Učinkovitost uporabe mobilne aplikacije za samooskrbo v vodenju pacienta s sladkorno boleznijo tipa 2

Gosak, Lucija

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Title:	Učinkovitost uporabe mobilne aplikacije za samooskrbo v vodenju pacienta s sladkorno boleznijo tipa 2
Authors:	ID Gosak, Lucija (Author) ID Štiglic, Gregor (Mentor) More about this mentor... ID Pajnkihar, Majda (Comentor)
Files:	DOK_Gosak_Lucija_2025.pdf (8,77 MB) MD5: 165852AF76547B77F60CE265C58B48EF
Language:	Slovenian
Work type:	Doctoral dissertation
Typology:	2.08 - Doctoral Dissertation
Organization:	FZV - Faculty of Health Sciences
Abstract:	Uvod: Sladkorna bolezen tipa 2 postaja vse večji javnozdravstveni izziv in zahteva upoštevanje kompleksnega režima zdravljenja. V sodobni zdravstveni oskrbi se poudarja aktivna odgovornost pacientov za samooskrbo bolezni, kar vključuje sprejemanje zdravih življenjskih navad. Z rastjo digitalne tehnologije se povečuje tudi število mobilnih aplikacij, namenjenih samooskrbi. Namen doktorske disertacije je oceniti učinkovitost uporabe mobilne aplikacije za izboljšanje samooskrbe pacientov s sladkorno boleznijo tipa 2. Metode: Izvedli smo sistematično iskanje mobilnih aplikacij v spletnih trgovinah Google Play Store in iPadian. Funkcije vedenja samooskrbe so bile ocenjene v skladu z okvirjem AADE7, kakovost pa je bila ocenjena z uporabo lestvice uMARS. Uporabili smo dva anketna vprašalnika, "Self-Care of Diabetes Inventory" za oceno samooskrbe in "Brief Illness Perception Questionnaire" za oceno percepcije bolezni, ki sta bila validirana v pilotni raziskavi. V randomizirani klinični raziskavi smo ocenili vpliv uporabe mobilne aplikacije na izboljšanje samooskrbe, percepcije bolezni in zdravstvenega stanja pacienta. Pred začetkom raziskave in po štirih tednih so pacienti izpolnili oba anketna vprašalnika, ter izvedli klinične meritve. V končnem delu so sledili delno strukturirani intervjuji z medicinskimi sestrami in pacienti. Rezultati: Mobilna aplikacija forDiabetes: diabetes self-management app je bila izbrana kot najprimernejša za nadaljnjo raziskavo. V pilotni raziskavi je sodelovalo 141 pacientov z diagnosticirano sladkorno boleznijo tipa 2. Svojo samozavest za izvajanje samooskrbe so ocenili z najvišjo povprečno oceno, medtem ko so najnižje ocenili upravljanje samooskrbe. Anketni vprašalnik Self-Care of Diabetes Inventory je bil na podlagi rezultatov pilotne raziskave slabo usklajen z metrikami uporabniškega modela za spremljanje samooskrbe, samozavest in upravljanje samooskrbe, vendar je CFA za vzdrževanje samooskrbe pokazal dobro ujemanje. Cronbachova alfa je pokazala odlične rezultate za samozavest, dobre za spremljanje, sprejemljive za vzdrževanje in šibke za upravljanje samooskrbe. Izračuni za vprašalnik Brief Illness Perception Questionnaire so pokazali visoko stopnjo strinjanja med ocenjevalci in odlično veljavnost vprašanj. Cronbachova alfa za zanesljivost je bila 0,652, kar kaže na zadovoljivo notranjo skladnost. V glavni raziskavi štiri tedne po uporabi mobilne aplikacije ni bilo mogoče zaznati statistično pomembnega izboljšanja v samooskrbi, percepciji bolezni in kliničnih meritvah. Na podlagi kvalitativnega dela raziskave smo ugotovili, da imajo zdravstveni delavci in pacienti pozitiven pogled na uporabo mobilne aplikacije ter da jim je uporaba pripomogla k večji doslednosti pri spremljanju svoje bolezni in lažji vpogled v meritve. Na podlagi pridobljenih rezultatov smo adaptirali teorijo srednjega obsega za samooskrbo kroničnih bolezni v povezavi z mobilnim zdravjem in dodatno vključili naslednje komponente: znanje, doslednost, karakteristike mobilnega zdravja in mobilne aplikacije, varovanje in integriteta pacientovih podatkov, izidi pri pacientu, priporočene značilnosti in funkcionalnosti mobilne aplikacije ter usmeritve za implementacijo mobilnega zdravja v zdravstveno oskrbo. Razprava in sklep: V doktorski raziskavi smo ugotovili, da pri pacientih s sladkorno boleznijo tipa 2 prihaja do odstopanj v samooskrbi. Čeprav vključitev mobilnih aplikacij v samooskrbo ni prinesla klinično pomembnih rezultatov, so tako zdravstveni delavci kot pacienti izrazili pozitiven pogled na njihovo uporabo. Ugotovitve raziskave nakazujejo potrebo po uvedbi enotnih smernic, ki bi opredeljevale standarde za uporabo mobilnega zdravja v vseh zdravstvenih institucijah v državi. Za natančnejšo oceno dolgoročnega učinka uporabe mobilne aplikacije na samooskrbo, percepcijo bolezni in zdravstveno stanje pacientov bi bilo smiselno izvesti raziskave na večjem vzorcu in v daljšem časovnem obdobju.
Keywords:	sladkorna bolezen tipa 2, mobilno zdravje, zdravstvene mobilne aplikacije, samooskrba, samoupravljanje bolezni
Place of publishing:	Maribor
Publisher:	[L. Gosak]
Year of publishing:	2025
PID:	20.500.12556/DKUM-92566
UDC:	616.379-008.64:004.9(043.3)
COBISS.SI-ID:	238863363
Publication date in DKUM:	17.06.2025
Views:	188
Downloads:	143
Metadata:
Categories:	FZV
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Licences

