Self-management Application Research Articles

Effects of an interactive coaching intervention on quality of life and psychological factors for colorectal cancer survivors: A single group pre and posttest design

ObjectiveTo develop and evaluate the effects of an interactive coaching intervention, using a self-management mobile application, on quality of life and physical and psychological factors for colorectal cancer survivors. MethodsWe developed a self-management mobile application providing social support services for post-treatment CRC survivors and evaluated its effects through baseline and post-intervention surveys. Using the biopsychosocial holistic model as the theoretical framework, automated interactive coaching technology was applied for six weeks to provide supportive services tailored for each user. To evaluate the effects of the application, self-efficacy, health practice index, depression, fear of cancer recurrence, and quality of life measures were administered to participants. A total of 34 men and 5 women were included in the analysis. ResultsParticipants’ mean age were 54.10 years and 78% of them had been diagnosed within the last five years. There were significant increases in self-efficacy (z = 2.09, p = .04), health practice index (t = 2.35, p = .02), and quality of life (t = 2.03, p = .05). More specifically, the emotional functional score increased (z = 2.23, p = .03) while both of the total symptom score (t = 2.10, p = .04) and the fatigue symptom score (z = 2.54, p = .01) decreased after six weeks of using the mobile application. ConclusionsInterventions supporting colorectal cancer survivors’ self-management are critical for addressing the challenges they face after treatment and improving their quality of life. Providing social support through mobile applications could be a good strategy in terms of usability and effectiveness.

Digital health applications in the self-management of epilepsy-A survey on patients' perspective.

Digital health applications can be prescribed since 2019 in Germany, which is likely to facilitate a broad use of epilepsy self-management applications, possibly directly connected to clinical systems via telematics infrastructures. This article reports on patients' interest in digital support for epilepsy self-management, influencing factors and patients' knowledge about digitization of health care in Germany. This work is based on self-reported data from 115 people with epilepsy participating in an anonymous online survey with a total of 54 questions covering several topics, including sociodemographics and epilepsy manifestation, use of technology in general and for treatment support, training programs, affinity for technology, knowledge on the digital infrastructure in Germany, and self-efficacy in dealing with chronic illness. The self-constructed questionnaire uses existing instruments like TA-EG, SES6G, and Hoffmeyer-Zlotnik sociodemographic questionnaire. To analyze the knowledge about digitalization in health care, a combination of self-assessment and knowledge quiz was used. The analysis was performed using descriptive methods and inferential statistics (t-test, reliability analysis, and correlations). Participants were most interested in seizure alerting and documentation with the possibility to share documentation with physicians. The analysis of technology affinity showed medium enthusiasm, with positively perceived consequences being rated higher than the negatively perceived consequences of technology use. Knowledge on national health infrastructures was mediocre and training on this was judged to be essential and desired. Furthermore, a significant correlation was found between interest in use and affinity for technology (enthusiasm for technology [r = 0.29; P = 0.00]) and positively perceived consequences of technology (r = 0.33; P = 0.00). Our results underline the high relevance of digital solutions for patients and the importance of individual training opportunities in digital health literacy, thereby enabling patients to decide competently for or against offered digital solutions.

Effects of a mobile application on improving self-management of adult patients receiving peritoneal dialysis: A randomized controlled trial.

This study aimed to develop a mobile application for improving self-management and to evaluate its effects in adult patients on peritoneal dialysis (PD). This randomized controlled trial was registered with the Korean Clinical Research Information Service Registry (KCT0007267) and conducted at a tertiary hospital. A self-management mobile application (SMA) was developed based on social cognitive theory and the ADDIE (analysis, design, development, implementation, and evaluation) model. The SMA includes information about disease management; self-recording of data on diet, exercise, medication, and health behavior; and healthcare providers' support and feedback. Participants aged 19-65 years were randomly allocated to the intervention group (n = 27) using the SMA for 10 weeks, and the control group (n = 26) receiving usual care. PD-related knowledge and self-efficacy, PD-related health behavior, biomarkers, and health-related quality of life (HRQoL) were surveyed pretest/posttest and analyzed using SPSS 23.0. Compared to the controls, the intervention group showed significant improvement in PD-related knowledge and health behavior, albumin, and hemoglobin. HRQoL domains of symptoms/problems of kidney disease and disease impact on daily activity were improved in the intervention group. The SMA is an effective intervention for enhancing health behaviors as well as improving the HRQoL of patients with PD. Without any limitations on time or location, patients with PD can easily use the SMA to monitor their health conditions, efficiently manage their disease, and perform PD-related behaviors. Nurses can implement high-quality tailored healthcare by using patients' lifelog data from the SMA.

