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Bagheri Toolaroud P, Nabovati E, Akbari H, Tamimi P, Mobayen M, Rangraz Jeddi F. Evaluation of the effectiveness of a smartphone-based educational intervention on the outcomes of children's burns: A randomized controlled trial. Int Wound J 2024; 21:e14642. [PMID: 38272800 PMCID: PMC10789650 DOI: 10.1111/iwj.14642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
Children's burns are a major public health concern due to their long-term physical, psychological, and social impacts, as well as their high financial burden. This study aimed to evaluate the effectiveness of a smartphone-based educational program on outcomes of children with severe burns. This study was designed as a double-blinded, randomized controlled trial (RCT) to test the effectiveness of a developed mobile application. A total of 93 participants were included in the final analysis. The participants were randomly assigned to either the intervention or control groups. Participants in both groups received usual self-care training at discharge, but those in the intervention group used an Android-based application for 2 months. The primary goal of the burn application was scar recovery, and the secondary goals were to increase child caregivers' satisfaction rate and decrease unplanned hospital readmissions. Data collection was conducted using valid and reliable questionnaires. Data were analysed using SPSS software. The study showed that the mobile application significantly affected the frequency of patient visits to the burn clinic and the satisfaction of caregivers of children with burns with the treatment process (p-value <0.05). Also, there was a significant relationship between the duration of application use and wound healing status ((p-value <0.001). These findings suggest that smartphone-based educational programs can be valuable for optimizing care for children with severe burns. Further research is warranted to explore the long-term impact of this intervention and its potential application in different healthcare settings.
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Affiliation(s)
- Parissa Bagheri Toolaroud
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
- Department of Health Information Management & TechnologyKashan University of Medical SciencesKashanIran
| | - Ehsan Nabovati
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
- Department of Health Information Management & TechnologyKashan University of Medical SciencesKashanIran
| | - Hossein Akbari
- Social Determinants of Health (SDH) Research Center, Department of Biostatistics and EpidemiologySchool of Public Health, Kashan University of Medical SciencesKashanIran
| | - Pegah Tamimi
- Center for Research and Training in Skin Diseases and LeprosyTehran University of Medical SciencesTehranIran
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Fatemeh Rangraz Jeddi
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
- Department of Health Information Management & TechnologyKashan University of Medical SciencesKashanIran
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Rangraz Jeddi F, Nabovati E, Mobayen M, Akbari H, Feizkhah A, Osuji J, Bagheri Toolaroud P. Health care needs, eHealth literacy, use of mobile phone functionalities, and intention to use it for self-management purposes by informal caregivers of children with burns: a survey study. BMC Med Inform Decis Mak 2023; 23:236. [PMID: 37872538 PMCID: PMC10591411 DOI: 10.1186/s12911-023-02334-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND This study aimed to assess health care needs, electronic health literacy, mobile phone usage, and intention to use it for self-management purposes by informal caregivers of children with burn injuries. METHODS This cross-sectional research was carried out in 2021 with 112 informal caregivers of children with burns in a burn center in the north of Iran. The data collection tools were questionnaires that included the participants' demographics, their E-Health Literacy, their current mobile phone usage, and their desires for mobile phone use for burn care services. RESULTS Most informal caregivers had smartphones (83.0%) and Internet access (81.3%). Most participants occasionally used phone calls (63.4%), the Internet (45.5%), and social media (42.9) to receive information about psychosocial disorders, infection control, wound care, pain, itch, physical exercise, and feeding. Most participants have never used some of the mobile phone functionalities to receive burn-related information, such as applications/Software (99.1%) and e-mail (99.1%). Nevertheless, most informal caregivers desire to use mobile applications for self-management purposes in the future (88.4%). The mean eHealth literacy score was 25.01 (SD = 9.61). Informal caregivers who had higher education levels, access to the Internet, and lived in urban areas had higher eHealth literacy (P < 001). CONCLUSION The current research delivers beneficial information about the healthcare needs of informal caregivers and their preference to use mobile functionality to receive burns-related healthcare and rehabilitation information post-discharge. This information can help design and implement mobile health (mHealth) interventions to enhance the self-care skills of informal caregivers.
