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一项关于利益相关者对使用数字应用程序进行支持性自我管理以改善精神病早期干预服务的看法的定性研究。

A qualitative study of stakeholder views on the use of a digital app for supported self-management in early intervention services for psychosis.

机构信息

Division of Psychiatry, University College London, Maple House, London, W1T 7NF, UK.

Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.

出版信息

BMC Psychiatry. 2021 Jun 19;21(1):311. doi: 10.1186/s12888-021-03317-9.

Abstract

BACKGROUND

Digital tools such as Smartphones have the potential to increase access to mental health support including self-management interventions for individuals with psychosis, and ultimately to improve outcomes. Self-management strategies, including relapse prevention and crisis planning and setting personal recovery goals, are intended to assist people with long-term conditions to take an active role in their recovery, with evidence for a range of benefits. However, their implementation is inconsistent, and access and uptake need to be improved. The current study explores the acceptability of a Smartphone app (My Journey 3) that has been developed to facilitate supported self-management in Early Intervention in Psychosis (EIP) services.

METHODS

Semi-structured one-to-one interviews were conducted with twenty-one EIP service users who had access to My Journey 3 as part of a feasibility trial, and with thirteen EIP service clinicians who were supporting service users with the app. Interviews focused on the acceptability and usability of My Journey 3. Data was coded to themes based on the Acceptability of Healthcare Interventions framework.

RESULTS

Many service user participants found My Journey 3 to be acceptable. The symptom and medication trackers in particular were described as helpful. A smaller number of service users disliked the intervention. Individual-level factors that appeared to influence acceptability and engagement included recovery stage and symptom severity. Clinicians tended to report that My Journey 3 was a potentially positive addition to service users' care, but they often felt unable to provide support due to competing demands in their work, which in turn may have impacted acceptability and usage of the app.

CONCLUSIONS

Our findings suggest that the app is perceived as having potential to improve users' capacity to self-manage and work towards recovery goals, but barriers prevented many clinicians providing consistent and effective support as intended. Further evaluation of supported self-management apps in psychosis is warranted but needs to address implementation challenges from the start.

摘要

背景

智能手机等数字工具有可能增加获得心理健康支持的机会,包括为精神病患者提供自我管理干预,最终改善治疗效果。自我管理策略,包括预防复发、危机规划和设定个人康复目标,旨在帮助长期患病者积极参与康复,有一系列的益处。然而,它们的实施并不一致,需要改善获取和参与度。目前的研究探讨了一款智能手机应用程序(My Journey 3)的可接受性,该应用程序旨在为早期精神病干预(EIP)服务中提供支持性的自我管理。

方法

对 21 名 EIP 服务用户进行了半结构化的一对一访谈,这些用户在可行性试验中可以使用 My Journey 3,对 13 名 EIP 服务临床医生进行了访谈,这些临床医生在支持使用该应用程序的服务用户。访谈重点关注 My Journey 3 的可接受性和可用性。根据医疗保健干预措施的可接受性框架对数据进行了主题编码。

结果

许多服务用户认为 My Journey 3 是可以接受的。症状和药物跟踪器尤其被认为是有帮助的。但也有少数服务用户不喜欢该干预措施。个人层面的因素似乎会影响可接受性和参与度,包括康复阶段和症状严重程度。临床医生往往报告称,My Journey 3 是服务用户护理的潜在积极补充,但由于工作中的竞争需求,他们常常无法提供支持,这反过来又可能影响应用程序的可接受性和使用。

结论

我们的研究结果表明,该应用程序被认为有潜力提高用户自我管理和实现康复目标的能力,但障碍使许多临床医生无法按预期提供一致和有效的支持。有必要进一步评估精神病中的支持性自我管理应用程序,但需要从一开始就解决实施挑战。

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