A Health Mobile Application for Self-Care of Colostomy Patients

Jozpoor, Elahe; Tahvildarzadeh, Monireh; Hoseini, Azam Sadat; Shahmoradi, Mohammad Kazem; Almasian, Mohammad; Moghaddasi, Hamid

doi:10.1055/s-0044-1779604

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Journal of Coloproctology (Rio de Janeiro)

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Original Article • J. Coloproctol. (Rio J.) 44 (1) • 2024 • https://doi.org/10.1055/s-0044-1779604 copy

A Health Mobile Application for Self-Care of Colostomy Patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction and Objective

In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life. Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients.

Materials and Methods

In the present applied research, first the functional requirements of the software were determined considering the self-care requirements of colostomy patients. Then, the software was designed based on object-oriented analysis, and according to it, the application was coded in Java and developed in the Android Studio environment. Finally, to evaluate the software, the opinions and comments of 5 gastroenterologists and 10 adult colostomy patients in the age range between 27 and 64 years who had at least a high school diploma were used as the basis of judgment at this stage. The instruments used in the evaluation included a checklist, derived from three standard questionnaires (the System Usability Scale [SUS], the mHealth App Usability Questionnaire [MAUQ], and the User Version of the Mobile Application Rating Scale [uMARS]) to measure the user-friendliness indicator, and a researcher-made checklist to measure the performance indicator of the various services provided.

Results

The services of the software developed include the provision of medical information and self-care instructions regarding colostomy surgery, as well as alerts for the user to schedule an appointment with a doctor and the time to take medications. Based on the results of the evaluation stage, the users were generally satisfied with the interface, services, and general features of the software. In general, the software was evaluated at the “acceptable” level, with a rate of 85%.

Discussion and Conclusion

Based on the findings of the current research, thesoftware developed can be significantly effective in facilitating the education of colostomy patients and improving their self-care. Proper and continuous self-care and education for colostomy patients is necessary to prevent and control complications resulting from surgery and to improve their quality of life. Therefore, in addition to patients, all health care staff, organizations, and associations which support colostomy patients can also use this software to educate patients and improve the care provided to them.

Keywords
mobile health; mHealth; self-care; colostomy; stoma

Row	Variable		Frequency
Row	Variable		n	Percentage
1	Gender	Male	7	70%
1	Gender	Female	3	30%
2	Level of schooling	Below high school	0	0%
		High school	1	10%
		Bachelor’s degree	6	60%
		Master’s degree	3	30%
		Ph.D.	0	0%
3	Age (in years)	<27	0 0%
		27–30	3	30%
		30–40	4	40%
		40–50	2	20%
		50–64	1	10%
		> 64	0	0%

