Addressing Depression Comorbid With Diabetes or Hypertension in Resource-Poor Settings: A Qualitative Study About User Perception of a Nurse-Supported Smartphone App in Peru

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art_BRANDT_Addressing_Depression_Comorbid_With_Diabetes_or_Hypertension_in_2019.PDF (728.38 KB)
Citações na Scopus
21
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
JMIR PUBLICATIONS, INC
Autores
BRANDT, Lena R.
HIDALGO, Liliana
DIEZ-CANSECO, Francisco
ARAYA, Ricardo
MOHR, David C.
MIRANDA, J. Jaime
Citação
JMIR MENTAL HEALTH, v.6, n.6, article ID UNSP e11701, 20p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Smartphone apps could constitute a cost-effective strategy to overcome health care system access barriers to mental health services for people in low- and middle-income countries. Objective: The aim of this paper was to explore the patients' perspectives of CONEMO (Emotional Control, in Spanish: Control Emocional), a technology-driven, psychoeducational, and nurse-supported intervention delivered via a smartphone app aimed at reducing depressive symptoms in people with diabetes, hypertension or both who attend public health care centers, as well as the nurses' feedback about their role and its feasibility to be scaled up. Methods: This study combines data from 2 pilot studies performed in Lima, Peru, between 2015 and 2016, to test the feasibility of CONEMO. Interviews were conducted with 29 patients with diabetes, hypertension or both with comorbid depressive symptoms who used CONEMO and 6 staff nurses who accompanied the intervention. Using a content analysis approach, interview notes from patient interviews were transferred to a digital format, coded, and categorized into 6 main domains: the perceived health benefit, usability, adherence, user satisfaction with the app, nurse's support, and suggestions to improve the intervention. Interviews with nurses were analyzed by the same approach and categorized into 4 domains: general feedback, evaluation of training, evaluation of study activities, and feasibility of implementing this intervention within the existing structures of health system. Results: Patients perceived improvement in their emotional health because of CONEMO, whereas some also reported better physical health. Many encountered some difficulties with using CONEMO, but resolved them with time and practice. However, the interactive elements of the app, such as short message service, android notifications, and pop-up messages were mostly perceived as challenging. Satisfaction with CONEMO was high, as was the self-reported adherence. Overall, patients evaluated the nurse accompaniment positively, but they suggested improvements in the technological training and an increase in the amount of contact. Nurses reported some difficulties in completing their tasks and explained that the CONEMO intervention activities competed with their everyday work routine. Conclusions: Using a nurse-supported smartphone app to reduce depressive symptoms among people with chronic diseases is possible and mostly perceived beneficial by the patients, but it requires context-specific adaptations regarding the implementation of a task shifting approach within the public health care system. These results provide valuable information about user feedback for those building mobile health interventions for depression.
Palavras-chave
mental health, depression, noncommunicable diseases, mHealth, smartphone, developing countries
URI
https://observatorio.fm.usp.br/handle/OPI/33160
