The effect of using smartphone applications on self-care in patients with heart failure
,
Abstract
Background & Aim: Due to the chronic nature of heart failure, it is necessary to observe and maintain self-care behaviors accordingly. Tele-monitoring using smartphone applications can be effective in this regard. This study aimed to determine the effect of using smartphone applications on self-care behaviors in patients with heart failure.
Methods & Materials: This randomized controlled clinical trial was conducted between August and March in 2018. Using consecutive sampling, 120 patients were selected and were allocated to the two groups by a random quadruple block approach. The participants in both groups completed the European heart failure self-care questionnaire before and after the intervention. Patients in both groups received routine hospital care; however, patients in the intervention group used an Android smartphone application for three months daily as well. Via the application, there were ongoing interactions between patients and researchers, depending on the needs of patients and their conditions. The data were analyzed using SPSS V.16 software.
Results: There was a statistically significant difference between groups in terms of the mean score of self-care after the intervention where the mean score in the intervention group was lower (p<0.001), which indicates better self-care. Based on the results, the intervention effect was reported at 0.787.
Conclusion: The findings of this study showed that using a smartphone application can improve self-care in patients with heart failure. Therefore, it is recommended to health care providers to use this mobile application to care and monitor remote patients with HF.
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2. Kiuchi MG, Nolde JM, Villacorta H, Carnagarin R, Chan JJ, Lugo-Gavidia LM, Ho JK, Matthews VB, Dwivedi G, Schlaich MP. New Approaches in the Management of Sudden Cardiac Death in Patients with Heart Failure—Targeting the Sympathetic Nervous System. International Journal of Molecular Sciences. 2019 Jan;20(10):2430.
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4. Mehralian H, Salehi S, Moghaddasi J, Amiri M, Rafiei H. The comparison of the effects of education provided by nurses on the quality of life in patients with congestive heart failure (CHF) in usual and home-visit cares in Iran. Global journal of health science. 2014 May; 6(3): 256.
5. Ruppar TM, Cooper PS, Johnson ED, Riegel B. Self‐care interventions for adults with heart failure: A systematic review and meta‐analysis protocol. Journal of Advanced Nursing. 2019 Mar; 75(3): 676-82.
6. Vaillant-Roussel H, Laporte C, Pereira B, Tanguy G, Cassagnes J, Ruivard M, Clément G, Le Reste JY, Lebeau JP, Chenot JF, Pouchain D. Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial. BMC family practice. 2014 Dec 1; 15(1): 208.
7. Riegel B, Moser DK, Buck HG, Dickson VV, Dunbar SB, Lee CS, Lennie TA, Lindenfeld J, Mitchell JE, Treat‐Jacobson DJ, Webber DE. Self‐care for the prevention and management of cardiovascular disease and stroke: A scientific statement for healthcare professionals from the American Heart Association. Journal of the American Heart Association. 2017 Aug 31; 6(9): e006997.
8. Cameron J, Rendell PG, Ski CF, Kure CE, McLennan SN, Rose NS, Prior DL, Thompson DR. PROspective MEmory Training to improve HEart failUre Self-care (PROMETHEUS): study protocol for a randomised controlled trial. Trials. 2015 Dec 1; 16(1): 196.
9. Dunbar SB, Butts B, Reilly CM, Gary RA, Higgins MK, Ferranti EP, Culler SD, Butler J. A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes. Nursing outlook. 2014 Mar 1; 62(2): 97-111.
10. Deek H, Chang S, Newton PJ, Noureddine S, Inglis SC, Al Arab G, Kabbani S, Chalak W, Timani N, Macdonald PS, Davidson PM. An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomised controlled trial (the FAMILY study). International journal of nursing studies. 2017 Oct 1; 75: 101-11.
11. Oscalices MI, Okuno MF, Lopes MC, Campanharo CR, Batista RE. Discharge guidance and telephone follow-up in the therapeutic adherence of heart failure: randomized clinical trial. Revista latino-americana de enfermagem. 2019;27.
12. Holden RJ, Schubert CC, Mickelson RS. The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers. Applied ergonomics. 2015 Mar 1; 47:133-50.
