Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care - a mixed-method study on patient perspectives.
Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care - a mixed-method study on patient perspectives.
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DOI：
10.1186/s12913-022-07831-8
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发表时间：
2022-04-04
影响因子：
2.8
通讯作者：
Ekman I
中科院分区：
文献类型：
--
作者：
Barenfeld E;Fuller JM;Wallström S;Fors A;Ali L;Ekman I
过程评估有助于澄清随机对照试验 (RCT) 获得的结果。传统上，过程评估中干预的使用程度是通过测量剂量或评估实施保真度来监控的。从以人为本的角度来看，此类评估应辅以患者有意义的使用体验，因为干预措施的使用应在利益相关方之间达成一致，并针对每位患者进行定制。本研究旨在通过加深对干预措施是否、如何以及为谁做出有意义的使用的理解，阐明患者对远程以人为本的护理 (PCC) 干预的体验。患者 (n = 86) 是从 RCT PROTECT 干预组中招募的。实施了收敛混合方法。数据是在正在进行的随机对照试验的同时通过一项调查收集的，包括对有意义或无意义使用的评级和书面评论。此外，还对 12 名特意挑选的参与者进行了采访。采用了描述性统计、逻辑回归和内容分析。数据源已集成到结果中。大多数参与者认为整体干预措施是有意义的，其中电话支持被认为是最有意义的。访谈和书面评论显示，患者对有意义使用的评分分为四类：不需要、沟通不足、日常生活中的好处和个人提升。通过独居预测数字平台上评级症状的有意义使用（调整后的比值比 [aOR] = 2.8 P = .044）。慢性阻塞性肺病 (COPD) 的诊断预示着数字平台直接消息传递的有意义使用 (aOR = 3.5，P = .045)。此外，能够使用直拨电话联系解释了技术能力评级较低的参与者的有意义的使用（aOR = 3.6，P = .014）。数字平台和结构化电话支持的结合可能有助于确定预防措施，以维持被诊断为慢性阻塞性肺病和慢性心力衰竭的患者的健康，但对于被诊断为慢性阻塞性肺病的患者来说往往更有意义。总体而言，与电话支持相比，数字平台的采用率较低。数字平台的实施中存在一些缺陷，会对有意义的使用体验产生负面影响。使用后，事实证明，该干预措施是一种易于应用且有价值的工具，可以以人为本的方式支持预防行动。
Process evaluations are useful in clarifying results obtained from randomised controlled trials (RCTs). Traditionally, the degree of intervention usage in process evaluations is monitored by measuring dose or evaluating implementation fidelity. From a person-centred perspective, such evaluations should be supplemented with patients’ experiences of meaningful use, given that intervention use should be agreed upon between interested parties and tailored to each patient. This study aimed to elucidate patients’ experiences of a remote person-centred care (PCC) intervention by deepening the understanding of, if, how and for whom the intervention contributed to meaningful use. Patients (n = 86) were recruited from the RCT PROTECT intervention group. A convergent mixed-method approach was implemented. Data were collected in parallel with the ongoing RCT via a survey, including ratings and written comments on meaningful or non-meaningful use. Also, interviews were performed with twelve purposefully selected participants. Descriptive statistics, logistic regression and content analysis were employed. Data sources were integrated in the results. Most participants rated the overall intervention as meaningful to use, with the telephone support rated as most meaningful. Interviews and written comments showed that patient ratings on meaningful use were explained by four categories: Not in need, Communication deficiency, Benefits in everyday life and A personal boost. Meaningful use of rating symptoms on the digital platform was predicted by living alone (adjusted odds ratio [aOR] = 2.8 P = .044). A diagnosis of chronic obstructive pulmonary disease (COPD) predicted meaningful use of digital platform direct messaging (aOR = 3.5, P = .045). Moreover, having access to direct-dial telephone contact explained meaningful use among participants with low ratings of technical competence (aOR = 3.6, P = .014). The combined digital platform and structured telephone support could be helpful in identifying preventive actions to maintain health for people diagnosed with COPD and chronic heart failure but tends to be more meaningful for those diagnosed with COPD. Overall, lower adoption of the digital platform was seen compared to telephone support. Shortcomings were noted in the digital platform’s implementation that negatively influences experiences of meaningful use. When used, the intervention proved to be an easily applicable and valued tool to support preventive actions in a person-centred manner.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
2.6
作者：
Guidetti S;Gustavsson M;Tham K;Andersson M;Fors U;Ytterberg C
通讯作者：
Ytterberg C
影响因子：
3.7
作者：
Kenealy TW;Parsons MJ;Rouse AP;Doughty RN;Sheridan NF;Hindmarsh JK;Masson SC;Rea HH
通讯作者：
Rea HH
DOI：
10.1136/bmj.h1258
发表时间：
2015-03-19
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moore GF;Audrey S;Barker M;Bond L;Bonell C;Hardeman W;Moore L;O'Cathain A;Tinati T;Wight D;Baird J
通讯作者：
Baird J
影响因子：
3.7
作者：
Barenfeld E;Ali L;Wallström S;Fors A;Ekman I
通讯作者：
Ekman I