Barriers to and Facilitators of Using eHealth to Support Gestational Diabetes Mellitus Self-management: Systematic Literature Review of Perceptions of Health Care Professionals and Women With Gestational Diabetes Mellitus.
Barriers to and Facilitators of Using eHealth to Support Gestational Diabetes Mellitus Self-management: Systematic Literature Review of Perceptions of Health Care Professionals and Women With Gestational Diabetes Mellitus.
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使用电子健康支持妊娠期糖尿病自我管理的障碍和促进者：保健专业人员和妊娠期糖尿病妇女认知的系统文献综述。
DOI：
10.2196/39689
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发表时间：
2022-10-27
影响因子：
7.4
通讯作者：
Whitford, Heather
中科院分区：
文献类型：
--
作者：
Safiee, Ladan;Rough, Daniel John;Whitford, Heather
妊娠糖尿病（GDM）是妊娠期间最常见的并发症之一。事实证明，电子医疗技术在支持医疗状况的自我管理方面是成功的。数字技术有潜力改善 GDM 自我管理。本系统文献综述的主要目的是确定卫生专业人员 (HP) 和 GDM 女性对于使用电子健康进行 GDM 自我管理的看法。第二个目标是调查使用这些技术时的可用性和用户满意度。遵循 PRISMA（系统评价和荟萃分析的首选报告项目）方法，检索包括关于使用 MEDLINE、CINAHL、Embase、ACM 和 IEEE 数据库评估 2008 年 1 月至 2021 年 9 月支持 GDM 自我管理的技术的英文主要论文。先前系统文献综述中与技术和 GDM 相关的参考文献列表也进行了初步研究。纳入并评估了采用定性、定量和混合方法的论文。使用 Cochrane 协作工具、国家健康与护理卓越研究所临床指南、关键评估技能计划定性检查表和麦吉尔大学混合方法评估工具对所选论文进行质量评估。 NVivo（QSR International）用于提取定性数据，并进行主题分析。叙述合成用于分析定量数据。共纳入评审论文26篇。其中，19% (5/26) 的研究使用定量研究方法，19% (5/26) 使用定性研究方法，62% (16/26) 使用混合方法。总之，从定性数据中确定了 4 个主题：使用技术的好处、通过技术与人们互动、技术的可用性以及使用技术的阻碍因素。主题分析揭示了使用 GDM 自我管理系统的大量挑战和促进因素。挑战包括系统的可用性、技术问题、数据隐私、缺乏情感支持、报告数据的准确性以及惠普对系统的采用。便利性、改进的 GDM 自我管理、同伴支持、增强的动力、增强的独立性和一致的监控是使用这些技术的促进因素。定量数据表明，GDM 自我管理系统的可用性有提高的潜力。它还表明，方便性、有用性、增强GDM自我管理的动力、帮助GDM自我管理以及受到HP的监控是使用GDM自我管理系统的促进因素。这篇新颖的系统文献综述表明，HP 和 GDM 女性在使用 GDM 自我管理系统时遇到了一些挑战。 GDM 系统的可用性是来自定性和定量结果的主要挑战，而 GDM 自我管理的便利性、一致监控和优化则成为重要的促进因素。
Gestational diabetes mellitus (GDM) is one of the most common medical complications during pregnancy. eHealth technologies are proving to be successful in supporting the self-management of medical conditions. Digital technologies have the potential to improve GDM self-management. The primary objective of this systematic literature review was to identify the views of health professionals (HPs) and women with GDM regarding the use of eHealth for GDM self-management. The secondary objective was to investigate the usability and user satisfaction levels when using these technologies. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, the search included primary papers in English on the evaluation of technology to support self-management of GDM from January 2008 to September 2021 using MEDLINE, CINAHL, Embase, ACM, and IEEE databases. The lists of references from previous systematic literature reviews, which were related to technology and GDM, were also examined for primary studies. Papers with qualitative, quantitative, and mixed methodologies were included and evaluated. The selected papers were assessed for quality using the Cochrane Collaboration tool, National Institute for Health and Care Excellence clinical guidelines, Critical Appraisal Skills Programme Qualitative Checklist, and McGill University Mixed Methods Appraisal Tool. NVivo (QSR International) was used to extract qualitative data, which were subjected to thematic analysis. Narrative synthesis was used to analyze the quantitative data. A total of 26 papers were included in the review. Of these, 19% (5/26) of studies used quantitative research methodologies, 19% (5/26) used qualitative methods, and 62% (16/26) used mixed methods. In all, 4 themes were identified from the qualitative data: the benefits of using technology, engagement with people via technology, the usability of technology, and discouragement factors for the use of technology. The thematic analysis revealed a vast scope of challenges and facilitators in the use of GDM self-management systems. The challenges included usability aspects of the system, technical problems, data privacy, lack of emotional support, the accuracy of reported data, and adoption of the system by HPs. Convenience, improved GDM self-management, peer support, increased motivation, increased independence, and consistent monitoring were facilitators to use these technologies. Quantitative data showed that there is potential for improving the usability of the GDM self-management systems. It also showed that convenience, usefulness, increasing motivation for GDM self-management, helping with GDM self-management, and being monitored by HPs were facilitators to use the GDM self-management systems. This novel systematic literature review shows that HPs and women with GDM encountered some challenges in using GDM self-management systems. The usability of GDM systems was the primary challenge derived from qualitative and quantitative results, with convenience, consistent monitoring, and optimization of GDM self-management emerging as important facilitators.
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