13. Anglada-Martínez H, Martin-Conde M, Rovira-Illamola M, Sotoca-Momblona JM, Sequeira E, Aragunde V, Moreno MA, Catalan M, Codina-Jané C. Feasibility and Preliminary Outcomes of a Web and Smartphone–Based Medication Self-Management Platform for Chronically Ill Patients. Journal of medical systems. 2016 Apr 1; 40(4): 99.
14. Creber RM, Patey M, Dickson VV, DeCesaris M, Riegel B. Motivational interviewing tailored interventions for heart failure (MITI-HF): study design and methods. Contemporary Clinical Trials. 2015; 41: 62-8.
15. Bos-Touwen I, Jonkman N, Westland H, Schuurmans M, Rutten F, de Wit N, et al. Tailoring of self-management interventions in patients with heart failure. Current Heart Failure Reports. 2015; 12(3): 223-35.
16. Cossette S, Belaid H, Heppell S, Mailhot T, Guertin M-C. Feasibility and acceptability of a nursing intervention with family caregiver on self-care among heart failure patients: a randomized pilot trial. Pilot and Feasibility Studies. 2016; 2(1): 34.
17. Jaana M, Tamim H, Sherrard H, Pare G. Telemonitoring for seniors with chronic heart failure: patient self-care, empowerment, and adoption factors. InProceedings of the 50th Hawaii International Conference on System Sciences 2017 Jan 4.
18. Clark AP, McDougall G, Riegel B, Joiner-Rogers G, Innerarity S, Meraviglia M, et al. Health status and self-care outcomes following an education-support intervention for people with chronic heart failure. The Journal of Cardiovascular Nursing. 2015; 30(4 0 1): S3.
19. Black JT, Romano PS, Sadeghi B, Auerbach AD, Ganiats TG, Greenfield S, et al. A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition-Heart Failure (BEAT-HF) randomized controlled trial. Trials. 2014; 15(1): 124.
20. Kamei T, Yamamoto Y, Kajii F, Nakayama Y, Kawakami C. Systematic review and meta‐analysis of studies involving telehome monitoring‐based telenursing for patients with chronic obstructive pulmonary disease. Japan Journal of Nursing Science. 2013;10(2):180-92.
21. Varnfield M, Karunanithi M, Lee C-K, Honeyman E, Arnold D, Ding H, et al. Smartphone-based home care model improved use of cardiac rehabilitation in post myocardial infarction patients: results from a randomised controlled trial. Heart. 2014; 100(22): 1770-9.
22. Lupton D. Quantifying the body: monitoring and measuring health in the age of mHealth technologies. Critical Public Health. 2013; 23(4): 393-403.
23. Barton AJ. The regulation of mobile health applications. BMC medicine. 2012;10(1):46.
24. Marceglia S, Fontelo P, Rossi E, Ackerman M. A standards-based architecture proposal for integrating patient mhealth apps to electronic health record systems. Applied Clinical Informatics. 2015; 6(03): 488-505.
25. Creber RMM, Maurer MS, Reading M, Hiraldo G, Hickey KT, Iribarren S. Review and analysis of existing mobile phone apps to support heart failure symptom monitoring and self-care management using the Mobile Application Rating Scale (MARS). JMIR mHealth and uHealth. 2016; 4(2): e74.
26. Hale K, Capra S, Bauer J. A framework to assist health professionals in recommending high-quality apps for supporting chronic disease self-management: illustrative assessment of type 2 diabetes apps. JMIR Mhealth Uhealth. 2015 Sep 14; 3(3): e87. doi: 10.2196/mhealth.4532.
27. Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, et al. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010 Jun;16(6): e1-194. doi: 10.1016/j.cardfail.2010.04.004.
28. Marley J, Farooq S. Mobile telephone apps in mental health practice: uses, opportunities and challenges. BJPsych bulletin. 2015; 39(6): 288-90.
29. Nocum AA, Baltao JM, Agustin DR, Portus AJ. Ergonomic evaluation and design of a mobile application for maternal and infant health for smartphone users among lower-income class filipinos. Procedia Manufacturing. 2015; 3: 5411-8.
