The impact of an mHealth app on knowledge, skills and anxiety about dressing changes: A randomized controlled trial

Abstract

Aims: To evaluate the effectiveness of a mobile health (mHealth) application, based on self-regulation theory, on patients’ knowledge of wound care, skills in changing dressings and anxiety. Design: A prospective randomized controlled trial. Methods: Seventy patients (or family members) at a 1,500-bed university hospital in Taiwan were randomized into an experimental (N = 35) or control group (N = 35) from March to December 2016. The experimental group used a mHealth application for wound care; the control group received verbal instructions and a booklet. Instruments to collect data were a wound care knowledge scale, wound care skills scale, State-Trait Anxiety Inventory, and a digital heart variability device. Data were collected at baseline, after three additional demonstrations and before discharge. The generalized estimating equation was used for statistical analysis. Results: The experimental group showed significantly higher levels of wound care knowledge, improved wound care skills, lower levels of state anxiety, and lower heart rate variability than the control group after baseline data collection. Conclusions: Results support hat a mHealth application may be effective in health education. Clinicians can use the results to promote patients’ wound care knowledge, enhance their wound care skills, and reduce anxiety related to dressing changes. Impact: Lack of wound care knowledge and skills can affect the willingness and ability to perform effective wound dressing changes, producing anxiety and having an impact on a patient's self-care after hospital discharge. mHealth applications (apps) have the potential to deliver health information in targeted and tailored ways that strengthen the self-management of diseases. mHealth app can increase wound care knowledge, improve care skills, and reduce anxiety related to wound care. mHealth app effectively supports self-monitoring of the wound healing process, self-judgement of the wound condition, and self-reaction of wound care accuracy. mHealth app provides step-by-step visual tutorials on wound care that allow patients and family caregivers to take pictures of the wounds and monitor the wound healing process. mHealth app for wound care knowledge is an effective and individualized method for learning. Clinical Trial: This study was registered by U.S. National Library of Medicine, ClinicalTrials.gov (ID: NCT03683303).