Toben Daan, de Wind Astrid, van der Meij Eva, Huirne Judith A F, Anema Johannes R
Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Societal Participation & Health , Amsterdam Public Health research institute, Amsterdam, The Netherlands.
JMIR Perioper Med. 2025 Jan 14;8:e58878. doi: 10.2196/58878.
Day surgery is being increasingly implemented across Europe, driven in part by capacity problems. Patients recovering at home could benefit from tools tailored to their new care setting to effectively manage their convalescence. The mHealth application ikHerstel is one such tool, but although it administers its functions in the home, its implementation hinges on health care professionals within the hospital.
We conducted a feasibility study of an additional patient-oriented implementation strategy for ikHerstel. This strategy aimed to empower patients to access and use ikHerstel independently, in contrast to implementation as usual, which hinges on the health care professional acting as gatekeeper. Our research question was "How well are patients able to use ikHerstel independently of their health care professional?"
We investigated the implementation strategy in terms of its recruitment, reach, dose delivered, dose received, and fidelity. Patients with a recent or prospective elective surgery were recruited using a wide array of materials to simulate patient-oriented dissemination of ikHerstel. Data were collected through web-based surveys. Descriptive analysis and open coding were used to analyze the data.
Recruitment yielded 213 registrations, with 55 patients ultimately included in the study. The sample was characterized by patients undergoing abdominal surgery, with high literacy and above average digital health literacy, and included an overrepresentation of women (48/55, 87%). The implementation strategy had a reach of 81% (63/78), with 87% (55/67) of patients creating a recovery plan. Patients were satisfied with their independent use of ikHerstel, rating it an average 7.0 (SD 1.9) of 10, and 54% (29/54) of patients explicitly reported no difficulties in using it. A major concern of the implementation strategy was conflicts in recommendations between ikHerstel and the health care professionals, as well as the resulting feelings of insecurity experienced by patients.
In this small feasibility study, most patients were satisfied with the patient-oriented implementation strategy. However, the lack of involvement of health care professionals due to the strategy contributed to patient concerns regarding conflicting recommendations between ikHerstel and health care professionals.
在容量问题的部分推动下，日间手术在欧洲越来越多地得到实施。在家康复的患者可以从为其新护理环境量身定制的工具中受益，以有效管理他们的康复过程。移动健康应用程序ikHerstel就是这样一种工具，但尽管它在家庭中执行其功能，但其实施取决于医院内的医护人员。
我们对ikHerstel的另一种以患者为导向的实施策略进行了可行性研究。与通常依赖医护人员作为把关人的实施方式不同，该策略旨在使患者能够独立访问和使用ikHerstel。我们的研究问题是“患者在不依赖医护人员的情况下使用ikHerstel的效果如何？”
我们从招募、覆盖范围、提供的剂量、接受的剂量和保真度方面对实施策略进行了调查。使用各种材料招募近期或即将进行择期手术的患者，以模拟ikHerstel以患者为导向的传播。通过基于网络的调查收集数据。使用描述性分析和开放编码来分析数据。
招募产生了213个注册，最终有55名患者纳入研究。样本的特点是接受腹部手术的患者，识字率高且数字健康素养高于平均水平，女性比例过高（48/55，87%）。实施策略的覆盖范围为81%（63/78），87%（55/67）的患者制定了康复计划。患者对独立使用ikHerstel感到满意，在10分制中平均评分为7.0（标准差1.9），54%（29/54）的患者明确表示使用时没有困难。实施策略的一个主要问题是ikHerstel与医护人员之间的建议冲突，以及患者由此产生的不安全感。
在这项小型可行性研究中，大多数患者对以患者为导向的实施策略感到满意。然而，由于该策略导致医护人员未参与，引发了患者对ikHerstel与医护人员之间建议冲突的担忧。
