Effects of mobile phone App-based continuing nursing care on self-efficacy, quality of life, and motor function of stroke patients in the community

A Mobile Application for Anticoagulation Management in Patients After Heart Valve Replacement: A Usability Study

Purpose

Individualized anticoagulation therapy is a major challenge for patients after heart valve replacement. Mobile applications assisted by Artificial intelligence (AI) have great potential to meet the individual needs of patients. The study aimed to develop an AI technology-assisted mobile application (app) for anticoagulation management, understand patients' acceptance of such applications, and determine its feasibility.

Methods

After using the mobile application for anticoagulation management for 2 weeks, patients, doctors, and nurses rated its usability using the System Usability Scale (SUS). Additionally, semi-structured interviews were conducted with some patients, doctors, and nurses to gain insights about their thoughts and suggestions regarding the procedure.

Results

The study comprised 80 participants, including 38 patients, 18 doctors, and 24 nurses. The average SUS score for patients was 82.37±5.45; for doctors, it was 84.17±5.82; and for nurses, it was 81.88±6.44. This means the patients, physicians, and nurses rated the app highly usable. Semi-structured interviews were conducted on the app's usability with 18 participants (six nurses, three physicians, and nine patients). The interview results revealed that patients found the application of anticoagulation management simple and convenient, with high expectations for a precise dosage recommendation of anticoagulant drugs. Some patients expressed concerns regarding personal information security. Both doctors and nurses believed that elderly patients needed assistance from young family members to use the app and that it could improve patients' anticoagulant self-management ability. Some nurses also mentioned that the use of the app brought great convenience for transitional care.

Conclusion

This study confirmed the feasibility of using an AI technology-assisted mobile application for anticoagulation management in patients after heart valve replacement. To further develop this application, challenges lie in continuously improving the accuracy of recommended drug doses, obtaining family support, and ensuring information security.

Impact of Mobile Health Literacy, Stroke-Related Health Knowledge, Health Beliefs, and Self-Efficacy on the Self-Care Behavior of Patients with Stroke

Background: The recent substantial increase in the incidence of stroke cases has resulted in high medical expenses. Stroke necessitates ongoing care, emphasizing the importance of consistent self-management. The occurrence of stroke impacts healthcare costs and has far-reaching effects on social services, encompassing disability, unemployment, and other related concerns beyond individuals and families. This study aimed to assess the impact of mobile health literacy, stroke-related health knowledge, health beliefs, and self-efficacy on self-care behaviors of patients with stroke to plan tailored self-care interventions for this patient population. Methods: This descriptive survey included 99 stroke patients from three hospitals, which provided treatment equivalent to or better than general hospitals, in City C and was conducted between 7 July 2023 and 30 May 2024. The data collected from hospitalized stroke patients were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, and multiple linear regression. Results: The self-care behavior of patients with stroke who participated in the study was 73.01 ± 12.24 points. Stroke self-efficacy was identified as a significant factor influencing stroke self-care behaviors and eating habits. Mobile health literacy and stroke self-efficacy also influenced medication and self-care behavior, whereas hypertension and stroke self-efficacy affected lifestyle self-care behaviors. Conclusions: Strengthening stroke self-efficacy, improving mobile health literacy, and addressing comorbidities such as hypertension are important for promoting self-care behavior in stroke patients.

Technology-Based Health Promotion Training Among Stroke Patients: A Randomized Controlled Trial

Stroke is a disease with a heavy social and familial care burden that can cause permanent brain damage, long-term disability, and/or death. This study aimed to determine the effect of technology-based health promotion training on the daily life activities, quality of life, and self-care of stroke patients. The study design was a Randomized Controlled Trial. The study sample included persons diagnosed with stroke diagnosed with stroke and were receiving inpatient treatment in the neurology clinic of a university hospital. The sample size was calculated as a total of 70 patients, 35 interventions and 35 controls. The intervention group patients received telephone-based education and follow-up grounded in Orem's Self-Care Theory over a 12-week period subsequent to their discharge. The educational content was divided into three distinct categories: self-care needs with regard to health deviations, developmental self-care needs, and universal self-care practices. Data were collected using the Montreal Cognitive Assessment Scale, the Katz Index of Independence in Activities of Daily Living, Stroke-Specific Quality of Life Scale, and the Exercise of Self-Care Agency Scale. The Independent Sample T-Test was used for intergroup comparisons, and the Dependent Sample T-Test was used for intragroup pre-test and post-test comparisons. Independent variables affecting the post-test scores, such as age and gender, were analyzed using the multiple linear regression model. The scale sub-dimension variables were compared using the multivariate analysis of variance test according to the groups. When compared with the control group patients after the training, it was determined that there was a statistically significant difference in the intervention group patients' mean scores for the Stroke-Specific Quality of Life Scale (t = 11.136, p = .001) and the Exercise of Self-Care Agency Scale (t = 14.358, p = .000). Training interventions led to enhanced awareness and knowledge about stroke among the intervention group patients. They also fostered the development of healthier lifestyle behaviors and bolstered both self-care abilities and quality of life.

