代表性不足患者的抑郁护理中对健康信息交换和患者门户使用的可接受性。
Acceptability of Health Information Exchange and Patient Portal Use in Depression Care Among Underrepresented Patients.
机构信息
Graduate School of Social Service, Fordham University, New York, NY, USA.
Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
出版信息
J Gen Intern Med. 2022 Nov;37(15):3947-3955. doi: 10.1007/s11606-022-07427-2. Epub 2022 Feb 7.
BACKGROUND
Depression is often untreated or undertreated, particularly among underrepresented groups, such as racial and ethnic minorities, and individuals of lower socioeconomic status. Electronic health information exchange (HIE) is a recommended practice to improve care coordination and encourage patient engagement in services, but it remains underutilized in depression care. Understanding factors affecting acceptance and adoption of this technology among underrepresented patient populations is needed to increase dissemination of HIE within mental health treatment.
OBJECTIVE
The present study aims to identify patient barriers and facilitators towards the acceptance of HIE within the context of depression treatment and to examine how HIE impacts depression-related care coordination and patient activation.
DESIGN
Semi-structured qualitative interviews were conducted with 27 patients.
PARTICIPANTS
Respondents were English-speaking adults (> 18) receiving depression treatment within a large, safety-net primary care clinic.
APPROACH
A grounded theory approach was used to code and analyze data for emergent themes. Thematic analysis was guided by the Unified Theory of Acceptance and Use of Technology, a leading informatics theory used to predict end-user adoption of technology.
KEY RESULTS
Respondents reported that HIE made depression care more convenient, transparent, and trustworthy. Though respondents desired greater access to their health records, stigma surrounding depression inhibited acceptance of electronic communication and information sharing. Confusing electronic interface also diminished perceived benefits of HIE.
CONCLUSION(S): Respondents desire greater transparency in their depression care. While HIE was perceived to improve the overall quality of depression care, stigma associated with mental illness undermined more robust adoption of this technology among underserved populations.
背景
抑郁症经常未得到治疗或治疗不足，尤其是在代表性不足的群体中，如少数族裔和少数民族，以及社会经济地位较低的个体。电子健康信息交换（HIE）是改善医疗服务协调和鼓励患者参与服务的推荐做法，但在抑郁症治疗中仍未得到充分利用。了解影响代表性不足的患者群体接受和采用这项技术的因素，对于增加心理健康治疗中 HIE 的传播至关重要。
目的
本研究旨在确定患者在抑郁症治疗背景下接受 HIE 的障碍和促进因素，并探讨 HIE 如何影响与抑郁症相关的医疗服务协调和患者激活。
设计
对 27 名患者进行了半结构化定性访谈。
参与者
受访者为在大型医疗保障初级保健诊所接受抑郁症治疗的英语使用者（>18 岁）。
方法
采用扎根理论方法对数据进行编码和分析，以发现新的主题。主题分析以接受和使用技术的统一理论（UTAUT）为指导，这是一种用于预测最终用户采用技术的领先信息学理论。
主要结果
受访者报告说，HIE 使抑郁症治疗更加便捷、透明和值得信赖。尽管受访者希望更方便地访问他们的健康记录，但抑郁症相关的耻辱感抑制了他们对电子通信和信息共享的接受程度。混乱的电子界面也降低了他们对 HIE 的感知收益。
结论
受访者希望在抑郁症治疗中获得更高的透明度。尽管 HIE 被认为可以提高抑郁症治疗的整体质量，但与精神疾病相关的耻辱感削弱了服务不足的人群对这项技术的更广泛采用。
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