TY - JOUR AU - de Batlle, Jordi AU - Massip, Mireia AU - Vargiu, Eloisa AU -纳达尔，Nuria AU - Fuentes, Araceli AU - Ortega Bravo, Marta AU - Colomina, Jordi AU - Drudis, Reis AU - Torra, Montserrat AU - Pallisó， Francesc AU - Miralles, Felip AU - barb， Ferran AU - Torres, Gerard PY - 2020 DA - 2020/11/20 TI -为复杂慢性患者实施移动医疗综合护理:患者和专业人员的可接受性研究JO - JMIR移动健康Uhealth SP - e22136 VL - 8 IS - 11 KW -移动健康KW -电子健康KW -患者接受医疗保健KW -患者满意度KW -健康计划实施KW -慢性疾病AB -背景:综合护理(IC)可以通过优先考虑以患者为中心的预防性模式、整理护理碎片和跨健康层的协作来促进健康和社会护理效率，而移动医疗(mHealth)可以成为采用IC的基石。目的:本研究旨在评估患者和卫生专业人员对复杂慢性患者的移动医疗IC模型的可接受性、可用性和满意度。方法:作为CONNECARE Horizon 2020项目的一部分，于2018年7月至2019年8月在西班牙加泰罗尼亚的一个农村地区进行了一项前瞻性、务实、双支队、平行、混合有效性实施试验。研究招募了55岁及以上有慢性阻塞性肺疾病或心力衰竭住院史的居家患者(用例[UC] 1)，或预定的主要选择性髋关节或膝关节置换术(UC2)。在3个月的时间里，患者体验了一种支持移动健康的集成电路模型，包括患者自我管理应用程序、一套集成传感器和一个基于网络的平台，该平台连接来自不同环境或常规护理的专业人员。以人为中心的协调护理体验问卷(P3CEQ)和奈梅亨连续性问卷(NCQ)评估以人为中心和护理的连续性。采用净推荐值(NPS)和系统可用性量表(SUS)评估IC臂患者和工作人员的可接受性。结果:分析包括77例IC患者，58例完成随访的对照组和30名卫生保健专业人员。两个研究组的平均年龄为78岁(SD 9)。 Perception of patient-centeredness was similarly high in both arms (usual care: mean P3CEQ score 16.1, SD 3.3; IC: mean P3CEQ score 16.3, SD 2.4). IC patients reported better continuity of care than controls (usual care: mean NCQ score 3.7, SD 0.9; IC: mean NCQ score 4.0, SD 1; P=.04). The scores for patient acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. Professionals’ acceptability was low (UC1: NPS −25%; UC2: NPS −35%), whereas usability was average (UC1: mean SUS score 63, SD 20; UC2: mean SUS score 62, SD 19). The actual use of technology was high; 77% (58/75) of patients reported physical activity for at least 60 days, and the ratio of times reported over times prescribed for other sensors ranged from 37% for oxygen saturation to 67% for weight. Conclusions: The mHealth-enabled IC model showed outstanding results from the patients’ perspective in 2 different UCs but lacked maturity and integration with legacy systems to be fully accepted by professionals. This paper provides useful lessons learned through the development and assessment process and may be of use to organizations willing to develop or implement mHealth-enabled IC for older adults. SN - 2291-5222 UR - https://mhealth.www.mybigtv.com/2020/11/e22136 UR - https://doi.org/10.2196/22136 UR - http://www.ncbi.nlm.nih.gov/pubmed/33216004 DO - 10.2196/22136 ID - info:doi/10.2196/22136 ER -