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电子健康自我管理干预措施用于慢性肾脏病成人患者:My Kidneys My Health 混合方法研究

An eHealth self-management intervention for adults with chronic kidney disease, My Kidneys My Health: a mixed-methods study.

机构信息

Department of Medicine (Donald, Smekal, Gil, Elliott, James, Hemmelgarn), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Daphne Cockwell School of Nursing (Beanlands), Ryerson University; Department of Medicine (Straus), University of Toronto; Li Ka Shing Knowledge Institute (Straus), St. Michael's Hospital, Toronto, Ont.; London Health Sciences Centre (Harwood), London, Ont.; Can-SOLVE CKD Patient Partner (Waldvogel, Delgado, Sparkes), Vancouver, BC; Sydney School of Public Health (Tong), The University of Sydney, Sydney, New South Wales, Australia; Department of Family & Community Medicine (Grill, Tu) University of Toronto, Ont.; Centre for Mental Health (Novak), University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ont.; Department of Medicine (Brimble), McMaster University, Hamilton, Ont.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.

出版信息

CMAJ Open. 2022 Aug 16;10(3):E746-E754. doi: 10.9778/cmajo.20210332. Print 2022 Jul-Sep.

Abstract

BACKGROUND

There is limited research of electronic tools for self-management for patients with chronic kidney disease (CKD). We sought to evaluate participant engagement, perceived self-efficacy and website usage in a preliminary evaluation of My Kidneys My Health, a patient-facing eHealth tool in Canada.

METHODS

We conducted an explanatory sequential mixed-methods study of adults with CKD who were not on kidney replacement therapy and who had access to My Kidneys My Health for 8 weeks. Outcomes included acceptance (measured by the Technology Acceptance Model), self-efficacy (measured by the Chronic Disease Self-Efficacy Scale [CDSES]) and website usage patterns (captured using Google Analytics). We analyzed participant interviews using qualitative content analysis.

RESULTS

Twenty-nine participants with CKD completed baseline questionnaires, of whom 22 completed end-of-study questionnaires; data saturation was achieved with 15 telephone interviews. Acceptance was high, with more than 70% of participants agreeing or strongly agreeing that the website was easy to use and useful. Of the 22 who completed end-of-study questionnaires, 18 (82%) indicated they would recommend its use to others and 16 (73%) stated they would use the website in the future. Average scores for website satisfaction and look and feel were 7.7 (standard deviation [SD] 2.0) and 8.2 (SD 2.0) out of 10, respectively. The CDSES indicated that participants gained an increase in CKD information. Interviewed participants reported that the website offered valuable information and interactive tools for patients with early or newly diagnosed CKD, or for those experiencing changes in health status. Popular website pages and interactive features included Food and Diet, What is CKD, My Question List and the Depression Screener.

INTERPRETATION

Participants indicated that the My Kidneys My Health website provided accessible content and tools that may improve self-efficacy and support in CKD self-management. Further evaluation of the website's effectiveness in supporting self-management among a larger, more heterogenous population is warranted.

摘要

背景

针对慢性肾脏病(CKD)患者的自我管理电子工具研究有限。我们旨在评估 My Kidneys My Health 在加拿大面向患者的电子健康工具的初步评估中患者的参与度、感知自我效能和网站使用情况。

方法

我们对未接受肾脏替代治疗且可使用 My Kidneys My Health 的 CKD 成人进行了一项解释性序贯混合方法研究,为期 8 周。结果包括接受度(采用技术接受模型衡量)、自我效能(采用慢性病自我效能量表 [CDSES] 衡量)和网站使用模式(通过 Google Analytics 捕获)。我们使用定性内容分析方法对参与者访谈进行了分析。

结果

29 名 CKD 患者完成了基线问卷,其中 22 名完成了研究结束时的问卷;15 次电话访谈实现了数据饱和。接受度较高,超过 70%的参与者同意或强烈同意该网站易于使用且有用。在完成研究结束时问卷的 22 名参与者中,18 名(82%)表示会将其推荐给他人使用,16 名(73%)表示将来会使用该网站。网站满意度和外观满意度的平均得分为 7.7(标准差 [SD] 2.0)和 8.2(SD 2.0)。CDSES 表明参与者增加了 CKD 信息。接受访谈的参与者报告称,该网站为早期或新诊断的 CKD 患者或健康状况发生变化的患者提供了有价值的信息和互动工具。热门网站页面和互动功能包括“食物与饮食”、“什么是 CKD”、“我的问题列表”和“抑郁筛查器”。

结论

参与者表示,My Kidneys My Health 网站提供了可访问的内容和工具,可能会提高 CKD 自我管理中的自我效能感并提供支持。需要进一步评估该网站在支持更大、更异质人群的自我管理方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4ac/9388218/bd57909f9ba4/cmajo.20210332f1.jpg

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