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肌肉骨骼物理治疗中使用移动健康运动应用程序的患者体验与障碍

Patient experience and barriers of using a mHealth exercise app in musculoskeletal (MSK) Physiotherapy.

作者信息

Grodon Jack, Tack Christopher, Eccott Laura, Cairns Mindy C

机构信息

School of Health and Social Work, University of Hertfordshire, Hatfield, United Kingdom.

Musculoskeletal Physiotherapy Outpatients, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

出版信息

PLOS Digit Health. 2024 Oct 7;3(10):e0000626. doi: 10.1371/journal.pdig.0000626. eCollection 2024 Oct.

Abstract

Digital transformation has led to an abundance of digital health technologies (DHTs) readily available for Physiotherapists. In July 2020, the Physiotherapy department at a London NHS Trust implemented a mobile health (mHealth) exercise application (app), Physitrack. This service evaluation aims to evaluate patient experience and identify any barriers to using Physitrack/PhysiApp in musculoskeletal (MSK) Physiotherapy. An online experience survey was sent to 10,287 MSK Physiotherapy patients who had appointments between January 17th and April 9th 2022.The survey received 1,447 responses (response rate: 14.07%), with 954 (65.93%) respondents previously provided PhysiApp as part of their Physiotherapy management. Most participants used PhysiApp (83.06%), found it easy to use (82.20%) and had positive perceptions on how it added value to their Physiotherapy treatment through its functionality. However, negative impacts on patient-centred care and practical exercise demonstration were apparent in the qualitative results. Key barriers to use included suboptimal explanation, digital exclusion, registration/ login issues and opinion that PhysiApp was superfluous to Physiotherapy treatment. These differed to the main barriers of why participants stopped using/ used PhysiApp less: if they were confident exercising without it, their condition improved/ resolved, loss of motivation, their exercise programme ended or if they found their exercise programme was unsuitable. Despite multiple interdependent factors influencing patient experience and barriers of using PhysiApp, the survey results revealed the significant influence that is exerted by MSK Physiotherapists. The patient-physiotherapist interaction can positively or negatively impact upon many barriers of use and the subsequent potential added value of PhysiApp to MSK Physiotherapy treatment. Future research should focus on those at most risk of digital exclusion and health inequalities, exploring their barriers to using mHealth apps and other DHTs.

摘要

数字转型使得大量数字健康技术(DHTs)可供物理治疗师使用。2020年7月,伦敦一家国民保健服务信托基金的物理治疗部门实施了一款移动健康(mHealth)运动应用程序(应用),即Physitrack。这项服务评估旨在评估患者体验,并确定在肌肉骨骼(MSK)物理治疗中使用Physitrack/PhysiApp的任何障碍。向2022年1月17日至4月9日期间预约的10287名MSK物理治疗患者发送了一份在线体验调查问卷。该调查收到了1447份回复(回复率:14.07%),其中954名(65.93%)受访者此前曾将PhysiApp作为其物理治疗管理的一部分。大多数参与者使用了PhysiApp(83.06%),认为它易于使用(82.20%),并对其功能如何为物理治疗增添价值持积极看法。然而,定性结果显示了对以患者为中心的护理和实际运动示范的负面影响。使用的主要障碍包括解释不充分、数字排斥、注册/登录问题以及认为PhysiApp对物理治疗多余的观点。这些与参与者停止使用/减少使用PhysiApp的主要原因不同:如果他们在没有它的情况下有信心锻炼、病情改善/解决、失去动力、锻炼计划结束或者发现锻炼计划不合适。尽管有多个相互依存的因素影响患者体验和使用PhysiApp的障碍,但调查结果显示了MSK物理治疗师所发挥的重大影响。患者与物理治疗师的互动可能对许多使用障碍以及PhysiApp对MSK物理治疗的后续潜在附加价值产生积极或消极影响。未来的研究应关注那些面临数字排斥和健康不平等风险最大的人群,探索他们使用移动健康应用程序和其他DHTs的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2caf/11458024/a070d0bf25f5/pdig.0000626.g001.jpg

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