背景:数字技术和游戏化应用程序在医疗保健环境中很有用。游戏化使用技术通过类似游戏的体验来影响用户的行为和动机。患者坚持增强术后恢复(ERAS)计划对于实现术后早期恢复至关重要,并且持续监测对于获得良好结果至关重要。
目的:本研究旨在描述用于增强术后恢复的移动应用程序(MobERAS)的开发和验证,一个游戏化的移动健康应用程序,用于根据ERAS计划在术后期间对患者进行远程监护,并评估其功能和可用性以及患者的体验,卫生保健专业人员,和计算机专业人员使用它。
方法:我们开发了用于术后远程监测的MobERAS,在患者积极参与的过程中,并为卫生团队提供实时信息。应用程序开发过程包括理想化,跨学科团队组建,潜在需求评估,和产品部署。在整个开发过程中进行了可用性测试,并进行了改进,技术调整,和更新。定稿后,进行了全面的验证试验。评估的参数是那些可以影响住院时间的参数,比如恶心,呕吐,疼痛量表,恢复正常的胃肠功能,和血栓栓塞事件。MobERAS旨在由用户在手机上下载,片剂,或其他移动设备,并提供术后数据。该应用程序有一个GPS,监测患者的步行时间和距离,并连接到存储收集的数据的虚拟数据库。
结果:纳入接受中型和大型妇科肿瘤手术的妇女。我们纳入了65例患者,平均年龄为53.2岁(SD7.4,范围18-85岁)。使用时间为23.4至70小时(平均45.1,SD19.2小时)。关于坚持使用MobERAS,平均填充率为56.3%(标准差为12.1%,范围41.7%-100%),并获得了65例患者中60例(92.3%)的下床数据。研究人员可以实时访问患者填写的数据。患者很好地接受了MobERAS的使用,与应用程序的可用性的良好评价。MobERAS易于使用,并且由于其游戏化的设计而被认为具有吸引力。该应用程序在所有项目中被医疗保健专业人员(n=20)和专门从事技术创新的专业人员(n=10)评为好或非常好。
结论:MobERAS易于使用,安全,被患者接受,并得到专家的良好评估。它可以在临床外科实践中非常有用,并且是使患者和医疗保健专业人员更多参与ERAS计划的重要工具。
BACKGROUND: Digital technology and gamified apps can be useful in the health care context. Gamification uses technology to influence users\' actions and motivations through experiences that resemble games. Patient adherence to the enhanced recovery after surgery (ERAS) program is crucial for achieving early recovery after surgery and continuous monitoring is essential for obtaining good results.
OBJECTIVE: This
study aimed to describe the development and validation of a mobile app for enhanced recovery after surgery (MobERAS), a gamified mobile health app for telemonitoring patients in the postoperative period based on the ERAS program, and to evaluate its functionality and usability and the experience of patients, health care professionals, and computer professionals with its use.
METHODS: We developed MobERAS for postoperative telemonitoring, with active participation of patients in the process, and offering availability of real-time information for the health team. The app development process included idealization, interdisciplinary team formation, potential needs assessment, and product deployment. Usability tests were conducted throughout the development process with improvements, technical adjustments, and updates. After finalization, comprehensive verification tests were performed. The parameters evaluated are those that can influence the length of hospital stay, such as nausea, vomiting, pain scales, return to normal gastrointestinal function, and thromboembolic events. MobERAS was designed to be downloaded by users on their phones, tablets, or other mobile devices and to provide postoperative data. The app has a GPS that monitors the patient\'s walking time and distance and is connected to a virtual database that stores the collected data.
RESULTS: Women undergoing medium and major gynecologic oncologic surgeries were included. We included 65 patients with an average age of 53.2 (SD 7.4, range 18-85) years. The time of use ranged from 23.4 to 70 hours (mean 45.1, SD 19.2 hours). Regarding adherence to the use of MobERAS, the mean fill rate was 56.3% (SD 12.1%, range 41.7%-100%), and ambulation data were obtained for 60 (92.3%) of the 65 patients. The researcher had access to the data filled out by the patients in real time. There was good acceptance of the use of MobERAS by the patients, with good evaluation of the app\'s usability. MobERAS was easy to use and considered attractive because of its gamified design. The app was rated as good or very good in all items by health care professionals (n=20) and professionals specializing in technological innovation (n=10).
CONCLUSIONS: MobERAS is easy to use, safe, well accepted by patients, and well evaluated by experts. It can be of great use in clinical surgical practice and an important tool for greater engagement of patients and health care professionals with the ERAS program.