A Qualitative Study of How Patients with Type 2 Diabetes Use an Electronic Stand-Alone Personal Health Record
A Qualitative Study of How Patients with Type 2 Diabetes Use an Electronic Stand-Alone Personal Health Record
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DOI：
10.1089/tmj.2014.0084
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发表时间：
2015-04-01
影响因子：
4.7
通讯作者：
Galt, Kimberly A.
中科院分区：
文献类型：
--
作者：
Fuji, Kevin T.;Abbott, Amy A.;Galt, Kimberly A.
背景资料：病人使用个人健康记录（PHR）来管理他们的健康信息，已经被提出来增强病人的知识，并使病人能够改变他们的自我护理行为。然而，对患者实际使用PHR行为的理解仍然存在差距。本质性研究的目的是探讨2型糖尿病患者如何使用PHR来管理他们的糖尿病相关的自我保健信息。材料与方法：59例2型糖尿病患者在接受免费的基于网络的PHR的初始培训后3-6个月接受了访谈。访谈进行了音频记录，转录，并使用体内编码，分类和主题开发的迭代过程进行分析。结果如下：出现了九个主题，其中三个表达了积极的经验：完整和可访问的记录;提高认识;和行为变化。其余六个主题表达了负面体验：眼不见心不烦;如果我病得更重，我会使用它;经济，基础设施和计算机素养障碍;缺乏患者-提供者参与;双重跟踪;以及隐私和安全问题。结论：尽管PHR的使用带来了一些潜在的积极效益，但随着时间的推移，一些障碍会抑制持续有效的使用。提供者和患者关于使用PHR的益处以及关于填补基于提供者的记录中的信息空白的潜力的教育是吸引患者并刺激PHR采用和使用的关键。
Background: Patient use of personal health records (PHRs) to manage their health information has been proposed to enhance patient knowledge and empower patients to make changes in their self-care behaviors. However, there remains a gap in understanding about patients' actual PHR use behaviors. The purpose of this qualitative study was to explore how patients with type 2 diabetes used a PHR to manage their diabetes-related health information for self-care. Materials and Methods: Fifty-nine patients with type 2 diabetes were interviewed 3-6 months after receiving initial training on a free-of-charge, Web-based PHR. Interviews were audio-recorded, transcribed, and analyzed using an iterative process of in vivo coding, categorization, and theme development. Results: Nine themes emerged, three of which expressed positive experiences: complete and accessible record; increased awareness; and behavioral changes. The remaining six themes expressed negative experiences: out of sight, out of mind; I would have used it if I were sicker; economic, infrastructure, and computer literacy barriers; lack of patient-provider engagement; double tracking; and privacy and security concerns. Conclusions: Despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. Provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.