Veldman Manon Hj, van der Aa Hilde Pa, Knoop Hans, Bode Christina, van Rens Ger Hmb, van Nispen Ruth Ma
Amsterdam UMC, location Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam, The Netherlands.
Quality of Care, Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands.
JMIR Form Res. 2025 Aug 7;9:e53080. doi: 10.2196/53080.
BACKGROUND: Fatigue is a common symptom occurring in individuals with visual impairment (VI). Feeling fatigued has a strong impact on an individual's well-being, with profound consequences. Cognitive and emotional functioning, social roles, and participation are negatively affected in severely fatigued individuals with VI. Therefore, we developed E-nergEYEze, a blended vision-specific eHealth intervention based on cognitive behavioral therapy and self-management to reduce fatigue severity in adults with VI. OBJECTIVE: We aimed to report the experience of patients and professionals with E-nergEYEze. To complement cost-effectiveness outcomes, the user experiences from both perspectives were considered relevant for a better understanding of the intervention uptake. METHODS: E-nergEYEze was studied in a randomized controlled trial. User experiences of participants with VI and severe fatigue (51/98, 52%; median age 58.0, IQR 53.0-65.0 years; female participants: 32/51, 63%), who were randomized to the intervention group, and professionals (n=11), who provided blended support, were evaluated. The Dutch Mental Health Care Thermometer questionnaire and a therapist evaluation were used and analyzed using mixed methods. A focus group meeting with social workers (4/7, 57%), a computer trainer (1/7, 14%), and psychologists (2/7, 29%) was held for more in-depth information. The eHealth platform provided data on user engagement from both perspectives. RESULTS: E-nergEYEze was completed by 63% (32/51) of patients for more than 80% of the module steps. Overall, results on user engagement showed that a median 89% (IQR 45%-100%) of all assigned module steps were completed, with all modules being completed by at least 50% (37/51) of the patients. Completion of the intervention was related to the presence of digital proficiency; having the appropriate expectations; content that matches personal preferences and life context; and the absence of impeding personal circumstances, mental health issues, or other concurrent rehabilitation programs. The intervention was given a median grade of 7.0 out of 10.0 (IQR 6.0-8.0), and 87% (39/45) of the patients reported that they would recommend E-nergEYEze to others. However, improvements in the frequency and quality of guidance were considered highly relevant. Professionals reported that E-nergEYEze required patients' self-efficacy, motivation, and digital skills; therefore, preselection was seen as essential. Professionals' affinity with eHealth was considered important to provide appropriate remote support. CONCLUSIONS: eHealth provides treatment opportunities for individuals with VI for which guidance is considered highly relevant. During participation in E-nergEYEze, patients were engaged, internalized personally relevant topics, and made use of the benefits of eHealth. More attention to the suitability of patients and training of professionals for providing remote support is considered essential. These user experiences underlined the potential of E-nergEYEze to reduce fatigue severity in adults with VI and provided valuable insights to learn from and optimize E-nergEYEze. TRIAL REGISTRATION: International Clinical Trials Registry Platform (ICTRP) NL7764; https://tinyurl.com/32b3xt74.
背景:疲劳是视力障碍(VI)患者常见的症状。感到疲劳对个人幸福有很大影响,会产生深远后果。在患有视力障碍且严重疲劳的个体中,认知和情感功能、社会角色及参与度都会受到负面影响。因此,我们开发了E-nergEYEze,这是一种基于认知行为疗法和自我管理的针对视力障碍的混合式电子健康干预措施,旨在减轻成年视力障碍患者的疲劳严重程度。 目的:我们旨在报告患者和专业人员对E-nergEYEze的体验。为补充成本效益结果,从这两个角度的用户体验被认为对于更好地理解干预措施的采用情况具有相关性。 方法:在一项随机对照试验中对E-nergEYEze进行了研究。对随机分配到干预组的视力障碍且严重疲劳的参与者(51/98,52%;中位年龄58.0岁,四分位距53.0 - 65.0岁;女性参与者:32/51,63%)以及提供混合支持的专业人员(n = 11)的用户体验进行了评估。使用了荷兰心理健康护理温度计问卷和治疗师评估,并采用混合方法进行分析。与社会工作者(4/7,57%)、计算机培训师(1/7,14%)和心理学家(2/7,29%)举行了焦点小组会议以获取更深入的信息。电子健康平台从两个角度提供了用户参与度数据。 结果:63%(32/51)的患者完成了E-nergEYEze超过80%的模块步骤。总体而言,用户参与度结果显示,所有分配的模块步骤的完成率中位数为89%(四分位距45% - 100%),所有模块至少有50%(37/51)的患者完成。干预措施的完成与数字技能水平、有适当的期望、内容符合个人偏好和生活背景以及不存在阻碍个人情况、心理健康问题或其他并发康复计划有关。该干预措施的中位数评分为7.0(满分10.0,四分位距6.0 - 8.0),87%(39/45)的患者表示他们会向他人推荐E-nergEYEze。然而,指导的频率和质量的改进被认为非常重要。专业人员报告称,E-nergEYEze需要患者的自我效能感、动力和数字技能;因此,预先筛选被视为至关重要。专业人员对电子健康的亲和力被认为对于提供适当的远程支持很重要。 结论:电子健康为视力障碍个体提供了治疗机会,其中指导被认为非常重要。在参与E-nergEYEze期间,患者积极参与,将个人相关主题内化,并利用了电子健康的优势。更多关注患者的适用性以及对专业人员进行提供远程支持的培训被认为至关重要。这些用户体验强调了E-nergEYEze在减轻成年视力障碍患者疲劳严重程度方面的潜力,并为学习和优化E-nergEYEze提供了有价值的见解。 试验注册:国际临床试验注册平台(ICTRP)NL7764;https://tinyurl.com/32b3xt74 。
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