要结果

在应答者(n=2552)中,75%的患者表示在过去 6 个月内设定了健康目标,约 42%的患者报告实现了目标。男性(与女性相比)设定目标的可能性较低(比值比:0.71;95%置信区间:0.53-0.97),健康状况较差(与较好相比)的可能性也较低(比值比:0.18;95%置信区间:0.04-0.88)。接受过高等教育(有一些大学/本科学位和研究生学位)的个体设定目标的可能性更高(比值比:1.35;95%置信区间:1.01-1.79;比值比:1.71;95%置信区间:1.28-2.28)。那些报告与医疗服务提供者讨论过目标的人更有可能设定目标(比值比:3.60;95%置信区间:2.97-4.35)。患者使用移动健康应用程序(apps)与目标实现之间没有统计学关联。

结论

为了进一步促进患者主导的目标设定,应利用医患对话的影响力。使用面向患者的技术,特别是移动健康应用程序(apps),可以促进以目标为导向的护理,但还需要进一步研究应用程序支持患者目标的潜在益处,如果医疗服务提供者与患者讨论并认可这些应用程序的使用。

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