The Relationship Between Insufficient Vision and Technology Access and Use Among Hospitalized Adults at an Urban Academic Hospital: Observational Study.
The Relationship Between Insufficient Vision and Technology Access and Use Among Hospitalized Adults at an Urban Academic Hospital: Observational Study.
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DOI：
10.2196/40103
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发表时间：
2023-05-24
影响因子：
2.2
通讯作者：
Press, Valerie G.
中科院分区：
文献类型：
--
作者：
Gupta, Juhi C.;Arora, Vineet M.;Vollbrecht, Hanna;Kappel, Nicole;Meltzer, David;Press, Valerie G.
关键词：
在基于电子健康的慢性病干预日益普及的情况下，足够的视力在自我管理中的作用是显著的。然而，视力不足与自我管理之间的关系研究不足。
我们旨在评估在一家城市学术医院中，视力不足和视力正常的成年人在获取和使用技术方面的差异。
这是一项对住院的成年普通内科患者进行的观察性研究，是一项名为“住院医师研究”的更大规模的质量改进研究的一部分。“住院医师研究”提供了人口统计学和健康素养数据（简易健康素养筛查）。我们的子研究包括多项测量。经过验证的调查评估了技术获取和使用情况，包括来自美国皮尤全国调查的基准问题，以确定在家中获取、使用意愿以及自述使用技术的能力，特别是用于自我管理的能力，以及评估出院后未来使用电子健康的意愿的电子健康特定问题。使用电子健康素养量表（eHEALS）来评估电子健康素养。使用斯内伦便携式视力表评估视力，将至少一只眼睛视力≤20/50定义为低视力。使用Stata进行描述性统计、双变量卡方分析和多变量逻辑回归（针对年龄、种族、性别、教育水平和电子健康素养进行调整）。
共有59名参与者完成了我们的子研究。平均年龄为54岁（标准差16.4岁）。有几名参与者缺失“住院医师研究”的人口统计学数据。在做出回应的参与者中，大多数为黑人（n = 34，79%）和女性（n = 26，57%），并且大多数报告至少接受过一些大学教育（n = 30，67%）。大多数参与者拥有技术设备（n = 57，97%）并且之前使用过互联网（n = 52，86%），视力不足和视力正常的参与者之间没有显著差异（n = 34对n = 25）。尽管笔记本电脑拥有率的效应量为2倍，视力正常的人更有可能拥有笔记本电脑，但视力不足的人与视力正常的人相比，更不可能报告有能力在无协助的情况下执行在线任务，包括使用搜索引擎（n = 22，65%对n = 23，92%；P = 0.02）、打开附件（n = 17，50%对n = 22，88%；P = 0.002）以及使用在线视频（n = 20，59%对n = 22，88%；P = 0.01）。在多变量分析中，独立打开在线附件的能力不再具有统计学意义（P = 0.01）。
在这一人群中，技术设备拥有率和互联网使用率较高，但视力不足的参与者（与视力正常的参与者相比）报告独立执行在线任务的能力降低。为确保高危人群有效使用电子健康技术，需要进一步研究视力与技术使用之间的关系。
The role of sufficient vision in self-management is salient with respect to the growing prevalence of eHealth-based interventions for chronic diseases. However, the relationship between insufficient vision and self-management has been understudied. We aimed to assess differences in access to and use of technology among adults with and without insufficient vision at an academic urban hospital. This is an observational study of hospitalized adult general medicine patients that is part of a larger quality improvement study called the hospitalist study. The hospitalist study provided demographic and health literacy data (Brief Health Literacy Screen). Our substudy included several measures. Validated surveys assessed technology access and use, and included benchmarked questions from the National Pew Survey to determine access to, willingness to use, and self-described ability to use technology at home, particularly for self-management, and eHealth-specific questions assessing future willingness to access eHealth post discharge. The eHealth Literacy Scale (eHEALS) was used to assess eHealth literacy. Visual acuity was assessed using the Snellen pocket eye chart with low vision defined as visual acuity ≤20/50 in at least one eye. Descriptive statistics, bivariate chi-square analyses, and multivariate logistic regressions (adjusted for age, race, gender, education level, and eHealth literacy) were performed using Stata. A total of 59 participants completed our substudy. The mean age was 54 (SD 16.4) years. Demographic data from the hospitalist study was missing for several participants. Among those who responded, most identified as Black (n=34, 79%) and female (n=26, 57%), and most reported at least some college education (n=30, 67%). Most participants owned technology devices (n=57, 97%) and had previously used the internet (n=52, 86%), with no significant differences between those with insufficient and sufficient vision (n=34 vs n=25). Though there was a 2x effect size for laptop ownership, with those with sufficient vision more likely to own a laptop, those with insufficient vision versus sufficient vision were less likely to report an ability to perform online tasks without assistance, including using a search engine (n=22, 65% vs n=23, 92%; P=.02), opening an attachment (n=17, 50% vs n=22, 88%; P=.002), and using an online video (n=20, 59% vs n=22, 88%; P=.01). In multivariate analysis, the ability to independently open an online attachment did not remain statistically significant (P=.01). Technology device ownership and internet use rates are high in this population, yet participants with insufficient vision (vs sufficient vision) reported a reduced ability to independently perform online tasks. To ensure the effective use of eHealth technologies by at-risk populations, the relationship between vision and technology use needs to be further studied.
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