JMIR Publications

ABSTRACT

Background:

Hybrid interventions combining inpatient and digitally supported care hold promise for improving care continuity in mental health. Yet little is known about how patients experience the transition between phases or the integration of both components within a coherent care pathway.

Objective:

This study examines participant experiences of a hybrid intervention bridging inpatient care and an app-supported training phase within an mixed-methods approach.

Methods:

A convergent mixed-methods design was applied, with qualitative data as the primary strand. Online focus groups were conducted with participants during the digital training phase of the intervention and were analysed using qualitative content analysis. Complementary quantitative data were drawn from standardised questionnaires administered at baseline (n = 416) and end of the digital phase (n = 163), as well as a dropout survey (n = 34).

Results:

Participants described the hybrid intervention not as two sequential components but as a continuous process in which therapeutic accompaniment may serve as a relational condition that makes digital interventions individually meaningful. The inpatient phase served as a therapeutic anchor while the transition to the digital phase was experienced as abrupt and fragile, with the steepest dropout occurring between weeks four and six. Therapeutic guidance emerged as a central moderating condition.

Conclusions:

Participants experienced hybrid care as a structured transformation process rather than an additive combination of components. Reduced digital activity over time should not be equated with disengagement, as for some participants, declining app use reflected internalisation rather than disengagement. These findings point to a more expansive understanding of hybrid care. Clinical Trial: Trial Registration: DRKS-ID: DRKS00033080 (Date: 07 December 2023)