Faber Jasper S, Kraal Jos J, Ter Hoeve Nienke, Al-Dhahir Isra, Breeman Linda D, Chavannes Niels H, Evers Andrea W M, Bussmann Hans B J, Visch Valentijn T, van den Berg-Emons Rita J G
Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, Delft 2628 CE, The Netherlands.
Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.
Eur Heart J Digit Health. 2024 Nov 14;6(1):115-125. doi: 10.1093/ehjdh/ztae084. eCollection 2025 Jan.
Cardiac rehabilitation (CR) shows lower effectiveness and higher dropouts among people with a low socioeconomic position (SEP) compared to those with a high SEP. This study evaluated an eHealth intervention aimed at supporting patients with a low SEP during their waiting period preceding CR.
Participants with a low SEP in their waiting period before CR were randomized into an intervention group, receiving guidance videos, patient narratives, and practical tips, or into a control group. We evaluated adherence (usage metrics), acceptance (modified Usefulness, Satisfaction, and Ease of use questionnaire), and changes in feelings of certainty and guidance between the waiting period's start and end. Semi-structured interviews provided complementary insights. The study involved 41 participants [median interquartile range (IQR) age 62 (14) years; 33 males], with 21 participants allocated to the intervention group, using the eHealth intervention for a median (IQR) duration of 16 (10) days, using it on a median (IQR) of 100% (25) of these days, and viewing 88% of the available messages. Key adherence themes were daily routine compatibility and curiosity. Acceptance rates were 86% for usability, 67% for satisfaction, and 43% for usefulness. No significant effects on certainty and guidance were observed, but qualitative data suggested that the intervention helped to inform and set expectations.
The study found the eHealth intervention feasible for cardiac patients with a low SEP, with good adherence, usability, and satisfaction. However, it showed no effect on feelings of certainty and guidance. Through further optimization of its content, the intervention holds promise to improve emotional resilience during the waiting period.
This trial is registered as follows: 'Evaluation of a Preparatory eHealth Intervention to Support Cardiac Patients During Their Waiting Period (PReCARE)' at ClinicalTrials.gov (NCT05698121, https://clinicaltrials.gov/study/NCT05698121).
与社会经济地位高的人群相比，社会经济地位低的人群接受心脏康复治疗（CR）的效果较差，且退出率较高。本研究评估了一种电子健康干预措施，旨在在CR之前的等待期为社会经济地位低的患者提供支持。
在CR之前等待期的社会经济地位低的参与者被随机分为干预组和对照组，干预组接受指导视频、患者叙述和实用技巧。我们评估了依从性（使用指标）、接受度（修改后的有用性、满意度和易用性问卷），以及等待期开始和结束之间确定感和指导感的变化。半结构化访谈提供了补充见解。该研究纳入了41名参与者[年龄中位数（四分位间距）为62（14）岁；男性33名]，其中21名参与者被分配到干预组，使用电子健康干预的中位（四分位间距）时长为16（10）天，在这些天数的中位（四分位间距）时间内使用了100%（25），并观看了88%的可用信息。关键的依从性主题是日常兼容性和好奇心。可用性的接受率为86%，满意度为67%，有用性为43%。未观察到对确定感和指导感有显著影响，但定性数据表明该干预有助于提供信息并设定期望。
该研究发现电子健康干预对社会经济地位低的心脏病患者可行，具有良好的依从性、可用性和满意度。然而，它对确定感和指导感没有影响。通过进一步优化其内容，该干预有望在等待期提高情绪恢复力。
本试验注册如下：“评估一种在等待期支持心脏病患者的电子健康预干预措施（PReCARE）”，ClinicalTrials.gov（NCT05698121，https://clinicaltrials.gov/study/NCT05698121）。
