A Study Of The Effect Of Mobile Learning Towards Quality Of Life And Recovery Processes Of The Spontaneously Closed Cannula Ileostomy(SCCI) Patients

Objective:1. Investigate the impact of the effect of Mobile Learning (using mobile devices such as smart phone, tablet, etc. in the education of patients about health) towards Quality of life and recovery processes of the spontaneously closed cannula ileostomy (SCCI) patients.2. Recording rehabilitation care video segments of SCCI patients after surgery, setting up a WeChat Public Platform for rehabilitation of SCCI patients, and creating a QQ group for rehabilitation of SCCI patients to discover a systematic and innovative health education method for SCCI patients at different recovery processes after surgery. These approaches also extend the meaning of continuity of care for low rectal cancer patients after surgery and provide the basic data for the nursing clinicians to improve the health education mode on SCCI patients.3. Compare the differences between the health education based on Mobile Learning and traditional health education on the Quality of life and recovery processes of the SCCI patients, by which to find out the advantages of Mobile Learning in health education.Methods:From June 2014 to May 2015,187 patients undergoing SCCI treatments from one Tertiary level hospital in Zhejiang were investigated. According to the diffrent wards were divided into an experimental group and a control group, in which the patiens in one ward is the control group (91 in total), the patients in the other ward is the experimental group (96 in total). The control group received the traditional health education mode (dictation approach and brochure and telephone follow-up) which was provided by the primary nurse. While based on the dictation approach, the experimental group adopted Mobile learning method which including several approaches:using mobile devices such as smart phone, tablet, etc. to watch the health care videos, join in the WeChat Public Platform, and answer the questions through the QQ group, and the like. In order to investigate and compare the Self-care ability, Quality of life, surgery complications and recovery time of abdominal wound of patients from these two groups, two time points (one is the second week after surgery,the other is the third month after surgery) in the recovery processes after surgery were selected according to the exercise of Self-care Agency scale (ESCA), City of Hope Quality of Life-ostomy Questionaire (COH-QOL-OQ) and third version of European Organization for Research and Treatment of Cancer (EORTC QLQ-C30).Results:1.The second week after surgery, the mean score and standard deviation of Self-care ability in the control group is 113.44±4.69 and that in the experimental group is 130.11±8.37. The t value from the comparison of the mean score of Self-care ability in the control group and the experimental group is 5.202, P< 0.05.This difference has statistical significance which suggests the experimental group is higher than that of the control group.2. The second week after surgery, the physiological health, psychological health, social health, mental health score and standard deviation of life quality in the control group is 65.02±9.32,6.92±10.33,88.47±25.69,52.84±8.61 and that in the experimental group is 68.23±10.32,70.58±12.62,98.32±22.35.57.41±10.11.The t value from the comparison of the mean score of life quality in the control group and the experimental group is 2.228,2.164,2.801,3.319, P<0.05. This difference has statistical significance, which means the life quality of patients during the period of ileostomy for the Mobile learning group is higher than that of the traditional health education group.3. The third month after surgery, the mean score and standard deviation of life quality in the control group is 74.23±15.09 and that in the experimental group is 80.11± 10.12. The t value from the comparison of the mean score of life quality in the control group and the experimental group is 3.144, P<0.05. The life quality of patients in the rehabilitation period after extubation from the experimental group is higher than that of the control group(p<0.05).4. The comparison of the total number of surgery complications from the two groups, P<0.05.This difference has statistical significance which shows that the rate of surgery complications from the experimental group is lower than that of the control group.5.The comparison of recovery time of abdominal wound of patients from the two groups, P<0.05,This difference has statistical significance which suggests that the recovery time of abdominal wound of patients from the experimental group is less than the control group.6. The comparison of the rate of unplanned readmissions from the two groups, P>0.05. This difference has none statistical significance which indicates that there is no significant differences between the rate of unplanned readmissions between the experimental group and the control group.Conclusion:Using terminal devices like cell phone for Mobile learning such as watching the health care videos, joining in the Wechat Official Account Platform, and answering the questions through the QQ group and the like approaches are suitable for the clinical practice of the rehabilitation of SCCI patients.The study of Mobile learning for health education can relatively increase the Self-care ability and Quality of life of patients. Mobile learning for health education can reduce the rate of surgery complications of SCCI patients and shorten the recovery time of abdominal wound of patients after extubation. The methods of health education are not the main factors that have an influence on the rate of the unplanned readmissions of patients.