Perceptions of rural maternal and child health workers on using smartphone-based virtual patients to evaluate perinatal depression screening abilities: a qualitative study

农村妇幼保健工作者对使用基于智能手机的虚拟病人评估围产期抑郁症筛查能力的看法:一项定性研究

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Abstract

AIMS: This study aims to explore the perceptions of maternal and child health (MCH) workers regarding the use of smartphone-based virtual patients (VPs) to assess perinatal depression (PND) screening abilities and to collect feedback for iterative enhancement of the VPs. DESIGN: A qualitative study employing inductive content analysis to identify key themes from the responses of MCH workers. SETTING: The study was conducted in six counties across Yueyang City and Yiyang City, Hunan Province, between November 2023 and January 2024. METHODS: The MCH workers who completed the VPs test were selected through convenience and purposive sampling to participate in semistructured interviews via video conferencing. A total of 40 MCH workers completed semistructured individual interviews. Qualitative content analysis was carried out using NVivo 12.0 software. RESULTS: The participants identified two primary themes with 12 subthemes. The first theme, perceived usefulness of smartphone-based VPs, comprises six subthemes reflecting participants' perceptions that VPs supported PND knowledge acquisition, deepened understanding of screening procedures, provided opportunities to practise communication, facilitated screening practice and supported ongoing learning related to PND. The second theme, challenges of smartphone-based VPs, includes six subthemes: operational difficulties, increased workload and time demands, usability and interface limitations, insufficient health education content, restricted access to assessment results and limited diversity of PND case scenarios. CONCLUSIONS: Our study indicates that while smartphone-based VPs are well-received by MCH workers and perceived as beneficial for PND screening practice, operational challenges and procedural ambiguities remain. Addressing these barriers is essential to maximise the potential of smartphone-based VPs in supporting PND screening. Future research should focus on refining the interfaces and procedures of smartphone-based VPs to better support rural MCH workers nationwide.

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