Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study
Drivers for successful long-term lifestyle change, the role of e-health: a qualitative interview study
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DOI：
10.1136/bmjopen-2017-017466
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发表时间：
2018-03-01
期刊：
影响因子：
2.9
通讯作者：
Sondergaard, Jens
中科院分区：
文献类型：
--
作者：
Brandt, Carl Joakim;Clemensen, Jane;Sondergaard, Jens
目的使用协作式电子健康工具帮助患者改变生活方式，可以有效地治疗糖尿病、心血管疾病和慢性阻塞性肺病等非传染性疾病，这些疾病是由不健康的生活方式引起或加重的，形式包括不健康的饮食、缺乏运动或吸烟。在一项前瞻性的试点研究中，我们在全科医学中测试了一个在线协作电子健康工具。本研究的目的是从患者的角度找出长期改变个人生活方式的重要驱动因素，包括同行和医疗保健专业人员的支持。在南丹麦地区设立全科诊所。参与者10名超重患者，他们之前成功地使用了面对面和在线咨询相结合的混合在线协作电子健康工具来减肥。结果确定的主要主题是促进者、障碍和来自家庭和同龄人的支持。与医疗保健专业人员建立可信赖的关系是至关重要的。对于患者来说，用现实的目标和信任的人的反馈来监测可测量的结果是很重要的。通常，重大的生活事件被认为是成功的长期生活方式改变的催化剂。改变的主要障碍是对无法克服的障碍的看法、缺乏自我效能的经历以及过量食用高卡路里食物。最后，对值得信赖的个人对个人论坛的体验、对被推荐人的认可的需要以及来自家人和同龄人的支持是长期改变生活方式的重要驱动因素。结论长期减肥最重要的驱动因素是与医疗保健专业人员的牢固关系。协作式电子保健工具可以通过监测和提供相关反馈来支持关系和行为的变化。来自家人和同龄人的支持也很重要，长期的成功取决于在日常基础上建立强大的积极支持的能力。
Objectives Assisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes, cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet, physical inactivity or tobacco smoking. In a prospective pilot study, we tested an online collaborative e-health tool in general practice. The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool, including the support of peers and healthcare professionals.Setting General practice clinics in the Region of Southern Denmark.Participants 10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations to lose weight.Results The main themes identified were facilitators, barriers and support from family arid peers. Establishment of a trustworthy relationship with the healthcare professionals was of paramount importance. It was important for the patients to monitor the measurable outcomes with realistic goals and feedback from a trusted person. Often, significant life events were identified as catalysts for successful long-term lifestyle changes. Dominant barriers to change were perception of insurmountable obstacles, experience of lack of self efficacy and excess eating of high-calorie food. Finally, experiencing of trustworthy person-to-person forums, need for acknowledgement from referent others and support from family and peers were important drivers for long-term lifestyle change.Conclusion The most important driver in long-term weight loss was a strong relationship with a healthcare professional. Collaborative e-health tools can support the relationship and behavioural changes through monitoring arid providing relevant feedback. The support from family and peers also matters, and long-term success depends on the ability to establish strong, positive support on a day-to-day basis.