Response Checklist items		Yes (1)	No (0)	Score	Percentage
Software user interface (the appearance of the software)	1. Is the introductory screen of the application indicative of the main purpose of the software in terms of logo and title?	8	2	8	80%
	2. Can you easily input information into the application, including reminders, registration etc.?³²32 Stoyanov SR, Hides L, Kavanagh DJ, Wilson H. Mobile Application Rating Scale: User Version (uMARS). (appears in: Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS).) Copyright: Creative Commons License. 2016	9	1	9	90%
	3. Is the appearance of the software characteristics (colors, menus, images, and icons) good?³²32 Stoyanov SR, Hides L, Kavanagh DJ, Wilson H. Mobile Application Rating Scale: User Version (uMARS). (appears in: Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS).) Copyright: Creative Commons License. 2016	8	2	8	80%
	4. Are the layout, size of buttons, icons, menus, and content on the screen appropriate and relevant?³²32 Stoyanov SR, Hides L, Kavanagh DJ, Wilson H. Mobile Application Rating Scale: User Version (uMARS). (appears in: Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS).) Copyright: Creative Commons License. 2016	9	1	9	90%
	5. Is it possible to quit the application in each section?	10	0	10	100%
	6. Is it possible to return to the main page in all parts of the software?	10	0	10	100%
	7. Is thenavigationmenu(directionbuttons such as return,home page, exit etc.) stable when moving between application pages?³⁴34 Zhou L, Bao J, Setiawan IM. A, Saptono A, Parmanto B. The mHealth App Usability Questionnaire (MAUQ): development and validation study. JMIR Mhealth Uhealth 2019	10	0	10	100%
	8. Does the title bar on different pages indicate the use of that page?	7	3	7	70%
	9.Isthecontentofthesoftwareappropriateintermsoffont, resolution and size, and is it easily visible?	8	2	8	80%
	10. Are different components of the program in coordination? (Brock, 1996)	8	2	8	80%
	11. Do the different components of the program (buttons, menus etc.) work accurately and quickly?³²32 Stoyanov SR, Hides L, Kavanagh DJ, Wilson H. Mobile Application Rating Scale: User Version (uMARS). (appears in: Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS).) Copyright: Creative Commons License. 2016	9	1	9	90%
	12. Can you easily use all the features of the program through the user interface?³⁴34 Zhou L, Bao J, Setiawan IM. A, Saptono A, Parmanto B. The mHealth App Usability Questionnaire (MAUQ): development and validation study. JMIR Mhealth Uhealth 2019	10	0	10	100%
	13. Can the software be used easily? (Brock, 1996)	8	2	8	80%
	14. Does the application have all the features and services you expect?³⁴34 Zhou L, Bao J, Setiawan IM. A, Saptono A, Parmanto B. The mHealth App Usability Questionnaire (MAUQ): development and validation study. JMIR Mhealth Uhealth 2019	7	3	7	70%
	15. Would you like to use this software again?³⁴34 Zhou L, Bao J, Setiawan IM. A, Saptono A, Parmanto B. The mHealth App Usability Questionnaire (MAUQ): development and validation study. JMIR Mhealth Uhealth 2019	10	0	10	100%
	Mean percentage				87%

Response Question			Yes (1)	No (0)	Score	Percentage
Services and general features of the software	Alerts and reminders	1. Are the tasks, including recording, editing, and deleting information in the reminders management section, including warning to take medicines and visit a doctor, carried out easily?	4	1	4	80%
		2. Are warning messages displayed in the right place on the screen?	3	2	3	60%
		3. Are alert and reminder messages clear and understandable for the patients?	4	1	4	80%
		4. Are alert and reminder operations performed accurately in the software?	3	2	3	60%
	Educational content	5. Are educational materials and self-care recommendations and their subcategories classified correctly and can you easily find the materials you need?	3	2	3	60%
		6. Are the recommendations and educational content in the software simple and understandable?	4	1	4	80%
		7. Are the educational content and self-care recommendations appropriate to the self-care goals of colostomy patients?	5	0	5	100%
		8. In general, is the educational content provided in the software, including medical knowledge and self-care recommendations through videos and images, sufficient and appropriate to the needs of patients?	4	1	4	80%
		9. Are all videos, images, and sounds of good quality?	5	0	5	100%
		10. In general, can the educational content of the software help improve the care provided to colostomy patients?	5	0	5	100%
		11. In your opinion, is this application satisfactory overall?	5	0	5	100%
Mean percentage						81%

Responses Question			Yes (1)	No (0)	Score	Percentage
Services and features of the software	Alerts and reminders	1. Can you easily record, edit, and delete information in the reminder management section, including warnings to take medications and visit a doctor?	7	3	7	70%
		2. Are warning messages displayed in the right place on the screen?	8	2	8	80%
		3. Are alerts and reminders clear and understandable for patients?	7	3	7	70%
		4. Are alert and reminder operations performed accurately and on time in the software?	8	2	8	80%
	Educational content of the software	5. Are educational materials and self-care advice and their subcategories classified correctly, and can you easily find the materials you need?	8	2	8	80%
		6. Are the advice and educational content simple and understandable?	9	1	9	90%
		7. Are the educational content and self-care advice appropriate to the self-care goals of colostomy patients?	10	0	10	100%
		8. In general, is the educational content of the software, including medical knowledge and self-care advice taught through videos and pictures, sufficient and appropriate to the needs of patients?	7	3	7	70%
		9. Are videos, images, and sounds of good quality?	10	0	10	100%
		10. In general, is the educational content of the software useful to improve the care of patients with colostomy?	10	0	10	100%
		11. Is this application generally satisfactory?	10	0	10	100%
	Mean percentage					85%

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[1] ⁎Address for correspondence Hamid Moghaddasi, Department of Health Information Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (e-mail: moghaddasi@sbmu.ac.ir).