| Objective:To design and develop a mHealth application(APP)for rehabilitation management in the elderly based on actual needs after total knee arthroplasty by using design thinking,and to evaluate its applicability and effectiveness among elderly empty-nesters with total knee arthroplasty.Methods:1.In APP development,five steps of design thinking including empathy,definition,ideate,prototype and test were adopted.Interview was to explore the needs of elderly patients after total knee arthroplasty in empathy stage.In the definition stage,persona was used to define and structure patient characteristics.At the ideation stage,the functional framework of mobile medical APP system was initially conceived through the suggestions of medical and informatics experts interviewed.In the prototype stage,Axure RP8.0 was adopted by the researcher to design the APP prototype.In the test stage,interview and heuristic evaluation were used to evaluate usability of prototype.Based on the test results,APP iteration was carried out in collaboration with the researchers and software engineers to finally build a mobile medical APP for total knee arthroplasty rehabilitation management2.A pilot study was conducted on 72 empty-nest elderly with total knee arthroplasty who were admitted to a tertiary teaching hospital in Jinan,Shandong Province from 15th May to 22th September 2019.According to the admission time,it was divided into intervention group(36 cases)and control group(36 cases).The patients in the intervention group were provided with mHealth APP as their post-discharge rehabilitation program,including pushing rehabilitation video,education,online interaction and rehabilitation guidance,etc.The patients in the control group received routine health education including rehabilitation exercise methods and regular outpatient follow up.Data were collected before surgery and one month and three months after surgery to evaluate the knee function and quality of life of patients.The mHealth APP intervention was evaluated at three months after operation.Statistical software SPSS 22.0 was used for quantit),data entry.and the chi-square test and two independent sample t tests were used to compare the differences in knee function indexes and quality of life between the two groups.Results:1.A mHealth APP involving six function including rehabilitation plan,knowledge learning,rehabilitation diary,online interaction,test and my information for elderly total knee arthroplasty was developed according to the 5 phases of the theory of design thinking.2.A total of 63 subjects were included,35 for intervention group and 34 for the control group.The results showed that ①there was no significant difference in age,gender,education background,BMI,range of motion,knee function score and quality of life between the two groups before operation(P>0.05).The baseline data of patients were comparable.②One month after operation,the range of motion of the intervention group was significantly higher than that of the control group(P<0.05),but there was no significant difference in knee function score and quality of life between the two groups(P>0.05).③Three months after operation,the range of motion,knee function score and quality of life of the intervention group were significantly better than the control group(P<0.05).App’s usability evaluation was high.Conclusion:1.This study focuses on elderly patients and applies design thinking theory to the construction process of APP.The results show that the APP for total knee arthroplasty rehabilitation management based on design thinking theory can meet the needs of elderly patients.2.Based on mHealth APP,the treatment of the elderly patients after the total knee arthroplasty rehabilitation was carried out.The results showed that the mHealth APP could be a good tool for improving the compliance of home-based rehabilitation of elderly patients after total knee arthroplasty and promoting the recovery of joint function.. |
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