30. Koehler N, Vujovic O, McMenamin C. Healthcare professionals’ use of mobile phones and the internet in clinical practice. JMTM. 2013; 2(1S): 3-13. DOI:10.7309/jmtm.2.1.2
31. Creber RMM, Maurer MS, Reading M, Hiraldo G, Hickey KT, Iribarren S. Review and analysis of existing mobile phone apps to support heart failure symptom monitoring and self-care management using the mobile application rating scale (MARS). JMIR Mhealth Uhealth. 2016 Apr-Jun; 4(2): e74. doi: 10.2196/mhealth.5882
32. Najafi Ghezeljeh T, Davodi M, Saeedi A, Peyravi H, Kiaroosta N. Design and evaluate a smartphone-based application to manage people with heart failure. Iran J War Public Health. 2019; 11 (3): 125-131
33. Jaarsma T, Årestedt KF, Mårtensson J, Dracup K, Strömberg A. The European Heart Failure Self‐care Behaviour scale revised into a nine‐item scale (EHFScB‐9): a reliable and valid international instrument. European Journal of Heart Failure. 2009;11(1):99-105.
34. Shojaei F, Asemi S, Najafi YA, Hosseini F. Self-care behaviors in patients with heart failure. Payesh, 2009; 8 (4): 361-369.
35. Arulnathan A, Vaaheesan S, Denecke K, Fachhochschule B. A mobile application for self-monitoring for patients with heart failure. Studies in health Technology and Informatics. 2019; 259:113-6.
36. Brouwers RW, Kraal JJ, Traa SC, Spee RF, Oostveen LM, Kemps HM. Effects of cardiac telerehabilitation in patients with coronary artery disease using a personalised patient-centred web application: protocol for the SmartCare-CAD randomised controlled trial. BMC Cardiovascular Disorders. 2017; 17(1): 46.
37. Goyal S, Nunn CA, Rotondi M, Couperthwaite AB, Reiser S, Simone A, et al. A mobile app for the self-management of type 1 diabetes among adolescents: a randomized controlled trial. JMIR mHealth and uHealth. 2017; 5(6): e82.
38. Shin S, Oh H, Kang M, Park M, Koh B-H, Hwang M. Feasibility and effectiveness assessment of a mobile application for subhealth management: Study protocol for a randomized controlled trial. Medicine. 2019; 98(21): e15704.
2. Kiuchi MG, Nolde JM, Villacorta H, Carnagarin R, Chan JJ, Lugo-Gavidia LM, Ho JK, Matthews VB, Dwivedi G, Schlaich MP. New Approaches in the Management of Sudden Cardiac Death in Patients with Heart Failure—Targeting the Sympathetic Nervous System. International Journal of Molecular Sciences. 2019 Jan;20(10):2430.
3. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN. Heart disease and stroke Statistics-2019 update a report from the American Heart Association. Circulation. 2019; 139: e56–e528. https://doi.org/10.1161/CIR.0000000000000659
4. Mehralian H, Salehi S, Moghaddasi J, Amiri M, Rafiei H. The comparison of the effects of education provided by nurses on the quality of life in patients with congestive heart failure (CHF) in usual and home-visit cares in Iran. Global journal of health science. 2014 May; 6(3): 256.
5. Ruppar TM, Cooper PS, Johnson ED, Riegel B. Self‐care interventions for adults with heart failure: A systematic review and meta‐analysis protocol. Journal of Advanced Nursing. 2019 Mar; 75(3): 676-82.
6. Vaillant-Roussel H, Laporte C, Pereira B, Tanguy G, Cassagnes J, Ruivard M, Clément G, Le Reste JY, Lebeau JP, Chenot JF, Pouchain D. Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial. BMC family practice. 2014 Dec 1; 15(1): 208.
7. Riegel B, Moser DK, Buck HG, Dickson VV, Dunbar SB, Lee CS, Lennie TA, Lindenfeld J, Mitchell JE, Treat‐Jacobson DJ, Webber DE. Self‐care for the prevention and management of cardiovascular disease and stroke: A scientific statement for healthcare professionals from the American Heart Association. Journal of the American Heart Association. 2017 Aug 31; 6(9): e006997.
