Skeletal Biology and Engineering Research Centre, KU Leuven, Leuven, Belgium.
Rheumatology, University Hospitals Leuven, Leuven, Belgium.
BMC Musculoskelet Disord. 2021 Aug 30;22(1):746. doi: 10.1186/s12891-021-04624-8.
Shifts in treatment strategies for rheumatoid arthritis (RA) have made ambulatory care more labour-intensive. These developments have prompted innovative care models, including mobile health (mHealth) applications. This study aimed to explore the perceptions of mHealth-inexperienced stakeholders concerning these applications in RA care.
We performed a qualitative study by focus group interviews of stakeholders including RA patients, nurses specialised in RA care and rheumatologists. The qualitative analysis guide of Leuven (QUAGOL), which is based on grounded theory principles, was used to thematically analyse the data. In addition, the Persuasive Systems Design (PSD) model was used to structure recommended app-features.
In total, 2 focus groups with nurses (total n = 16), 2 with patients (n = 17) and 2 with rheumatologists (n = 25) took place. Six overarching themes emerged from the analysis. Efficiency of care and enabling patient empowerment were the two themes considered as expected benefits of mHealth-use in practice by the stakeholders. In contrast, 4 themes emerged as possible barriers of mHealth-use: the burden of chronic app-use, motivational aspects, target group aspects, and legal and organisational requirements. Additionally, recommendations for an ideal mHealth-app could be structured into 4 domains (Primary Task Support, Dialogue Support, Social Support and System Credibility) according to the PSD-framework. Most recommended features were related to improving ease of use (Task Support) and System Credibility.
Although mHealth-apps were expected to improve care efficiency and stimulate patient empowerment, stakeholders were concerned that mHealth-app use could reinforce negative illness behaviour. For mHealth-apps to be successful in practice, challenges according to stakeholders were avoiding long-term poor compliance, finding the target audience and tailoring a legal and organisational framework. Finally, the ideal mHealth-application should above all be trustworthy and easy to use.
类风湿关节炎 (RA) 治疗策略的转变使得门诊护理更加耗费人力。这些发展促使创新的护理模式，包括移动健康 (mHealth) 应用程序。本研究旨在探讨对 mHealth 应用程序在 RA 护理中的应用缺乏经验的利益相关者对这些应用程序的看法。
我们通过焦点小组访谈对利益相关者（包括 RA 患者、专门从事 RA 护理的护士和风湿病学家）进行了定性研究。使用基于扎根理论原则的鲁汶定性分析指南 (QUAGOL) 对数据进行主题分析。此外，还使用了有说服力的系统设计 (PSD) 模型来构建推荐的应用程序功能。
共进行了 2 次护士焦点小组（共 n=16）、2 次患者焦点小组（n=17）和 2 次风湿病学家焦点小组（n=25）。分析得出 6 个总体主题。利益相关者认为，mHealth 使用在实践中的预期效益是提高护理效率和增强患者能力。相比之下，mHealth 使用的 4 个主题被认为是可能的障碍：慢性应用使用负担、动机方面、目标群体方面和法律和组织要求。此外，根据 PSD 框架，可以将理想的 mHealth 应用程序的建议分为 4 个领域（主要任务支持、对话支持、社会支持和系统可信度）。最推荐的功能与提高易用性（任务支持）和系统可信度有关。
尽管 mHealth 应用程序有望提高护理效率并激发患者的能力，但利益相关者担心 mHealth 应用程序的使用可能会强化负面的疾病行为。为了使 mHealth 应用程序在实践中取得成功，利益相关者面临的挑战包括避免长期依从性差、找到目标受众和调整法律和组织框架。最后，理想的 mHealth 应用程序首先应该是值得信赖且易于使用的。
