Effects of App-Based Transitional Care on the Self-Efficacy and Quality of Life of Patients With Spinal Cord Injury in China: Randomized Controlled Trial
Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. Wi...
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Published in | JMIR mHealth and uHealth Vol. 9; no. 4; p. e22960 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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01.04.2021
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Abstract | Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. With the prevalence of mobile terminals, the usage of mobile health apps has the potential to fill this gap by extending qualified medical resources to the families of SCI patients. Our team developed the app Together for the transitional care of home-dwelling SCI patients in China.
This study aimed to evaluate the effects of app-based transitional care on the self-efficacy and QOL of SCI patients.
Through a three-round Delphi process, an Android app was designed. Both medical staff and patients could access the app. Medical staff used it for providing remote transitional care to SCI patients. Patients used it to view transitional care time and send messages to medical staff. Thereafter, a multicenter and assessor-blinded randomized controlled trial was conducted. Participants (n=98) who had SCI and lived at home following discharge were recruited and randomly assigned to a study group (n=49) and control group (n=49) using a randomized number list in four research centers. Patients in both groups received systematic discharge education before discharge. The study group received five follow-ups conducted by trained nurses through the app, which had four core functions, namely remote assessment, health education, interdisciplinary referral, and patient interaction, at weeks 2, 4, 6, 8, and 12 following discharge. The control group received a routine telephone follow-up conducted by nurses at week 12 following discharge. The outcome measures were the Moorong Self-Efficacy Scale (MSES) and 36-item Short-Form Health Survey (SF-36) scores. Data were collected before discharge (T
) and at weeks 12 (T
) and 24 following discharge (T
). Differences between the groups were tested by repeated measures analysis of variance and simple effect analysis.
After the follow-up, the total MSES scores in the study group improved over time (T
=67.80, T
=71.90, and T
=76.29) and were higher than those in the control group (T
=64.49) at 24 weeks following discharge (simple effect analysis: F
=8.506, P=.004). Regarding the total SF-36 score, although it was higher in patients from the study group (T
=65.36) than those from the control group (T
=58.77) at 24 weeks following discharge, only time effects were significant (F
=6.671, P=.002) and neither the group effects nor the interaction effects influenced the change in QOL (group effects: F
=0.082, P=.78; interaction effects: F
=3.059, P=.052).
This study confirmed that app-based transitional care improves the self-efficacy of SCI patients. Nevertheless, QOL improvement is not yet evident. Future investigations with larger sample sizes and longer observation periods are warranted to further verify the effects.
Chinese Clinical Trial Registry ChiCTR-IPR-17012317; http://www.chictr.org.cn/showproj.aspx?proj=19828. |
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AbstractList | Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. With the prevalence of mobile terminals, the usage of mobile health apps has the potential to fill this gap by extending qualified medical resources to the families of SCI patients. Our team developed the app Together for the transitional care of home-dwelling SCI patients in China.
This study aimed to evaluate the effects of app-based transitional care on the self-efficacy and QOL of SCI patients.
Through a three-round Delphi process, an Android app was designed. Both medical staff and patients could access the app. Medical staff used it for providing remote transitional care to SCI patients. Patients used it to view transitional care time and send messages to medical staff. Thereafter, a multicenter and assessor-blinded randomized controlled trial was conducted. Participants (n=98) who had SCI and lived at home following discharge were recruited and randomly assigned to a study group (n=49) and control group (n=49) using a randomized number list in four research centers. Patients in both groups received systematic discharge education before discharge. The study group received five follow-ups conducted by trained nurses through the app, which had four core functions, namely remote assessment, health education, interdisciplinary referral, and patient interaction, at weeks 2, 4, 6, 8, and 12 following discharge. The control group received a routine telephone follow-up conducted by nurses at week 12 following discharge. The outcome measures were the Moorong Self-Efficacy Scale (MSES) and 36-item Short-Form Health Survey (SF-36) scores. Data were collected before discharge (T
) and at weeks 12 (T
) and 24 following discharge (T
). Differences between the groups were tested by repeated measures analysis of variance and simple effect analysis.
