Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming City, China.
Coronary Heart Disease Center, Fuwai Yunnan Cardiovascular Hospital, Kunming City, China.
J Med Internet Res. 2024 Oct 31;26:e57115. doi: 10.2196/57115.
Chronic heart failure has become a serious threat to the health of the global population, and self-management is key to treating chronic heart failure. The emergence of mobile health (mHealth) provides new ideas for the self-management of chronic heart failure in which the informal caregiver plays an important role. Current research has mainly studied the experiences with using mHealth among patients with chronic heart failure from the perspective of individual patients, and there is a lack of research from the dichotomous perspective.
The aim of this study was to explore the experiences with mHealth use among patients with chronic heart failure and their informal caregivers from a dichotomous perspective.
This descriptive phenomenological study from a post-positivist perspective used a dyadic interview method, and face-to-face semistructured interviews were conducted with patients with chronic heart failure and their informal caregivers. Data were collected and managed using NVivo 12 software, and data analysis used thematic analysis to identify and interpret participants' experiences and perspectives. The thematic analysis included familiarizing ourselves with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report.
A total of 14 dyads of patients with chronic heart failure and their informal caregivers (13 men and 15 women) participated in this study, including 3 couples and 11 parent-child pairs. We constructed 4 key themes and their subthemes related to the experiences with mHealth use: (1) opposing experiences with mHealth as human interaction or trauma (great experience with mHealth use; trauma), (2) supplement instead of replacement (it is useful but better as a reference; offline is unavoidable sometimes), (3) both agreement and disagreement over who should be the adopter of mHealth (achieving consensus regarding who should adopt mHealth; conflict occurs when considering patients as the adopter of mHealth), (4) for better mHealth (applying mHealth with caution; suggestions for improved mHealth).
This study reported that the experiences with mHealth use among patients with chronic heart failure and their informal caregivers were mixed, and it highlighted the human touch of mHealth and the importance of network security. These results featured mHealth as a complement to offline hospitals rather than a replacement. In the context of modern or changing Chinese culture, we encourage patients to use mHealth by themselves and their informal caregivers to provide help when necessary. In addition, we need to use mHealth carefully, and future mHealth designs should focus more on ease of use and be oriented more toward older adults.
慢性心力衰竭已成为全球人口健康的严重威胁，而自我管理是治疗慢性心力衰竭的关键。移动医疗（mHealth）的出现为慢性心力衰竭的自我管理提供了新的思路，其中非正式照护者起着重要作用。目前的研究主要从个体患者的角度研究了慢性心力衰竭患者使用 mHealth 的体验，而缺乏从二元视角的研究。
本研究旨在从二元视角探讨慢性心力衰竭患者及其非正式照护者使用 mHealth 的体验。
本研究采用描述性现象学研究方法，从后实证主义视角出发，采用对偶访谈方法，对慢性心力衰竭患者及其非正式照护者进行面对面半结构化访谈。使用 NVivo 12 软件进行数据的收集和管理，采用主题分析方法对数据进行分析，以识别和解释参与者的体验和观点。主题分析包括熟悉数据、生成初始代码、寻找主题、审查主题、定义和命名主题以及生成报告。
共有 14 对慢性心力衰竭患者及其非正式照护者（男 13 名，女 15 名）参与了本研究，包括 3 对夫妻和 11 对亲子。我们构建了与 mHealth 使用体验相关的 4 个关键主题及其子主题：（1）作为人际互动或创伤的 mHealth 使用体验的两面性（mHealth 使用体验很好；mHealth 使用带来创伤），（2）补充而非替代（有用但更好作为参考；离线有时是不可避免的），（3）关于谁应该成为 mHealth 使用者的认同和分歧（达成关于谁应该采用 mHealth 的共识；当考虑将患者作为 mHealth 使用者时会产生冲突），（4）更好的 mHealth（谨慎应用 mHealth；对改进 mHealth 的建议）。
本研究报告称，慢性心力衰竭患者及其非正式照护者对 mHealth 使用的体验是混合的，这突显了 mHealth 的人性化以及网络安全的重要性。这些结果表明，mHealth 是线下医院的补充，而非替代。在现代或变化中的中国文化背景下，我们鼓励患者自己使用 mHealth，并在需要时由其非正式照护者提供帮助。此外，我们需要谨慎使用 mHealth，未来的 mHealth 设计应更加注重易用性，并更多地面向老年人。
