Development and Evaluation of an Infection Prevention Self-care Application for Cancer Patients with Chemotherapy

Si Won Park; Jeong Sook Park

doi:10.5388/aon.2016.16.4.197

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Park and Park: Development and Evaluation of an Infection Prevention Self-care Application for Cancer Patients with Chemotherapy

Original Article

Asian Oncology Nursing 2016; 16(4): 197-207.

Published online: 31 December 2016

DOI: https://doi.org/10.5388/aon.2016.16.4.197

Development and Evaluation of an Infection Prevention Self-care Application for Cancer Patients with Chemotherapy

Si Won Park¹, Jeong Sook Park²

¹Department of Nursing, Keimyung University Dongsan Medical Center, Daegu, Korea.

²College of Nursing, Keimyung University, Daegu, Korea.

Address reprint requests to: Park, Jeong Sook. College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3916, jsp544@kmu.ac.kr

Received 1 August 2016 Revised 4 November 2016 Accepted 21 November 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study is to develop and evaluate an infection prevention self-care application for cancer patients who have been discharged from hospital after receiving chemotherapy.

Methods

The app was developed through five stages: analysis, design, development, implementation and evaluation. The app's contents included infection prevention education, checking daily self-management, checking daily inquiry and information about the app. Cancer patients undergoing chemotherapy were asked to use the app and then a nonequivalent control group non-synchronized design was conducted to analyze the effect of the app on infection prevention self-care knowledge, self-care performance, infection occurrence and temperature. Twenty-two patients in the experimental group and twenty-four patients in the control group participated in this study.

Results

The self-care knowledge score (t=6.74, p<.001) and self-care performance score (t=13.44, p<.001) were statistically higher in the experimental group compared with the control group respectively. The infection occurrence was not different between the experimental and control groups. But temperature in the control group was statistically higher than in the experimental group (t=-2.39, p=.021).

Conclusion

The infection prevention self-care application for cancer patients receiving chemotherapy was an effective intervention to decrease infections during home care.

Keywords: Infection, Self-Care, Antineoplastic Agents, Mobile Applications

Figures and Tables

Table 1

Contents of Infection Prevention Self-care Application

Main menus	Submenus	Form
Infection prevention education	Hand washing	Text and image, MP3 files
	Oral care	Text and photos
	Food and kitchen care	Text and photos, picture
	Daily activities management	Text and picture
	In the event of infection and symptom management	Text
Checking the daily self-management	Body temperature measurement	Text and input window
	Checking the infection prevention	Text (check list)
	Checking the infection symptom	Text (check list)
Checking the daily inquiry	Body temperature measurements views	The bar graph
	Infection prevention results views	The bar graph
	Infection symptom results views	The bar graph
Application information	Application information	Text
	Application user’s guide	Text
	Application references	Text

MP3= Moving picture experts group-1 audio layer-3.

Table 2

Expert Evaluation and User Satisfaction with Infection Prevention Self-care Application

Criteria	Categories	CVI of expert evaluation	Mean score of user satisfaction
System convenience	Easy to use the system	0.84	3.67
System convenience	Friendly to use	0.75	3.33
Design	Attractive design	0.75	3.33
Contents relevancy	Accurate contents	0.97	4.00
	Rich contents	0.78	3.33
	Clear information	0.97	3.83
	Necessary information	1.00	4.00
	Reliable information	0.97	3.83
	Up to date information	1.00	4.00
	Detailed contents	0.97	3.83
	Well arranged information	0.94	3.83
Contents usefulness	Contents related to me	1.00	4.00
	Useful for my health behavior	0.91	3.67
	Easy to understand	0.84	3.83
Total		0.91	3.75

CVI= Content validity index.

Table 3

Homogeneity Test between Experimental and Control Group (N=46)

Criteria	Categories	Exp. (n=22)	Cont. (n=24)	χ² or t	p
Criteria	Categories	n (%) or M±SD	n (%) or M±SD	χ² or t	p
Gender	Male	6 (27.3)	7 (29.2)	0.02	.887
Gender	Female	16 (72.7)	17 (70.8)	0.02	.887
Age (year)		51.1±6.47	51.1±5.72	0.01	.995
Education level	Middle school	4 (18.2)	10 (41.7)	3.16	.183^*
	High school	14 (63.6)	10 (41.7)
	≥University	4 (18.2)	4 (16.6)
Spouse	Yes	19 (86.4)	22 (91.7)	0.33	.659^*
Spouse	No	3 (13.6)	2 (8.3)	0.33	.659^*
Religion	Yes	10 (45.5)	12 (50.0)	0.10	.758
Religion	No	12 (54.5)	12 (50.0)	0.10	.758
Job	Yes	4 (18.2)	6 (25.0)	0.31	.725^*
Job	No	18 (81.8)	18 (75.0)	0.31	.725^*
Economic state	Bad	8 (36.4)	12 (50.0)	0.87	.351
Economic state	Good	14 (63.6)	12 (50.0)	0.87	.351
Diagnosis	Breast cancer	8 (36.4)	7 (29.2)	0.88	.873^*
	Lymphoma	5 (22.7)	4 (16.7)
	Gynecologic cancer	3 (13.6)	5 (20.8)
	Miscellaneous	6 (27.3)	8 (33.3)
Duration of cancer (month)		6.5±8.34	7.1±11.07	-0.23	.819
Stage of cancer	1	0 (0.0)	2 (8.3)	5.20	.331^*
	2	12 (54.5)	10 (41.7)
	3	3 (13.6)	6 (25.0)
	4	5 (22.7)	6 (25.0)
	Unknown	2 (9.2)	0 (0.0)
ECOG PS	0	1 (4.5)	3 (12.5)	0.92	.815^*
	1	13 (59.1)	13 (54.2)
	2	8 (36.4)	8 (33.3)

^*Fisher's exact test; Exp.= Experimental group; Cont.= Control group; ECOG PS= Eastern Cooperative Oncology Group performance status.

Table 4

Comparison the Dependent Variables between Experimental and Control Group (N=46)

Dependent variables		Exp. (n=22)	Cont. (n=24)	χ² or t	p
Dependent variables		n (%) or M±SD	n (%) or M±SD	χ² or t	p
Self care knowledge		19.86±1.39	16.88±1.60	6.74	<.001
Self care performance		131.18±6.52	101.54±8.25	13.44	<.001
Infection	Yes	2 (4.3)	5 (10.9)	1.23	.268
Infection	No	20 (43.5)	19 (41.3)	1.23	.268
ANC (/mm³)		2,049.63±1,415.35	1,430.83±1,091.30	1.67	.102
Body temperature (℃)		36.66±0.56	37.26±1.04	−2.39	.021

Exp.= Experimental group; Cont.= Control group; ANC= Absolute neutrophil count.

Notes

This article is based on a part of the first author's master's thesis from Keimyung University.

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