After the follow-up, the total MSES scores in the study group improved over time (T
=67.80, T
=71.90, and T
=76.29) and were higher than those in the control group (T
=64.49) at 24 weeks following discharge (simple effect analysis: F
=8.506, P=.004). Regarding the total SF-36 score, although it was higher in patients from the study group (T
=65.36) than those from the control group (T
=58.77) at 24 weeks following discharge, only time effects were significant (F
=6.671, P=.002) and neither the group effects nor the interaction effects influenced the change in QOL (group effects: F
=0.082, P=.78; interaction effects: F
=3.059, P=.052).
This study confirmed that app-based transitional care improves the self-efficacy of SCI patients. Nevertheless, QOL improvement is not yet evident. Future investigations with larger sample sizes and longer observation periods are warranted to further verify the effects.
Chinese Clinical Trial Registry ChiCTR-IPR-17012317; http://www.chictr.org.cn/showproj.aspx?proj=19828. Background: Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. With the prevalence of mobile terminals, the usage of mobile health apps has the potential to fill this gap by extending qualified medical resources to the families of SCI patients. Our team developed the app Together for the transitional care of home-dwelling SCI patients in China. Objective: This study aimed to evaluate the effects of app-based transitional care on the self-efficacy and QOL of SCI patients. Methods: Through a three-round Delphi process, an Android app was designed. Both medical staff and patients could access the app. Medical staff used it for providing remote transitional care to SCI patients. Patients used it to view transitional care time and send messages to medical staff. Thereafter, a multicenter and assessor-blinded randomized controlled trial was conducted. Participants (n=98) who had SCI and lived at home following discharge were recruited and randomly assigned to a study group (n=49) and control group (n=49) using a randomized number list in four research centers. Patients in both groups received systematic discharge education before discharge. The study group received five follow-ups conducted by trained nurses through the app, which had four core functions, namely remote assessment, health education, interdisciplinary referral, and patient interaction, at weeks 2, 4, 6, 8, and 12 following discharge. The control group received a routine telephone follow-up conducted by nurses at week 12 following discharge. The outcome measures were the Moorong Self-Efficacy Scale (MSES) and 36-item Short-Form Health Survey (SF-36) scores. Data were collected before discharge (T0) and at weeks 12 (T1) and 24 following discharge (T2). Differences between the groups were tested by repeated measures analysis of variance and simple effect analysis. Results: After the follow-up, the total MSES scores in the study group improved over time (T0=67.80, T1=71.90, and T2=76.29) and were higher than those in the control group (T2=64.49) at 24 weeks following discharge (simple effect analysis: F1=8.506, P=.004). Regarding the total SF-36 score, although it was higher in patients from the study group (T2=65.36) than those from the control group (T2=58.77) at 24 weeks following discharge, only time effects were significant (F2,95=6.671, P=.002) and neither the group effects nor the interaction effects influenced the change in QOL (group effects: F1,96=0.082, P=.78; interaction effects: F2,95=3.059, P=.052). Conclusions: This study confirmed that app-based transitional care improves the self-efficacy of SCI patients. Nevertheless, QOL improvement is not yet evident. Future investigations with larger sample sizes and longer observation periods are warranted to further verify the effects. Trial Registration: Chinese Clinical Trial Registry ChiCTR-IPR-17012317; http://www.chictr.org.cn/showproj.aspx?proj=19828 BACKGROUNDSpinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. With the prevalence of mobile terminals, the usage of mobile health apps has the potential to fill this gap by extending qualified medical resources to the families of SCI patients. Our team developed the app Together for the transitional care of home-dwelling SCI patients in China.OBJECTIVEThis study aimed to evaluate the effects of app-based transitional care on the self-efficacy and QOL of SCI patients.METHODSThrough a three-round Delphi process, an Android app was designed. Both medical staff and patients could access