Integrating mobile-phone based assessment for psychosis into people's everyday lives and clinical care: a qualitative study.
Integrating mobile-phone based assessment for psychosis into people's everyday lives and clinical care: a qualitative study.
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DOI：
10.1186/1471-244x-13-34
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发表时间：
2013-01-23
期刊：
影响因子：
4.4
通讯作者：
Lewis SW
中科院分区：
文献类型：
--
作者：
Palmier-Claus JE;Rogers A;Ainsworth J;Machin M;Barrowclough C;Laverty L;Barkus E;Kapur S;Wykes T;Lewis SW
在过去的十年里，政策制定者强调了医疗技术在长期疾病管理中的重要性。基于移动电话的评估可能是促进临床和成本效益干预的一种方法，并增加服务使用者的自主权和独立性。最近，人们开发了短信和智能手机界面，用于实时评估精神分裂症患者的症状。目前，对于患者对这些系统的看法，以及如何将它们应用到日常日常和临床护理中，人们知之甚少。24名来自社区的非情感性精神病患者完成了一项随机重复测量交叉设计研究，在这项研究中，他们通过自己手机上的短信或为Android智能手机设计的专用软件应用程序填写了关于他们症状的自我报告问题，为期六天。我们进行了定性访谈，以探讨参与者对设备的感知和体验，并使用主题分析来分析数据。从数据中出现了三个主题：i)可用性和熟悉性的吸引力，ii)可接受性，有效性和融入国内常规，以及iii)对临床护理的感知影响。虽然参与者普遍认为这项技术不会让人感到耻辱，而且很好地融入了他们的日常活动，但问题的重复被认为是长期采用的一个可能障碍。在辅助临床医生、更快、更有效的数据交换和辅助患者-临床医生沟通方面，可以看到对所接受的护理质量的潜在好处。然而，患者往往没有看到这些系统与他们个人情况的相关性，并强调对他们的护理中以人为本的要素的威胁。论文中提出的反馈表明，患者意识到基于手机的评估可以给临床护理带来的好处，而且这项技术可以成功地融入日常生活。然而，它也表明，向患者展示这项技术的个人和理论上的好处是很重要的。在未来，确定临床从业者是否能够将这项技术作为个性化心理健康制度的一部分将是很重要的。
Over the past decade policy makers have emphasised the importance of healthcare technology in the management of long-term conditions. Mobile-phone based assessment may be one method of facilitating clinically- and cost-effective intervention, and increasing the autonomy and independence of service users. Recently, text-message and smartphone interfaces have been developed for the real-time assessment of symptoms in individuals with schizophrenia. Little is currently understood about patients’ perceptions of these systems, and how they might be implemented into their everyday routine and clinical care. 24 community based individuals with non-affective psychosis completed a randomised repeated-measure cross-over design study, where they filled in self-report questions about their symptoms via text-messages on their own phone, or via a purpose designed software application for Android smartphones, for six days. Qualitative interviews were conducted in order to explore participants’ perceptions and experiences of the devices, and thematic analysis was used to analyse the data. Three themes emerged from the data: i) the appeal of usability and familiarity, ii) acceptability, validity and integration into domestic routines, and iii) perceived impact on clinical care. Although participants generally found the technology non-stigmatising and well integrated into their everyday activities, the repetitiveness of the questions was identified as a likely barrier to long-term adoption. Potential benefits to the quality of care received were seen in terms of assisting clinicians, faster and more efficient data exchange, and aiding patient-clinician communication. However, patients often failed to see the relevance of the systems to their personal situations, and emphasised the threat to the person centred element of their care. The feedback presented in this paper suggests that patients are conscious of the benefits that mobile-phone based assessment could bring to clinical care, and that the technology can be successfully integrated into everyday routine. However, it also suggests that it is important to demonstrate to patients the personal, as well as theoretical, benefits of the technology. In the future it will be important to establish whether clinical practitioners are able to use this technology as part of a personalised mental health regime.