Background: In the past years, a mobile health (mHealth) app called the Dutch Talking Touch Screen Questionnaire (DTTSQ) was developed in The Netherlands. The aim of development was to enable Dutch physical therapy patients to autonomously complete a health-related questionnaire regardless of their level of literacy and digital skills. Objective: The aim of this study was to evaluate the usability (defined as the effectiveness, efficiency, and satisfaction) of the prototype of the DTTSQ for Dutch physical therapy patients with diverse levels of experience in using mobile technology. Methods: The qualitative Three-Step Test-Interview method, including both think-aloud and retrospective probing techniques, was used to gain insight into the usability of the DTTSQ. A total of 24 physical therapy patients were included. The interview data were analyzed using a thematic content analysis approach aimed at analyzing the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took the participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating that was used to provide a rough estimate of the need for additional usability efforts. Results: All participants within this study were very satisfied with the ease of use of the DTTSQ. Overall, 9 participants stated that the usability of the app exceeded their expectations. The group of 4 average-/high-experienced participants encountered only 1 problem in total, whereas the 11 little-experienced participants encountered an average of 2 problems per person and the 9 inexperienced participants an average of 3 problems per person. A total of 13 different kind of problems were found during this study. Of these problems, 4 need to be addressed before the DTTSQ will be released because they have the potential to negatively influence future usage of the tool. The other 9 problems were less likely to influence future usage of the tool substantially. Conclusions: The usability of the DTTSQ needs to be improved before it can be released. No problems were found with satisfaction or efficiency during the usability test. The effectiveness needs to be improved by (1) making it easier to navigate through screens without the possibility of accidentally skipping one, (2) enabling the possibility to insert an answer by tapping on the text underneath a photograph instead of just touching the photograph itself, and (3) making it easier to correct wrong answers. This study shows the importance of including less skilled participants in a usability study when striving for inclusive design and the importance of measuring not just satisfaction but also efficiency and effectiveness during such studies.
LINK
Background: Effective telemonitoring is possible through repetitive collection of electronic patient-reported outcome measures (ePROMs) in patients with chronic diseases. Low adherence to telemonitoring may have a negative impact on the effectiveness, but it is unknown which factors are associated with adherence to telemonitoring by ePROMs. The objective was to identify factors associated with adherence to telemonitoring by ePROMs in patients with chronic diseases. Methods: A systematic literature search was conducted in PubMed, Embase, PsycINFO and the Cochrane Library up to 8 June 2021. Eligibility criteria were: (1) interventional and cohort studies, (2) patients with a chronic disease, (3) repetitive ePROMs being used for telemonitoring, and (4) the study quantitatively investigating factors associated with adherence to telemonitoring by ePROMs. The Cochrane risk of bias tool and the risk of bias in nonrandomized studies of interventions were used to assess the risk of bias. An evidence synthesis was performed assigning to the results a strong, moderate, weak, inconclusive or an inconsistent level of evidence. Results: Five studies were included, one randomized controlled trial, two prospective uncontrolled studies and two retrospective cohort studies. A total of 15 factors potentially associated with adherence to telemonitoring by ePROMs were identified in the predominate studies of low quality. We found moderate-level evidence that sex is not associated with adherence. Some studies showed associations of the remaining factors with adherence, but the overall results were inconsistent or inconclusive. Conclusions: None of the 15 studied factors had conclusive evidence to be associated with adherence. Sex was, with moderate strength, not associated with adherence. The results were conflicting or indecisive, mainly due to the low number and low quality of studies. To optimize adherence to telemonitoring with ePROMs, mixed-method studies are needed.
Purpose: The Patient-Generated Subjective Global Assessment (PG-SGA), including the PG-SGA Short Form (SF, aka ‘abridged’), was originally developed in the mid 1990’s as a scored, patient self-report, paperbased instrument and has been widely validated. The PG-SGA (SF) has been used for screening, assessment and monitoring, triageing for multimodal intervention and for evaluation of clinical and health economic outcomes. There have been ad hoc translations, often with permission of the originator (FDO) but broad international use requires consistent, medically accurate, and certified translations. Although the PG-SGA (or SF) is known to be quick and easy, current advances in technology could further improve and facilitate quick and easy use of global patient screening and assessment, standardized scoring algorithms, limiting inter-observer variability, and global collaboration and communication. We aimed to develop a user friendly, cross-culturally validated, multilingual digital app and resources to support the clinical and research applications of the PG-SGA (SF) and Pt-Global app in the context of a global centralized database and research consortium. Methods: After completion of a Dutch PG-SGA cross-cultural adaptation project, a digital app based on the English and Dutch PG-SGA was developed. Steps included: 1) development and testing of standardized scoring and decision-making algorithms based on the validated PG-SGA scoring system; 2) compatibility with iOS, Android and WindowsPhone platforms; 3) development and pilot testing of prototype by an international test panel (n=35; professionals testing the app on patients as part of routine care process, researchers, and lay persons) from Australia, Belgium, Canada, Norway, Sweden, The Netherlands and USA, evaluating the app on lay-out, user friendliness, relevance and time of completion; 4) improvement based on input; 5) launch of app and supportive website at www.pt-global.org on 12 Jun 2014, including complimentary introductory use; 5) international education activities; 6) digital presence through Twitter, Facebook, LinkedIn and YouTube; 7) launch of web-based version on 15 September 2014. Results: 15 professionals (Pros; 11 dietitians, 1 doctor, 1 physiotherapist) and 2 lay persons participated in the pilot testing. Included settings were: 9 hospitals, 4 cancer centers, 2 nursing homes, 3 research. 8/15 had experience with the PG-SGA, 7/15 PG-SGA were naïve. 5 Pros tested on 1-5 patients, and 9 on 6-10 patients. 88% rated layout (very) good with feedback: calm, professional, clear, intuitive, easy; 88% rated good for user friendliness. 75% rated flow/user interface (very) good. In 88% Patient screens were completed by Pros. Reported time to complete Patient screens was: 65% in 0-5 minutes, 29% in 5-10 min; 6% (n=1) >10 minutes. Interestingly, patients started completing the app spontaneously. Some issues with concerns about touch screen were expressed. 87% completed the professional section in.
The pressure on the European health care system is increasing considerably: more elderly people and patients with chronic diseases in need of (rehabilitation) care, a diminishing work force and health care costs continuing to rise. Several measures to counteract this are proposed, such as reduction of the length of stay in hospitals or rehabilitation centres by improving interprofessional and person-centred collaboration between health and social care professionals. Although there is a lot of attention for interprofessional education and collaborative practice (IPECP), the consortium senses a gap between competence levels of future professionals and the levels needed in rehabilitation practice. Therefore, the transfer from tertiary education to practice concerning IPECP in rehabilitation is the central theme of the project. Regional bonds between higher education institutions and rehabilitation centres will be strengthened in order to align IPECP. On the one hand we deliver a set of basic and advanced modules on functioning according to the WHO’s International Classification of Functioning, Disability and Health and a set of (assessment) tools on interprofessional skills training. Also, applications of this theory in promising approaches, both in education and in rehabilitation practice, are regionally being piloted and adapted for use in other regions. Field visits by professionals from practice to exchange experiences is included in this work package. We aim to deliver a range of learning materials, from modules on theory to guidelines on how to set up and run a student-run interprofessional learning ward in a rehabilitation centre. All tested outputs will be published on the INPRO-website and made available to be implemented in the core curricula in tertiary education and for lifelong learning in health care practice. This will ultimately contribute to improve functioning and health outcomes and quality of life of patients in rehabilitation centres and beyond.