Creating a Self-management Mobile Application for People With Chronic Low Back Pain: A Focus Group Study of Unmet Needs and Strategies.

Mobile health can fulfill the unmet needs of patients with chronic low back pain by recommending individualized management plans. Limited mobile applications have been developed based on the needs, preferences, and values relative to self-management of patients with chronic low back pain. This study aimed to explore the experience of patients with chronic low back pain and the desired content, designs, and features of a self-management application. We conducted five focus groups (N = 24). Participants provided feedback on draft contents and they also discussed the desired designs and features of an application while reviewing a low-fidelity prototype. Data were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis. Three categories and eight subcategories emerged. Participants: (1) confronted difficulties of their pain experience along with vicious cycles of pain and unmet needs; (2) acknowledged the importance of self-management as they lived with chronic low back pain and realized how to self-manage their pain; and (3) suggested ways to fulfill needs and preferences among patients with chronic low back pain. The nature of chronic low back pain causes disruptions well-being and requires constant management. Developing user-centered strategies to enhance knowledge and promote self-management among chronic low back pain patients is required.

Development, Implementation, And Evaluation of An Informatics Platform for Home Based Self- Management of Chronic Obstructive Pulmonary Disease: A Study Protocol

Background: The burden of chronic obstructive pulmonary disease to patients, their caretakers, and health system is gradually increasing and is associated with the morbidity, mortality, disability adjusted life years and higher costs. Self-management of COPD is a vital strategy for its management. This study aims to develop, implement, and evaluate an informatics platform for the home-based self-management of Chronic Obstructive Pulmonary Disease. Method: A systematic review will be conducted to synthesize and appraise the evidence on self-management informatics tool or platform for COPD. An evidence-based COPD self-management application will be developed and implemented to 35 COPD patients at identified hospitals of New Delhi using prospective non-randomized study. A mixed methods study will be conducted to evaluate the effectiveness of this informatics platform at selected hospitals of Delhi. Outcomes will be measured in terms of self-management for COPD related exacerbations, number of health care facility admissions for COPD and hospitalization days, adherence to the informatics platform, number of exacerbations requiring hospital visits, health related quality of life. Conclusion: The development and evaluation of home-based self-management of informatics platform for COPD would be an innovative strategy for the COPD patients in India.

COVID-19-related disruptions in implementation of a randomized control trial: An autoethnographic report

Background and aimsThe SARS-Cov-2 virus (COVID-19) has not only threatened the health of the world's population but also presented challenges for conducting human subject research studies. Although many institutions have now established guidelines for conducting research during the COVID-19 pandemic, reports of the practical experiences of researchers are limited. This report presents the challenges nurse researchers encountered when conducting a randomized controlled trial to develop an arthritis self-management application during the COVID-19 pandemic in Taiwan and how researchers responded to the challenges. MethodsQualitative data from five nurse researchers were collected from August 2020 to July 2022 at a rheumatology clinic in northern Taiwan. This collaborative autoethnographic report was drawn from data comprised of detailed field notes and weekly discussions regarding research challenges we were confronting. Data were analyzed to determine successful strategies employed to overcome the challenges and allow for completion of the study. ResultsMinimizing the risk of exposure to the virus for researchers and participants resulted in four major challenges to conducting our research: patient screening and recruitment, delivery of the intervention, obtaining follow-up data, and unanticipated budget increases. ConclusionsChallenges reduced sample size, altered intervention delivery, increased time and money beyond what was originally budgeted, and delayed completion of the study. Adapting to a new healthcare environment required flexibility for recruitment, alternate means of providing intervention instructions, and an awareness of disparities in participants' internet proficiency. Our experiences can serve as an example for other institutions and researchers faced with similar challenges.