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Affiliation(s)
- Fatemeh Rangraz Jeddi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran
| | - Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hossein Akbari
- Social Determinants of Health (SDH) Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Feizkhah
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Department of Medical Physics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Joseph Osuji
- School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Ab, Canada
| | - Parissa Bagheri Toolaroud
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran.
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran.
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Lesher A, McDuffie L, Smith T, Foster A, Ruggiero K, Barroso J, Gavrilova Y. Optimizing an Outpatient mHealth Intervention for Children with Burns: A Convergent Mixed-Methods Study. J Burn Care Res 2023; 44:1092-1099. [PMID: 36779787 PMCID: PMC10483473 DOI: 10.1093/jbcr/irad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Indexed: 02/14/2023]
Abstract
Burn injury is one of the most common traumatic injuries in childhood. Fortunately, 90% of pediatric burns may be treated in the outpatient setting after appropriate burn triage. Patients with burns face significant geographic disparities in accessing expert burn care due to regionalized care. To aid patients and their families during acute outpatient burn recovery, we developed a smartphone app, Telemedicine Optimized Burn Intervention (TOBI). With this app, we aimed to increase access to care by allowing secure, streamlined communication between patients and burn providers, including messaging and wound image transfer. The purpose of this study was to systematically evaluate user feedback to optimize the patient and provider experience. TOBI was evaluated using a convergent mixed-methods approach consisting of qualitative semi-structured interviews and quantitative measurements of app usability via the mHealth App Usability Questionnaire. Participants included 15 caregivers of pediatric patients with burns who used TOBI during treatment and ten burn providers. Users found TOBI to be a highly usable application in terms of usefulness, ease of use, satisfaction, and functionality. Qualitative data provided insight into user experience, satisfaction and preferences, difficulty navigating, usability and acceptability, and potential improvements. Although most users were highly satisfied, improvements were needed to optimize the burn app. We systematically made these improvements before we released TOBI for routine patient use. This study uncovered helpful recommendations for app improvements that can be generalized to other mobile health apps to increase their appeal and adoption.
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Affiliation(s)
- Aaron Lesher
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Lucas McDuffie
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Tiffany Smith
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Abigail Foster
- Department of Public Health, College of Charleston, Charleston, SC, USA
| | - Kenneth Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Julie Barroso
- School of Nursing, Vanderbilt University, Nashville, TN, USA
| | - Yulia Gavrilova
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Rangraz Jeddi F, Nabovati E, Mobayen M, Akbari H, Feizkhah A, Motalebi Kashani M, Bagheri Toolaroud P. A Smartphone Application for Caregivers of Children With Severe Burns: A Survey to Identify Minimum Data Set and Requirements. J Burn Care Res 2023; 44:1200-1207. [PMID: 37095065 DOI: 10.1093/jbcr/irad027] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Recent advances in digital health and increasing access to mobile health (mHealth) tools have led to more effective self-care. This study aimed to identify the minimum data set (MDS) and the requirements of a smartphone application (app) to support caregivers of children with severe burns. The study was performed in three phases in a burn center in the north of Iran in 2022. In the first phase, a literature review was performed. In the second phase, interviews were conducted with 18 caregivers. The third phase was performed in two stages: first, an initial questionnaire was prepared in which the content validity ratio and content validity index were calculated. The final questionnaire included 71 data elements about the MDS and requirements and open-ended elements. Then, the data elements were surveyed by 25 burn experts using the Delphi technique. The minimum acceptable mean score for each item was 3.75. Out of the 71 elements in the first Delphi round, 51 were accepted. In the second Delphi round, 14 data elements were assessed. The most important elements for the MDS were a family relationship, TBSA, the primary cause of the burn, anatomical location, itch, pain, and infection. User registration, educational materials, caregiver-clinician communication, chat box, and appointment booking were the most highlighted functional requirements. Safe login was the most important element for the nonfunctional requirements. It is recommended that health managers and software designers use these functionalities in designing smartphone apps for caregivers of children with burns.