the app. Medical staff used it for providing remote transitional care to SCI patients. Patients used it to view transitional care time and send messages to medical staff. Thereafter, a multicenter and assessor-blinded randomized controlled trial was conducted. Participants (n=98) who had SCI and lived at home following discharge were recruited and randomly assigned to a study group (n=49) and control group (n=49) using a randomized number list in four research centers. Patients in both groups received systematic discharge education before discharge. The study group received five follow-ups conducted by trained nurses through the app, which had four core functions, namely remote assessment, health education, interdisciplinary referral, and patient interaction, at weeks 2, 4, 6, 8, and 12 following discharge. The control group received a routine telephone follow-up conducted by nurses at week 12 following discharge. The outcome measures were the Moorong Self-Efficacy Scale (MSES) and 36-item Short-Form Health Survey (SF-36) scores. Data were collected before discharge (T0) and at weeks 12 (T1) and 24 following discharge (T2). Differences between the groups were tested by repeated measures analysis of variance and simple effect analysis.RESULTSAfter the follow-up, the total MSES scores in the study group improved over time (T0=67.80, T1=71.90, and T2=76.29) and were higher than those in the control group (T2=64.49) at 24 weeks following discharge (simple effect analysis: F1=8.506, P=.004). Regarding the total SF-36 score, although it was higher in patients from the study group (T2=65.36) than those from the control group (T2=58.77) at 24 weeks following discharge, only time effects were significant (F2,95=6.671, P=.002) and neither the group effects nor the interaction effects influenced the change in QOL (group effects: F1,96=0.082, P=.78; interaction effects: F2,95=3.059, P=.052).CONCLUSIONSThis study confirmed that app-based transitional care improves the self-efficacy of SCI patients. Nevertheless, QOL improvement is not yet evident. Future investigations with larger sample sizes and longer observation periods are warranted to further verify the effects.TRIAL REGISTRATIONChinese Clinical Trial Registry ChiCTR-IPR-17012317; http://www.chictr.org.cn/showproj.aspx?proj=19828. Background Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. With the prevalence of mobile terminals, the usage of mobile health apps has the potential to fill this gap by extending qualified medical resources to the families of SCI patients. Our team developed the app Together for the transitional care of home-dwelling SCI patients in China. Objective This study aimed to evaluate the effects of app-based transitional care on the self-efficacy and QOL of SCI patients. Methods Through a three-round Delphi process, an Android app was designed. Both medical staff and patients could access the app. Medical staff used it for providing remote transitional care to SCI patients. Patients used it to view transitional care time and send messages to medical staff. Thereafter, a multicenter and assessor-blinded randomized controlled trial was conducted. Participants (n=98) who had SCI and lived at home following discharge were recruited and randomly assigned to a study group (n=49) and control group (n=49) using a randomized number list in four research centers. Patients in both groups received systematic discharge education before discharge. The study group received five follow-ups conducted by trained nurses through the app, which had four core functions, namely remote assessment, health education, interdisciplinary referral, and patient interaction, at weeks 2, 4, 6, 8, and 12 following discharge. The control group received a routine telephone follow-up conducted by nurses at week 12 following discharge. The outcome measures were the Moorong Self-Efficacy Scale (MSES) and 36-item Short-Form Health Survey (SF-36) scores. Data were collected before discharge (T0) and at weeks 12 (T1) and 24 following discharge (T2). Differences between the groups were tested by repeated measures analysis of variance and simple effect analysis. Results After the follow-up, the total MSES scores in the study group improved over time (T0=67.80, T1=71.90, and T2=76.29) and were higher than those in the control group (T2=64.49) at 24 weeks following discharge (simple effect analysis: F1=8.506, P=.004). Regarding the total SF-36 score, although it was higher in patients from the study group (T2=65.36) than those from the control group (T2=58.77) at 24 weeks following discharge, only time effects were significant (F2,95=6.671, P=.002) and neither the group effects nor the interaction effects influenced the change in QOL (group effects: F1,96=0.082, P=.78; interaction effects: F2,95=3.059, P=.052). Conclusions This study confirmed that app-based transitional care improves the self-efficacy of SCI patients. Nevertheless, QOL improvement is not yet evident. Future investigations with larger sample sizes and longer observation periods are warranted to further verify the effects. