TY -的盟Kip Hanneke盟——Sieverink地板AU - van Gemert-Pijnen Lisette J E W C盟——Bouman伊冯H盟——Kelders Saskia M PY - 2020 DA - 2020/5/26 TI -整合人,环境,和技术实现的一个基于web的干预法医精神卫生保健:混合方法研究乔- J地中海互联网Res SP - e16906六世- 22 - 5 KW -电子健康KW -混合保健KW -实现千瓦日志数据KW -法医精神卫生保健AB -背景:虽然精神卫生干预措施可以为精神卫生保健带来许多潜在的好处，但实施结果往往令人失望。为了改善这些结果，需要更好地理解各种实施相关因素之间复杂的动态相互作用。应该从整体上研究这些相互作用和过程，注意与环境、技术和人有关的因素。目的:本混合方法研究的主要目的是全面评估在法医精神卫生保健组织中实施精神卫生干预的策略和结果。方法:首先，对18份关于实施过程的文件进行案头研究。其次，通过日志数据分析721名患者和172名治疗师对干预措施的使用情况。第三，对一家门诊诊所的所有18名治疗师进行了半结构化访谈，以确定影响实施结果的广泛因素。访谈通过演绎分析的组合进行分析，使用不采用，放弃，规模扩大，传播和可持续性框架和归纳，开放编码。结果:通过桌面研究生成的时间轴显示，实施策略侧重于治疗师的技术技能培训。 Log data analyses demonstrated that 1019 modules were started, and 18.65% (721/3865) of patients of the forensic hospital started at least one module. Of these patients, 18.0% (130/721) completed at least one module. Of the therapists using the module, 54.1% (93/172 sent at least one feedback message to a patient. The median number of feedback messages sent per therapist was 1, with a minimum of 0 and a maximum of 460. Interviews showed that therapists did not always introduce the intervention to patients and using the intervention was not part of their daily routine. Also, therapists indicated patients often did not have the required conscientiousness and literacy levels. Furthermore, they had mixed opinions about the design of the intervention. Important organization-related factors were the need for more support and better integration in organizational structures. Finally, therapists stated that despite its current low use, the intervention had the potential to improve the quality of treatment. Conclusions: Synthesis of different types of data showed that implementation outcomes were mostly disappointing. Implementation strategies focused on technical training of therapists, while little attention was paid to changes in the organization, design of the technology, and patient awareness. A more holistic approach toward implementation strategies—with more attention to the organization, patients, technology, and training therapists—might have resulted in better implementation outcomes. Overall, adaptivity appears to be an important concept in eHealth implementation: a technology should be easily adaptable to an individual patient, therapists should be trained to deal flexibly with an eMental health intervention in their treatment, and organizations should adapt their implementation strategies and structures to embed a new eHealth intervention. SN - 1438-8871 UR - //www.mybigtv.com/2020/5/e16906/ UR - https://doi.org/10.2196/16906 UR - http://www.ncbi.nlm.nih.gov/pubmed/32348285 DO - 10.2196/16906 ID - info:doi/10.2196/16906 ER -