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将移动医疗信息和通信技术融入撒哈拉以南非洲医院的临床环境中:定性研究。

Integration of mHealth Information and Communication Technologies Into the Clinical Settings of Hospitals in Sub-Saharan Africa: Qualitative Study.

机构信息

Department of Information Technology, Faculty of Informatics and Design, Cape Peninsula University of Technology, Cape Town, South Africa.

Graduate Centre for Management, Faculty of Business and Management Services, Cape Peninsula University of Technology, Cape Town, South Africa.

出版信息

JMIR Mhealth Uhealth. 2021 Oct 13;9(10):e26358. doi: 10.2196/26358.

Abstract

BACKGROUND

There is a rapid uptake of mobile-enabled technologies in lower- and upper-middle-income countries because of its portability, ability to reduce mobility, and facilitation of communication. However, there is limited empirical evidence on the usefulness of mobile health (mHealth) information and communication technologies (ICTs) to address constraints associated with the work activities of health care professionals at points of care in hospital settings.

OBJECTIVE

This study aims to explore opportunities for integrating mHealth ICTs into the work activities of health care professionals at points of care in clinical settings of hospitals in Sub-Saharan Africa. Thus, the research question is, "How can mHealth ICTs be integrated into the work activities of health care professionals at points of care in hospital settings?"

METHODS

A qualitative approach was adopted to understand the work activities and points at which mHealth ICTs could be integrated to support health care professionals. The techniques of inquiry were semistructured interviews and co-design activities. These techniques were used to ensure the participation of frontline end users and determine how mHealth ICTs could be integrated into the point of care in hospital settings. Purposive and snowball sampling techniques were used to select tertiary hospitals and participants for this study from South Africa and Nigeria. A total of 19 participants, including physicians, nurses, and hospital managers, were engaged in the study. Ethical clearance was granted by the University research committee and the respective hospitals. The data collected were sorted and interpreted using thematic analysis and Activity Analysis and Development model.

RESULTS

The findings show that mHealth ICTs are suitable at points where health care professionals consult with patients in the hospital clinics, remote communication is needed, and management of referrals and report writing are required. It was inferred that mHealth ICTs could be negatively disruptive, and some participants perceived the use of mobile devices while engaging with patients as unprofessional. These findings were informed by the outcomes of the interplay between human attributes and technology capabilities during the transformation of the motives of work activity into the intended goal, which is enhanced service delivery.

CONCLUSIONS

The opportunities to integrate mHealth ICTs into clinical settings depend on the inefficiencies of interaction moments experienced by health care professionals at points of care during patient consultation, remote communication, referrals, and report writing. Thus, the timeliness of mHealth ICTs to address constraints experienced by health care professionals during work activities should take into consideration the type of work activity and the contextual factors that may result in contradictions in relation to technology features. This study contributes toward the design of mHealth ICTs by industry vendors and its usability evaluation for the work activity outcomes of health care professionals.

摘要

背景

由于移动技术具有便携性、减少移动性和促进沟通的能力,在中低收入国家,移动技术得到了迅速普及。然而,关于移动医疗(mHealth)信息和通信技术(ICT)在解决医院环境中护理点医护人员工作活动相关限制方面的有用性,实证证据有限。

目的

本研究旨在探讨将 mHealth ICT 整合到撒哈拉以南非洲医院临床环境护理点医护人员工作活动中的机会。因此,研究问题是,“如何将 mHealth ICT 整合到医院环境中护理点医护人员的工作活动中?”

方法

采用定性方法来了解工作活动以及可以整合 mHealth ICT 的切入点,以支持医护人员。探究技术包括半结构化访谈和共同设计活动。这些技术用于确保一线最终用户的参与,并确定如何将 mHealth ICT 整合到医院环境中的护理点。采用目的性和滚雪球抽样技术从南非和尼日利亚选择了三级医院和参与者进行这项研究。共有 19 名参与者,包括医生、护士和医院管理人员,参与了这项研究。大学研究委员会和各医院均批准了伦理审查。使用主题分析和活动分析与开发模型对收集的数据进行分类和解释。

结果

研究结果表明,mHealth ICT 在以下情况下适用于医护人员在医院诊所为患者就诊、需要远程沟通以及需要管理转诊和报告书写的地方。有人推断,mHealth ICT 可能具有负面干扰性,一些参与者认为在与患者互动时使用移动设备不专业。这些发现是由人类属性和技术能力在将工作活动动机转化为预期目标(即增强服务提供)的过程中的相互作用结果得出的。

结论

将 mHealth ICT 整合到临床环境中的机会取决于医护人员在患者就诊、远程沟通、转诊和报告书写期间在护理点遇到的交互低效时刻。因此,为解决医护人员在工作活动中遇到的限制,mHealth ICT 的及时性应考虑工作活动的类型和可能导致技术特征产生矛盾的相关情境因素。本研究为行业供应商设计 mHealth ICT 并评估其对医护人员工作活动结果的可用性做出了贡献。

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