Kohta Masushi, Takahashi Mayumi, Koyanagi Hiroe, Sugama Junko
Research Center for Implementation Nursing Science Initiative, Fujita Health University, Toyoake, Japan.
Department of Nursing, Akabane Central General Hospital, Kita-ku, Tokyo, Japan.
JMIR Form Res. 2025 Feb 7;9:e57768. doi: 10.2196/57768.
The use of mobile apps to promote knowledge level, practice, and behavioral change potential has become increasingly common. However, studies on apps targeting social welfare employees working in the home-care setting to prevent pressure injury (PI) are lacking. The care manager (CM) plays a key role in connecting the demand and supply of home-care services. PI is more prevalent in the home-care setting, where resources are limited, than in acute settings.
The research hypothesis was that CMs who use a mobile app will have improved general knowledge and heightened practice for PI prevention, compared to that before using the app. This study aimed to assess the effectiveness of a PI prevention support mobile app prototyping model (Pips-Map) in improving the knowledge level, practice, and behavioral change potential of CMs in PI prevention in the home-care setting.
This was conducted between December 2021 and December 2023 as a single-arm, pre-post pilot study including 27 CMs who worked in a Japanese city. Pips-Map was used for 6 months in daily practice, and a self-administered test questionnaire was used to assess participants' knowledge and practice in PI prevention before or after using Pips-Map. At the end of the posttest, a validated App Behavior Change Scale was used to analyze behavioral change potential. This study followed the Consolidated Standards of Reporting Trials (CONSORT) extension to pilot and feasibility trials.
In total, 19 participants were analyzed. Out of 55 points, the total mean knowledge score significantly increased from 30.9 (SD 5.9) in the pretest group to 36.1 (SD 5.9) in the posttest group (P=.0003). The number of participants with a total score of >70% (adequate knowledge level) increased from 2 (11%) to 7 (36.8%), but the difference was not statistically significant (P=.07). For the level of practice, out of 21 points, the total score increased from 15.2 (SD 3.1) in the pretest group to 16.2 (SD 3.0) in the posttest group, but no statistically significant differences were observed (P=.16). The behavior change scale revealed that participants positively evaluated the Pips-Map to provide information on PI prevention guidelines but had concerns regarding inadequate usability and financial incentives of Pips-Map.
The use of Pips-Map for 6 months in actual practice increased the knowledge level of Japanese CMs in PI prevention, but it did not change the level of practice. Considering the need for updating apps that aim to promote behavioral change, this study identified some limitations of Pips-Map. Thus, revisions must be made to adapt Pips-Map to home-based care needs.
使用移动应用程序来提升知识水平、实践能力以及行为改变潜力已变得越来越普遍。然而，针对家庭护理环境中预防压力性损伤（PI）的社会福利员工的应用程序研究却很缺乏。护理经理（CM）在连接家庭护理服务的供需方面起着关键作用。与急性护理环境相比，PI在资源有限的家庭护理环境中更为普遍。
研究假设是，与使用应用程序之前相比，使用移动应用程序的CM在预防PI方面将具有更高的一般知识水平和更强的实践能力。本研究旨在评估PI预防支持移动应用程序原型模型（Pips-Map）在提高家庭护理环境中CM预防PI的知识水平、实践能力和行为改变潜力方面的有效性。
本研究于2021年12月至2023年12月进行，是一项单臂、前后对照的试点研究，包括27名在日本一个城市工作的CM。Pips-Map在日常实践中使用6个月，使用一份自填式测试问卷来评估参与者在使用Pips-Map之前或之后在PI预防方面的知识和实践。在后测结束时，使用经过验证的应用行为改变量表来分析行为改变潜力。本研究遵循了试验报告的统一标准（CONSORT）对试点和可行性试验的扩展。
总共分析了19名参与者。在55分中，前测组的总平均知识得分从30.9（标准差5.9）显著提高到后测组的36.1（标准差5.9）（P = 0.0003）。总分>70%（足够知识水平）的参与者人数从2人（11%）增加到7人（36.8%），但差异无统计学意义（P = 0.07）。对于实践水平，在21分中，前测组的总分从15.2（标准差3.1）增加到后测组的16.2（标准差3.0），但未观察到统计学上的显著差异（P = 0.16）。行为改变量表显示，参与者对Pips-Map提供PI预防指南信息给予了积极评价，但对Pips-Map的可用性不足和经济激励措施存在担忧。
在实际实践中使用Pips-Map 6个月提高了日本CM预防PI的知识水平，但没有改变实践水平。考虑到需要更新旨在促进行为改变的应用程序，本研究确定了Pips-Map的一些局限性。因此，必须进行修订以使Pips-Map适应家庭护理需求。
