| ObjectiveThe objective of this study is to explore the current status,willingness and demand of diabetes management applications(apps)for patients and doctors,analyze the influencing factors,and provide a reference for the optimization and promotion of diabetes management apps and the self-management of diabetes patients.Methods1?On the basis of literature review and professional knowledge,I constructed a questionnaire on general information of diabetes patients and medical staff and a questionnaire on diabetes management apps.Literature review,qualitative interviews and Delphi expert consultation were used to initially construct the "pre-test scale of patients'willingness to use diabetes management apps" and the "pre-test scale of medical staff's willingness to use diabetes management apps ".The pre-test scale of patients' willingness to use diabetes management apps was composed of 6 dimensions and 27 items,including willingness to adopt,perceived usefulness,perceived ease of use,social impact,resistance to change and perceived risk.The pre-test scale of medical staffs willingness to use diabetes management apps was composed of six dimensions and 19 items,including willingness to adopt,perceived usefulness,perceived ease of use,social impact,resistance to change and perceived risk.After a preliminary survey,a formal questionnaire is formed.2?A convenient sampling method was adopted to select the diabetic patients in the outpatient and ward of endocrinology department of the first affiliated hospital of Soochow university from December 2018 to May 2019,as well as the medical staff of the first affiliated hospital of Soochow university,the second affiliated hospital,Suzhou municipal hospital and Suzhou hospital of traditional Chinese medicine who were engaged in the treatment and nursing of diabetes.Questionnaire was used for the investigation,and questionnaires of 511(patients)and 146(medical staff)were eventually collected.The data were checked by two persons and then entered into SPSS 18.0 software for statistical analysis.Chi-square test and binary Logistic regression were used to analyze the factors affecting the awareness and use of diabetes management apps by doctors and patients,and the factors influencing the willingness of doctors and patients to use diabetes management apps were analyzed by rank sum test and multiple linear regression.Results1?The awareness and use rate of patients' diabetes management apps are low,which are 15.7%and 7.6%,respectively.Chi-square test showed that there was a difference in the awareness rate of diabetes management apps among patients of different ages and smartphone proficiency,and the difference was statistically significant(P=0.046;P=0.001);the use rate of diabetes management apps was present in patients with different education levels and smartphone proficiency,the difference was statistically significant(P<0.001).Binary logistic regression analysis found that the awareness of diabetes management apps was 12.500 times(OR=12.500)for bachelor's degree and above,and that the diabetes management apps for patients treated with hypoglycemic drugs+insulin was pure insulin therapy 6.803 times(OR=6.803),the knowledge of diabetes management apps in patients with very smart phones is 10.989 times(OR=10.989)of the average level of proficiency of smartphone;the use of diabetes management apps in patients with monthly incomes above 15,000 is 5,000 monthly income 2.638 times(OR=2.638)and 3.425 times(OR=3.425)of patients with 10000 and 10000-15000,and the use of diabetes management apps was 2.041 times(OR=2.041)in patients with complications.2?Demographic characteristics and clinical data of patients on patients' willingness to use diabetes management apps:patients of different ages,education levels,occupations,monthly income,medical expenses,the type of diabetes,course of disease,and smartphone proficiency are willing to adopt and perceived usefulness,The scores were compared,and the differences were statistically significant(P<0.05 to P<0.001);The scores of perceived ease of use and social impact of patients with different gender,age,education level,occupation,monthly income,medical expenses,diabetes type,disease course and smartphone proficiency were all statistically significant(P<0.05 to P<0.001).The scores of resistance to change in patients with different age,education level,monthly income,diabetes type and smartphone proficiency were all statistically significant(P<0.05 to P<0.001).3?Multivariate linear regression analysis of factors affecting patient diabetes management apps adoption willingness found that perceived usefulness,perceived ease of use,social impact and smartphone proficiency had a positive effect on patient diabetes management apps adoption willingness,and resistance to change on patient diabetes management apps adoption willingness has a negative effect.4?The awareness rate and utilization rate of diabetes management apps were not high among medical staff,which were 23.9%and 16.4%,respectively.Chi-square test showed that there were differences in the awareness rate and usage rate of diabetes management apps among doctors of different ages,and the differences were statistically significant(P<0.05).Binary Logistic regression analysis found that the awareness rate of diabetes management apps for medical staff in the 46-60 age group was 9.091 times that of the 30-45 age group(OR=9.091),and the awareness rate of diabetes management apps for medical staff working in tertiary hospitals was 3.270 times that of workers in secondary hospitals(OR=3.270).5?Demographic characteristics and occupational characteristics on the willingness of doctors to use diabetes management apps:the scores of adoption willingness and perceived usefulness of medical staff with different professional titles were compared,and the differences were statistically significant(P=0.012;P=0.016).The perceived ease of use scores of medical staff with different smartphone proficiency were compared,and the difference was statistically significant(P=0.009).The scores of resistance to change of medical workers with different ages,working years,hospital grades and smartphone proficiency were all statistically significant(P<0.05 to P<0.01).The perceived risk scores of medical staff of different hospital levels were compared,and the difference was statistically significant(P=0.004).6?Multiple linear regression analysis of the factors influencing the adoption intention of diabetes management apps for medical staff found that perceived usefulness and social influence had an impact on the adoption intention of diabetes management apps for medical staff.Conclusions:1?Patients are willing to adopt diabetes management apps,but the awareness rate and utilization rate of diabetes management apps are low.2?Most medical staff are willing to use diabetes management apps to manage patients,but the awareness rate and utilization rate in actual work are low.3?Perceived usefulness,perceived ease of use,social impact,resistance to change and smartphone proficiency are the main factors influencing the adoption of diabetes management apps by patients,while perceived usefulness and social impact are the main factors influencing the adoption of diabetes management apps by medical staff.The development and design of diabetes management apps should,on the basis of meeting the use needs of patients and medical staff,adopt reasonable promotion and use management methods and doctor-patient interaction mode,supplemented by policy support,so as to truly and effectively play its role in the self-management of diabetes patients. |
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