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采用数字健康干预措施管理 COPD 的障碍和促进因素:范围综述。

Barriers and facilitators to the adoption of digital health interventions for COPD management: A scoping review.

机构信息

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD 11, 10 Medical Drive 117597, Singapore.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD 11, 10 Medical Drive 117597, Singapore.

出版信息

Heart Lung. 2023 May-Jun;59:117-127. doi: 10.1016/j.hrtlng.2023.02.004. Epub 2023 Feb 15.

Abstract

BACKGROUND

Knowledge of the barriers and facilitators in the adoption of digital health interventions (DHI) is sparse yet crucial to facilitate chronic obstructive pulmonary disease (COPD) management.

OBJECTIVES

This scoping review aimed to summarize patient- and healthcare provider-level barriers and facilitators in the adoption of DHIs for COPD management.

METHODS

Nine electronic databases were searched from inception up till October 2022 for English language evidence. Inductive content analysis was used.

RESULTS

This review included 27 papers. Frequent patient-level barriers were poor digital literacy (n = 6), impersonal care delivery (n = 4), and fear of being controlled by telemonitoring data (n = 4). Frequent patient-level facilitators were improved disease understanding and management (n = 17), bi-directional communication and contact with healthcare providers (n = 15), and remote monitoring and feedback (n = 14). Frequent healthcare provider-level barriers were increased workload (n = 5), lack of technology interoperability with existing health systems (n = 4), lack of funding (n = 4), and lack of dedicated and trained manpower (n = 4). Frequent healthcare provider-level facilitators were improved efficiency of care delivery (n = 6) and DHI training programmes (n = 5).

CONCLUSION

DHIs have the potential to facilitate COPD self-management and improve efficiency of care delivery. However, several barriers challenge its successful adoption. Attaining organizational support in developing user centric DHIs that can be integrated and are interoperable with existing health systems is crucial if we are to witness tangible return on investments at the patient-, healthcare provider- and healthcare system-level.

摘要

背景

对数字健康干预措施(DHI)采用的障碍和促进因素的了解很少,但对于促进慢性阻塞性肺疾病(COPD)管理至关重要。

目的

本范围综述旨在总结患者和医疗保健提供者在采用 DHI 进行 COPD 管理方面的障碍和促进因素。

方法

从开始到 2022 年 10 月,我们在 9 个电子数据库中搜索了英文证据。采用归纳内容分析法。

结果

本综述包括 27 篇论文。患者层面常见的障碍包括数字素养差(n=6)、护理缺乏人情味(n=4)以及担心被远程监控数据控制(n=4)。患者层面常见的促进因素包括改善疾病认识和管理(n=17)、双向沟通和与医疗保健提供者联系(n=15)以及远程监测和反馈(n=14)。医疗保健提供者层面常见的障碍包括工作量增加(n=5)、与现有卫生系统的技术互操作性差(n=4)、缺乏资金(n=4)以及缺乏专门和训练有素的人力(n=4)。医疗保健提供者层面常见的促进因素包括提高护理效率(n=6)和 DHI 培训计划(n=5)。

结论

DHI 有可能促进 COPD 自我管理并提高护理效率。然而,一些障碍对其成功采用构成挑战。如果我们要在患者、医疗保健提供者和医疗保健系统层面看到投资的实际回报,那么获得开发以用户为中心的 DHI 的组织支持至关重要,这些 DHI 可以与现有卫生系统集成并且具有互操作性。

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