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012317; http://www.chictr.org.cn/showproj.aspx?proj=19828 BackgroundSpinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. With the prevalence of mobile terminals, the usage of mobile health apps has the potential to fill this gap by extending qualified medical resources to the families of SCI patients. Our team developed the app Together for the transitional care of home-dwelling SCI patients in China. ObjectiveThis study aimed to evaluate the effects of app-based transitional care on the self-efficacy and QOL of SCI patients. MethodsThrough a three-round Delphi process, an Android app was designed. Both medical staff and patients could access the app. Medical staff used it for providing remote transitional care to SCI patients. Patients used it to view transitional care time and send messages to medical staff. Thereafter, a multicenter and assessor-blinded randomized controlled trial was conducted. Participants (n=98) who had SCI and lived at home following discharge were recruited and randomly assigned to a study group (n=49) and control group (n=49) using a randomized number list in four research centers. Patients in both groups received systematic discharge education before discharge. The study group received five follow-ups conducted by trained nurses through the app, which had four core functions, namely remote assessment, health education, interdisciplinary referral, and patient interaction, at weeks 2, 4, 6, 8, and 12 following discharge. The control group received a routine telephone follow-up conducted by nurses at week 12 following discharge. The outcome measures were the Moorong Self-Efficacy Scale (MSES) and 36-item Short-Form Health Survey (SF-36) scores. Data were collected before discharge (T0) and at weeks 12 (T1) and 24 following discharge (T2). Differences between the groups were tested by repeated measures analysis of variance and simple effect analysis. ResultsAfter the follow-up, the total MSES scores in the study group improved over time (T0=67.80, T1=71.90, and T2=76.29) and were higher than those in the control group (T2=64.49) at 24 weeks following discharge (simple effect analysis: F1=8.506, P=.004). Regarding the total SF-36 score, although it was higher in patients from the study group (T2=65.36) than those from the control group (T2=58.77) at 24 weeks following discharge, only time effects were significant (F2,95=6.671, P=.002) and neither the group effects nor the interaction effects influenced the change in QOL (group effects: F1,96=0.082, P=.78; interaction effects: F2,95=3.059, P=.052). ConclusionsThis study confirmed that app-based transitional care improves the self-efficacy of SCI patients. Nevertheless, QOL improvement is not yet evident. Future investigations with larger sample sizes and longer observation periods are warranted to further verify the effects. Trial RegistrationChinese Clinical Trial Registry ChiCTR-IPR-17012317; http://www.chictr.org.cn/showproj.aspx?proj=19828 |
Author | Li, Kun Wang, Yingmin He, Xiaokuo Yan, Tiebin Xie, Sumei Tang, Jie Liu, Ting |
AuthorAffiliation | 5 Department of Rehabilitation Medicine The Fifth Hospital of Xiamen Xiamen China 1 Department of Rehabilitation Medicine The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen China 3 Department of Rehabilitation Medicine Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China 6 School of Nursing Sun Yat-sen University Guangzhou China 2 Department of Spinal Cord Injury Rehabilitation Guangdong Provincial Work Injury Rehabilitation Hospital Guangzhou China 4 Department of Spinal Cord Injury Rehabilitation Sichuan Provincial Rehabilitation Hospital Chengdu China |
