Effect of mobile-based self-management application on stroke outcomes: a study protocol for triple blinded randomized controlled trial.

BACKGROUND: Stroke is the main leading cause of long-term disabilities in the world. This protocol will be implemented for a study to evaluate the effects of an Android-based self-care application on patients with stroke. METHODS: The first stage will include the development of an android-based application using JAVA programming language for developing the user interface and ASP.NET Core for developing Web server. The second stage will be conducted using triple blinded randomized clinical trial (RCT). The sample size will include 60 patients with recent stroke and partial paralysis of limbs, who will be divided into two groups of intervention and control through permuted block randomization method. Patients in both groups will receive usual medical care, but those in the intervention group will also use an Android-based application for a period of two months. Outcomes will be assessed using valid and reliable questionnaires. DISCUSSION: The assessed outcomes will include stroke severity using National Institute of Health Stroke Scale (NIHSS) score, ability to perform activities of daily living using Barthel Index (BI) score, depression rate using Beck Depression Inventory (BDI-II) score, quality of life using EQ-5D-3L score, medication adherence using Modified Morisky Medication Adherence Scale (MMAS-8) score, patient satisfaction using Patient Satisfaction Questionnaire (PSQ) score and the number and type of complications in patients in two groups. These outcomes will be assessed at baseline, after two months and after three months from the beginning of the intervention. Intervention effects on the measured variables will also be evaluated using appropriate statistical tests based on the type of variable distribution. Potential consequences of the study might be the improvement of the measured variables in the intervention group compared to that of the control group. The expected results are that the intervention may significantly improve the status of the measured variables in the intervention group compared to that of the control group. If the outcomes of the intervention group do not change significantly compared to those of the control group, it can be due to different reasons. However, this can most likely be attributed to incorrect or insufficient use of the application by patients. TRIAL REGISTRATION: This protocol is registered in the Iranian registration of clinical trial (IRCT) on November 7, 2020 with the code IRCT20201015049037N1. URL: https://irct.ir/trial/51674.

Functional requirements of a mobile-based application for stroke self-management: A Delphi study.

This study aimed to determine the functional requirements of a self-management mobile application for stroke survivors. For extracting the initial functional requirements, a literature review as well as interviews with 17 patients and caregivers were done. The results were analyzed using the content analysis method. The initial extracted requirements were then provided to the specialists by the Delphi technique to determine the final functional requirements. Content validity ratio (CVR) and content validity index (CVI) were calculated according to the Lawshe model. Criteria for item approval included CVR > 0.49 and CVI > 0.79. Finally, the approved items were turned into a five-point Likert scale questionnaire and were then provided to 53 experts and items with a mean score higher than 3.75 were approved. Functional requirements including creating a user account, educational material, support services, providing reminders and alerts for drugs administration and physician appointments, and rehabilitation exercises (to improve balance, upper and lower extremities rehabilitation, and activities of daily living (ADLs)) were approved. Most of the approved functional requirements were related to rehabilitation exercises for improving upper limb motor function. The experts did not approve the requirements for using splints and slings or the recommendation to take some medications.

Usability evaluation of a nursing information system by applying cognitive walkthrough method.

BACKGROUND AND OBJECTIVE: The user interface usability of the nursing information system (NIS) should be such that the nurses can learn and interact with it easily and quickly. Therefore, it is necessary to identify and solve the usability problems of these systems. The present study aimed to evaluate the usability of a NIS using the cognitive walkthrough (CW) evaluation method. METHODS: Based on five selected scenarios, five evaluators evaluated the NIS in Shafa Hospital Information System. After identifying the problems, the evaluators assigned each problem to one of the usability attributes. The severity of each identified problem was determined by the evaluators and five real users of the system. RESULTS: In total, 24 unique problems were identified. The average severity of the problems was determined by the evaluators (2.77) and the actual users (2.82) in the "major problem" category. The highest number of problems were assigned to the scenarios 3 and 2 with 15 and 14 problems, respectively. The highest average severity in terms of evaluations and actual users was related to the scenario 5 (3.06 and 2.94, respectively), which was in the "major problem" category. The highest number of problems were associated with learnability (8 problems) and efficiency (6 problems). CONCLUSION: Since most of the nurses do not have enough time for learning the system, and given that the selected scenarios for evaluation were based on the most frequent daily tasks that nurses performed using the NIS; The correction of usability problems in the scenarios 3 and 2 that had the highest number of problems and the scenario 5 that had the highest average severity and execution time; it can reduce the nurses' cognitive load and the learning time of the system and increase the efficiency of nurses.