Referências
  1. Abas M, 2016, INT J MENT HEALTH SY, V10, DOI 10.1186/s13033-016-0071-9
  2. Abaza H, 2017, METHOD INFORM MED, V56, pE105, DOI 10.3414/ME17-05-0003
  3. Anderson RJ, 2001, DIABETES CARE, V24, P1069, DOI 10.2337/diacare.24.6.1069
  4. Andersson Gerhard, 2009, Cognitive Behaviour Therapy, V38, P196, DOI 10.1080/16506070903318960
  5. Andreoulakis E, 2012, HIPPOKRATIA, V16, P205
  6. [Anonymous], 2018, LANCET, V391, P1637, DOI 10.1016/S0140-6736(18)30941-3
  7. Bakker D, 2016, JMIR MENT HEALTH, V3, DOI 10.2196/mental.4984
  8. Barth J, 2004, PSYCHOSOM MED, V66, P802, DOI 10.1097/01.psy.0000146332.53619.b2
  9. BEBBINGTON P, 1995, INT J METHOD PSYCH, V5, P11
  10. Ben-Zeev D, 2015, ADM POLICY MENT HLTH, V42, P157, DOI 10.1007/s10488-014-0556-2
  11. Bengtsson M., 2016, NURSPLUS OPEN, V2, P8, DOI 10.1016/J.NPLS.2016.01.001
  12. Berg BL, 2019, QUALITATIVE RES METH
  13. Blaya JA, 2010, HEALTH AFFAIR, V29, P244, DOI 10.1377/hlthaff.2009.0894
  14. Burnard P, 1991, Nurse Educ Today, V11, P461, DOI 10.1016/0260-6917(91)90009-Y
  15. Buttorff C, 2012, B WORLD HEALTH ORGAN, V90, P813, DOI 10.2471/BLT.12.104133
  16. Callaghan M, 2010, HUM RESOUR HEALTH, V8, DOI 10.1186/1478-4491-8-8
  17. Chatterjee S, 2014, LANCET, V383, P1385, DOI 10.1016/S0140-6736(13)62629-X
  18. Christensen H, 2009, J MED INTERNET RES, V11, DOI 10.2196/jmir.1194
  19. Collado A, 2016, J CONSULT CLIN PSYCH, V84, P651, DOI 10.1037/ccp0000103
  20. Collins PY, 2011, NATURE, V475, P27, DOI 10.1038/475027a
  21. Dahne J, 2018, COGN BEHAV PRACT, V25, P44, DOI 10.1016/j.cbpra.2017.05.004
  22. Davidson Karina W, 2012, ISRN Cardiol, V2012, P743813, DOI 10.5402/2012/743813
  23. Diez-Canseco F, 2018, J MED INTERNET RES, V20, DOI 10.2196/jmir.9208
  24. Downe-Wamboldt B, 1992, Health Care Women Int, V13, P313
  25. East ML, 2015, JMIR MENT HEALTH, V2, DOI 10.2196/mental.3954
  26. Egede LE, 2007, GEN HOSP PSYCHIAT, V29, P409, DOI 10.1016/j.genhosppsych.2007.06.002
  27. Ekers D, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0100100
  28. Emdin CA, 2012, AFR HEALTH SCI, V12, P318, DOI 10.4314/ahs.v12i3.11
  29. Eysenbach G, 2005, J MED INTERNET RES, V7, DOI 10.2196/jmir.7.1.e11
  30. Firth J, 2017, WORLD PSYCHIATRY, V16, P287, DOI 10.1002/wps.20472
  31. Fulton BD, 2011, HUM RESOUR HEALTH, V9, DOI 10.1186/1478-4491-9-1
  32. Golden SH, 2008, JAMA-J AM MED ASSOC, V299, P2751, DOI 10.1001/jama.299.23.2751
  33. Graneheim UH, 2004, NURS EDUC TODAY, V24, P105, DOI 10.1016/j.nedt.2003.10.001
  34. Huffman Jeff C, 2013, Cardiovasc Psychiatry Neurol, V2013, P695925, DOI 10.1155/2013/695925
  35. Instituto Nacional de Salud Mental, 2013, EP STUD MENT HLTH ME
  36. Instituto Nacional de Salud Mental, 2009, EP STUD MENT HLTH RU
  37. Miranda JJ, 2017, LANCET PSYCHIAT, V4, P90, DOI 10.1016/S2215-0366(16)30350-9
  38. Joshi R, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0103754
  39. Kredo T, 2014, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD007331.pub3
  40. Krishna S, 2009, TELEMED J E-HEALTH, V15, P231, DOI 10.1089/tmj.2008.0099
  41. Kroenke K, 2001, J GEN INTERN MED, V16, P606, DOI 10.1046/j.1525-1497.2001.016009606.x
  42. Laurant M, 2005, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD001271.pub2
  43. Learmonth D, 2008, COUNS PSYCHOTHER RES, V8, P117, DOI 10.1080/14733140801976290
  44. Lejuez CW, 2011, BEHAV MODIF, V35, P111, DOI 10.1177/0145445510390929
  45. Lejuez CW, 2001, BEHAV MODIF, V25, P255, DOI 10.1177/0145445501252005
  46. Lie Silje Stangeland, 2017, J Med Internet Res, V19, pe187, DOI 10.2196/jmir.7479
