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

Pilar Bas-Sarmiento; Martina Fernández-Gutiérrez; Miriam Poza-Méndez; Mª Ángeles Carrasco-Bernal; Magdalena Cuenca-García; Mercedes Díaz-Rodríguez; Mª Paz Gómez-Jiménez; Olga Paloma-Castro; Alezandra Torres-Castaño; Antonio-Jesús Marín-Paz

doi:10.1177/20552076231180466

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

Digit Health. 2023 Jun 8:9:20552076231180466. doi: 10.1177/20552076231180466. eCollection 2023 Jan-Dec.

Authors

Pilar Bas-Sarmiento^{1

2}, Martina Fernández-Gutiérrez^{1

2}, Miriam Poza-Méndez^{1

3}, Mª Ángeles Carrasco-Bernal⁴, Magdalena Cuenca-García^{2

5}, Mercedes Díaz-Rodríguez^{1

3}, Mª Paz Gómez-Jiménez^{1

6}, Olga Paloma-Castro^{1

2}, Alezandra Torres-Castaño⁷, Antonio-Jesús Marín-Paz^{1

3}

Affiliations

¹ Department of Nursing and Physiotherapy, University of Cadiz, Cadiz, Spain.
² Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain.
³ The University Research Institute for Sustainable Social Development (INDESS), University of Cadiz, Cadiz, Spain.
⁴ Línea de la Concepción Hospital, Andalusian Health Service, Cadiz, Spain.
⁵ GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain.
⁶ Puerta del Mar University Hospital, Andalusian Health Service, Cadiz, Spain.
⁷ Evaluation Unit of the Canary Islands Health Service (SESCS), Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.

Abstract

Objective: 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 heart failure (HF).

Methods: The three-phase 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. Data collection continued until data saturation was reached. All data were transcribed verbatim and analysed using a framework approach. Thematic analysis technique following the methods of Braun and Clarke was used for emerging themes.

Results: 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 that 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 (a) components that increase the patient's understanding of HF, (b) self-care, (c) self-efficacy and participation of the family/informal caregiver, (4) psychosocial well-being and (5) professional support and use of technology. User stories revealed that patients prioritized improvements in direct contact with health services in case of emergency (90%), nutritional information (70%), type of exercises in order to improve their physical condition (75%) and information about food and drug interaction (60%). The importance of motivation messages (60%) was highlighted by transversal way.

Conclusions: The three-phase process integrating theoretical basis, evidence from integrative reviews and research findings from target users has been considered a guide for future app development.

Keywords: eHealth; heart failure; multi-morbidity; perception; qualitative research.