对印度中央邦精神分裂症患者、照料者及临床医生在使用心理健康应用程序方面的感知需求和障碍的定性探索。
A qualitative exploration of perceived needs and barriers of individuals with schizophrenia, caregivers and clinicians in using mental health applications in Madhya Pradesh, India.
作者信息
Bondre Ameya P, Shrivastava Ritu, Raghuram Harikeerthan, Tugnawat Deepak, Khan Azaz, Gupta Snehil, Kumar Mohit, Mehta Urvakhsh Meherwan, Keshavan Matcheri, Lakhtakia Tanvi, Chand Prabhat Kumar, Thirthalli Jagadisha, Patel Vikram, Torous John, Rozatkar Abhijit R, Naslund John A, Bhan Anant
机构信息
Sangath, 120 Deepak Society, Chuna Bhatti, Bhopal, Madhya Pradesh, 462016, India.
All India Institute of Medical Sciences (AIIMS), Saket Nagar, Bagh Swaniya, Bhopal, Madhya Pradesh, 462020, India.
出版信息
SSM Ment Health. 2022 Dec;2:100063. doi: 10.1016/j.ssmmh.2022.100063.
INTRODUCTION
About 3.5 million people are living with schizophrenia in India, with most failing to receive minimally adequate care. Digital mental health applications could potentially decrease this treatment gap; however, these applications should be tailored to meet the needs and overcoming barriers of its end-users to ensure their adoption and sustained usage. Few studies in India have explored the perspectives of target stakeholders to understand how digital tools could be viable for supporting care. Therefore, this study explores the perceived needs and barriers of patients with schizophrenia, caregivers and clinicians in using digital mental health applications.
METHODS
Focus group discussions (FGDs) were conducted with patients having schizophrenia attending outpatient clinics at a government tertiary hospital, and their caregivers, and mental health clinicians in Bhopal, Madhya Pradesh, India. FGDs were audio-recorded and coded. Framework analysis was employed to guide the analysis, involving deductive and inductive generation of themes, data triangulation and comparison of perspectives between participant groups.
RESULTS
Six FGDs were conducted with individuals with schizophrenia (n = 11), their caregivers (n = 14), and mental health clinicians (n = 19). Four themes were established: a) Prior experiences with health applications; b) Content of a mental health application; c) Involvement of caregivers in mental health application usage and d) Supporting doctors' work through mental health applications. Additionally, two themes were generated inductively: a) Qualities of a mental health application and b) Data privacy and confidentiality.
CONCLUSION
Exploration of stakeholder perspectives on the content, features, and uses of mental health applications is crucial to yield initial insights about the use of these digital programs in India. This study generated a multitude of suggestions on app functionality and components, which can guide ongoing efforts to develop and deliver digital mental health applications for patients living with schizophrenia in low-resource settings, with limited access to mental health services.
引言
印度约有350万人患有精神分裂症，大多数人未能获得最基本的适当护理。数字心理健康应用程序有可能缩小这一治疗差距；然而，这些应用程序应进行定制，以满足最终用户的需求并克服其障碍，以确保他们采用并持续使用。印度很少有研究探讨目标利益相关者的观点，以了解数字工具如何能够切实支持护理。因此，本研究探讨了精神分裂症患者、护理人员和临床医生在使用数字心理健康应用程序方面的感知需求和障碍。
方法
在印度中央邦博帕尔的一家政府三级医院，对前来门诊就诊的精神分裂症患者及其护理人员以及心理健康临床医生进行了焦点小组讨论（FGD）。FGD进行了录音和编码。采用框架分析来指导分析，包括主题的演绎和归纳生成、数据三角测量以及参与者群体之间观点的比较。
结果
对11名精神分裂症患者、14名护理人员和19名心理健康临床医生进行了6次FGD。确定了四个主题：a）健康应用程序的既往经历；b）心理健康应用程序的内容；c）护理人员参与心理健康应用程序的使用；d）通过心理健康应用程序支持医生的工作。此外，还归纳生成了两个主题：a）心理健康应用程序的质量；b）数据隐私和保密性。
结论
探索利益相关者对心理健康应用程序的内容、功能和用途的观点，对于初步了解这些数字程序在印度的使用情况至关重要。本研究就应用程序的功能和组件提出了许多建议，可指导在资源匮乏、获得心理健康服务有限的环境中，为精神分裂症患者开发和提供数字心理健康应用程序的持续努力。
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