TY -非盟的器皿,帕特里克盟——Dorai叶盟-罗斯,希瑟·J AU - Cafazzo,约瑟夫•AU - Laporte奥黛丽盟——Boodoo克里斯盟——濑户,艾米丽PY - 2019 DA - 2019/02/26 TI -心力衰竭病人坚持基于移动电话远程控制计划:一个纵向混合方法研究乔- Uhealth Mhealth JMIR SP - e13259六世- 7 - 2 KW -遥控千瓦Mhealth KW -坚持KW -心脏衰竭AB -背景:远程监测(TM)可以通过促进患者自我护理和临床决策支持来改善心力衰竭(HF)的预后。然而，这些结果只有在患者坚持进行规定的家庭读数时才有可能实现。目的:本研究的目的是(1)量化在基于手机的TM计划的情况下，患者坚持记录规定的家庭读数的程度，(2)解释基于计划注册时间、患者特征和患者对TM计划的感知的纵向坚持率。方法:为满足2个研究目标，采用混合方法的解释顺序设计，所有解释方法均以技术接受与使用统一理论2 (UTAUT2)为指导。总体依从率的计算方法是，根据患者参加该项目1年以内的总天数中，测量体重、血压、心率和症状读数的天数所占的比例。每月依从率也计算为患者在项目注册后每30天内接受相同4个读数的天数比例。接下来，进行简单回归和多元回归，以确定时间、年龄、性别和疾病严重程度对依从率的影响。其他解释方法包括6个月和12个月时的问卷调查，调查患者对TM计划的感知益处和使用的容易程度，分析患者离开该计划的原因，并对坚持率和人口统计数据范围内的患者(n=24)进行有目的抽样的半结构化访谈。结果:总体平均坚持率为73.6% (SD 25.0)，平均坚持率随着时间的推移以每月1.4%的速度下降(P<.001)。 The multivariate regressions found no significant effect of sex and disease severity on adherence rates. When grouping patients’ ages by decade, age was a significant predictor (P=.04) whereby older patients had higher adherence rates over time. Adherence rates were further explained by patients’ perceptions with regard to the themes of (1) performance expectancy (improvements in HF management and peace of mind), (2) effort expectancy (ease of use and technical issues), (3) facilitating conditions (availability of technical support and automated adherence calls), (4) social influence (support from family, friends, and trusted clinicians), and (5) habit (degree to which taking readings became automatic). Conclusions: The decline in adherence rates over time is consistent with findings from other studies. However, this study also found adherence to be the highest and most consistent over time in older age groups and progressively lower over time for younger age groups. These findings can inform the design and implementation of TM interventions that maximize patient adherence, which will enable a more accurate evaluation of impact and optimization of resources. International Registered Report Identifier (IRRID): RR2-10.2196/resprot.9911 SN - 2291-5222 UR - http://mhealth.www.mybigtv.com/2019/2/e13259/ UR - https://doi.org/10.2196/13259 UR - http://www.ncbi.nlm.nih.gov/pubmed/30806625 DO - 10.2196/13259 ID - info:doi/10.2196/13259 ER -