TY - JOUR AU - Kerr, Cicely AU - Murray, Elizabeth AU - Noble, Lorraine AU - Morris, Richard AU - Bottomley, Christian AU - Stevenson, Fiona AU - Patterson, David AU - Peacock, Richard AU - Turner, Indra AU - Jackson, Keith AU - Nazareth, Irwin PY - 2010 DA - 2010/12/02 TI -基于网络的心脏病自我管理干预的潜力:一项混合方法调查[J] Med Internet Res SP - e56 VL - 12 IS - 4 KW - Internet KW -冠心病KW -心脏病KW -初级卫生保健KW -自我保健KW -选择性登记KW -数字鸿沟KW -医疗保健差距AB -背景:支持心脏病患者自我管理的现有举措似乎并未达到最需要的患者。通过互联网提供自我管理程序(基于网络的干预)可能有助于通过接触更多的患者来减少健康差距。然而，目前尚不清楚他们是否能实现这一目标，以及他们的有效性是否会受到数字鸿沟的限制。目的:探讨一种基于网络的干预措施在减少冠心病(CHD)患者获得自我管理支持的不平等方面的有效性。方法:采用定量和定性方法探讨基于网络的干预措施在9个月期间的使用情况。从英国伦敦北部不同社会经济和民族地区的初级保健中心招募了有或没有家庭互联网接入或以前使用互联网经验的冠心病患者。支持没有家庭互联网的病人使用公共互联网服务。结果:只有10.6%的符合条件的患者选择参加(N=168)。参与者主要是受过良好教育的白人男性，参与者中男性和年轻冠心病患者的比例高于参与初级保健实践的患者。 Most had been diagnosed with CHD a number of years prior to the study. Relatively few had been newly diagnosed or had experienced a cardiac event in the previous 5 years. Most had home Internet access and prior experience using the Internet. A greater use of the intervention was observed in older participants (for each 5-year age increase, OR 1.25 for no, low or high intervention use, 95% CI, 1.06-1.47) and in those that had home Internet access and prior Internet experience (OR 3.74, 95% CI, 1.52-9.22). Less use was observed in participants that had not recently experienced a cardiac event or diagnosis (≥ 5 years since cardiac event or diagnosis; OR 0.69, 95% CI, 0.50-0.95). Gender and level of education were not statistically related to level of use of the intervention. Data suggest that a recent cardiac event or diagnosis increased the need for information and advice in participants. However, participants that had been diagnosed several years ago showed little need for information and support. The inconvenience of public Internet access was a barrier for participants without home Internet access. The use of the intervention by participants with little or no Internet experience was limited by a lack of confidence with computers and discomfort with asking for assistance. It was also influenced by the level of participant need for information and by their perception of the intervention. Conclusions: The availability of a web-based intervention, with support for use at home or through public Internet services, did not result in a large number or all types of patients with CHD using the intervention for self-management support. The effectiveness of web-based interventions for patients with chronic diseases remains a significant challenge. SN - 1438-8871 UR - //www.mybigtv.com/2010/4/e56/ UR - https://doi.org/10.2196/jmir.1438 UR - http://www.ncbi.nlm.nih.gov/pubmed/21156471 DO - 10.2196/jmir.1438 ID - info:doi/10.2196/jmir.1438 ER -