Journal of Korean Academy of Nursing

Development and Evaluation of an App-Based Self-Management Program for Exercise Practice of Breast Cancer Survivors: A Non-Randomized Controlled Trial: Maeng, Suyoun , Yu, Jungok; J Korean Acad Nurs 2024;54(2):250-265. Published online May 31, 2024; DOI: https://doi.org/10.4040/jkan.23119

Abstract PDF: Purpose
This study aimed to develop an app-based self-management program based on the transtheoretical model (TTM) for breast cancer survivors’ exercise practice, as well as to investigate the program’s effects on the stage of change for exercise, exercise self-efficacy, exercise decisional balance, exercise amount, and body composition.
Methods
This non-randomized controlled study included 52 participants (26 in each of the experimental and control groups, respectively). An app-based self-management program based on the TTM was conducted with the experimental group for a 12-week period. The program comprised three components: individual coaching for each stage of change for exercise based on TTM, amount of exercise and body composition monitoring, and online self-help meetings.
Results
Compared with the control group, the experimental group had significantly higher stages of change for exercise (p < .001), exercise self-efficacy (p < .001), exercise decisional balance (p = .002), exercise amount (p < .001), and body composition (body weight [p = .006], body mass index [p = .005], and body fat percentage [p = .010]) immediately and four weeks after the intervention.
Conclusion
An appbased self-management program based on the TTM improves exercise behaviors in breast cancer survivors and provides physical benefits.

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1 Web of Science

The Development of Automated Personalized Self-Care (APSC) Program for Patients with Type 2 Diabetes Mellitus: Park, Gaeun , Lee, Haejung , Khang, Ah Reum; J Korean Acad Nurs 2022;52(5):535-549. Published online October 31, 2022; DOI: https://doi.org/10.4040/jkan.22046

Abstract PDF: Purpose
The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects.
Methods
The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus.
Results
The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences.
Conclusion
The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients’ self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

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3 Web of Science

Untact Visit Service Development Based on an Application Reflecting the Circumstances during COVID-19: Focusing on Utilization in the Pediatric Intensive Care Units: Woo, Dahae , Yu, Hanui , Kim, Hyo Jin , Choi, Minyoung , Kim, Dong Hee; J Korean Acad Nurs 2021;51(5):573-584. Published online October 31, 2021; DOI: https://doi.org/10.4040/jkan.21143

Abstract PDF: Purpose
This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19.
Methods
This study adopted the double diamond process of service design comprising the discovery, defining, and development stages.
Results
We developed an untact visit service based on an application that considered the child’s status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder.
Conclusion
Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child’s information in real-time, and provide one-stop service without increasing healthcare providers’ work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.

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8 Web of Science

Development and Effects of Smartphone App-Based Walking Exercise Program for Taxi Drivers: Based on Bandura’s Self Efficacy Theory: Choi, Yun Ha , Chae, Min-Jeong; J Korean Acad Nurs 2020;50(2):242-254. Published online April 30, 2020; DOI: https://doi.org/10.4040/jkan.2020.50.2.242

Abstract PDF: Purpose
The purpose of this study was to examine the effects of smart-phone app-based walking exercise programs for taxi drivers on self-efficacy and outcome expectations for exercise, health-related quality of life, walking as an exercise, and physiological indexes.
Methods
A nonequivalent control group with a pre-post-test design was used. The subjects were recruited in G metropolitan city. Subjects were assigned to the experimental (n=31) or control groups (n=30). The smart phone app-based walking exercise program consisted of educations via the app, twelve short message services, and one individual telephone counseling session, which was spread over 12 weeks.
Results
Self-efficacy, outcome expectations, and health-related quality of life had significantly higher pre-post test differences in scores in the experimental group. Additionally, blood pressure, body mass index, and waist circumference had significantly decreased prepost- test difference levels in the experimental group. Walking as an exercise (which consisted of days walked, number of steps walked, and amount of time walked) had significantly increased in the experimental group after 7~12 weeks in the period following the intervention program rather than 1~6 weeks after the program.
Conclusion
The smart phone app-based walking exercise program based on the self-efficacy theory demonstrates a significant effect on improving self-efficacy, outcome expectations physical activities, and health-related quality of life for taxi drivers. Therefore, it is recommended to actively use the program as a tool to promote self-efficacy, physical activities, and health behaviors in taxi drivers.

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8 Web of Science

Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory: Kyengjin Kim, Wanju Park; J Korean Acad Nurs 2019;49(3):274-285. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.3.274

Abstract PDF: Abstract Purpose
This study aimed to examine the effects of a mobile navigation program on uncertainty, resilience, and growth through uncertainty in colorectal cancer patients.
Methods
To verify the effectiveness of the mobile navigation program, 61 participants diagnosed with colorectal cancer undergoing surgery were selected. A nonequivalent control group nonsynchronized design was used to evaluate the program. Uncertainty was measured using the Korean version of the Uncertainty in Illness Scale, resilience was measured using the Korean version of the Connor-Davidson Resilience Scale, and growth through uncertainty was measured using the Growth through Uncertainty Scale.
Results
Compared with the control group, patients in the mobile navigation program group showed significant differences in scores for uncertainty (F=7.22, p=.009) and resilience (F=4.31, p=.042), but not for growth through uncertainty (F=2.76, p=.102).
Conclusion
These results suggest that the mobile navigation program has positive effects on decreasing uncertainty and increasing resilience among colorectal cancer patients. The mobile navigation program could play a significant role in assisting colorectal cancer patients in regard to the continuity and usability of the program.

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9 Web of Science

Effect of Smartphone Apps Applying BodyThink Program on Obesity in Adolescent Girls: Min-Kyung Jun, Ju-Young Ha; J Korean Acad Nurs 2016;46(3):390-399. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.390

Abstract PDF: Purpose
The purpose of this study was to determine the effects of smartphone apps applying BodyThink program on BMI, percentage of body fat, skeletal muscle rate, body image, and self-esteem of adolescent girls.
Methods
Sixty-eight high school girls with a BMI of over 25kg/m² were recruited to participate in this study. Girls from four schools were divided into two groups: the experimental group, which used the smartphone apps applying BodyThink program, and the control group, which used smartphone apps and small group counseling. The experimental group received the BodyThink program 6 times, scheduled once a week, with each session lasting 40~50 minutes. Test measures were completed before and after the 6 week intervention period for all participants. Collected data was analyzed using Shapiro-Wilk test, descriptive statistics, χ² test, independent t-test, Mann-Whitney U test with the SPSS/WIN 18.0 program.
Results
The girls in the experimental group significantly improved their results in BMI(Z=-1.67, p=.042), percentage of body fat (Z=-3.01, p=.001), skeletal muscle rate (t=-3.50, p<.001), and self-esteem (t=2.66, p=.005) after the program, compared to the girls in the control group.
Conclusion
Mobile applications applying psychological and emotional intervention programs have the potential to be effective alternative methods to improve the body composition and self-esteem of obese adolescent girls.

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