van de Vijver Steven, Hummel Deirdre, van Dijk Annericht Hester, Cox Jan, van Dijk Oscar, Van den Broek Nicoline, Metting Esther
Amsterdam Health & Technology Institute, Amsterdam University Medical Center, Amsterdam, Netherlands.
Family Medicine Department, OLVG, Amsterdam, Netherlands.
JMIR Form Res. 2022 Aug 3;6(8):e38424. doi: 10.2196/38424.
Population aging and multimorbidity has led to increasing chronic care needs associated with new challenges in managing growing costs, rising health care professional workloads, and the adoption of rigorous guidelines. These issues could all benefit from greater digitalization and a more patient-centered approach to chronic care, a situation brought to the fore by the COVID-19 pandemic. Little is known about real-life use in primary care.
This study aimed to explore the views, thoughts, usability, and experiences concerning a recently introduced digital self-care platform for chronic conditions in 3 Dutch primary care practices.
We conducted an explorative study combining questionnaires and interviews among patients and general practitioners from 3 general practices that used the digital platform. Questionnaires were sent to patients in each practice to seek the views and experiences of both patient nonusers (n=20) and patient users (n=58) of the platform, together with standardized questionnaires about illness perception and quality of life. In addition, patients (n=15) and general practitioners (n=4) who used the platform took part in semistructured interviews. We transcribed interviews verbatim and performed qualitative content analysis using a deductive approach. The results of the questionnaires were analyzed with descriptive analysis.
Among patients who had not actively used the platform but had received an explanation, only 35% (7/20) would recommend its use due to concerns over communication and handling. However, this percentage increased to 76.3% (45/59) among the people who actively used the platform. Interviews with patients and general practitioners who used the platform uncovered several key benefits, including reduced time requirements, reduced workload, improved care quality, and improved accessibility due to the greater patient-centeredness and use of different communication tools. In addition, the self-management tool led to greater patient autonomy and empowerment. Although users considered the platform feasible, usable, and easy to use, some technical issues remained and some patients expressed concerns about the reduction in human contact and feedback.
The overall experience and usability of the platform was good. Support for the online self-management platform for chronic care increased when patients actively used the tool and could experience or identify important advantages. However, patients still noted several areas for improvement that need to be tackled in future iterations. To ensure benefit in the wider population, we must also evaluate this platform in cohorts with lower digital and health literacy.
人口老龄化和多种疾病并存导致慢性护理需求不断增加，这给管理不断增长的成本、医护人员工作量的上升以及严格指南的采用带来了新的挑战。这些问题都可以从更大程度的数字化和更以患者为中心的慢性护理方法中受益，新冠疫情凸显了这种情况。对于该平台在初级护理中的实际使用情况，我们知之甚少。
本研究旨在探讨荷兰3家初级护理机构中患者和全科医生对最近推出的慢性病数字自我护理平台的看法、想法、可用性和体验。
我们开展了一项探索性研究，对3家使用该数字平台的全科诊所的患者和全科医生进行问卷调查和访谈。向每家诊所的患者发放问卷，以了解未使用该平台的患者（n = 20）和使用该平台的患者（n = 58）的看法和体验，同时还发放了关于疾病认知和生活质量的标准化问卷。此外，使用该平台的患者（n = 15）和全科医生（n = 4）参与了半结构化访谈。我们逐字转录访谈内容，并采用演绎法进行定性内容分析。问卷结果采用描述性分析。
在未积极使用该平台但已收到相关解释的患者中，只有35%（7/20）的人会因对沟通和操作的担忧而推荐使用该平台。然而，在积极使用该平台的人群中，这一比例增至76.3%（45/59）。对使用该平台的患者和全科医生的访谈发现了几个关键益处，包括时间需求减少、工作量减轻、护理质量提高以及由于更以患者为中心和使用不同沟通工具而使可及性提高。此外，自我管理工具增强了患者的自主性和权能感。尽管用户认为该平台可行、可用且易于使用，但仍存在一些技术问题，一些患者对人际接触和反馈减少表示担忧。
该平台的总体体验和可用性良好。当患者积极使用该工具并能体验或认识到重要优势时，对慢性护理在线自我管理平台的支持度会增加。然而，患者仍指出了几个需要在未来迭代中解决的改进领域。为确保在更广泛人群中受益，我们还必须在数字素养和健康素养较低的人群中评估该平台。