Mobile App Interventions for Parkinson's Disease, Multiple Sclerosis and Stroke: A Systematic Literature Review

Central nervous system diseases (CNSDs) lead to significant disability worldwide. Mobile app interventions have recently shown the potential to facilitate monitoring and medical management of patients with CNSDs. In this direction, the characteristics of the mobile apps used in research studies and their level of clinical effectiveness need to be explored in order to advance the multidisciplinary research required in the field of mobile app interventions for CNSDs. A systematic review of mobile app interventions for three major CNSDs, i.e., Parkinson's disease (PD), multiple sclerosis (MS), and stroke, which impose significant burden on people and health care systems around the globe, is presented. A literature search in the bibliographic databases of PubMed and Scopus was performed. Identified studies were assessed in terms of quality, and synthesized according to target disease, mobile app characteristics, study design and outcomes. Overall, 21 studies were included in the review. A total of 3 studies targeted PD (14%), 4 studies targeted MS (19%), and 14 studies targeted stroke (67%). Most studies presented a weak-to-moderate methodological quality. Study samples were small, with 15 studies (71%) including less than 50 participants, and only 4 studies (19%) reporting a study duration of 6 months or more. The majority of the mobile apps focused on exercise and physical rehabilitation. In total, 16 studies (76%) reported positive outcomes related to physical activity and motor function, cognition, quality of life, and education, whereas 5 studies (24%) clearly reported no difference compared to usual care. Mobile app interventions are promising to improve outcomes concerning patient's physical activity, motor ability, cognition, quality of life and education for patients with PD, MS, and Stroke. However, rigorous studies are required to demonstrate robust evidence of their clinical effectiveness.

Smartphone App in Stroke Management: A Narrative Updated Review

The spread of smartphones and mobile-Health (m-health) has progressively changed clinical practice, implementing access to medical knowledge and communication between doctors and patients. Dedicated software called Applications (or Apps), assists the practitioners in the various phases of clinical practice, from diagnosis to follow-up and therapy management. The impact of this technology is even more important in diseases such as stroke, which are characterized by a complex management that includes several moments: primary prevention, acute phase management, rehabilitation, and secondary prevention. This review aims to evaluate and summarize the available literature on Apps for the clinical management of stroke. We described their potential and weaknesses, discussing potential room for improvement. Medline databases were interrogated for studies concerning guideline-based decision support Apps for stroke management and other medical scenarios from 2007 (introduction of the first iPhone) until January 2022. We found 551 studies. Forty-three papers were included because they fitted the scope of the review. Based on their purpose, Apps were classified into three groups: primary prevention Apps, acute stroke management Apps, and post-acute stroke Apps. We described the aim of each App and, when available, the results of clinical studies. For acute stroke, several Apps have been designed with the primary purpose of helping communication and sharing of patients' clinical data among healthcare providers. However, interactive systems Apps aiming to assist clinicians are still lacking, and this field should be developed because it may improve stroke patients' management.

Internet+Continuous Nursing Mode in Home Nursing of Patients with T-Tube after Hepatolithiasis Surgery

This study was to explore the effect of a continuous nursing model based on the mobile Internet in the home nursing of patients with T-tube after hepatolithiasis surgery. A continuous nursing system based on the mobile Internet was constructed, and 94 discharged patients with T-tube after biliary tract surgery were selected as the study subjects. The differences of complication rate, referral rate, nursing satisfaction, self-care ability, and quality of life score through the 36-item short form health survey (SF-36) after routine health education nursing (control group, n = 47) and continuous nursing mode based on the Internet (observation group, n = 47) were explored. The results showed that the success rate of the continuous nursing system based on mobile Internet in processing user requests was 96.2%. After nursing, the total complication rates of the control group and the observation group were 34.0% and 6.4%, the total satisfaction rates were 42.6% and 87.2%, and the referral rates were 23.4% and 6.4%, respectively, and the difference was statistically significant (P < 0.05). After nursing, the scores of self-care ability and SF-36 quality of life in the observation group were higher than those in the control group, and the difference was statistically significant (P < 0.05). In summary, the continuous nursing platform based on mobile Internet technology can meet the needs of users, and the nursing mode can significantly improve the home self-care ability of discharged patients with T-tube after surgery and improve the nursing effect, which is conducive to the rehabilitation of patients.