Development And Application Of Professional Care App For Stroke Patients At Home

Objectives1.To design and develop a professional care App for stroke patients at home;2.Verify the effect of professional care App.MethodsThis study was divided into two parts.The development and testing stage for professional care App:the first draft of core module for App was constructed on the basis of the chronic electronic medical care model,technology acceptance model,the professional care needs,the functional analysis and literature review.And then revised it to the final draft through expert consultation.In 2018,the researcher and the industrial technology research institute of zhengzhou university jointly developed the professional care smartphone App(version 1.0);After the preliminary test,the professional care App(1.0)was optimized and upgraded to App(2.0)by interviewing the experience of patients.Evaluation stage of professional care App:From December 2017 to June 2018,10 resident communities under the nanguan community health service center were conveniently selected,and randomly assigned into intervention group and control group according to the number of residents of each residential areas,Finally,38 cases in the intervention group group,39 cases in the intervention group group.The intervention group received professional care App intervention for 3 months.The control group received routine community follow-up for 3 months.Data were collected in the follow time points:pre-intervention,1 month-intervention,3 months-intervention,1 month post intervention.The evaluation tools included Professional Care Demands Questionnaire for Stroke Survivors Lived in Community,Questionnaire of stroke-related Knowledge(SKQ)and Eight-Item Morisky Medication Adherence Scale(MMSA-8).And patients in the intervention group evaluated App and experience after the intervention.Data were analyzed with IBM SPSS Statistics 21.0,the main methods are the descriptive statistics,T test,Kruskal-Wallis rank sum test,chi-square text,generalized estimating equation,repetitive measurement analysis of variance.Results1.As of June 2018,we have developed two App versions with the industrial technology research institute of zhengzhou university.Professional care App(2.0)includes two parts:patient-side and medical-side.The patient-side mainly provides health education,rehabilitation guidance,medication reminder,online consultation and other.Medica sideis mainly online for patients.2.90 cases were included at first in this study,13 cases were lost,and the loss rate was 14.4%.Then the final effective samples were 77 cases.The cases were25~74 years old,mean age(57.35±9.28)years.The intervention group(n=38)with mean age(57.24±11.13)and control group(n=39)with mean age(57.46±7.18)(t=-0.105,P=0.917).The comparison of the general data was shown in table 2.1~table 2.2,with no statistical significance(P>0.05).(1)The results of the generalized estimation equation showed that the professional care needs for patients had group effect(Waldχ~2=63.265,P<0.001) and time effect(Waldχ~2=884.380,P<0.001).And the scores of professional care demands firstly decreased and then increased.(2)The results of repeated-measures analysis indicated the SKQ of patients had groups effect(F=16.511,P<0.001)and time effect(F=138.059,P<0.001).There was an interaction between the group effect and time effect(F=10.225,P<0.001).The contour interactive graph showed that with the prolongation of time,the SKQ scores in the intervention group firstly increased and then decreased.(3)The results of the generalized estimation equation showed that the medication compliance had group effect(Waldχ~2=5.823,P=0.016)and time effect(Waldχ~2=129.909,P<0.001).And the scores of medication compliance firstly increasedand then decreased.(4)The scores of usefulness,learnability,usability,credibility,acceptance and satisfaction for professional care App in the intervention group were(1.04±0.08),(1.77±0.41),(1.78±0.45),(1.63±0.46),(1.73±0.28),(1.97±0.16),respectively.(5)The overall user experience of App for patients in the intervention group was good,but there was still room for improvement.ConclusionsProfessional care App is an effective professional care tool for stroke patients at home,which can meet the needs of professional care,improve the level of knowledge and medication compliance for stroke patients at home.