Counson Isabelle, Bartholomew Alexandra, Crawford Joanna, Petrie Katherine, Basarkod Geetanjali, Moynihan Victoria, Pires Josie, Cohen Rachel, Glozier Nicholas, Harvey Samuel, Sanatkar Samineh
Black Dog Institute, Randwick, Australia.
School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia.
JMIR Form Res. 2021 Dec 2;5(12):e26370. doi: 10.2196/26370.
Junior physicians report higher levels of psychological distress than senior doctors and report several barriers to seeking professional mental health support, including concerns about confidentiality and career progression. Mobile health (mHealth) apps may be utilized to help overcome these barriers to assist the emotional well-being of this population and encourage help-seeking.
This study describes the development and pilot trial of the Shift mHealth app to provide an unobtrusive avenue for junior physicians to seek information about, and help for, well-being and mental health concerns, which is sensitive to workplace settings.
A 4-phase iterative development process was undertaken to create the content and features of Shift involving junior physicians using the principles of user-centered design. These 4 phases were-needs assessment, on the basis of interviews with 12 junior physicians; prototype development with user experience feedback from 2 junior physicians; evaluation, consisting of a pilot trial with 22 junior physicians to assess the usability and acceptability of the initial prototype; and redesign, including user experience workshops with 51 junior physicians.
Qualitative results informed the content and design of Shift to ensure that the app was tailored to junior physicians' needs. The Shift app prototype contained cognitive behavioral, mindfulness, value-based actions, and psychoeducational modules, as well as a tracking function that visualized patterns of daily variations in mood and health behaviors. Pilot-testing revealed possible issues with the organization of the app content, which were addressed through a thorough restructuring and redesign of Shift with the help of junior physicians across 3 user experience workshops.
This study demonstrates the importance of ongoing end user involvement in the creation of a specialized mHealth app for a unique working population experiencing profession-specific stressors and barriers to help-seeking. The development and pilot trial of this novel Shift mHealth app are the first steps in addressing the mental health and support-seeking needs of junior physicians, although further research is required to validate its effectiveness and appropriateness on a larger scale.
初级医生报告的心理困扰水平高于资深医生，并且报告了寻求专业心理健康支持的几个障碍，包括对保密性和职业发展的担忧。移动健康（mHealth）应用程序可用于帮助克服这些障碍，以促进这一人群的情绪健康并鼓励他们寻求帮助。
本研究描述了Shift移动健康应用程序的开发和试点试验，为初级医生提供一条不显眼的途径，以寻求有关幸福感和心理健康问题的信息及帮助，该应用程序对工作场所环境敏感。
采用四阶段迭代开发过程来创建Shift的内容和功能，该过程涉及使用以用户为中心的设计原则的初级医生。这四个阶段分别是：需求评估，基于对12名初级医生的访谈；原型开发，从2名初级医生那里获得用户体验反馈；评估，包括对22名初级医生进行试点试验，以评估初始原型的可用性和可接受性；重新设计，包括与51名初级医生举办用户体验研讨会。
定性结果为Shift的内容和设计提供了参考，以确保该应用程序是根据初级医生的需求量身定制的。Shift应用程序原型包含认知行为、正念、基于价值观的行动和心理教育模块，以及一个跟踪功能，可直观显示情绪和健康行为的每日变化模式。试点测试揭示了应用程序内容组织方面可能存在的问题，在3次用户体验研讨会的初级医生的帮助下，通过对Shift进行全面的重组和重新设计解决了这些问题。
本研究表明，终端用户持续参与为经历特定职业压力源和寻求帮助障碍的独特工作人群创建专门的移动健康应用程序非常重要。这款新颖的Shift移动健康应用程序的开发和试点试验是满足初级医生心理健康和寻求支持需求的第一步，不过还需要进一步研究以在更大规模上验证其有效性和适用性。