8. Cameron J, Rendell PG, Ski CF, Kure CE, McLennan SN, Rose NS, Prior DL, Thompson DR. PROspective MEmory Training to improve HEart failUre Self-care (PROMETHEUS): study protocol for a randomised controlled trial. Trials. 2015 Dec 1; 16(1): 196.
9. Dunbar SB, Butts B, Reilly CM, Gary RA, Higgins MK, Ferranti EP, Culler SD, Butler J. A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes. Nursing outlook. 2014 Mar 1; 62(2): 97-111.
10. Deek H, Chang S, Newton PJ, Noureddine S, Inglis SC, Al Arab G, Kabbani S, Chalak W, Timani N, Macdonald PS, Davidson PM. An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomised controlled trial (the FAMILY study). International journal of nursing studies. 2017 Oct 1; 75: 101-11.
11. Oscalices MI, Okuno MF, Lopes MC, Campanharo CR, Batista RE. Discharge guidance and telephone follow-up in the therapeutic adherence of heart failure: randomized clinical trial. Revista latino-americana de enfermagem. 2019;27.
12. Holden RJ, Schubert CC, Mickelson RS. The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers. Applied ergonomics. 2015 Mar 1; 47:133-50.
13. Anglada-Martínez H, Martin-Conde M, Rovira-Illamola M, Sotoca-Momblona JM, Sequeira E, Aragunde V, Moreno MA, Catalan M, Codina-Jané C. Feasibility and Preliminary Outcomes of a Web and Smartphone–Based Medication Self-Management Platform for Chronically Ill Patients. Journal of medical systems. 2016 Apr 1; 40(4): 99.
14. Creber RM, Patey M, Dickson VV, DeCesaris M, Riegel B. Motivational interviewing tailored interventions for heart failure (MITI-HF): study design and methods. Contemporary Clinical Trials. 2015; 41: 62-8.
15. Bos-Touwen I, Jonkman N, Westland H, Schuurmans M, Rutten F, de Wit N, et al. Tailoring of self-management interventions in patients with heart failure. Current Heart Failure Reports. 2015; 12(3): 223-35.
16. Cossette S, Belaid H, Heppell S, Mailhot T, Guertin M-C. Feasibility and acceptability of a nursing intervention with family caregiver on self-care among heart failure patients: a randomized pilot trial. Pilot and Feasibility Studies. 2016; 2(1): 34.
17. Jaana M, Tamim H, Sherrard H, Pare G. Telemonitoring for seniors with chronic heart failure: patient self-care, empowerment, and adoption factors. InProceedings of the 50th Hawaii International Conference on System Sciences 2017 Jan 4.
18. Clark AP, McDougall G, Riegel B, Joiner-Rogers G, Innerarity S, Meraviglia M, et al. Health status and self-care outcomes following an education-support intervention for people with chronic heart failure. The Journal of Cardiovascular Nursing. 2015; 30(4 0 1): S3.
19. Black JT, Romano PS, Sadeghi B, Auerbach AD, Ganiats TG, Greenfield S, et al. A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition-Heart Failure (BEAT-HF) randomized controlled trial. Trials. 2014; 15(1): 124.
20. Kamei T, Yamamoto Y, Kajii F, Nakayama Y, Kawakami C. Systematic review and meta‐analysis of studies involving telehome monitoring‐based telenursing for patients with chronic obstructive pulmonary disease. Japan Journal of Nursing Science. 2013;10(2):180-92.
21. Varnfield M, Karunanithi M, Lee C-K, Honeyman E, Arnold D, Ding H, et al. Smartphone-based home care model improved use of cardiac rehabilitation in post myocardial infarction patients: results from a randomised controlled trial. Heart. 2014; 100(22): 1770-9.
22. Lupton D. Quantifying the body: monitoring and measuring health in the age of mHealth technologies. Critical Public Health. 2013; 23(4): 393-403.
