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International Journal of Medical Informatics
Article . 2025 . Peer-reviewed
License: CC BY
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Staff expectations for the implementation of digital remote monitoring in services for people with psychosis: A qualitative study using normalisation process theory

A qualitative study using normalisation process theory
Authors: Hannah Ball; Emily Eisner; Jennifer Nicholas; Paul Wilson; Sandra Bucci;

Staff expectations for the implementation of digital remote monitoring in services for people with psychosis: A qualitative study using normalisation process theory

Abstract

BACKGROUND: Digital remote monitoring (DRM) utilises devices such as smartphones and wearables to remotely collect health-related data, providing insights into the mental health of individuals with psychosis. This data can be shared with mental health services to aid clinical assessment. DRM has been found to effectively identify early signs of psychosis relapse, enabling clinicians to intervene earlier and improve outcomes for service users. However, there are challenges to its implementation in services. This study used Normalisation Process Theory (NPT) as a framework to examine mental health professionals' expectations regarding the barriers and facilitators to implementing DRM in psychosis care.METHODS: Semi-structured interviews were conducted with 59 multi-disciplinary mental health professionals from nine UK National Health Service mental health Trusts/Health Boards. Interviews were inductively thematically analysed, then deductively analysed by mapping themes to the core constructs of NPT.FINDINGS: Findings were similar across all settings and applicable to three NPT constructs (coherence, cognitive participation and collective action) and their subcomponents. One inductive theme, 'own experiences of technology' was not captured by NPT. Participants understood DRM's purpose for detecting early signs of relapse. However, several barriers to implementation were identified: uncertainty about professional roles, resource issues, concerns about inaccurate DRM data, complexity of the technology, security/privacy issues, and concerns about using DRM with certain clinical presentations. Suggested implementation strategies included staff training and ongoing technical support, developing guidance regarding professionals' responsibilities, using an in-house 'DRM expert' to lead its integration within services, enhancing clinician's knowledge of the evidence base for DRM in psychosis care, and actively involving both clinicians and service users in DRM system development. Interpretation Findings identify key factors and actionable implementation strategies essential for successful early adoption of DRM in routine care. By addressing these considerations, implementation effectiveness can be optimised, ultimately improving outcomes for people with psychosis. Funding Wellcome Trust, National Institute for Health and Care Research.

Country
United Kingdom
Related Organizations
Keywords

Mental Health Services, Male, Adult, Attitude of Health Personnel, Humans, Psychotic Disorders/therapy, Female, Health Personnel/psychology, Qualitative Research, Telemedicine, United Kingdom

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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hybrid