RESUMEN
Introduction and Objective: In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life. Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients. Materials and Methods: In the present applied research, first the functional requirements of the software were determined considering the self-care requirements of colostomy patients. Then, the software was designed based on object-oriented analysis, and according to it, the application was coded in Java and developed in the Android Studio environment. Finally, to evaluate the software, the opinions and comments of 5 gastroenterologists and 10 adult colostomy patients in the age range between 27 and 64 years who had at least a high school diploma were used as the basis of judgment at this stage. The instruments used in the evaluation included a checklist, derived from three standard questionnaires (the System Usability Scale [SUS], the mHealth App Usability Questionnaire [MAUQ], and the User Version of the Mobile Application Rating Scale [uMARS]) to measure the user-friendliness indicator, and a researcher-made checklist to measure the performance indicator of the various services provided. Results The services of the software developed include the provision of medical information and self-care instructions regarding colostomy surgery, as well as alerts for the user to schedule an appointment with a doctor and the time to take medications. Based on the results of the evaluation stage, the users were generally satisfied with the interface, services, and general features of the software. In general, the software was evaluated at the "acceptable" level, with a rate of 85%. Discussion and Conclusion Based on the findings of the current research, thesoftware developed can be significantly effective in facilitating the education of colostomy patients and improving their self-care. Proper and continuous self-care and education for colostomy patients is necessary to prevent and control complications resulting from surgery and to improve their quality of life. Therefore, in addition to patients, all health care staff, organizations, and associations which support colostomy patients can also use this software to educate patients and improve the care provided to them. (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Autocuidado , Colostomía , Aplicaciones Móviles , Educación del Paciente como AsuntoRESUMEN
Objective. This study aimed to compare home visits and telephone follow-up effectiveness on patients' self-efficacy undergoing Coronary Artery Bypass Graft Surgery -CABG- and caregivers' burden. Methods. In this randomized clinical trial, 114 patients undergoing CABG were assigned to the three groups of home visits, telephone follow-up, and control based on the stratified block randomization. The self-management program of the home visit group included four face-to-face 60-minute training sessions once a week, and for the telephone follow-up group, four 30-minute telephone counseling sessions twice each week for a month. The control group received routine care. Data were collected using the cardiac rehabilitation self-efficacy questionnaire and the caregiver burden scale before and after the intervention. Results. Before the study, there were no statistically significant differences between the three groups in terms of the means of self-efficacy and caregiver burden scores. However, there was a statistically significant difference between the home visit and control groups (p<0.001) and between the telephone follow-up and control groups (p<0.001) after the intervention, with increased self-efficacy and reduced caregiver burden reported. In contrast, there was no significant difference between the home visit and telephone follow-up groups regarding self-efficacy and caregiver burden scores. Conclusion. Both methods of self-management education have similar effectiveness in increasing self-efficacy and reducing the caregiver burden after discharge for patients who have undergone CABG.
Objetivo. Comparar la eficacia de las visitas domiciliarias y del seguimiento telefónico sobre la autoeficacia de los pacientes sometidos a cirugía de derivación arterial coronaria con injerto (CABG en inglés) y la carga de sus cuidadores. Métodos. En este ensayo clínico aleatorio, 114 pacientes sometidos a CABG se asignaron a uno de los tres grupos de investigación: visitas domiciliarias, seguimiento telefónico y control sobre la base de la aleatorización en bloque estratificada. El programa de educación en autoeficacia en el grupo de visitas domiciliarias incluía cuatro sesiones presenciales de formación de 60 minutos una vez a la semana, y para el grupo de seguimiento telefónico, cuatro sesiones de asesoramiento telefónico de 30 minutos dos veces por semana por un mes. El grupo de control recibió atención rutinaria. Los datos se recogieron mediante el cuestionario de autoeficacia de la rehabilitación cardíaca y la escala de carga del cuidador antes y después de la intervención. Resultados. Antes del estudio, no hubo diferencias entre los tres grupos en cuanto a las medias de las puntuaciones de las escalas de autoeficacia y carga del cuidador. Sin embargo, se encontró una diferencia estadísticamente significativa entre los grupos de visitas domiciliarias y de control (p<0.001) y entre los grupos de seguimiento telefónico y de control (p<0.001) después de la intervención, con un aumento de la autoeficacia y una reducción de la carga del cuidador. Es de anotar que no hubo diferencias significativas entre los grupos de visita domiciliaria y de seguimiento telefónico en cuanto a las puntuaciones de autoeficacia y de carga del cuidador. Conclusión. Ambos métodos de educación en este estudio tuvieron una efectividad similar en el aumento de la autoeficacia y la reducción de la carga de los cuidadores tras el alta de los pacientes sometidos a CABG.
Objetivo. Comparar a eficácia das visitas domiciliares e do seguimento telefónico sobre a autoeficácia dos pacientes submetidos a cirurgia de derivação arterial coronária com enxerto (CABG em inglês) e a carga dos seus cuidadores. Métodos. Neste ensaio clínico aleatório, 114 pacientes submetidos a CABG foram designados a um dos três grupos de investigação: visitas domiciliares, seguimento telefónico e controle sobre a base aleatorizada em blocos estratificada. O programa de educação em autoeficácia no grupo de visitas domiciliares incluía quatro sessões de formação presenciais de 60 minutos uma vez por semana, e para o grupo de seguimento telefónico, quatro sessões de assessoramento telefónico de 30 minutos duas vezes por semana durante um mês. O grupo de controle recebeu atenção rotineira. Os dados se recolheram mediante o questionário de autoeficácia da reabilitação cardíaca e a escala de carga do cuidador antes e depois da intervenção. Resultados. Antes do estudo, não houve diferenças entre os três grupos enquanto às médias das pontuações das escalas de autoeficácia e carga do cuidador. Porém, se encontrou uma diferença estatisticamente significativa entre os grupos de visitas domiciliares e de controle (p<0.001) e entre os grupos de seguimento telefónico e de controle (p<0.001) depois da intervenção, com um aumento da autoeficácia e uma redução da carga do cuidador. É importante anotar que não houve diferenças significativas entre os grupos de visita domiciliar e de seguimento telefónico enquanto às pontuações de autoeficácia e de carga do cuidador. Conclusão. Ambos os métodos de educação neste estudo tiveram uma efetividade similar no aumento da autoeficácia e a redução da carga dos cuidadores após a alta dos pacientes submetidos a CABG.