影响使用基于web的应用程序支持2型糖尿病患者自我护理的因素:纵向研究%A Nijland,Nicol %A van Gemert-Pijnen,Julia EWC %A Kelders,Saskia M %A Brandenburg,Bart J %A Seydel,Erwin R %+特温特大学行为科学学院心理健康与技术系/电子健康研究和疾病管理中心，Drienerlolaan 5，邮政信箱217，恩斯德德，7500 AE，荷兰，31 651071559，n.nijland@utwente.nl %K互联网%K技术%K电子健康%K电子邮件%K通信%K初级保健%K自我保健%K糖尿病%D 2011 %7 30.09.2011 %9原始论文%J J医学互联网Res %G英语%X背景:电子健康应用的使用率总体上仍然相当低，用户流失率通常很高。关于特定患者群体使用电子保健技术的信息有限。目的:本研究的目的是探讨影响基于web的应用程序(DiabetesCoach)用于支持2型糖尿病患者自我护理的初始和长期使用的因素。方法:采用混合方法研究设计，对Web应用程序在2年期间的实际使用情况进行过程分析，并确定用户配置文件。研究工具包括日志文件、访谈、可用性测试和调查。结果:DiabetesCoach主要用于交互式功能，如在线监测、个人数据和患者-护士电子邮件联系。这种持续的个人反馈特别吸引病人;他们感到护士更加密切地监督他们，并鼓励他们在自我管理疾病方面发挥更积极的作用。 Despite the positive outcomes, usage of the Web application was hindered by low enrollment and nonusage attrition. The main barrier to enrollment had to do with a lack of access to the Internet (146/226, 65%). Although 68% (34/50) of the enrollees were continuous users, of whom 32% (16/50) could be defined as hardcore users (highly active), the remaining 32% (16/50) did not continue using the Web application for the full duration of the study period. Barriers to long-term use were primarily due to poor user-friendliness of the Web application (the absence of “push” factors or reminders) and selection of the “wrong” users; the well-regulated patients were not the ones who could benefit the most from system use because of a ceiling effect. Patients with a greater need for care seemed to be more engaged in long-term use; highly active users were significantly more often medication users than low/inactive users (P = .005) and had a longer diabetes duration (P = .03). Conclusion: Innovations in health care will diffuse more rapidly when technology is employed that is simple to use and has applicable components for interactivity. This would foresee the patients’ need for continuous and personalized feedback, in particular for patients with a greater need for care. From this study several factors appear to influence increased use of eHealth technologies: (1) avoiding selective enrollment, (2) making use of participatory design methods, and (3) developing push factors for persistence. Further research should focus on the causal relationship between using the system’s features and actual usage, as such a view would provide important evidence on how specific technology features can engage and captivate users. %M 21959968 %R 10.2196/jmir.1603 %U //www.mybigtv.com/2011/3/e71/ %U https://doi.org/10.2196/jmir.1603 %U http://www.ncbi.nlm.nih.gov/pubmed/21959968