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BACKGROUND: None of the early M-Health applications are designed for case management care services. This study aims to describe the process of developing a M-health component for the case management model in breast cancer transitional care and to highlight methods for solving the common obstacles faced during the application of M-health nursing service. METHODS: We followed a four-step process: (a) Forming a cross-functional interdisciplinary development team containing two sub-teams, one for content development and the other for software development. (b) Applying self-management theory as the theoretical framework to develop the M-health application, using contextual analysis to gain a comprehensive understanding of the case management needs of oncology nursing specialists and the supportive care needs of out-of-hospital breast cancer patients. We validated the preliminary concepts of the framework and functionality of the M-health application through multiple interdisciplinary team discussions. (c) Adopting a multi-stage optimization strategy consisting of three progressive stages: screening, refining, and confirmation to develop and continually improve the WeChat mini-programs. (d) Following the user-centered principle throughout the development process and involving oncology nursing specialists and breast cancer patients at every stage. RESULTS: Through a continuous, iterative development process and rigorous testing, we have developed patient-end and nurse-end program for breast cancer case management. The patient-end program contains four functional modules: "Information", "Interaction", "Management", and "My", while the nurse-end program includes three functional modules: "Consultation", "Management", and "My". The patient-end program scored 78.75 on the System Usability Scale and showed a 100% task passing rate, indicating that the programs were easy to use. CONCLUSIONS: Based on the contextual analysis, multi-stage optimization strategy, and interdisciplinary team work, a WeChat mini-program has been developed tailored to the requirements of the nurses and patients. This approach leverages the expertise of professionals from multiple disciplines to create effective and evidence-based solutions that can improve patient outcomes and quality of care.
RESUMO
A total of 186 type 2 diabetic patients(DM group)and 72 healthy subjects(NDM group)were enrolled. Metabolic parameters and serum irisin levels were measured. The effects of intensity and time of the physical activity were evaluated. According to quartiles of plasma irisin levels,all subjects were divided into four groups and the prevalence of type 2 diabetes mellitus(T2DM) among four groups was compared. The relationship between plasma irisin level and physical activity in DM group was investigated. The results showed that plasma irisin levels were correlated negatively with the prevalence of T2DM(OR=0.984,95% CI 0.973~0.996);also negatively correlated with age(r=-0. 227, P=0. 029) and blood uric acid (r=-0. 225, P=0. 032) in the DM group. When corresponding exercise time was up to grade 4,the intensity of exercise would influence the irisin levels(χ2=7.319, P=0.025). After controlling for potential confounders such as age,metabolic parameters,intensity of work,timing of work,plasma irisin levels in DM group were correlated positively with the intensity of exercise (β=0.326, P=0.014) and negatively with corresponding exercise time(β=-0.454,P=0.001). These results suggest that the prevalence of T2DM decreases with the increase of plasma irisin level. Plasma irisin levels are increased after moderate intensity exercise(5~7 times weekly and 1h each time) or by short-term high-intensity exercise.