Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory

Kyengjin Kim; Wanju Park

doi:10.4040/jkan.2019.49.3.274

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Kim and Park: Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory

Original Article

J Korean Acad Nurs 2019;49(3):274-285.

Published online: 15 January 2019

DOI: https://doi.org/10.4040/jkan.2019.49.3.274

Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory

Kyengjin Kim^1,², Wanju Park^1,

¹College of Nursing, Kyungpook National University, Daegu

²Department of Quality Improvement, Kyungpook National University Chilgok Hospital, Daegu, Korea

Address reprint requests to : Park, Wanju College of Nursing, Kyungpook National Univeristy, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea Tel: +82-53-420-4977 Fax: +82-53-255-4977 E-mail: wanjupark@knu.ac.kr

Received 13 November 2018 Revised 23 April 2019 Accepted 14 May 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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.

Keywords: Colorectal Neoplasms, Uncertainty, Patient Navigation, Mobile Applications

References

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Figure 1.

Conceptual framework for this study.

Figure 2.

Flow chart of participant selection of evaluation.

Table 1.

Development of Contents for Menu App

Main page	Sub-page	Detailed contents	Navigation program		Reduce uncertainty
Main page	Sub-page	Detailed contents	Continuity	Empowerment	Clarity	Simplicity	Consistency	Predictability
Diagnosis	CRC information	Definition	○	-	○	-	○	-
		Risk	○	-	○	-	○	-
		Cancer stages	○	-	○	-	○	-
		Treatment stages	○	-	○	-	○	-
		Surgical methods	○	-	○	-	○	-
		Treatment types	○	-	○	-	○	-
	Guide of ward		○	-	-	○	○	-
	Guide of outpatient clinic		○	-	-	○	○	-
	Preparation for admission		○	-	-	○	○	-
Admission	Operation and treatment plan		○	△	○	○	○	○
	The day before operation	Pre-examination	○	-	-	○	○	△
		Pre-medication	○	-	-	○	○	△
		Pre-diet	○	-	-	○	○	△
		Consent form	○	-	-	○	○	△
		Self-medication	○	-	-	○	○	△
	The operation day	Operation preparation	○	-	-	○	○	○
		Respiratory exercise	○	△	○	-	○	△
		Relaxation therapy	○	○	○	-	○	△
		Drainage management	○	○	○	-	○	△
	The day after operation	Day-1	○	-	○	○	○	△
		Day-2	○	-	○	○	○	△
		Day-3	○	-	○	○	○	△
		Day-4	○	-	○	○	○	△
		Day-5	○	-	○	○	○	△
		Day-6	○	-	○	○	○	△
		Discharge preparation	○	-	○	○	○	○
Discharge	Medication		○	-	-	-	○	-
	Diet plan		○	○	-	-	○	-
	Excercise plan		○	○	-	-	○	-
	Health management	Excercise diary	○	○	○	-	△	○
		Diet diary	○	○	○	-	△	○
	Stoma management		○	○	○	-	○	-
	Symptom management	Wound management	○	○	○	-	○	-
	(self-care)	Constipation/Diarrhea	○	○	○	-	○	-
		Fatigue	○	○	○	-	○	-
		Sleep disorder	○	○	○	-	○	-
		Nausea/Vomiting	○	○	○	-	○	-
		Pain/Fever	○	○	○	-	○	-
		Intestinal obstruction	○	○	○	-	○	-
Feedback	FAQ		○	○	○	○	○	-
	Message to nurse		-	○	○	○	○	○
My page	Check diary		○	○	○	-	○	○
	Self group community (Support system)		-	○	○	○	○	○
	Total	43	41	20	31	20	43	22

○= sufficient; △= insufficient; -= not included.

CRC=Colorectal cancer; FAQ= Frequently asked questions.

Table 2.

Homogeneity General Characteristics and Study Variables in Pre-test between Experimental and Control Groups (N=61)

Characteristics	Categories	Exp.(n=31)		Cont.(n=30)		χ²	p
Characteristics	Categories	n	(%)	n	(%)	χ²	p
Age (yr)	<50	2	(6.5)	6	(20.0)	2.46	.292
	50~59	16	(51.6)	13	(43.3)
	≥60	13	(41.9)	11	(36.7)
Gender	Male	20	(64.5)	20	(66.7)	0.03	.860
	Female	11	(35.5)	10	(33.3)
Marital status	Unmarried	2	(6.5)	4	(13.3)	1.17	.557
	Married	24	(77.4)	23	(76.7)
	Others (Divorce, Separation)	5	(16.1)	3	(10.0)
Occupation	Yes	17	(54.8)	16	(53.3)	0.98	.611
	No	14	(45.2)	14	(46.7)
Education level	≤Middle school	19	(61.3)	13	(43.3)	2.32	.314
	High school	5	(16.1)	9	(30.0)
	≥College	7	(22.6)	8	(26.7)
Diagnosis	Colon cancer	14	(45.2)	20	(66.7)	2.86	.091
	Rectal cancer	17	(54.8)	10	(33.3)
Pre-operative chemotherapy	Yes	7	(22.6)	8	(26.7)	0.14	.711
	No	24	(77.4)	22	(73.3)
Family cancer history	Yes	11	(35.5)	9	(30.0)	0.21	.648
	No	20	(64.5)	21	(70.0)
Drinking	Yes	11	(35.5)	14	(46.7)	0.79	.375
	No	20	(64.5)	16	(53.3)
Smoking	Yes	5	(16.1)	9	(30.0)	1.66	.198
	No	26	(83.9)	21	(70.0)

Study variables	Range	Exp. (n=31)		Cont. (n=30)		t	p
Study variables	Range	M±SD		M±SD		t	p

Uncertainty	33~165	95.16±9.12		98.03±9.31		1.22	.228
Resilience	0~100	62.35±16.00		63.10±15.13		0.19	.852
Growth through uncertainty	39~234	159.35±19.17		159.97±13.66		0.14	.887

Exp.=Experimental group; Cont.=Control group; M=Mean; SD=Standard Deviation.

Table 3.

Comparison of Uncertainty, Resilience, Growth through Uncertainty between Experimental and Control Groups (N=61)

	Group	Pre-test (M±SD)	Post-test		Source	F	p
	Group	Pre-test (M±SD)	Post-1 (M±SD)	Post-2 (M±SD)	Source	F	p
Uncertainty	Exp. (n=31)	95.16±9.12	86.84±8.06	93.71±8.64	Group	7.22	.009
	Cont. (n=30)	98.03±9.31	97.20±10.37	98.73±11.73	Time	18.87	<.001
	t	1.22	4.37	1.91	G*T	10.86	<.001
	p	.228	<.001	.061
Resilience	Exp. (n=31)	62.35±16.00	75.10±11.25	76.68±10.20	Group	4.31	.042
	Cont. (n=30)	63.10±15.13	68.97±13.02	62.57±12.38	Time	40.34	<.001
	t	0.19	-1.97	-4.87	G*T	23.90	<.001
	p	.852	.054	<.001
Growth through	Exp. (n=31)	159.35±19.17	168.52±15.64	170.06±14.75	Group	2.76	.102
Uncertainty	Cont. (n=30)	159.97±13.66	163.30±11.06	159.00±14.53	Time	5.83	.004
	t	0.14	-1.50	-2.95	G*T	4.61	.012
	p	.887	.139	.005

Pre-test=Admission; Post-1=Discharge; Post-2=4 weeks after discharge; G*T=Interaction between group and time. Exp.=Experimental group; Cont.=Control group; M=Mean; SD=Standard Deviation.

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