Anttila Marjo-Riitta, Soderlund Anne, Paajanen Teemu, Kivistö Heikki, Kokko Katja, Sjögren Tuulikki
Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Department of Physiotherapy, University of Mälardalen, Västerås, Sweden.
JMIR Rehabil Assist Technol. 2021 Nov 3;8(4):e16864. doi: 10.2196/16864.
Digital development has caused rehabilitation services and rehabilitees to become increasingly interested in using technology as a part of rehabilitation. This study was based on a previously published study that categorized 4 groups of patients with cardiac disease based on different experiences and attitudes toward technology (e-usage groups): feeling outsider, being uninterested, reflecting benefit, and enthusiastic using.
This study identifies differences in the biopsychosocial profiles of patients with cardiac disease in e-usage groups and deepen the understanding of these profiles in cardiac rehabilitation.
Focus group interviews and measurements were conducted with 39 patients with coronary heart disease, and the mean age was 54.8 (SD 9.4, range 34-77) years. Quantitative data were gathered during a 12-month rehabilitation period. First, we used analysis of variance and Tukey honestly significant difference test, a t test, or nonparametric tests-Mann-Whitney and Kruskal-Wallis tests-to compare the 4 e-usage groups-feeling outsider, being uninterested, reflecting benefit, and enthusiastic using-in biopsychosocial variables. Second, we compared the results of the 4 e-groups in terms of recommended and reference values. This analysis contained 13 variables related to biomedical, psychological, and social functioning. Finally, we formed biopsychosocial profiles based on the integration of the findings by constant comparative analysis phases through classic grounded theory.
The biomedical variables were larger for waistline (mean difference [MD] 14.2; 95% CI 1.0-27.5; P=.03) and lower for physical fitness (MD -0.72; 95% CI -1.4 to -0.06; P=.03) in the being uninterested group than in the enthusiastic using group. The feeling outsider group had lower physical fitness (MD -55.8; 95% CI -110.7 to -0.92; P=.047) than the enthusiastic using group. For psychosocial variables, such as the degree of self-determination in exercise (MD -7.3; 95% CI -13.5 to -1.1; P=.02), the being uninterested group had lower values than the enthusiastic using group. Social variables such as performing guided tasks in the program (P=.03) and communicating via messages (P=.03) were lower in the feeling outsider group than in the enthusiastic using group. The feeling outsider and being uninterested groups had high-risk lifestyle behaviors, and adherence to the web-based program was low. In contrast, members of the being uninterested group were interested in tracking their physical activity. The reflecting benefit and enthusiastic using groups had low-risk lifestyle behavior and good adherence to web-based interventions; however, the enthusiastic using group had low self-efficacy in exercise. These profiles showed how individuals reflected their lifestyle risk factors differently. We renamed the 4 groups as building self-awareness, increasing engagement, maintaining a healthy lifestyle balance, and strengthening self-confidence.
The results facilitate more effective and meaningful personalization guidance and inform the remote rehabilitation. Professionals can tailor individual web-based lifestyle risk interventions using these biopsychosocial profiles.
数字技术的发展使康复服务和康复者越来越有兴趣将技术作为康复的一部分来使用。本研究基于之前发表的一项研究，该研究根据对技术的不同体验和态度将4组心脏病患者进行了分类（电子使用组）：感觉被排斥者、不感兴趣者、认识到益处者和热情使用者。
本研究旨在确定心脏病患者在电子使用组中的生物心理社会特征差异，并加深对心脏康复中这些特征的理解。
对39例冠心病患者进行了焦点小组访谈和测量，平均年龄为54.8（标准差9.4，范围34 - 77）岁。在12个月的康复期内收集定量数据。首先，我们使用方差分析、Tukey真实显著差异检验、t检验或非参数检验——Mann-Whitney检验和Kruskal-Wallis检验——来比较4个电子使用组（感觉被排斥者、不感兴趣者、认识到益处者和热情使用者）在生物心理社会变量方面的差异。其次，我们将4个电子组的结果与推荐值和参考值进行比较。该分析包含13个与生物医学、心理和社会功能相关的变量。最后，我们通过经典扎根理论的持续比较分析阶段，基于研究结果的整合形成生物心理社会特征。
与热情使用者组相比，不感兴趣组的腰围生物医学变量更大（平均差异[MD] 14.2；95%置信区间1.0 - 27.5；P = 0.03），而身体素质更低（MD -0.72；95%置信区间 -1.4至 -0.06；P = 0.03）。感觉被排斥者组的身体素质低于热情使用者组（MD -55.8；95%置信区间 -110.7至 -0.92；P = 0.047）。对于心理社会变量，如运动中的自我决定程度（MD -7.3；95%置信区间 -13.5至 -1.1；P = 0.02），不感兴趣组的值低于热情使用者组。感觉被排斥者组在项目中执行指导任务（P = 0.03）和通过消息交流（P = 0.03）等社会变量低于热情使用者组。感觉被排斥者组和不感兴趣组有高风险的生活方式行为，对基于网络的项目的依从性较低。相比之下，不感兴趣组的成员对跟踪自己的身体活动感兴趣。认识到益处者组和热情使用者组有低风险的生活方式行为，对基于网络的干预措施依从性良好；然而，热情使用者组在运动方面的自我效能较低。这些特征表明了个体对生活方式风险因素的不同反映方式。我们将这4组重新命名为建立自我意识、增加参与度、保持健康生活方式平衡和增强自信心。
这些结果有助于提供更有效和有意义的个性化指导，并为远程康复提供信息。专业人员可以利用这些生物心理社会特征来定制基于网络的个体生活方式风险干预措施。
