Effects of a Mobile-App-Based Self-Management Support Program For Elderly Hemodialysis Patients

OBJECTIVES: To identify the effects of a mobile-app-based self-management program for elderly hemodialysis patients on their sick-role behavior, basic psychological needs, and self-efficacy. METHODS: A nonequivalent control group with a non-synchronized design was utilized, and 60 participants (30 in each of the experimental and control groups) were recruited from Chungnam National University Hospital from March to August 2018. The program consisted of continuous training on how to use the mobile-app, self-checking via the app, message transfer through Electronic Medical Records, and feedback. The control group received the usual care. Data were analyzed using the χ(2)-test, the t-test, the repeated-measures ANOVA, and the McNemar test. A formalized messaging program was developed, and the app was developed with consideration of the specific physical and cognitive limitations of the elderly. RESULTS: Comparisons were conducted between the experimental (n = 28) and control (n = 28) groups. Statistically significant increases in sick-role behavior, basic psychological needs, and self-efficacy were found in the experimental group (p < 0.001). Physiological parameters were maintained within the normal ranges in the experimental group, and the number of non-adherent patients decreased, although the change was not statistically significant. CONCLUSIONS: The mobile-app-based self-management program developed in this study increased the sick-role behavior, basic psychological needs, and self-efficacy of elderly hemodialysis patients, while physiological parameters were maintained within the normal range. Future studies are needed to develop management systems for high-risk hemodialysis patients and family-sharing apps to manage non-adherent patients.