Factors Associated With Intention to Adopt mHealth Apps Among Dementia Caregivers With a Chronic Condition: Cross-sectional, Correlational Study.
Factors Associated With Intention to Adopt mHealth Apps Among Dementia Caregivers With a Chronic Condition: Cross-sectional, Correlational Study.
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DOI：
10.2196/27926
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发表时间：
2021-08-31
影响因子：
5
通讯作者：
Han HR
中科院分区：
文献类型：
--
作者：
Mendez KJW;Budhathoki C;Labrique AB;Sadak T;Tanner EK;Han HR
在美国，近80%的痴呆症患者的家庭照顾者至少有一种慢性病。痴呆症照顾者承受着巨大的压力和负担，这对他们的健康和自我管理产生了不利影响。MHealth应用程序可以改善患有慢性病的痴呆症照顾者的健康和自我管理。然而，痴呆症护理人员对mHealth应用程序的采用率很低，其原因尚不清楚。本研究的目的是探讨与痴呆症照顾者采用mHealth应用程序进行慢性病自我管理的意向相关的因素。我们进行了一项横断面的相关研究，并招募了一个方便的痴呆症照顾者样本。我们使用经过验证的工具创建了一项调查，并通过计算机辅助电话采访和基于网络的调查收集了数据。在新冠肺炎大流行之前，我们通过社区战略招募痴呆症照顾者，例如参加社区活动。在因疫情而在全国范围内关闭后，该团队专注于基于网络的招聘。用多元Logistic回归分析检验自变量和因变量之间的关系。我们的样本包括117名照顾者，他们的平均年龄为53岁(SD 17.4)，16年(SD 3.3)受教育，4年(SD 2.5)慢性疾病。照顾者以女性(92/117，78.6%)和少数民族(63/117，53.8%)为主，有过一定程度的经济困难(/117，54.7%)，是痴呆患者的子女或儿媳(53/117，45.3%)。在对控制变量进行调整的Logistic回归模型中，照顾者负担(优势比[OR]1.3，95%可信区间0.57-2.8；P=.57)、每周照顾时间(OR 1.7，95%可信区间0.77-3.9；P=.18)、慢性病和治疗负担(OR 2.3，95%可信区间0.91-5.7；P=0.08)与使用移动健康应用程序的意向没有显著关联。在最终的多元Logistic回归模型中，只有感知有用性(OR 23，95%CI 5.6-97；P<；.001)和护理者教育与慢性病和治疗负担的交互作用(OR 31，95%CI 2.2-430；P=.01)与他们使用移动健康应用程序的意愿显著相关。感知的易用性(OR 2.4，95%CI 0.67-8.7；P=.18)和社会影响力(OR 1.8，95%CI 0.58-5.7；P=.31)与采用mHealth应用的意愿没有显著关联。在为患有慢性病的痴呆症照顾者设计mHealth应用程序干预措施时，重要的是要考虑照顾者对mHealth应用程序帮助他们自我管理的程度的看法，以及哪些应用程序功能对自我管理最有用。照看因素可能与照顾者采用mHealth应用程序的意图无关。这是有希望的，因为移动健康战略可能会克服照顾者自我管理的障碍。未来的研究应该调查为什么教育水平低、慢性病和治疗负担低的照顾者采用mHealth应用程序进行自我管理的意愿显著降低的原因。
In the United States, nearly 80% of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. The purpose of this study is to explore factors associated with dementia caregivers’ intention to adopt mHealth apps for chronic disease self-management. We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community events. After nationwide closures due to the pandemic, the team focused on web-based recruitment. Multiple logistic regression analyses were used to test the relationships between the independent and dependent variables. Our sample of 117 caregivers had an average age of 53 (SD 17.4) years, 16 (SD 3.3) years of education, and 4 (SD 2.5) chronic conditions. The caregivers were predominantly women (92/117, 78.6%) and minorities (63/117, 53.8%), experienced some to extreme income difficulties (64/117, 54.7%), and were the child or child-in-law (53/117, 45.3%) of the person with dementia. In logistic regression models adjusting for the control variables, caregiver burden (odds ratio [OR] 1.3, 95% CI 0.57-2.8; P=.57), time spent caregiving per week (OR 1.7, 95% CI 0.77-3.9; P=.18), and burden of chronic disease and treatment (OR 2.3, 95% CI 0.91-5.7; P=.08) were not significantly associated with the intention to adopt mHealth apps. In the final multiple logistic regression model, only perceived usefulness (OR 23, 95% CI 5.6-97; P<.001) and the interaction term for caregivers’ education and burden of chronic disease and treatment (OR 31, 95% CI 2.2-430; P=.01) were significantly associated with their intention to adopt mHealth apps. Perceived ease of use (OR 2.4, 95% CI 0.67-8.7; P=.18) and social influence (OR 1.8, 95% CI 0.58-5.7; P=.31) were not significantly associated with the intention to adopt mHealth apps. When designing mHealth app interventions for dementia caregivers with a chronic condition, it is important to consider caregivers’ perceptions about how well mHealth apps can help their self-management and which app features would be most useful for self-management. Caregiving factors may not be relevant to caregivers’ intention to adopt mHealth apps. This is promising because mHealth strategies may overcome barriers to caregivers’ self-management. Future research should investigate reasons why caregivers with a low education level and low burden of chronic disease and treatment have significantly lower intention to adopt mHealth apps for self-management.
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