Assessing Therapeutic Alliance in the Context of mHealth Interventions for Mental Health Problems: Development of the Mobile Agnew Relationship Measure (mARM) Questionnaire.
Assessing Therapeutic Alliance in the Context of mHealth Interventions for Mental Health Problems: Development of the Mobile Agnew Relationship Measure (mARM) Questionnaire.
复制标题
DOI：
10.2196/jmir.8252
复制
发表时间：
2018-04-19
影响因子：
7.4
通讯作者：
Bucci S
中科院分区：
文献类型：
--
作者：
Berry K;Salter A;Morris R;James S;Bucci S
智能手机应用程序形式的数字卫生干预措施旨在改善心理健康，使人们能够在需要时获得支持，而不必面对在获得服务时可能遇到的耻辱。如果我们要评估移动健康（mHealth）应用程序并推进科学理解，我们还需要工具来帮助我们了解移动健康干预措施在哪些方面是有效的或无效的。治疗联盟的概念是衡量保健提供者和服务使用者之间关系质量的一种标准，是解释精神卫生干预措施效果的一个关键因素。Agnew关系测量（ARM）是面对面治疗中治疗联盟的有效测量方法。本研究首次尝试(1)探索服务用户对移动健康心理健康干预中关系概念的看法，(2)采用一种经过验证的面对面治疗联盟测量方法，即Agnew关系测量（ARM），用于移动健康干预。在第一阶段，我们就数字健康干预背景下的治疗联盟概念采访了9名心理健康服务使用者，并使用主题分析从访谈记录中得出关键主题。在第二阶段，我们使用评分量表和开放式问题来征求14名服务用户和10名心理健康工作人员对量表内容和面部效度的看法，用“应用程序”一词取代“治疗师”一词。在第三阶段，我们使用第一阶段和第二阶段的发现，在决策算法的支持下，对哪些项目进行调整，保留或调整。研究结果表明，在考虑移动医疗干预措施时，服务用户确实确定了关系概念，包括与应用程序建立联系以及与应用程序开放的能力。然而，与卫生专业人员的关系与与应用程序的关系之间存在关键差异。例如，应用程序没有针对每个人的独特需求进行定制和响应。此外，应用程序无法描绘出独特的类似人类的品质，如友好、合作和一致。我们对ARM做了一些修改，包括修改16个项目；因缺乏合适的替代品而移除4项；并添加一个项目来捕捉来自研究阶段1的关键主题（“这个应用程序就像我口袋里有一个护理团队的成员”）。本研究介绍了ARM的移动健康版本，mARM，具有良好的表面效度和内容效度。我们鼓励研究人员将这一易于使用的工具纳入数字健康干预研究，以收集有关其心理测量特性的进一步数据，并促进我们对治疗联盟如何影响移动健康干预效果的理解。国际标准随机对照试验号（ISRCTN） 34966555；http://www.isrctn.com/ISRCTN34966555（由WebCite在http://www.webcitation.org/6ymBVwKif存档）
Digital health interventions in the form of smartphone apps aim to improve mental health and enable people access to support as and when needed without having to face the stigma they may experience in accessing services. If we are to evaluate mobile health (mHealth) apps and advance scientific understanding, we also need tools to help us understand in what ways mHealth interventions are effective or not. The concept of therapeutic alliance, a measure of the quality of the relationship between a health care provider and a service user, is a key factor in explaining the effects of mental health interventions. The Agnew Relationship Measure (ARM) is a well-validated measure of therapeutic alliance in face-to-face therapy. This study presented the first attempt to (1) explore service users’ views of the concept of relationship within mHealth mental health interventions and (2) adapt a well-validated face-to-face measure of therapeutic alliance, the Agnew Relationship Measure (ARM), for use with mHealth interventions. In stage 1, we interviewed 9 mental health service users about the concept of therapeutic alliance in the context of a digital health intervention and derived key themes from interview transcripts using thematic analysis. In stage 2, we used rating scales and open-ended questions to elicit views from 14 service users and 10 mental health staff about the content and face validity of the scale, which replaced the word “therapist” with the word “app.” In stage 3, we used the findings from stages 1 and 2 to adapt the measure with the support of a decision-making algorithm about which items to drop, retain, or adapt. Findings suggested that service users do identify relationship concepts when thinking about mHealth interventions, including forming a bond with an app and the ability to be open with an app. However, there were key differences between relationships with health professionals and relationships with apps. For example, apps were not as tailored and responsive to each person’s unique needs. Furthermore, apps were not capable of portraying uniquely human-like qualities such as friendliness, collaboration, and agreement. We made a number of changes to the ARM that included revising 16 items; removing 4 items due to lack of suitable alternatives; and adding 1 item to capture a key theme derived from stage 1 of the study (“The app is like having a member of my care team in my pocket”). This study introduces the mHealth version of the ARM, the mARM, that has good face and content validity. We encourage researchers to include this easy-to-use tool in digital health intervention studies to gather further data about its psychometric properties and advance our understanding of how therapeutic alliance influences the efficacy of mHealth interventions. International Standard Randomized Controlled Trial Number (ISRCTN) 34966555; http://www.isrctn.com/ISRCTN34966555 (Archived by WebCite at http://www.webcitation.org/6ymBVwKif)
登录
查看更多内容
影响因子：
2.5
作者：
Bucci S;Barrowclough C;Ainsworth J;Morris R;Berry K;Machin M;Emsley R;Lewis S;Edge D;Buchan I;Haddock G
通讯作者：
Haddock G
影响因子：
2
作者：
Cavanagh, Kate;Millings, Abigail
通讯作者：
Millings, Abigail
影响因子：
5
作者：
Stoyanov, Stoyan R.;Hides, Leanne;Wilson, Hollie
通讯作者：
Wilson, Hollie
影响因子：
7.4
作者：
Berry N;Lobban F;Emsley R;Bucci S
通讯作者：
Bucci S
影响因子：
7.4
作者：
Kay-Lambkin, Frances;Baker, Amanda;Carr, Vaughan
通讯作者：
Carr, Vaughan