Development and usability evaluation of a mHealth application for albinism self-management

BackgroundReduced or absence of melanin poses physical, social, and psychological challenges to individuals with albinism. Mobile health (mHealth) applications have the potential to improve the accessibility of information and services while reducing time and costs. This study aimed to develop and evaluate a mHealth application for self-management of albinism.MethodsThis applied study was conducted in two stages (development and evaluation) in 2022. Initially, the functional requirements were determined, and the conceptual model of the application was then developed using Microsoft Visio 2021. In the second phase, the application was evaluated using the Mobile Application Usability Questionnaire (MAUQ) involving patients with albinism to reflect their views on the usability of the application.ResultsThe key capabilities of the application included: reminders, alerts, educational content, useful links, storage and exchange of images of skin lesions, specialist finder, and notifications for albinism-relevant events. Twenty-one users with albinism participated in the usability testing of the application. The users were predominantly satisfied with the application (5.53 ± 1.10; Max: 7.00).ConclusionsThe findings of this study suggest that the developed mobile application could assist individuals with albinism to effectively manage their condition by considering the users’ requirements and services that the application should deliver.

Mobile heath applications for self-management in chronic lung disease: a systematic review.

The online version contains supplementary material available at 10.1007/s13721-023-00419-0.

A Survey of Conversational Agents and Their Applications for Self-Management of Chronic Conditions.

Conversational agents have gained their ground in our daily life and various domains including healthcare. Chronic condition self-management is one of the promising healthcare areas in which conversational agents demonstrate significant potential to contribute to alleviating healthcare burdens from chronic conditions. This survey paper introduces and outlines types of conversational agents, their generic architecture and workflow, the implemented technologies, and their application to chronic condition self-management.

Perceptions of pharmacists and other healthcare professionals on marketed mobile applications used for self-management by type 2 diabetic patients: A systematic review

Purpose: To determine the level of awareness, beliefs and experience of healthcare professionals (HCPs) regarding mobile applications for self-management of type 2 diabetes mellitus.
 Methods: This review was done by searching the literature using three databases viz: PubMed, Web of Science and Scopus. Assessment of quality of studies was carried out using the scale of the Agency for Healthcare Research and Quality. The results were presented in accordance with the PRISMA 2020 guidelines.
 Results: The search strategy identified 725 unique research papers, 4 of which were included. A survey among pharmacists showed that 56 % of participants were aware of the existence of mobile health applications, and that 60 % of those who were aware recommended their use. In the multi-HCPs setting, depending on the study, apps recommendation rate varied from 45.5 to 62 %. Most of the participants (88 %) agreed that a mobile app would help strengthen their treatment recommendations to the patients (88 %), and 84 % also agreed that it would help patients manage diabetes better.
 Conclusion: Not much research has been done on this topic. Available data suggest that the awareness of HCPs regarding mobile applications is unsatisfactory, and that those familiar with these apps find them useful and are ready to recommend them to patients. There is need for further research and measures to increase awareness and knowledge of HCPs about available mobile applications, in order to ensure adequate support to patients with diabetes.

Penerapan Self-Management dan PHBS untuk Mencegah Angka Kejadian Diare pada Remaja