  47. Lin EHB, 2010, DIABETES CARE, V33, P264, DOI 10.2337/dc09-1068
  48. Mantani A, 2017, J MED INTERNET RES, V19, DOI 10.2196/jmir.8602
  49. Martinez-Perez B, 2015, J MED SYST, V39, DOI 10.1007/s10916-015-0303-6
  50. Mechael P. N., 2009, Innovations: Technology / Governance / Globalisation, V4, P103, DOI 10.1162/itgg.2009.4.1.103
  51. Menezes P, 2019, JMIR MENT HEALTH, V6, DOI 10.2196/11698
  52. Menezess Paulo R, 2015, Rev Fac Cien Med Univ Nac Cordoba, V72, P321
  53. Meyer B, 2009, J MED INTERNET RES, V11, DOI 10.2196/jmir.1151
  54. Mohr DC, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0070086
  55. Mohr DC, 2011, J MED INTERNET RES, V13, DOI 10.2196/jmir.1602
  56. Morgan D L, 1993, Qual Health Res, V3, P112, DOI 10.1177/104973239300300107
  57. Moussavi S, 2007, LANCET, V370, P851, DOI 10.1016/S0140-6736(07)61415-9
  58. Naslund JA, 2017, LANCET PSYCHIAT, V4, P486, DOI 10.1016/S2215-0366(17)30096-2
  59. Ogedegbe G, 2014, BMJ OPEN, V4, DOI 10.1136/bmjopen-2014-005983
  60. Perel P, 2006, PLOS MED, V3, P1448, DOI 10.1371/journal.pmed.0030344
  61. Petersen I, 2012, HEALTH POLICY PLANN, V27, P42, DOI 10.1093/heapol/czr012
  62. Pitt B, 2010, EUR HEART J, V31, P1036, DOI 10.1093/eurheartj/ehq031
  63. Prince M, 2011, INT J GERIATR PSYCH, V26, P899, DOI 10.1002/gps.2622
  64. Prince M, 2007, LANCET, V370, P859, DOI 10.1016/S0140-6736(07)61238-0
  65. Proudfoot J, 2004, BRIT J PSYCHIAT, V185, P46, DOI 10.1192/bjp.185.1.46
  66. Proudfoot J, 2010, J MED INTERNET RES, V12, DOI 10.2196/jmir.1475
  67. Raviola G, 2011, LANCET, V378, P1613, DOI 10.1016/S0140-6736(11)60941-0
  68. Rice RE, 2003, TELECOMMUN POLICY, V27, P597, DOI 10.1016/S0308-5961(03)00068-5
  69. Richards DA, 2016, LANCET, V388, P871, DOI 10.1016/S0140-6736(16)31140-0
  70. Riper H, 2008, ADDICTION, V103, P218, DOI 10.1111/j.1360-0443.2007.02063.x
  71. Rivas-Nieto AC, 2015, REV PERU MED EXP SAL, V32, DOI [10.17843/rpmesp.2015.322.1621, DOI 10.17843/RPMESP.2015.322.1621]
  72. Rotella F, 2013, J CLIN PSYCHIAT, V74, P32, DOI 10.4088/JCP.12r07922
  73. Sarkar U, 2016, J GEN INTERN MED, V31, P1417, DOI 10.1007/s11606-016-3771-6
  74. Schueller SM, 2015, INT CONF PER COMP, P25, DOI 10.4108/icst.pervasivehealth.2015.260115
  75. Shen N, 2015, JMIR MHEALTH UHEALTH, V3, DOI 10.2196/mhealth.3713
  76. Singla D, 2014, J AFFECT DISORDERS, V168, P452, DOI 10.1016/j.jad.2014.07.017
  77. The Academy of Medical Sciences, 2018, MULT PRIOR GLOB HLTH
  78. Toyama M, 2017, INT J HEALTH POLICY, V6, P501, DOI 10.15171/ijhpm.2017.07
  79. van Ginneken N, 2013, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD009149.pub2
  80. Van Voorhees BW, 2011, PSYCHIAT CLIN N AM, V34, P167, DOI 10.1016/j.psc.2010.11.002
  81. van't Hof E, 2009, CNS SPECTRUMS, V14, P34, DOI 10.1017/S1092852900027279
  82. Velasquez A., 2009, REV PERU MED EXP SAL, V26, P221
  83. WHO, 2016, MHGAP INT GUID MENT
  84. World Health Organization, 2011, GLOBAL STATUS REPORT
  85. World Health Organization, 2008, TREAT TRAIN RET TASK
  86. World Health Organization, 2013, INV MENT HLTH EV ACT
  87. World Health Organization. Geneva, 2006, TAK SHOCK HLTH WORK
  88. Ye JN, 2016, MEDICINE, V95, DOI 10.1097/MD.0000000000004198
  89. Zhao J, 2016, J MED INTERNET RES, V18, DOI 10.2196/jmir.5692
  90. Zhu Q, 2012, 4 INT WORKSH SOFTW E, DOI [10.1109/SEHC.2012.6227006, DOI 10.1109/SEHC.2012.6227006]

Coleções
Artigos e Materiais de Revistas Científicas - FM/MPR
Artigos e Materiais de Revistas Científicas - LIM/39
Artigos e Materiais de Revistas Científicas - ODS/03