Charlotte D. Bjørnes

A Smartphone App to Foster Power in the Everyday Management of Living With Schizophrenia: Qualitative Analysis of Young Adults’ Perspectives

Background Literature indicates that using smartphone technology is a feasible way of empowering young adults recently diagnosed with schizophrenia to manage everyday living with their illness. The perspective of young adults on this matter, however, is unexplored. Objective This study aimed at exploring how young adults recently diagnosed with schizophrenia used and perceived a smartphone app (MindFrame) as a tool to foster power in the everyday management of living with their illness. Methods Using participatory design thinking and methods, MindFrame was iteratively developed. MindFrame consists of a smartphone app that allows young adults to access resources to aid their self-management. The app is affiliated with a website to support collaboration with their health care providers (HCPs). From January to December 2016, community-dwelling young adults with a recent diagnosis of schizophrenia were invited to use MindFrame as part of their care. They customized the resources while assessing their health on a daily basis. Then, they were invited to evaluate the use and provide their perspective on the app. The evaluation was qualitative, and data were generated from in-depth interviews. Data were analyzed using a hermeneutical approach. Results A total of 98 individuals were eligible for the study (mean age 24.8, range 18-36). Of these, 27 used MindFrame and 13 participated in the evaluation. The analysis showed that to the young adults, MindFrame served to foster power in their everyday management of living with schizophrenia. When MindFrame was used with the HCPs consistently for more than a month, it could provide them with the power to keep up their medication, to keep a step ahead of their illness, and to get appropriate help based on their needs. This empowered them to stay on track with their illness, thus in control of it. It was also reported that MindFrame could fuel the fear of restraint and illness exacerbation, thereby disempowering some from feeling certain and secure. Conclusions The findings demonstrate that young adults diagnosed with schizophrenia are amenable to use a smartphone app to monitor their health, manage their medication, and stay alert of the early signs of illness exacerbation. This may empower them to stay on track with their illness, thus in control of it. This indicates the potential of smartphone-based care being capable of aiding this specific population to more confidently manage their new life situation. The potentially disempowering aspect of MindFrame accentuates a need for further research to understand the best uptake and the limitations of smartphone-based schizophrenia care of young adults.

Human factors considerations when developing eHealth solutions to support patients: comparison of Danish and Australian experiences

Single snapshot evaluations of eHealth projects often lack depth when explaining the impact of human factor influences at the conceptualisation stages of a project. This paper explores the conceptualisation and prototype building of two eHealth projects undertaken in Denmark and Australia and develops a human factors evaluation framework applicable for use during the initial phases of eHealth projects for patient use. Initially the projects were reviewed using a human factors lens to identify individual project phases. Project elements in each project were determined and analysed using thematic analysis. A conceptual framework was then developed and applied to the project phases resulting in the identification and exploration of five key themes. The developed framework can complement existing eHealth evaluation frameworks and enrich them with a human factors viewpoint and highlights the need for further research on cultural influences and the intersections between each framework component. Finally, the paper highlights the need for patients to be considered as end users of eHealth systems and engaged early and throughout the development of eHealth systems.