Introduction: Diarrhea is a condition experienced by a person when the bowel movements are of an abnormal consistency, namely soft or liquid, the frequency of which can occur more than 3 times a day. Even if you have experienced severe diarrhea, the frequency can reach 10 times a day. Severe diarrhea can cause fluid loss and can be life-threatening, especially in children and adolescents who have nutritional deficiencies. Apart from causing fluid loss, there are also complications such as severe dehydration and even death. Objective: This community service aims to determine the effectiveness of self-management in PHBS as a form of effort to improve health and prevent diseases, especially diarrhea in adolescents at SMK Terpadu Al Hasan. Method: The methodology of health education that incorporates self-management. Participants in this counseling are anticipated to be able to apply a complete strategy, particularly in the creation of new behaviors, specifically PHBS in the school setting as well as the community. Result: Based on the results of pre- and post-implementation of Community service regarding the level of knowledge of the participants had increased. this shows that counseling with the application of self-management in PHBS has a positive impact on SMK Terpadu Al Hasan students. there is a significant effect before and after being given counseling. Conclusion: The conclusion from the implementation of health education activities regarding the application of self-management in PHBS in preventing diarrhea in adolescents is going according to plan. This activity is effective and has positive value for the students of SMK Terpadu Al Hasan. This can be seen from the enthusiasm and activeness of the participants in counseling as well as increased knowledge about self-management in PHBS in preventing diarrhea before and after being given counseling.

Hypoglycaemia prediction using information fusion and classifiers consensus

The recommendation that there must be a balance between insulin, food, and exercise to keep diabetes under control provides an opportunity for developing mobile applications for self-management of the disease. Real predictions can improve the quality of patients’ lives by avoiding unwanted events, namely, hypoglycaemia. We proposed a hypoglycaemia prediction approach combining information fusion and classifiers consensus to predict the risk of hypoglycaemia in a 24-h window. First, we train a multi-classifiers system from different sources of different patients. After using data from a unique patient, we performed the prediction of the risk of hypoglycaemia and evaluate the consensus decision of the single models resulting from the learning process. The predictions were performed for 54 patients from the University of California Irvine diabetes dataset. The results from classifiers consensus decision provide very promising results, which are acceptable considering that we used sparse data and data from self-monitoring blood glucose. Our approach shows that with a 24-h window is possible to catch appropriate patterns associated with the risk of hypoglycaemia and proposed a solution that can improve the hypoglycaemia prediction with a higher specificity, i.e. less false alarms, when compared with similar literature.

Design and Evaluation of an mHealth Application in Self-Management of Post -Traumatic Stress Disorder

Introduction: Recent developments in the use of mobile technologies have given rise to opportunities for more effective and cost -efficient services for people with chronic diseases. Considering the relatively high prevalence of post -traumatic stress disorder (PTSD) in Iran and the lack of a native application for the self-management of many complications of this disorder, the present study aims to develop and evaluate a mobile application for PTSD selfmanagement. Method: This developmental -applied study was conducted in two stages. In the first stage, interviews and a literature review were carried out to identify users’ requirements and expectations of the application. Then, the application was modeled, designed, developed, and tested based on the requirements. In the second stage, the usability of developed application was evaluated by experts and users. Results: The following services were implemented in the application: psychoeducation, coping skills, breathing exercise, relaxation, positive affect, social support, self-assessment, reminders, useful links, and self-monitoring. According to experts’ evaluation, the application was of acceptable quality (78.25%). The application was relatively acceptable from the users’ point of view (68.67%). In the evaluation process, experts were most satisfied with the functionality of the application (80 %) , and users were most satisfied with the application’s ease of use (76%). Conclusion: Using the application can be useful in promoting access to healthcare services for patients with PTSD, and in addition to saving time and costs, it can be effective in the selfmanagement of this disorder.

Design and usability evaluation of a mobile-based-self-management application for caregivers of children with severe burns.

Paediatric burns are a major public health issue because of long-term physical, psychological and social consequences and the high cost of treatment. The aim of this study was to design and evaluate a mobile-based self-management application for caregivers of children with severe burns. A participatory design technique was employed to develop the Burn application, which included three main phases: the determination of application requirements, the design and evaluation of the low-fidelity prototype, and the design and evaluation of the high-fidelity prototypes. In the first phase, application requirements were determined via validated paper questionnaires using the Delphi technique. In the second step, a low-fidelity prototype was prepared using conceptual models and evaluated through a focus group with specialists. Seven specialists reviewed the application and evaluated how this prototype meets functional requirements and objectives. The third phase was performed in three stages. First, the high-fidelity prototype was designed and developed by the JAVA programming language. Second, a cognitive walk-through was carried out to show how users can interact with the mobile application and how it works. Third, this program was installed on the mobile phones of 28 caregivers of burned children, eight IT experts, and two general surgeries, and the prototype's usability was evaluated. In the present study, most caregivers of children with burns stated that after discharge, they face problems regarding infection control and wound care (4.07) and how to perform physical activity (4.12). User registration, educational materials, caregiver-clinician communication, chat box, and appointment booking, safe login were the most important characteristic of the Burn application. Mean usability evaluation scores were in the range of 7.92 ± 0.238 to 8.10± 0.103, which is considered at a "good" level. From the Burn program design experience, it can be concluded that co-design with health care specialists can significantly support and meet the specialists' and patients' needs and ensure the program's usefulness. In addition, application evaluation by users involved and not involved in the application design process can help enhance usability.

