Human Factors and Data Logging Processes With the Use of Advanced Technology for Adults With Type 1 Diabetes: Systematic Integrative Review

Abstract

BackgroundPeople with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different.ObjectiveThis review described and examined the relationship between human factors and adherence with technology for data logging processes in adults with T1D.MethodsA systematic literature search was undertaken by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Quality appraisal was undertaken and data were abstracted and categorized into the themes that underpinned the human factor constructs that were examined.ResultsA total of 18 studies were included. A total of 6 constructs emerged from the data analysis: the relationship between adherence to data logging and measurable outcomes; satisfaction with the transition to advanced technology for self-management; use of advanced technology and time spent on diabetes-related activities; strategies to mediate the complexities of diabetes and the use of advanced technology; cognition in the wild; and meanings, views, and perspectives from the users of technology.ConclusionsIncreased treatment satisfaction was found on transition from traditional to advanced technology use—insulin pump and continuous glucose monitoring (CGM); the most significant factor was when blood glucose levels were consistently <7.00 mmol/L (P ≤.01). Participants spent considerable time on their diabetes self-care. Logging of data was positively correlated with increasing age when using an app that provided meaningful feedback (regression coefficient=55.8 recordings/year; P ≤.01). There were benefits of CGM for older people in mediating complexities and fears of hypoglycemia with significant differences in well-being (P ≤.001).Qualitative studies explored the contextual use and uptake of technology. The results suggested frustrations with CGM, continuous subcutaneous insulin infusion, calibration of devices, and alarms. Furthermore implications for “body image” and the way in which “significant others” impacted on the behavior and attitude of the individual toward technology use. There were wide variations in the normal use of and interaction with technology across a continuum of sociocultural contexts, which has implications for the way in which future technologies should be designed.Quantitative studies were limited by small sample sizes, making it difficult to generalize findings to other contexts. This was further limited by a sample that was predominantly white, well-controlled, and engaged with self-care. The use of critical appraisal frameworks demonstrated where research into human factors and dat...

The Efficacy of Mobile Phone Apps for Lifestyle Modification in Diabetes: Systematic Review and Meta-Analysis

“…Mobile phone apps are widely used in both developed and developing countries and have shown great potential to deliver personalized medical advice. In prior studies, apps were demonstrated to facilitate patients’ health promotion by improving their self-management awareness and compliance [7-9]. In practice, apps have been used to help people living with various health conditions and problems, including mental health [10,11], heart failure [12], and smoking cessation [13,14].…”

Psychosocial aspects of diabetes technology

“…Constantly wearing a diabetes device on one's body may negatively impact body image in select individuals . Body image concerns seem to substantially impact the user's attitude towards visibly worn diabetes technologies .…”

Psychosocial aspects of the usage of modern technologies in diabetes mellitus

“…Впоследствии позитивное влияние НМГ на психологическое благополучие неоднократно подтверждалось. Так, в представительном аналитическом обзоре Waite отмечается, что использование ППИИ в сочетании с НМГ более позитивно влияет на КЖ, чем только ППИИ [42]. Указанная закономерность справедлива не только для НМГ в сочетании с ППИИ.…”

“…В нем предпринята попытка структурирования ряда исследований в данной сфере, выделения ключевых не биомедицинских аспектов, связанных с использованием новых технологий, прежде всего ППИИ и НМГ. Авторы полагают, что их можно свести к следующим четырем блокам [42]: 1) поведенческий (барьеры приверженности; требования технологий, которые могут влиять на мотивацию ежедневного управления устройствами; время, затрачиваемое на лечение СД); 2) психологический (адаптация к СД; страх гипогликемии; эмоциональная нагрузка, обусловленная ответственностью за самостоятельное управление СД; вера в себя, влияние на КЖ, бессознательные мотивы; доверие технологии; депрессия и расстройства приема пищи; 3) социальный (удобство ношения устройства и образ тела; отношения с окружающими и выработка способов взаимодействия с ними; поддержка пациента его окружением в использовании технологий; выбор того, с кем можно поделиться результатами; стигматизация, связанная с использованием технологии в повседневных условиях); 4) когнитивный (образовательные нужды, в т.ч. обучение технологии и улучшение понимания того, как адаптировать дозы; дополнительное обучение, ассоциированное с использованием технологии; грамотность в отношении здоровья; обусловленное возрастом и образованием снижение когнитивных способностей).…”