Kötting Lukas, Derksen Christina, Keller Franziska Maria, Lippke Sonia
Psychology & Methods, Constructor University, Bremen, Germany.
JMIR Pediatr Parent. 2023 Jul 24;6:e44701. doi: 10.2196/44701.
Medical internet interventions such as asynchronous apps and synchronous digital live seminars can be effective behavior change interventions. The research question of this study was whether digital interventions based on the Health Action Process Approach can improve pregnant women's safe communication and patient safety in obstetric care.
This study aims to compare a digital live seminar with a web-based application intervention and a passive control group and to identify which social cognitive variables determine safe communication behavior and patient safety.
In total, 657 pregnant women were recruited, and hereof, 367 expectant mothers from 2 German university hospitals participated in the pre-post study (live seminar: n=142; web-based app: n=81; passive control group: n=144). All interventions targeted intention, planning, self-efficacy, and communication of personal preferences. The 2.5-hour midwife-assisted live seminar included exercises on empathy and clear communication. The fully automated web-based application consisted of 9 consecutive training lessons with the same content as that of the live seminar.
Controlled for sociodemographic characteristics, repeated measures analyses of covariance revealed that pregnant women significantly improved their self-reported communication behavior in all groups. The improvement was more pronounced after the digital live seminar than after the web-based application (P<.001; η=0.043). Perceived patient safety improved more for pregnant women participating in the live seminar than for those participating in the web-based application group (P=.03 η=0.015). A regression analysis revealed that social cognitive variables predicted safe communication behavior.
Overall, the web-based application intervention appeared to be less effective than the digital live training in terms of communication behavior. Application interventions addressing communication behaviors might require more face-to-face elements. Improving intention, coping planning, and coping self-efficacy appeared to be key drivers in developing safe communication behavior in pregnant women. Future research should include social learning aspects and focus on the practical application of medical internet interventions when aiming to improve pregnant women's communication and patient safety in obstetrics.
ClinicalTrials.gov NCT03855735; https://clinicaltrials.gov/ct2/show/NCT03855735.
诸如异步应用程序和同步数字直播研讨会等医学互联网干预措施可以成为有效的行为改变干预手段。本研究的研究问题是，基于健康行动过程方法的数字干预措施能否改善孕妇在产科护理中的安全沟通及患者安全状况。
本研究旨在比较数字直播研讨会与基于网络的应用程序干预措施以及一个被动对照组，并确定哪些社会认知变量决定了安全沟通行为和患者安全状况。
总共招募了657名孕妇，其中来自德国两家大学医院的367名准妈妈参与了这项前后对照研究（直播研讨会组：n = 142；基于网络的应用程序组：n = 81；被动对照组：n = 144）。所有干预措施均针对意图、计划、自我效能以及个人偏好的沟通。这场时长2.5小时、由助产士协助的直播研讨会包括共情和清晰沟通方面的练习。这个全自动的基于网络的应用程序由9节连续的培训课程组成，内容与直播研讨会相同。
在控制了社会人口学特征后，重复测量协方差分析显示，所有组的孕妇自我报告的沟通行为均有显著改善。数字直播研讨会后的改善比基于网络的应用程序后的改善更为明显（P <.001；η = 0.043）。参与直播研讨会的孕妇对患者安全的感知改善程度高于参与基于网络的应用程序组的孕妇（P = 0.03；η = 0.015）。回归分析显示，社会认知变量可预测安全沟通行为。
总体而言，在沟通行为方面，基于网络的应用程序干预措施似乎不如数字直播培训有效。针对沟通行为的应用程序干预措施可能需要更多面对面的元素。改善意图、应对计划和应对自我效能似乎是培养孕妇安全沟通行为的关键驱动因素。未来的研究在旨在改善孕妇在产科护理中的沟通及患者安全状况时，应纳入社会学习方面的内容，并关注医学互联网干预措施的实际应用。
ClinicalTrials.gov NCT03855735；https://clinicaltrials.gov/ct2/show/NCT03855735 。