23. Barton AJ. The regulation of mobile health applications. BMC medicine. 2012;10(1):46.
24. Marceglia S, Fontelo P, Rossi E, Ackerman M. A standards-based architecture proposal for integrating patient mhealth apps to electronic health record systems. Applied Clinical Informatics. 2015; 6(03): 488-505.
25. Creber RMM, Maurer MS, Reading M, Hiraldo G, Hickey KT, Iribarren S. Review and analysis of existing mobile phone apps to support heart failure symptom monitoring and self-care management using the Mobile Application Rating Scale (MARS). JMIR mHealth and uHealth. 2016; 4(2): e74.
26. Hale K, Capra S, Bauer J. A framework to assist health professionals in recommending high-quality apps for supporting chronic disease self-management: illustrative assessment of type 2 diabetes apps. JMIR Mhealth Uhealth. 2015 Sep 14; 3(3): e87. doi: 10.2196/mhealth.4532.
27. Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, et al. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010 Jun;16(6): e1-194. doi: 10.1016/j.cardfail.2010.04.004.
28. Marley J, Farooq S. Mobile telephone apps in mental health practice: uses, opportunities and challenges. BJPsych bulletin. 2015; 39(6): 288-90.
29. Nocum AA, Baltao JM, Agustin DR, Portus AJ. Ergonomic evaluation and design of a mobile application for maternal and infant health for smartphone users among lower-income class filipinos. Procedia Manufacturing. 2015; 3: 5411-8.
30. Koehler N, Vujovic O, McMenamin C. Healthcare professionals’ use of mobile phones and the internet in clinical practice. JMTM. 2013; 2(1S): 3-13. DOI:10.7309/jmtm.2.1.2
31. Creber RMM, Maurer MS, Reading M, Hiraldo G, Hickey KT, Iribarren S. Review and analysis of existing mobile phone apps to support heart failure symptom monitoring and self-care management using the mobile application rating scale (MARS). JMIR Mhealth Uhealth. 2016 Apr-Jun; 4(2): e74. doi: 10.2196/mhealth.5882
32. Najafi Ghezeljeh T, Davodi M, Saeedi A, Peyravi H, Kiaroosta N. Design and evaluate a smartphone-based application to manage people with heart failure. Iran J War Public Health. 2019; 11 (3): 125-131
33. Jaarsma T, Årestedt KF, Mårtensson J, Dracup K, Strömberg A. The European Heart Failure Self‐care Behaviour scale revised into a nine‐item scale (EHFScB‐9): a reliable and valid international instrument. European Journal of Heart Failure. 2009;11(1):99-105.
34. Shojaei F, Asemi S, Najafi YA, Hosseini F. Self-care behaviors in patients with heart failure. Payesh, 2009; 8 (4): 361-369.
35. Arulnathan A, Vaaheesan S, Denecke K, Fachhochschule B. A mobile application for self-monitoring for patients with heart failure. Studies in health Technology and Informatics. 2019; 259:113-6.
36. Brouwers RW, Kraal JJ, Traa SC, Spee RF, Oostveen LM, Kemps HM. Effects of cardiac telerehabilitation in patients with coronary artery disease using a personalised patient-centred web application: protocol for the SmartCare-CAD randomised controlled trial. BMC Cardiovascular Disorders. 2017; 17(1): 46.
37. Goyal S, Nunn CA, Rotondi M, Couperthwaite AB, Reiser S, Simone A, et al. A mobile app for the self-management of type 1 diabetes among adolescents: a randomized controlled trial. JMIR mHealth and uHealth. 2017; 5(6): e82.
38. Shin S, Oh H, Kang M, Park M, Koh B-H, Hwang M. Feasibility and effectiveness assessment of a mobile application for subhealth management: Study protocol for a randomized controlled trial. Medicine. 2019; 98(21): e15704.
| Files | ||
| Issue | Vol 7 No 4 (2020): Autumn | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v7i4.4041 | |
| Keywords | ||
| self-care behaviors; heart failure; applications; smartphone learning | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kiyarosta N, Ghezeljeh T, Naghashzadeh F, Feizi M, Haghani S. The effect of using smartphone applications on self-care in patients with heart failure. NPT. 2020;7(4):311-321.
