[Providing knowledge and support for caring relatives with the smartphone - the MoCaB project]

Nurses' Roles in mHealth App Development: Scoping Review

BACKGROUND

Although mobile health (mHealth) apps for both health consumers and health care providers are increasingly common, their implementation is frequently unsuccessful when there is a misalignment between the needs of the user and the app's functionality. Nurses are well positioned to help address this challenge. However, nurses' engagement in mHealth app development remains unclear.

OBJECTIVE

This scoping review aims to determine the extent of the evidence of the role of nurses in app development, delineate developmental phases in which nurses are involved, and to characterize the type of mHealth apps nurses are involved in developing.

METHODS

We conducted a scoping review following the 6-stage methodology. We searched 14 databases to identify publications on the role of nurses in mHealth app development and hand searched the reference lists of relevant publications. Two independent researchers performed all screening and data extraction, and a third reviewer resolved any discrepancies. Data were synthesized and grouped by the Software Development Life Cycle phase, and the app functionality was described using the IMS Institute for Healthcare Informatics functionality scoring system.

RESULTS

The screening process resulted in 157 publications being included in our analysis. Nurses were involved in mHealth app development across all stages of the Software Development Life Cycle but most frequently participated in design and prototyping, requirements gathering, and testing. Nurses most often played the role of evaluators, followed by subject matter experts. Nurses infrequently participated in software development or planning, and participation as patient advocates, research experts, or nurse informaticists was rare.

CONCLUSIONS

Although nurses were represented throughout the preimplementation development process, nurses' involvement was concentrated in specific phases and roles.

Wie kann eine assistierte Technologie pflegende Angehörige im Pflegealltag unterstützen? Ergebnisse einer Machbarkeitsstudie zur App Liv

Hintergrund

Aufgrund der älter werdenden Bevölkerung und der Zunahme von Menschen mit chronischen Erkrankungen im Alter, steigt die Zahl der pflegenden Angehörigen sowie deren Wert für die Versorgung. Dabei agieren sie meist ohne Vorerfahrungen im Bereich der Versorgung, haben begrenztes Verständnis für das Gesundheitssystem und erfüllen die Aufgabe neben der Bewältigung des eigenen Alltags. Daher gewinnen technische Unterstützungsmöglichkeiten wie die App Liv (entwickelt im Projekt münster.land.leben) an Bedeutung. Ziel der App Liv ist die Verbesserung der digitalen Gesundheitskompetenz der vulnerablen Gruppe der pflegenden Angehörigen in Deutschland.

Ziel der Arbeit (Fragestellung)

Ziel dieser Studie war, einen Prototyp der App Liv partizipativ mit pflegenden Angehörigen zu testen und das Konzept der App weiterzuentwickeln.

Material und Methoden

Mit 10 pflegenden Angehörigen wurden unter Zuhilfenahme eines Prototyps der App qualitative online Interviews geführt, mittels qualitativer Inhaltsanalyse ausgewertet.

Ergebnisse

Die pflegenden Angehörigen bewerteten das Layout und die Einfachheit der Funktionen insgesamt positiv. Als Voraussetzung für die Nutzung betonten die Interviewten die Einfachheit der Anwendung und eine Vielfalt an Dokumentationsmöglichkeiten. Erweiterungsvorschläge erfolgten in den Bereichen Spezifizierung der Aktivitäten, Hinzufügung von weiteren Kommunikationsformen, Reminder oder Bestätigungen für erledigte oder zu erledigende Aufgaben, Verweis auf weiterführende Informationen, Verknüpfung mit anderen digitalen Systemen und Hinterlegung wichtiger Dokumente.

Diskussion

Aus Sicht der Betroffenen stößt die App auf eine Versorgungslücke. Auf Grundlage der Vorschläge der Interviewteilnehmerinnen werden 6 Erweiterungen für die App diskutiert. Um die App nicht zu überfrachten, müssen diese in einer weiteren Studie auf ihre Nützlichkeit getestet werden.

[What support does a mobile, assistive app provide for informal caregivers? A qualitative analysis of the MoCaB app user experience]

BACKGROUND

In the joint project "Mobile Care Backup" funded by the German Federal Ministry of Education and Research, the smartphone-based app "MoCaB" was developed in close cooperation with informal caregivers. It provides individualized, algorithm-based information and can accompany and support caring relatives in everyday life. After a multi-step development, informal caregivers tested the MoCaB app in a home setting at the end of the research project. The goal was to find out how the test persons evaluate MoCaB and in which form the app can provide support to informal caregivers.

METHODS

Eighteen test persons caring for relatives participated in a four-week test of MoCaB. Guideline-based qualitative interviews to record usage behavior and experiences with the app were conducted after two and four weeks of testing, transcribed and analyzed using qualitative content analysis.

RESULTS

The test persons described the care-related information as helpful. The individualized, algorithm-based mode of information delivery and the exercises provided for family caregivers were generally rated as helpful, but their use depends on the individual usage style. Three dimensions can describe the effects of MoCaB: 1) expansion of care-relevant knowledge, 2) stimulation of self-reflection, and 3) behavior towards the care recipients.

DISCUSSION

With few exceptions, the testing caregivers felt that the MoCaB app was enriching. The support dimensions have an effect at different points in everyday life and vary in intensity, depending on the duration of the existing care activity and the individual preferences of the users.

CONCLUSION

The way in which caregivers used the app was not always consistent with the expected behaviors. This demonstrates the relevance of open-ended, qualitative research methods in the evaluation of health apps.