Personal health depends on physical factors as well as on the subject's behavior and lifestyle. Stress is the cause of numerous diseases unless it is in balance with sufficient relaxation and rest. Nowadays, continuous stress and, as a consequence, a burnout are steadily increasing, thus the need for prevention and stress management is growing too. Digital technologies allow for new methods of stress management to prevent burnout. However, the requirements for such systems remain largely unexplored. This work closes this research gap by offering a qualitative requirement survey and its analysis. For this purpose, 15 semi-structured interviews were conducted from four different perspectives (health insurance companies, care providers, private sector and users), which allowed to derive the requirements for successful digital stress management systems. These can be divided into three categories: Human Centricity, Medicine and Technology.
Objective Previous studies have shown positive treatment outcomes of e-mental health applications targeting depression. However, few applications provide personalized features. The aim of the present study is to ask for the user experience and acceptance of patients with depression and healthy adults, who tested the self-management app Self-administered Psycho Therapy SystemS over a period of 5 days. The results serve as a source for evidence-based recommendations for developers and clinicians. Methods A total of 110 participants (41 patients and 69 healthy controls) tested the app Self-administered Psycho Therapy SystemS over a period of 5 days and completed evaluation sheets developed for the purpose of this study. Quantitative measures were asked with 5-point Likert-scaled items (range: −2 to + 2) for the perceived quality of the programme and its components, its practicality (both referred to as user experience) and its acceptance. Student’s t-tests and Pearson correlations were calculated for group comparisons and associations, respectively. Open text fields were analysed by applying a qualitative structuring content analysis. Results The perceived quality of the total programme was rated with M = 0.96 (SD = 0.82), the practicality was M = 0.84 (SD = 0.08) and the acceptance was M = 0.25 (SD = 1.04). Patients rated perceived quality of the total programme and acceptance higher than healthy adults, while there was no difference in practicality. Acceptance was associated with increased depression scores (r = 0.33, p = .01), higher scores of perceived quality of the total programme (r = 0.48, p< .001) and of practicality (r = 0.45, p < .001). Feedback of both groups regarding usability, therapeutic content and personalization revealed a strong wish for guidance and insights into mood progress, opportunities for choice of interventions and features of customization for individualized treatment. Conclusions Patients with depression accepted the app Self-administered Psycho Therapy SystemS more than healthy adults and gave higher ratings in quality. User experience of all users shows a need for features of guidance, choice and personalization that clinicians and developers of future apps should pay attention to.
BACKGROUND The development of e-mental health applications for patients with depression has shown technological advances to a certain extent. Many feasibility studies reveal the acceptance of patients and evidence for positive treatment outcomes. However, few studies ask for the user experience regarding the personalized help of specific treatment components in self-management apps. OBJECTIVE The aim of the present study is to ask for the user experience and acceptance of patients with depression and healthy adults, who tested the app SELFPASS. The results serve as a source for evidence-based recommendations for developers and clinicians regarding the graphical and conceptual design of a self-management app for patients with depression with and without anxiety symptoms. METHODS The sample consisted of N=110 participants, of which 41 (37.3%) were adult patients and 69 (62.7%) healthy adults. They tested the app SELFPASS over a period of 5 days and filled out a self-developed evaluation questionnaire. Quantitative measures asked with 5-point Likert scaled items (range: -2 to +2) for the perceived quality of the program and its components, its practicality (both referred to as user experience), and its acceptance. Student t tests and Pearson correlations were calculated for comparisons of groups and associations between the measures. Open text fields were analyzed by applying a qualitative structuring content analysis regarding suggestions for usability, therapeutic content and personalization. RESULTS The perceived quality of the total program (PQTP) was rated with M=0.96 (SD=0.82), the practicality (P) was M=0.84 (SD=0.08), and the acceptance (A) was M=0.25 (SD=1.04). Patients rated PQTP and A higher than healthy adults, while there was no difference in P. Acceptance was associated with increased depression scores (r=.33, P=.01), higher scores of PQTP (r=0.48, P<.001) and of P (r=0.45, P<.001). Feedback of both groups regarding the usability, the therapeutic content and personalization revealed a strong wish for guidance and insights into mood progress, opportunities for choice of interventions and features of customization for an individualized treatment. CONCLUSIONS Patients with depression accepted the app SELFPASS more than healthy adults and gave higher ratings in quality. User experience of all users reveals a strong need for features of guidance, choice and personalization, that clinicians and developers of future apps should pay special attention to. CLINICALTRIAL Trial Registration: DRKS (DRKS00015614).
Der vorliegende Artikel untersucht, wie Psychotherapeuten die Systemakzeptanz digitaler Technologien zur Therapie von Depressionen bewerten. Neben der Bewertung der Systemakzeptanz werden geeignete Anwendungsbereiche für E-Health-Applikationen untersucht und Maßnahmen zur Verbesserung der Akzeptanz erarbeitet. Zur Beantwortung der Forschungsfrage wurden fünf leitfadengestützte Experteninterviews mit Psychotherapeuten geführt. Die Ergebnisse zeigen, dass die Mehrheit der Therapeuten Nutzen im Einsatz von E-Health-Applikationen sieht, jedoch nur als Ergänzung der Präsenztherapie oder in der Prävention. Akzeptanzprobleme für den Einsatz in der Praxis sehen sie vor allem im mangelhaften Datenschutz und in der nicht funktionierenden Erkennung von schwer depressiven Patienten, die nicht mit E-Health-Applikationen behandelt werden sollten. Auf Grundlage dieser Ergebnisse ist zu empfehlen, dass E-Health-Applikationen durch eine unabhängige Stelle auf ihre Qualität und Sicherheit überprüft werden und anschließend eine Kostenerstattung durch die gesetzlichen Krankenkassen erfolgt. Sie sollten im Bereich der Prävention und der Unterstützung der Präsenztherapie Anwendung finden. Zudem muss die Erkennung von schwer depressiven Patienten verbessert werden.
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