Acceptability, Use, and Safety of a Mobile Phone App (BlueIce) for Young People Who Self-Harm: Qualitative Study of Service Users' Experience.
Acceptability, Use, and Safety of a Mobile Phone App (BlueIce) for Young People Who Self-Harm: Qualitative Study of Service Users' Experience.
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DOI：
10.2196/mental.8779
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发表时间：
2018-02-23
影响因子：
5.2
通讯作者：
Stallard, Paul
中科院分区：
文献类型：
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作者：
Grist, Rebecca;Porter, Joanna;Stallard, Paul
背景：自我伤害在青少年中很常见，并与许多负面的心理社会后果有关，包括更高的自杀风险。最近的审查突出表明，缺乏针对自残儿童和年轻人的具体干预措施的研究。与有生活经验的人共同开发创新的干预措施，减少自我伤害是自我伤害预防的关键挑战。目的：本研究的目的是探索BlueIce的可接受性、使用和安全性。BlueIce是一款手机应用程序，面向正在接受儿童和青少年心理健康服务(CAMHS)的自残青少年。方法：这项研究是BlueIce第一阶段混合方法试验的一部分。招募了12-17岁参加CAMHS专科课程的年轻人。临床医生被邀请推荐有自我伤害或有自我伤害史的年轻人。在获得同意并采取基线措施后，参与者使用BlueIce作为常规护理的辅助工具，最初的熟悉期为2周。如果在这段时间之后，他们想继续使用BlueIce，他们会再使用10周。半结构访谈在熟悉后(使用BlueIce后2周)和使用后(使用BlueIce后12周)进行，以评估BlueIce的可接受性、使用和安全性。我们先用演绎的方法进行定性分析，然后再用归纳的方法来研究共同的主题。结果：对40名被试进行了熟悉后访谈。其中，37名参与者选择使用BlueIce，并对33名参与者进行了使用后访谈。这些数据产生了以下6个关键主题：(1)对BlueIce的评估，(2)BlueIce的可用性，(3)安全性，(4)BlueIce的好处，(5)机构和控制，以及(6)BlueIce的帮助较小。与会者报告说，BlueIce是可访问的、易于使用和方便的。许多人强调，情绪日记和情绪提升器部分尤其有助于提供一种跟踪他们情绪的方法，并提供新的策略来管理他们的想法，从而达到自我伤害的目的。没有不良反应的报道。对于那些认为BlueIce没有帮助的人来说，围绕阻止自我伤害的动机的问题阻碍了他们使用这款应用的能力。结论：BlueIce被认为是一种帮助青少年管理自我伤害想法的安全有效的方式。青少年报告说，使用BlueIce有很多好处，所有人都会向其他正在与自我伤害作斗争的年轻人推荐这款应用。这些初步发现令人鼓舞，并初步支持了BlueIce作为一种与传统面对面治疗结合使用的自助干预措施的可接受性。
BACKGROUND: Self-harm is common among adolescents and is associated with a number of negative psychosocial outcomes including a higher risk of suicide. Recent reviews highlight the lack of research into specific interventions for children and young people who self-harm. Developing innovative interventions that are coproduced with individuals with lived experience and that reduce self-harm are key challenges for self-harm prevention.OBJECTIVE: The aim of this study was to explore the acceptability, use, and safety of BlueIce, a mobile phone app for young people who self-harm and who are attending child and adolescent mental health services (CAMHS).METHODS: This study is part of a mixed methods phase 1 trial of BlueIce. Young people aged 12-17 years attending specialist CAMHS were recruited. Clinicians were invited to refer young people who were self-harming or who had a history of self-harm. On consent being obtained and baseline measures taken, participants used BlueIce as an adjunct to usual care for an initial familiarization period of 2 weeks. If after this time they wanted to continue, they used BlueIce for a further 10 weeks. Semistructured interviews were conducted at postfamiliarization (2 weeks after using BlueIce) and postuse (12 weeks after using BlueIce) to assess the acceptability, use, and safety of BlueIce. We undertook a qualitative analysis using a deductive approach, and then an inductive approach, to investigate common themes.RESULTS: Postfamiliarization interviews were conducted with 40 participants. Of these, 37 participants elected to use BlueIce, with postuse interviews being conducted with 33 participants. Following 6 key themes emerged from the data: (1) appraisal of BlueIce, (2) usability of BlueIce, (3) safety, (4) benefits of BlueIce, (5) agency and control, and (6) BlueIce less helpful. The participants reported that BlueIce was accessible, easy to use, and convenient. Many highlighted the mood diary and mood lifter sections as particularly helpful in offering a way to track their moods and offering new strategies to manage their thoughts to self-harm. No adverse effects were reported. For those who did not find BlueIce helpful, issues around motivation to stop self-harming impeded their ability to use the app.CONCLUSIONS: BlueIce was judged to be a helpful and safe way of supporting adolescents to manage thoughts of self-harming. Adolescents reported numerous benefits of using BlueIce, and all would recommend the app to other young people who were struggling with self-harm. These preliminary findings are encouraging and provide initial support for the acceptability of BlueIce as a self-help intervention used in conjunction with the traditional face-to-face therapy.