License:	CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International

Link:	http://creativecommons.org/licenses/by-nc-nd/4.0/
Description:	The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.
Licensing start date:	22.04.2025

Secondary language

Language:	English
Title:	Use of a mobile application for maintaining self-care of an individual with type 2 diabetes
Abstract:	Introduction: Type 2 diabetes is becoming an increasing public health challenge and requires adherence to a complex treatment regimen. Modern healthcare emphasises the active responsibility of patients to self-manage their disease, which includes adopting healthy lifestyle habits. With the growth of digital technology, the number of mobile applications for self-care is also increasing. The aim of this PhD thesis is to evaluate the effectiveness of using a mobile application to improve self-care for patients with type 2 diabetes. Methods: We conducted a systematic search for mobile apps on the Google Play Store and iPadian. Self-care behaviour functions were assessed according to the AADE7 framework and quality was assessed using the uMARS scale. Two questionnaires, the "Self-Care of Diabetes Inventory" to assess self-care and the "Brief Illness Perception Questionnaire" to assess illness perception, were used in the PhD thesis and validated in a pilot study. In a randomised clinical trial, we evaluated the impact of using a mobile app on improving self-care, illness perception and patient health status. Before the start of the study and after 4 weeks, patients completed both questionnaires and clinical measurements. Finally, semi-structured interviews with nurses and patients. Results: The mobile diabetes self-management app was selected as the most appropriate for further research. The pilot study involved 141 people with type 2 diabetes. They rated their confidence to practice self-sufficiency with the highest average score, while self-sufficiency management was rated the lowest. The Self-Care of Diabetes Inventory questionnaire showed poor agreement with the user model metrics for selfcare monitoring, self-care confidence and self-care management based on the pilot study results, but the CFA for self-care maintenance showed good agreement. Cronbach's alpha showed excellent results for self-confidence, good for self-care monitoring, acceptable for self-care maintenance and weak for self-care management. Calculations for the Brief Illness Perception Questionnaire showed high inter-rater agreement and excellent question validity. Cronbach's alpha for reliability was 0.652, indicating satisfactory internal consistency of the questionnaire. In the main study, no statistically significant improvement in self-care, illness perception and clinical measures could be detected four weeks after using the mobile app. However, based on the qualitative part of the study, we found that healthcare professionals and patients had a positive view of the use of mobile health and the mobile app, and that using the mobile app helped them to be more consistent in monitoring their condition and to have an easier insight into their measurements. Based on the results, we adapted a A MiddleRange Theory of Self-Care of Chronic Illness in relation to mobile health and additionally included the following components: knowledge, consistency, mobile health and mobile app characteristics, patient data protection and integrity, patient outcomes, recommended mobile app features and functionalities, and guidelines for implementing mobile health in healthcare. Discussion and conclusion: As part of our doctoral research, we found, that patients with type 2 diabetes have significant variations in self-care. Although the use of mobile apps in self-care did not lead to clinically meaningful results, both healthcare professionals and patients were positive about their use. The results of the survey suggest the need for the introduction of uniform guidelines setting standards for the use of mobile health in all healthcare institutions in the country. Future research with a larger sample size and over a longer period of time would be useful to more accurately assess the long-term impact of mobile app use on self-care, illness perception and patient health status.
Keywords:	Diabetes type 2, mHealth, mobile health applications, self-care, selfmanagement of diseases

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