Preferences of Older Adult Veterans With Heart Failure for Engaging With Mobile Health Technology to Support Self-care: Qualitative Interview Study Among Patients With Heart Failure and Content Analysis

Abstract

Background Heart failure (HF) affects approximately 6.5 million adults in the United States, disproportionately afflicting older adults. Mobile health (mHealth) has emerged as a promising tool to empower older adults in HF self-care. However, little is known about the use of this approach among older adult veterans. Objective The goal of this study was to explore which features of an app were prioritized for older adult veterans with HF. Methods Between January and July 2021, we conducted semistructured interviews with patients with heart failure aged 65 years and older at a single facility in an integrated health care system (the Veterans Health Administration). We performed content analysis and derived themes based on the middle-range theory of chronic illness, generating findings both deductively and inductively. The qualitative questions captured data on the 3 key themes of the theory: self-care maintenance, self-care monitoring, and self-care management. Qualitative responses were analyzed using a qualitative data management platform, and descriptive statistics were used to analyze demographic data. Results Among patients interviewed (n=9), most agreed that a smartphone app for supporting HF self-care was desirable. In addition to 3 a priori themes, we identified 7 subthemes: education on daily HF care, how often to get education on HF, support of medication adherence, dietary restriction support, goal setting for exercises, stress reduction strategies, and prompts of when to call a provider. In addition, we identified 3 inductive themes related to veteran preferences for app components: simplicity, ability to share data with caregivers, and positive framing of HF language. Conclusions We identified educational and tracking app features that can guide the development of HF self-care for an older adult veteran population. Future research needs to be done to extend these findings and assess the feasibility of and test an app with these features.

Patients with Heart Failure: Internet Use and Mobile Health Perceptions

“…[45][46][47] Though the literature on physician perspectives of mHealth is limited, one previous study found that physicians including cardiologists think mHealth apps could reduce delays in diagnosis and improve patient outcomes. 48 As indicated by our results and those of previous studies, 28,29 heart failure patients are receptive to mHealth solutions and their features such as tracking and reminders especially following the recommendation from their physician. 41 Since heart failure patients trust their physicians for recommendations and seek information about treatment and management options, patient-physician discussions about mHealth technologies may improve This article is protected by copyright.…”

Educational technologies used to promote self-care for people with diabetes mellitus: integrative review

“…In this context, collaborative and continuous efforts are necessary to identify or create the appropriate ET for an efficient education (24) . In this regard, the different uses of educational technologies for people with DM are shared and integrated to facilitate learning, so that the adherence of these individuals can interrupt the fragilities of knowledge in relation to the essence of self-care (6) .…”

“…This is because they provide the opportunity to build strategies based on the different needs of individuals, considering lifestyle, social contexts, living spaces and the main health problems (5) . In this context, the use of educational technologies (ET) as a resource for health education has shown promise (6) . Studies show that the applicability of ET by health professionals contributes to people with chronic conditions to obtain greater engagement in care actions for their health condition (7)(8) .…”

Tecnologias educacionais utilizadas para promoção do autocuidado de pessoas com diabetes mellitus: revisão integrativa

“…Nesse contexto, torna-se necessário os esforços colaborativos e contínuos para identificar ou criar a TE apropriada a uma educação eficiente (24) . Sobre isso, os diferentes usos de tecnologias educacionais para as pessoas com DM são compartilhadas e integralizadas para facilitar o aprendizado, de modo que a aderência desses indivíduos possa interromper as fragilidades de conhecimento em relação à essência do autocuidado (6) .…”

“…Isso porque oportunizam a construção de estratégias com base nas diferentes necessidades dos indivíduos, considerando o estilo de vida, contextos sociais, espaços de convivência e as principais problemáticas de saúde (5) . Nesse contexto, a utilização de tecnologias educativas (TE) como recurso para educação em saúde tem se mostrado promissora (6) . Estudos demonstram que a aplicabilidade de TE por profissionais da saúde colabora para que as pessoas com condições crônicas obtenham maior engajamento nas ações de cuidado para com sua condição de saúde (7)(8) .…”