College of Nursing, Dankook University, Republic of Korea.
College of Nursing, Seoul National University, Republic of Korea; Research Institute of Nursing Science, Seoul National University, Republic of Korea.
Appl Nurs Res. 2021 Apr;58:151408. doi: 10.1016/j.apnr.2021.151408. Epub 2021 Feb 11.
This study evaluated the effectiveness of a smartphone-based self-care health diary based on the Information-Motivation-Behavioral Skills model, designed to enable transplant recipients to self-manage their health and increase their adherence to medical advice.
Heart transplant recipients must take immunosuppressants to prevent rejection for the rest of their lives. As immunosuppressant drugs suppress the immune system, transplant recipients are like individuals battling chronic diseases and must be diligent about self-care to keep healthy.
This was a quasi-experimental study using a nonequivalent control group pretest-posttest non-synchronized design and mixed methods. The sample comprised of 56 patients, with 28 each in the experimental and control groups. The control group was recruited from May 25-June 19, 2018, and the experimental group from September 1-13, 2018. Self-efficacy and self-care adherence were assessed via questionnaires; user experiences were assessed via interviews after the application was used for 4 weeks.
After four weeks of use, transplant recipients reported significantly higher self-efficacy (F = 55.87, p < 0.001) and self-care adherence (F = 9.68, p = 0.003). Five themes were derived for the user experiences: (1) taking initiative for self-care, (2) utilizing a novel tool for self-care, (3) experiencing obstacles in ongoing self-care, (4) focusing on self-care adherence through the tool, and (5) expecting the application to serve as a personal medical assistant.
The health diary application is expected to motivate heart transplant recipients to perform self-care and improve adherence to medical advice.
本研究评估了基于信息-动机-行为技能模型的智能手机自我护理健康日记在心脏移植受者中的应用效果，旨在帮助他们自我管理健康并提高对医嘱的依从性。
心脏移植受者必须终身服用免疫抑制剂以预防排斥反应。由于免疫抑制剂会抑制免疫系统，因此移植受者就像患有慢性疾病的个体一样，必须勤奋地进行自我护理以保持健康。
这是一项采用非等同对照组前后测非同步设计的准实验研究，同时使用了混合方法。研究对象为 56 名患者，其中实验组和对照组各 28 名。对照组于 2018 年 5 月 25 日至 6 月 19 日招募，实验组于 2018 年 9 月 1 日至 9 月 13 日招募。采用问卷评估自我效能和自我护理依从性，在应用程序使用 4 周后通过访谈评估用户体验。
使用 4 周后，移植受者报告的自我效能（F=55.87，p<0.001）和自我护理依从性（F=9.68，p=0.003）均显著提高。用户体验得出 5 个主题：（1）主动进行自我护理，（2）使用新工具进行自我护理，（3）在持续自我护理中遇到障碍，（4）通过工具专注于自我护理依从性，以及（5）期望应用程序充当个人医疗助理。
健康日记应用有望激发心脏移植受者进行自我护理并提高对医嘱的依从性。