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Affiliation(s)
- Fatemeh Rangraz Jeddi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran
| | - Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hossein Akbari
- Social Determinants of Health (SDH) Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Feizkhah
- Department of Medical Physics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Parissa Bagheri Toolaroud
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran
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Toolaroud PB, Nabovati E, Mobayen M, Akbari H, Feizkhah A, Farrahi R, Jeddi FR. Design and usability evaluation of a mobile-based-self-management application for caregivers of children with severe burns. Int Wound J 2023; 20:2571-2581. [PMID: 36872302 PMCID: PMC10410343 DOI: 10.1111/iwj.14127] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 03/07/2023] Open
Abstract
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.
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Affiliation(s)
- Parissa Bagheri Toolaroud
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
- Department of Health Information Management & TechnologyKashan University of Medical SciencesKashanIran
| | - Ehsan Nabovati
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
- Department of Health Information Management & TechnologyKashan University of Medical SciencesKashanIran
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Hossein Akbari
- Social Determinants of Health (SDH) Research Center, Department of Biostatistics and Epidemiology, School of Public HealthKashan University of Medical SciencesKashanIran
| | - Alireza Feizkhah
- Department of Medical Physics, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Razieh Farrahi
- Department of Health Information Technology, Ferdows School of Health and Allied Medical SciencesBirjand University of Medical SciencesBirjandIran
| | - Fatemeh Rangraz Jeddi
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
- Department of Health Information Management & TechnologyKashan University of Medical SciencesKashanIran
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Jarvis NR, Jarvis T, Morris BE, Verhey EM, Rebecca AM, Howard MA, Teven CM. A Scoping Review of Mobile Apps in Plastic Surgery: Patient Care, Trainee Education, and Professional Development. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4943. [PMID: 37063506 PMCID: PMC10101243 DOI: 10.1097/gox.0000000000004943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/16/2023] [Indexed: 04/18/2023]
Abstract
Over the past 10 years, smartphones have become ubiquitous, and mobile apps serve a seemingly endless number of functions in our everyday lives. These functions have entered the realm of plastic surgery, impacting patient care, education, and delivery of services. This article reviews the current uses of plastic surgery mobile apps, app awareness within the plastic surgery community, and the ethical issues surrounding their use in patient care. Methods A scoping review of electronically available literature within PubMed, Embase, and Scopus databases was conducted in two waves in November and May 2022. Publications discussing mobile application use in plastic surgery were screened for inclusion. Results Of the 80 nonduplicate publications retrieved, 20 satisfied the inclusion criteria. Articles acquired from the references of these publications were reviewed and summarized when relevant. The average American Society of Plastic Surgeons evidence rating of the publications was 4.2. Applications could be categorized broadly into three categories: patient care and surgical applications, professional development and education, and marketing and practice development. Conclusions Mobile apps related to plastic surgery have become an abundant resource for patients, attending surgeons, and trainees. Many help bridge gaps in patient care and surgeon-patient communication, and facilitate marketing and practice development. Others make educational content more accessible to trainees and performance assessment more efficient and equitable. The extent of their impact on patient decision-making and expectations has not been completely elucidated.
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Affiliation(s)
| | - Tyler Jarvis
- Division of Plastic Surgery, Penn State Health Medical Center, Hershey, Penn
| | - Bryn E. Morris
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - Erik M. Verhey
- From the Mayo Clinic Alix School of Medicine, Scottsdale, Ariz
| | - Alanna M. Rebecca
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - Michael A. Howard
- Division of Plastic and Reconstructive Surgery, Northwestern Medicine, Chicago, Ill
| | - Chad M. Teven
- Division of Plastic and Reconstructive Surgery, Northwestern Medicine, Chicago, Ill
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