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开发和实施数字技术以早期发现医护人员中的痴呆症致病疾病时的关键考虑因素:定性研究。

Key Considerations When Developing and Implementing Digital Technology for Early Detection of Dementia-Causing Diseases Among Health Care Professionals: Qualitative Study.

机构信息

School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom.

Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.

出版信息

J Med Internet Res. 2023 Aug 22;25:e46711. doi: 10.2196/46711.

Abstract

BACKGROUND

The World Health Organization (WHO) promotes using digital technologies to accelerate global attainment of health and well-being. This has led to a growth in research exploring the use of digital technology to aid early detection and preventative interventions for dementia-causing diseases such as Alzheimer disease. The opinions and perspectives of health care professionals must be incorporated into the development and implementation of technology to promote its successful adoption in clinical practice.

OBJECTIVE

This study aimed to explore health care professionals' perspectives on the key considerations of developing and implementing digital technologies for the early detection of dementia-causing diseases in the National Health Service (NHS).

METHODS

Health care professionals with patient-facing roles in primary or secondary care settings in the NHS were recruited through various web-based NHS clinical networks. Participants were interviewed to explore their experiences of the current dementia diagnostic practices, views on early detection and use of digital technology to aid these practices, and the challenges of implementing such interventions in health care. An inductive thematic analysis approach was applied to identify central concepts and themes in the interviews, allowing the data to determine our themes. A list of central concepts and themes was applied systematically to the whole data set using NVivo (version 1.6.1; QSR International). Using the constant comparison technique, the researchers moved backward and forward between these data and evolving explanations until a fit was made.

RESULTS

Eighteen semistructured interviews were conducted, with 11 primary and 7 secondary care health care professionals. We identified 3 main categories of considerations relevant to health care service users, health care professionals, and the digital health technology itself. Health care professionals recognized the potential of using digital technology to collect real-time data and the possible benefits of detecting dementia-causing diseases earlier if an effective intervention were available. However, some were concerned about postdetection management, questioning the point of an early detection of dementia-causing diseases if an effective intervention cannot be provided and feared this would only lead to increased anxiety in patients. Health care professionals also expressed mixed opinions on who should be screened for early detection. Some suggested it should be available to everyone to mitigate the chance of excluding those who are not in touch with their health care or are digitally excluded. Others were concerned about the resources that would be required to make the technology available to everyone.

CONCLUSIONS

This study highlights the need to design digital health technology in a way that is accessible to all and does not add burden to health care professionals. Further work is needed to ensure inclusive strategies are used in digital research to promote health equity.

摘要

背景

世界卫生组织(WHO)提倡利用数字技术加速全球健康和福祉的实现。这导致了越来越多的研究探索利用数字技术来帮助早期发现和预防导致痴呆的疾病,如阿尔茨海默病。医疗保健专业人员的意见和观点必须纳入技术的开发和实施中,以促进其在临床实践中的成功采用。

目的

本研究旨在探讨医疗保健专业人员对为国民保健服务(NHS)中导致痴呆的疾病的早期检测而开发和实施数字技术的关键考虑因素的看法。

方法

通过各种基于网络的 NHS 临床网络,招募 NHS 中初级或二级保健环境中具有患者服务角色的医疗保健专业人员。通过访谈探讨他们对当前痴呆症诊断实践的经验、对早期检测和使用数字技术辅助这些实践的看法,以及在医疗保健中实施这些干预措施的挑战。采用归纳主题分析方法来确定访谈中的核心概念和主题,使数据确定我们的主题。使用 NVivo(版本 1.6.1;QSR 国际)系统地将一组核心概念和主题应用于整个数据集。研究人员使用恒比技术在这些数据和不断发展的解释之间来回移动,直到达到合适的结果。

结果

进行了 18 次半结构化访谈,其中包括 11 名初级保健和 7 名二级保健医疗保健专业人员。我们确定了与医疗保健服务使用者、医疗保健专业人员和数字健康技术本身相关的 3 个主要类别。医疗保健专业人员认识到使用数字技术实时收集数据的潜力,如果有有效的干预措施,早期发现导致痴呆的疾病可能会带来潜在的好处。然而,一些人对检测后的管理表示担忧,他们质疑如果无法提供有效的干预措施,早期发现导致痴呆的疾病是否有意义,并担心这只会导致患者的焦虑增加。医疗保健专业人员对谁应该进行早期检测也有不同的看法。一些人认为应该向所有人提供早期检测,以降低排除那些未与医疗保健联系或数字上被排除在外的人的机会。其他人则担心将技术提供给所有人所需的资源。

结论

本研究强调需要以一种对所有人都可访问且不会给医疗保健专业人员增加负担的方式设计数字健康技术。还需要进一步开展工作,以确保在数字研究中使用包容性策略来促进健康公平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdb8/10481214/de0ddb75ea27/jmir_v25i1e46711_fig1.jpg

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