Frost Alexandra C, Golijani-Moghaddam Nima, Burge Rupert, Dawson David L, Evangelou Nikos, Roche Bryan, Turton James, Hawton Annie, Law Graham, Rowan Elise, das Nair Roshan
Institute of Mental Health, Innovation Park, Triumph Rd, Nottingham, NG7 2TU, UK.
University of Lincoln, Sarah Swift Building, Brayford Pool, Lincoln, LN6 7TS, UK.
NIHR Open Res. 2022 May 23;2:39. doi: 10.3310/nihropenres.13274.1. eCollection 2022.
Multiple sclerosis (MS) is a chronic autoimmune, inflammatory neurological disease of the central nervous system (CNS), increasing in incidence and prevalence across both developed and developing countries. Cognitive difficulties are common in MS sufferers with 70% experiencing difficulties in higher-level brain functioning such as planning, attention, problem solving, and memory. Computerised cognitive training programmes may hold promise as a treatment option for improving cognitive function in people with MS, subject to exploring and addressing potential barriers to usability and acceptability.
This study aimed to test the usability and acceptability of a computerised cognitive training intervention-Strengthening Mental Abilities Through Relational Training (SMART) -for people with MS, through a mostly qualitative prefeasibility design ( = 12). There were two phases of testing: (1) initial usability testing via a think-aloud protocol ( = 6) and (2) alpha-testing to assess experienced acceptability over a four-week period of engagement ( = 6). Data from the two phases were subjected to Framework Analysis, wherein we deductively applied the Health IT Usability Evaluation Model and Theoretical Framework of Acceptability to assess usability and acceptability, respectively.
Results show SMART to have satisfactory usability with participants reacting positively to the formatting, visuality, and process of the interface. Minor suggestions were made on how best to adapt SMART for people with MS, but the programme and facilitative support were generally perceived to be acceptable, with participants expressing positive feelings about taking part in the intervention, despite associated burdens.
This prefeasibility study provides preliminary evidence of the usability and acceptability of SMART as a computerised cognitive training programme for people with MS. We conclude that we can now move forward with a feasibility trial of SMART, with the intention of proceeding to a definitive trial with cost-effectiveness analysis.
多发性硬化症(MS)是一种慢性自身免疫性炎症性中枢神经系统(CNS)疾病,在发达国家和发展中国家的发病率和患病率均呈上升趋势。认知困难在MS患者中很常见,70%的患者在高级脑功能方面存在困难,如计划、注意力、解决问题和记忆。计算机化认知训练计划有望成为改善MS患者认知功能的一种治疗选择,但前提是要探索并解决可用性和可接受性方面的潜在障碍。
本研究旨在通过一项主要为定性的预可行性设计(n = 12),测试一种计算机化认知训练干预措施——通过关系训练增强心理能力(SMART)——对MS患者的可用性和可接受性。测试分为两个阶段:(1)通过出声思考协议进行初始可用性测试(n = 6),以及(2)进行为期四周的参与式α测试以评估体验到的可接受性(n = 6)。对两个阶段的数据进行框架分析,其中我们分别演绎应用健康信息技术可用性评估模型和可接受性理论框架来评估可用性和可接受性。
结果显示SMART具有令人满意的可用性,参与者对界面的格式、可视性和流程反应积极。针对如何最好地使SMART适用于MS患者提出了一些小建议,但该计划和辅助支持总体上被认为是可接受的,尽管存在相关负担,参与者对参与干预仍表达了积极的感受。
这项预可行性研究提供了初步证据,证明SMART作为一种针对MS患者的计算机化认知训练计划具有可用性和可接受性。我们得出结论,现在可以推进SMART的可行性试验,并打算进行具有成本效益分析的确定性试验。