Usability evaluation of selected picture archiving and communication systems at the national level: Analysis of users' viewpoints.

BACKGROUND AND OBJECTIVES: Picture Archiving and Communication System (PACS) can be considered as one of the most important information systems used in healthcare facilities and its usability problems can lead to delays in the acceptance of information systems, increased medical errors and also user dissatisfaction. The primary purpose of this study was to evaluate the usability of PACS from the perspective of its main users. METHODS: This study used a combination of qualitative and quantitative methods and was carried out in 2019 where the research community consisted of PACS in five selected companies in Iran. The statistical sample included 200 individuals using the PACS in several hospitals across the country. Moreover, the sample was selected using the multistage random method. The data were then collected using the standard Computer System Usability Questionnaire (CSUQ) consisting of 5 sections and 19 items. Finally, the data were analyzed by SPSS software, version 18 using both descriptive and inferential methods. Content analysis was done for the qualitative data sets. RESULTS: It was indicated that ease of use, as a category, was not significantly different from the perspective of various PACS users. However, the ANOVA test revealed that there were significant differences in terms of information quality, user interface quality, overall user satisfaction and usability of PACS from the users' perspectives. Furthermore, content analysis of users' comments showed that speeding up the image processing and frequent system failures were amongst the most positive and negative aspects of the PACS, respectively. CONCLUSIONS: According to the perspective of the users of the investigated PACS in Iran, the usability of these PACS had a favorable status regarding ease of use while provided lower information quality. Generally, based on the users' viewpoints, the PACS from Company B were the most usable while the PACS provided by Company D were the least usable. It is suggested that the information quality and user interface of systems be improved by using appropriate analysis and needs assessment of the end users.

Identification and Classification of Usability Problems in a Nursing Information System: A Heuristic Evaluation.

Nursing information system is a system that nurses are required to use in order to perform their daily activities. Poor user interface design of nursing information system can cause problems in nurses' interaction with the system. This research aimed to evaluate the usability of nursing information system. During this study, five evaluators examined the nursing information system with the heuristic evaluation method and by using the checklist of Nielsen usability principles. Then, the identified problems were categorized into 10 Nielsen usability principles, and the severity of the problems was determined. They also attributed each problem to one of usability attributes. A total of 104 unique problems were identified. Most of the problems were related to the principle of "consistency and standards." More than a third of the identified problems were classed as major and catastrophe, with the highest severity in the average problems of "help and documentation" and "error prevention." Most of the identified problems were attributed to effectiveness and satisfaction. Because a significant number of identified usability problems in nursing information system were major and catastrophe and were attributed to effectiveness and satisfaction, being able to remedy the problems could improve nurses' interaction with the system user interface and increase satisfaction and effectiveness of nurses.

Investigating the satisfaction level of physicians in regards to implementing medical Picture Archiving and Communication System (PACS).

BACKGROUND: User satisfaction with PACS is considered as one of the important criteria for assessing success in using PACS. The objective of this study was to determine the level of user satisfaction with PACS and to compare its functional features with traditional film-based systems. METHODS: This study was conducted in 2017. Residents at three large university hospitals in Kerman filled-out a self-administered questionnaire consisting of three parts: demographic information of participants, user satisfaction with PACS, comparing features of the two digital and traditional imaging systems. The validity of this questionnaire was approved by five medical informatics, radiology, and health information management specialists and its reliability was confirmed by Cronbach's alpha (86%). Data were analyzed using descriptive statistics and the Spearman, Mann Whitney U and Kruskal-Wallis statistical tests. RESULTS: The mean of the participants' ages was 31.4 (±4.4) years and 59% of the participants were females. The mean of physicians' satisfaction with PACS' had no significant relationship with their age (P = 0.611), experience of using PACS (P = 0.301), specialty (P = 0.093), and percent of interpretation of images with PACS (P = 0.762). It had a significant relationship with the participants' computer skills (P = 0.022). CONCLUSIONS: The mean of physicians' satisfaction with PACS was at a moderate to a high level, yet there are still problems in the successful implementation of these systems and establishing interoperability between them. PACS has not fully met all the demands of physicians and has not achieved its predetermined objectives, such as all-access from different locations.