Needs of patients with multi-morbidity and heart failure for the development of a mHealth to improve their self-management: A qualitative analysis (Preprint)

Abstract

Background: Heart failure (HF) is becoming a global epidemic. To promote healthy behaviors and facilitate the strengthening of the provision of health services in these patients, it is essential to prioritize their opinions and needs. Mobile health applications seem to be an effective tool in the care of these patients. User-centered design and the Information Systems Research (ISR) perspective are well-established approaches to developing mobile applications that are responsive to the needs of these patients.

Objective: The aim of this study was to provide practical information regarding needs, preferences of content, and format of an App to assist the self-management in patients with multi-morbidity and HF.

Methods: This three phases study was conducted in Spain. Six integrative reviews, a qualitative methodology based on Van Manen's hermeneutic phenomenology through semi-structured interviews and user stories were used. A total of 20 patients were included in this study. Data collection continued until data saturation was reached. All data were transcribed verbatim and analyzed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes.

Results: The integrative reviews conducted included practical recommendations to include in the content and format of the App and helped create the interview guide. Interviews revealed 15 subthemes, related to the domains of food and nutrition, medication and treatment, rehabilitation and physical activity, signs and symptoms, self-management, and emotional management. These subthemes captured the meaning of narratives offering contextual insights into the development of the App. The main effective mechanisms of multicomponent interventions for patients with HF must contain: i) components that increase the patient's understanding of HF, ii) self-care, iii) self-efficacy, participation of the family / caregiver, iv) psychosocial well-being, and v) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), in nutritional information (70%), type of exercises in order to improve their physical condition (75%), and information about food and drugs interaction (60%). As a transversal element, in a large part of the user stories, was highlighted the importance of motivation messages (60%).

Conclusions: A 3-phases process integrating theoretical basis, evidence from integrative reviews, and research findings from target users has been considered a guide for future App development.

ClinicalTrials.gov NCT04725526

RR2-10.2196/35945