Patients' experiences and perspectives regarding the use of digital technology to support exercise-based cardiac rehabilitation: a qualitative interview study
Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg; Paracelsus Medical University
How they used Delve
Digital health researchers at the Ludwig Boltzmann Institute and Paracelsus Medical University in Salzburg used Delve to run a framework analysis of 25 interviews with Austrian cardiac rehabilitation patients, building a coding framework from line-by-line coding and charting the results into a thematic matrix on what makes digital exercise technology usable or unwelcome.
“Data analysis was conducted by AZ with methodological support from STK and using Delve qualitative analysis software (https://delvetool.com/). During the familiarisation process, AZ read and re-read the interview transcripts several times, listened to the interview recordings, and wrote down her thoughts and impressions in analytical notes. [...] AZ first read several transcripts and conducted line-by-line coding, describing her interpretation of quotes. These codes gave rise to the initial framework development.”
- Field
- Cardiac rehabilitation and digital health; what Austrian cardiac patients think about using digital technology for physical activity, and about data protection, data sharing and AI
- Data
- Semi-structured interviews with 25 current and former cardiac rehabilitation patients (18 men, 7 women, aged 39-83) with a range of cardiac conditions, recruited from a clinical site in Salzburg, Austria; audio-recorded and transcribed verbatim, supplemented by IPAQ-SF and TA-EG questionnaires. Analysis was deliberately restricted to the interview sections about digital technology.
- Approach
- Descriptive phenomenological approach analysed with the framework method as set out by Gale et al.: transcription, familiarisation, coding, developing a working analytical framework, applying it, charting data into a framework matrix, and interpretation. One analyst (AZ) did the coding with methodological support from a second and third author. She read and re-read transcripts, listened back to the recordings and recorded impressions in analytical notes, then line-by-line coded several transcripts to build an initial framework, which was discussed and reviewed iteratively with two colleagues until consensus. The agreed framework was applied to the remaining transcripts with an open 'other' category preserved for inductive codes. Data were then summarised by category, charted into a thematic matrix, and interpreted by generating typologies. The full coding framework and code definitions are published as a supplement.
- Data types
- Interviews
Abstract
Introduction: Despite the well-known benefits of exercise-based cardiac rehabilitation for the secondary prevention of cardiovascular disease, participation in cardiac rehabilitation programmes and adherence to secondary prevention recommendations remain limited. Digital technologies have the potential to address low participation and adherence but attempts at implementing digital health interventions in real-life clinical practice frequently encounter various barriers. Studies about patients’ experiences and perspectives regarding the use of digital technology can assist developers, researchers and clinicians in addressing or pre-empting patient-related barriers. This study was therefore conducted to investigate the experiences and perspectives of cardiac rehabilitation patients in Austria with regard to using digital technology for physical activity and exercise. Methods: Twenty-five current and former cardiac rehabilitation patients (18 men and 7 women, age range 39 to 83) with various cardiac conditions were recruited from a clinical site in Salzburg, Austria. Semi-structured qualitative interviews were audio-recorded and transcribed verbatim. The analysis followed a descriptive phenomenological approach, applying the framework analysis method. Results: The sample was diverse, including interviewees who readily used digital devices to support their physical activity, exercise and health monitoring, and interviewees who did not. Simplicity, convenience and accessibility were highlighted as important facilitators for the use of digital technology, while annoyance with digital devices, concerns about becoming dependent on them, or simply a preference to not use digital technology were commonly stated reasons for non-use. Interviewees’ views on data protection, data sharing and artificial intelligence revealed wide variations in individuals’ prior knowledge and experience about these topics, and a need for greater accessibility and transparency of data protection regulation and data sharing arrangements. Discussion: These findings support the importance that is attributed to user-centred design methodologies in the conceptualisation and design of digital health interventions, and the imperative to develop solutions that are simple, accessible and that can be personalised according to the preferences and capabilities of the individual patient. Regarding data protection, data sharing and artificial intelligence, the findings indicate opportunity for information and education, as well as the need to offer patients transparency and accountability in order to build trust in digital technology and digital health interventions.
Citation
Anna Zeller, Johanna Gutenberg, Josef Niebauer, Rik Crutzen, Stefan Tino Kulnik (2024). Patients' experiences and perspectives regarding the use of digital technology to support exercise-based cardiac rehabilitation: a qualitative interview study. Frontiers in Sports and Active Living. https://doi.org/10.3389/fspor.2024.1371652