AuthorAffiliation_xml | – name: 1 Department of Rehabilitation Medicine The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen China – name: 5 Department of Rehabilitation Medicine The Fifth Hospital of Xiamen Xiamen China – name: 2 Department of Spinal Cord Injury Rehabilitation Guangdong Provincial Work Injury Rehabilitation Hospital Guangzhou China – name: 6 School of Nursing Sun Yat-sen University Guangzhou China – name: 3 Department of Rehabilitation Medicine Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China – name: 4 Department of Spinal Cord Injury Rehabilitation Sichuan Provincial Rehabilitation Hospital Chengdu China |
Author_xml | – sequence: 1 givenname: Ting orcidid: 0000-0002-8466-8635 surname: Liu fullname: Liu, Ting organization: Department of Rehabilitation Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China – sequence: 2 givenname: Sumei orcidid: 0000-0003-4095-9884 surname: Xie fullname: Xie, Sumei organization: Department of Spinal Cord Injury Rehabilitation, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China – sequence: 3 givenname: Yingmin orcidid: 0000-0003-2727-0134 surname: Wang fullname: Wang, Yingmin organization: Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China – sequence: 4 givenname: Jie orcidid: 0000-0003-3830-3093 surname: Tang fullname: Tang, Jie organization: Department of Spinal Cord Injury Rehabilitation, Sichuan Provincial Rehabilitation Hospital, Chengdu, China – sequence: 5 givenname: Xiaokuo orcidid: 0000-0002-2533-0124 surname: He fullname: He, Xiaokuo organization: Department of Rehabilitation Medicine, The Fifth Hospital of Xiamen, Xiamen, China – sequence: 6 givenname: Tiebin orcidid: 0000-0002-0489-5142 surname: Yan fullname: Yan, Tiebin organization: Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China – sequence: 7 givenname: Kun orcidid: 0000-0002-0092-7178 surname: Li fullname: Li, Kun organization: School of Nursing, Sun Yat-sen University, Guangzhou, China |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33792555$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1016_j_apmr_2022_10_005 crossref_primary_10_1111_jjns_12532 crossref_primary_10_1155_2021_3634548 crossref_primary_10_1007_s10792_023_02666_6 crossref_primary_10_3389_fpsyt_2024_1289138 crossref_primary_10_1016_j_ijnss_2022_12_009 crossref_primary_10_1038_s41393_023_00948_5 crossref_primary_10_2196_34303 crossref_primary_10_1186_s13018_023_03804_7 crossref_primary_10_1002_ibra_12005 |
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Copyright | Ting Liu, Sumei Xie, Yingmin Wang, Jie Tang, Xiaokuo He, Tiebin Yan, Kun Li. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 01.04.2021. 2021. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Ting Liu, Sumei Xie, Yingmin Wang, Jie Tang, Xiaokuo He, Tiebin Yan, Kun Li. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 01.04.2021. 2021 |
Copyright_xml | – notice: Ting Liu, Sumei Xie, Yingmin Wang, Jie Tang, Xiaokuo He, Tiebin Yan, Kun Li. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 01.04.2021. – notice: 2021. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Ting Liu, Sumei Xie, Yingmin Wang, Jie Tang, Xiaokuo He, Tiebin Yan, Kun Li. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 01.04.2021. 2021 |
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Keywords | spinal cord injury quality of life transitional care mobile app self-efficacy |
Language | English |
License | Ting Liu, Sumei Xie, Yingmin Wang, Jie Tang, Xiaokuo He, Tiebin Yan, Kun Li. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 01.04.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included. |
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Snippet | Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of... Background Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and... Background: Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and... BACKGROUNDSpinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and... BackgroundSpinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and... |
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SubjectTerms | Blood pressure China - epidemiology Clinical trials Health education Hospitals Humans Interdisciplinary aspects Medical personnel Mobile Applications Nursing Original Paper Outpatient care facilities Patients Professionals Quality of Life Rehabilitation Research centers Self Efficacy Spinal cord injuries Spinal Cord Injuries - epidemiology Spinal Cord Injuries - therapy Transitional Care |
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Title | Effects of App-Based Transitional Care on the Self-Efficacy and Quality of Life of Patients With Spinal Cord Injury in China: Randomized Controlled Trial |
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