Healthcare in the pocket: A qualitative analysis of patients� perspectives of an mHealth application to foster power in everyday living with schizophrenia (Preprint)

Abstract

BACKGROUND We co-designed a mobile health application (mHealth app) – MindFrame - in partnership with individuals with schizophrenia and healthcare providers. The purpose of MindFrame is to empower patients to confidently manage everyday living when having been recently diagnosed with schizophrenia trough tracking of the mental health state, customized psychoeducation, medication adherence support, illness exacerbation alerts and delivery of time sensitive strategies for relapse prevention and self-management. OBJECTIVE This paper explores how young adults recently diagnosed with schizophrenia, used and perceived MindFrame as a tool to foster power in the daily management of their illness. METHODS From January to December 2016 patients from a first episode psychosis outpatient program in Denmark were invited to use MindFrame as part of their care. Along with MindFrame, they continued their usual care. They customized and used MindFrame based on their needs and preferences while assessing their mental health state on a daily basis. 27 patients used MindFrame and 13 subsequently evaluated it. The evaluation was qualitative and conducted using telephone interviews. Data were analysed using a hermeneutical approach. RESULTS The analysis showed that, for patients, MindFrame served to foster power in the everyday management of living with schizophrenia. When the app was used consistently for more than a month, and with the healthcare providers, it could provide the patients with the power to keep up their medication, to keep a step ahead of their illness and to get fast and timely help. This empowered them to stay on track with the illness, thus in control of it. Also, MindFrame could fuel the fear of restraint and illness exacerbation, thereby disempowering some from feeling certain and secure. CONCLUSIONS The findings demonstrate that MindFrame has the ability to empower young adults to manage their illness in the context of their daily lives. This contributes toward the potential of putting healthcare into the patient’s pocket. The disempowering aspect of MindFrame accentuates a need for further research to clarify the limitations of mHealth apps for patient empowerment in young adults with schizophrenia.