Designing digital health applications for climate change mitigation and adaptation.

Designing digital health applications for climate change mitigation and adaptation.

A Smart Monitoring System for Self-Nutrition Management in Pediatric Patients with Inherited Metabolic Disorders: Maple Syrup Urine Disease (MSUD).

A metabolic disorder is due to a gene mutation that causes an enzyme deficiency which leads to metabolism problems. Maple Syrup Urine Disease (MSUD) is one of the most common and severe hereditary metabolic disorders in Saudi Arabia. Patients and families were burdened by complex and regular dietary therapy menus because of the lack of information on food labels, it was also difficult to keep track of MSUD's typical diet. The prototype smart plate system proposed in this work may help patients with MSUD and their caregivers better manage the patients' MSUD diet. The use of knowledge-based, food identification techniques and a device could provide a support tool for self-nutrition management in pediatric patients. The requirements of the system are specified by using questionaries. The design of the prototype is divided into two parts: software (mobile application) and hardware (3D model of the plate). The knowledge-based mobile application contains knowledge, databases, inference, food recognition, food plan, monitor food plan, and user interfaces. The hardware prototype is represented in a 3D model. All the patients agreed that a smart plate system connected to a mobile application could help to track and record their daily diet. A self-management application can help MSUD patients manage their diet in a way that is more pleasant, effortless, accurate, and intelligent than was previously possible with paper records. This could support dietetic professional practitioners and their patients to achieve sustainable results.

“Ask, ‘When You Do This, How Much Pain Are You In?’”: Content Preferences for a Conversational Pain Self-Management Software Application

The purpose of the current study was to examine older adults' preferences for conversational pain management content to incorporate in an interactive application (app) for pain self-management. Conversational statements and questions were written as a script to encourage evidence-based pain self-management behaviors. The content was converted from text to female chatbot speech and saved as four groups of MP3 files. A purposive sample of 22 older adults participated in a guided interaction through the MP3 files. One-on-one interviews were conducted to garner participants' conversational content preferences. Overall, participants want the conversational content to increase health care provider engagement in pain management communication. Older adults preferred the inclusion of conversational statements and questions for monitoring the multifaceted dimensions of pain, treatment accountability, guidance for alternative treatments, and undesirable effects from pain treatments. The design of mobile health apps must incorporate the needs and preferences of older adults. [Journal of Gerontological Nursing, 49(1), 11-17.].

Usability evaluation of a self-management mobile application for individuals with a mild traumatic brain injury.

Mild traumatic brain injuries (mTBIs) are common and may result in persisting symptoms. Mobile health (mHealth) applications enhance treatment access and rehabilitation. However, there is limited evidence to support mHealth applications for individuals with an mTBI. The primary purpose of this study was to evaluate user experiences and perceptions of the Parkwood Pacing and Planning™ application, an mHealth application developed to help individuals manage their symptoms following an mTBI. The secondary purpose of this study was to identify strategies to improve the application. This study was conducted as part of the development process for this application. A mixed methods co-design encompassing an interactive focus group and a follow-up survey was conducted with patient and clinician-participants (n = 8, four per group). Each group participated in a focus group consisting of an interactive scenario-based review of the application. Additionally, participants completed the Internet Evaluation and Utility Questionnaire (UQ). Qualitative analysis on the interactive focus group recordings and notes was performed using phenomenological reflection through thematic analyses. Quantitative analysis included descriptive statistics of demographic information and UQ responses. On average, clinician and patient-participants positively rated the application on the UQ (4.0 ± .3, 3.8 ± .2, respectively). User experiences and recommendations for improving the application were categorized into four themes: simplicity, adaptability, conciseness, and familiarity. Preliminary analyses indicates patients and clinicians have a positive experience when using the Parkwood Pacing and Planning™ application. However, modifications that improve simplicity, adaptability, conciseness, and familiarity may further improve the user's experience.

