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临床医生与老年人对患者生成的健康数据在老年人护理中效用的看法:探索性混合方法研究

Clinicians and Older Adults' Perceptions of the Utility of Patient-Generated Health Data in Caring for Older Adults: Exploratory Mixed Methods Study.

作者信息

Kim Ben, Ghasemi Peyman, Stolee Paul, Lee Joon

机构信息

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.

Data Intelligence for Health Lab, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

出版信息

JMIR Aging. 2021 Nov 5;4(4):e29788. doi: 10.2196/29788.

Abstract

BACKGROUND

Many people are motivated to self-track their health and optimize their well-being through mobile health apps and wearable devices. The diversity and complexity of these systems have evolved over time, resulting in a large amount of data referred to as patient-generated health data (PGHD), which has recently emerged as a useful set of data elements in health care systems around the world. Despite the increased interest in PGHD, clinicians and older adults' perceptions of PGHD are poorly understood. In particular, although some clinician barriers to using PGHD have been identified, such as concerns about data quality, ease of use, reliability, privacy, and regulatory issues, little is known from the perspectives of older adults.

OBJECTIVE

This study aims to explore the similarities and differences in the perceptions of older adults and clinicians with regard to how various types of PGHD can be used to care for older adults.

METHODS

A mixed methods study was conducted to explore clinicians and older adults' perceptions of PGHD. Focus groups were conducted with older adults and health care providers from the Greater Toronto area and the Kitchener-Waterloo region. The participants were asked to discuss their perceptions of PGHD, including facilitators and barriers. A questionnaire aimed at exploring the perceived usefulness of a range of different PGHD was also embedded in the study design. Focus group interviews were transcribed for thematic analysis, whereas the questionnaire results were analyzed using descriptive statistics.

RESULTS

Of the 9 participants, 4 (44%) were clinicians (average age 38.3 years, SD 7 years), and 5 (56%) were older adults (average age 81.0 years, SD 9.1 years). Four main themes were identified from the focus group interviews: influence of PGHD on patient-provider trust, reliability of PGHD, meaningful use of PGHD and PGHD-based decision support systems, and perceived clinical benefits and intrusiveness of PGHD. The questionnaire results were significantly correlated with the frequency of PGHD mentioned in the focus group interviews (r=0.42; P=.03) and demonstrated that older adults and clinicians perceived blood glucose, step count, physical activity, sleep, blood pressure, and stress level as the most useful data for managing health and delivering high-quality care.

CONCLUSIONS

This embedded mixed methods study generated several important findings about older adults and clinicians' perceptions and perceived usefulness of a range of PGHD. Owing to the exploratory nature of this study, further research is needed to understand the concerns about data privacy, potential negative impact on the trust between older adults and clinicians, data quality and quantity, and usability of PGHD-related technologies for older adults.

摘要

背景

许多人通过移动健康应用程序和可穿戴设备来自我追踪健康状况并优化自身福祉。随着时间的推移,这些系统的多样性和复杂性不断演变,产生了大量被称为患者生成的健康数据(PGHD)的数据,这些数据最近已成为全球医疗保健系统中一组有用的数据元素。尽管人们对PGHD的兴趣日益增加,但临床医生和老年人对PGHD的看法却知之甚少。特别是,虽然已经确定了一些临床医生在使用PGHD时面临的障碍,如对数据质量、易用性、可靠性、隐私和监管问题的担忧,但从老年人的角度却知之甚少。

目的

本研究旨在探讨老年人和临床医生在如何使用各类PGHD来照顾老年人方面的看法异同。

方法

开展了一项混合方法研究,以探究临床医生和老年人对PGHD的看法。对大多伦多地区和基奇纳 - 滑铁卢地区的老年人及医疗保健提供者进行了焦点小组访谈。参与者被要求讨论他们对PGHD的看法,包括促进因素和障碍。研究设计中还嵌入了一份旨在探究一系列不同PGHD的感知有用性的问卷。焦点小组访谈记录进行主题分析,问卷结果则使用描述性统计进行分析。

结果

9名参与者中,4名(44%)是临床医生(平均年龄38.3岁,标准差7岁),5名(56%)是老年人(平均年龄81.0岁,标准差9.1岁)。焦点小组访谈确定了四个主要主题:PGHD对医患信任的影响、PGHD的可靠性、PGHD及基于PGHD的决策支持系统的有意义使用,以及PGHD的感知临床益处和侵扰性。问卷结果与焦点小组访谈中提及PGHD的频率显著相关(r = 0.42;P = 0.03),并表明老年人和临床医生认为血糖、步数、身体活动、睡眠、血压和压力水平是管理健康和提供高质量护理最有用的数据。

结论

这项嵌入式混合方法研究得出了一些关于老年人和临床医生对一系列PGHD的看法及感知有用性的重要发现。由于本研究的探索性质,需要进一步研究以了解对数据隐私的担忧、对老年人与临床医生之间信任的潜在负面影响、数据质量和数量,以及PGHD相关技术对老年人的可用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ae/8663681/2467a49b0ba6/aging_v4i4e29788_fig1.jpg

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