| BackgroundNeurogenic bladder(NGB)requires lifelong self-management,but the current status of patient self-management is not optimistic.Mobile health(mHealth)WeChat applet is a new area of health information services which has already achieved initial effect in the self-management of patients with other chronic diseases,but its application in NGB patients remains to be explored.ObjectivesThis study aims to evaluate the usability of the "NGB self-management WeChat applet version 1.0" developed by the research team,and based on the results of the usability evaluation,the second iteration of the applet will be upgraded to form the"NGB self-management WeChat applet version 2.0".In addition,the effectiveness and feasibility of the version 2.0 applet will be evaluated.Methods1.Usability evaluation of NGB self-management WeChat applet version 1.0(1)Medical staff interviews:Interviews were conducted with medical staff from relevant departments to understand their experience of using the applet,in-depth analysis of the advantages and disadvantages of the 1.0 version applet,and obtain suggestions for improvement.(2)User research:A mixed method combining questionnaire survey and semistructured interview was used to investigate the use behavior and experience of patients and caregivers on the 1.0 version applet,and analyze the target users’improvement needs.2.Development and testing of NGB self-management WeChat applet version 2.0(1)Delphi expert consultation:Based on the usability evaluation results,the intervention draft of version 2.0 applet was constructed through literature analysis,theoretical research and group discussions,and determined by the Delphi expert consultation.(2)Expert working group meeting:Relevant experts were included to discuss and clarify the way in which the intervention content was to be carried and the functionality implemented.(3)Development and testing of version 2.0 applet:Software engineers worked with the research team to develop version 2.0 applet using an agile development model.3.Evaluation of NGB self-management WeChat applet version 2.0A mixed methods research was conducted to evaluate the effectiveness and feasibility of version 2.0 applet.Quantitative research adopted the self-control before and after design,and conducted a one-month intervention on NGB patients.The main outcome indicator was the self-management ability of NGB patients,and the secondary outcome indicators were NGB-related symptoms and NGB-related quality of life.After the intervention,qualitative interviews were conducted with NGB patients to understand their experience.Results1.Usability evaluation of NGB self-management WeChat applet version 1.0(1)Medical staff interviews:A total of 9 medical staffs were interviewed.The results showed that there were many shortcomings in the content and functions of version 1.0,including unsystematic content of the health knowledge,specialized language,single form and lack of specificity of the bladder management program,etc.The medical staffs also made suggestions for improvement for each module.(2)User research:A total of 19 NGB patients and 5 family caregivers were included.During the 2-week test period,50%of the study participants used the app very rarely(once a week),with an overall low usage rate;the overall rating of the usability questionnaire score was 3.53,which was low;the results of the interviews revealed a number of needs for improvement of version 1.0 applet,including enriching the content of education and improving the comprehensiveness and relevance of bladder management.2.Development and testing of NGB self-management WeChat applet version 2.0(1)Delphi expert consultation:A total of 2 rounds of expert consultation were conducted,and the questionnaire recovery rates were 100%and 94.12%respectively;the authority coefficient of expert consultation were both 0.90;after the second round of consultation,the Kendall’s W of the first-level,second-level and third-level indicators were significantly higher than those of the first round,and P<0.05.The final version 2.0 applet intervention program included 4 first-level indicators,13 second-level indicators,and 70 third-level indicators.(2)Expert working group meeting:A total of 2 software engineers and 7 experts in NGB-related fields were included.The design scheme of each module of version 2.0 were explicated after thorough discussion.(3)Development and testing of the version 2.0 applet:Compared with version 1.0,functionally,version 2.0 has completed a total of 30 functional upgrades and added 1 educational video module;in terms of content,40 new tweets and 14 educational videos have been added.The bladder management module realized the management of NGB symptom classification.After testing without errors,the version 2.0 applet was launched on the WeChat platform.3.Evaluation of NGB self-management WeChat applet version 2.0A total of 44 NGB patients were included.The results of the study showed that NGB patients’ self-management ability were significantly improved after 1 month of the intervention compared to pre-intervention(p<0.05);qualitative interviews with 15 NGB patients showed that the applet was easy to use and useful,and the patients were willing to continue using it;the facilitators and barriers that influenced patients’ use of the applet were analysed;the suggestions for future improvement and promotion of the applet were summarised.ConclusionsThis study carried out a relatively objective and comprehensive usability evaluation of the 1.0 version applet initially developed by the research team.Based on the usability evaluation results,the content and functions of the applet were further iteratively upgraded through Delphi expert consultation and expert working group meeting,forming 2.0 version applet.A mixed methods research was used to evaluate its effectiveness and feasibility.The results showed that the applet could improve the self-management ability of NGB patients,and the user’s acceptability was good.However,there are also some hindering factors that need further attention and research. |
PDF Full Text Request