The Fast Health Interoperability Resources (FHIR) Standard and Homecare, a Scoping Review

The scoping review reported by this article aimed to analyze the state of the art of the use of Fast Health Interoperability Resources (FHIR) in the development of homecare applications and was informed by the following research questions: (i) what type of homecare applications benefit from the use of FHIR?; (ii) what FHIR resources are being implemented?; (iii) what publicly available development tools are being used?; and (iv) how privacy and security issues are being addressed? An electronic search was conducted, and 27 studies were included in the scoping review after the selection process. The results show a current interest in using FHIR to implement: i) applications to provide interoperable measurement devices for home monitoring; (ii) applications to remotely collected Patient Reported Outcome Measures (PROM); (iii) Personal Health Records (PHR); and (iv) specific applications for self-management. According to the results, the FHIR resources being implemented are quite diverse and contribute for the challenge of handling the variability caused by diverse healthcare processes. However, the use of publicly available development tools (e.g., SMART on FHIR or HAPI) is not yet generalized. Moreover, just a small number of studies reported the validation of the implemented resources using publicly available FHIR validators. Finally, in terms of privacy and security issues, different approaches were identified: authentication and authorizations mechanisms, end-to-end encrypted messaging mechanisms, and decentralized management and audit trail based on blockchain technologies.

Meta Analysis the Effect of Electronic Health-based Self Management in Controlling Blood Pressure in Hipertensive Patients

Background Consistent application of self-management is important in efforts to improve the quality of life and health status of hypertensive patients. Electronic health is here to facilitate self-management of hypertensive patients and provide health information to health workers in real time and promote lifestyle modifications. The purpose of this study was to analyze the influence of electronic health-based self-management on blood pressure control in hypertensive patients. Subjects and Method: : This study is a meta-analysis using PICO namely Population: Hypertensive patients; Intervention: Self-management based on electronic health; Comparison: No self-management based on electronic health; Outcome: Systolic and diastolic blood pressure. This study uses articles from several databases, i.e Pubmed, Google Scholar, Science Direct and the Cochrane Library using the following keywords “Hypertension” OR “Hypertensive” OR “Blood Pressure” OR “High Blood Pressure” AND “Self Management” OR “Self Care” OR “Self Monitoring” AND “Electronic Health” OR “eHealth” OR “Telemedicine” OR “Telehealth” OR “mHealth” OR “Mobile Health” OR “Mobile Application” OR “Message Text” OR “Phone Calls”. Articles included in the research are articles that use English with an RCT study design whose publication is within the period of 2012-2022. The steps in the systematic review are carried out based on the PRISMA flow diagram guidelines. Quantitative analysis was carried out using Review Manager (Revman) 5.3. Results: There were 9 articles from South Africa, America, South Korea, Spanish, England, Scotland, and Honduras, with a sample size of 3,071 hypertensive patients concluded that electronic health-based self-management could reduce systolic blood pressure by 0.38 units and was statistically significant (SMD= -0.38; 95% CI = -0.55 to -0.20; p<0.001 ). The meta-analysis synthesized 9 studies with a total sample size = 2.095 hypertensive patients concluded that electronic health-based self-management could reduce diastolic blood pressure by 0.21 units and was statistically significant (SMD= -0.21; 95% CI = -0.29 to -0.12; p< 0.001). Conclusion: Electronic health-based self-management can reduce systolic and diastolic blood pressure control in hypertensive patients. Keywords: Self management, electronic health, blood pressure, hypertension