OBJECTIVES: The purpose of the study was to develop and evaluate a clinical-guideline-based smartphone application ('app') for obesity management. METHODS: Obesity-related knowledge and functional requirements were extracted from clinical practice guidelines, a literature review, and consultations with experts. The extracted knowledge was used to design obesity-management algorithms, and the functions of the developed app are presented through a use case diagram and activity diagrams. The database and user interface were designed and then an app was developed. The proficiency and efficiency of the algorithm were evaluated using scenarios, while the user interface was assessed using a mobile heuristics evaluation tool, with its usability determined using the Post-Study System Usability Questionnaire. RESULTS: In total, 131 obesity-related knowledge statements and 11 functions for the app were extracted, and 5 algorithms (comprising 1 main algorithm and 4 subalgorithms) were developed. The database comprised 11 tables and 41 screens. The app was developed using the Android SDK platform 4.0.3, JDK 1.7.0, and Eclipse. The overall proficiency and efficiency scores of the algorithm were 88.0 and 69.1, respectively. In heuristics tests, 57 comments were made, and the mean usability score was 3.47 out of 5. Thirteen usability problems were identified by the heuristics and usability evaluations. CONCLUSIONS: The app developed in this study might be helpful for weight management because it can provide high-quality health information and intervention without spatial or temporal constraints. However, the clinical effectiveness of this app still requires further investigation.
Mobile Health Units ; Obesity* ; Referral and Consultation ; Telemedicine ; Weight Loss ; Surveys and Questionnaires

OBJECTIVES: The factors affecting the acceptance of mobile obesity-management applications (apps) by the public were analyzed using a mobile healthcare system (MHS) technology acceptance model (TAM). METHODS: The subjects who participated in this study were Android smartphone users who had an intent to manage their weight. They used the obesity-management app for two weeks, and then completed an 18-item survey designed to determine the factors influencing the acceptance of the app. Three questions were asked pertaining to each of the following six factors: compatibility, self-efficacy, technical support and training, perceived usefulness, perceived ease of use, and behavior regarding intention to use. Cronbach's alpha was used to assess the reliability of the scales. Pathway analysis was also performed to evaluate the MHS acceptance model. RESULTS: A total of 94 subjects participated in this study. The results indicate that compatibility, perceived usefulness, and perceived ease of use significantly affected the behavioral intention to use the mobile obesity-management app. Technical support and training also significantly affected the perceived ease of use; however, the hypotheses that self-efficacy affects perceived usefulness and perceived ease of use were not supported in this study. CONCLUSIONS: This is the first attempt to analyze the factors influencing mobile obesity-management app acceptance using a TAM. Further studies should cover not only obesity but also other chronic diseases and should analyze the factors affecting the acceptance of apps among healthcare consumers in general.
Chronic Disease ; Delivery of Health Care ; Factor Analysis, Statistical ; Intention ; Mobile Health Units ; Obesity* ; Telemedicine ; Weight Loss ; Weights and Measures

OBJECTIVES: This study developed a diabetes self-management mobile application based on the information-motivation-behavioral skills (IMB) model, evidence extracted from clinical practice guidelines, and requirements identified through focus group interviews (FGIs) with diabetes patients. METHODS: We developed a diabetes self-management (DSM) app in accordance with the following four stages of the system development life cycle. The functional and knowledge requirements of the users were extracted through FGIs with 19 diabetes patients. A system diagram, data models, a database, an algorithm, screens, and menus were designed. An Android app and server with an SSL protocol were developed. The DSM app algorithm and heuristics, as well as the usability of the DSM app were evaluated, and then the DSM app was modified based on heuristics and usability evaluation. RESULTS: A total of 11 requirement themes were identified through the FGIs. Sixteen functions and 49 knowledge rules were extracted. The system diagram consisted of a client part and server part, 78 data models, a database with 10 tables, an algorithm, and a menu structure with 6 main menus, and 40 user screens were developed. The DSM app was Android version 4.4 or higher for Bluetooth connectivity. The proficiency and efficiency scores of the algorithm were 90.96% and 92.39%, respectively. Fifteen issues were revealed through the heuristic evaluation, and the app was modified to address three of these issues. It was also modified to address five comments received by the researchers through the usability evaluation. CONCLUSIONS: The DSM app was developed based on behavioral change theory through IMB models. It was designed to be evidence-based, user-centered, and effective. It remains necessary to fully evaluate the effect of the DSM app on the DSM behavior changes of diabetes patients.
Blood Glucose Self-Monitoring ; Diabetes Mellitus ; Focus Groups ; Heuristics ; Humans ; Life Cycle Stages ; Methyltestosterone ; Mobile Applications* ; Mobile Health Units ; Self Care* ; Telemedicine

Purpose: The purpose of this study was to develop an instrument to assess nursing professional pride. Methods: Fifty-six preliminary items were identified through literature review and focus group interview of nurses working in a hospital. Of these, 45 preliminary instruments were completed over 0.80 of content validity index. To verify the reliability and validity of the preliminary instrument, data were collected from 294 nurses. The data were analyzed using factor analysis and multidimensional scaling analysis. Results: From the factor analysis, 27 significant items were divided into 5 subscales. These subscales were as follows: feeling of vocation, role satisfaction, role of problem solver, self-achievement, and willingness to stay. The nursing professional pride also established criterion-related validity, discriminant validity, and group validity. Cronbach’s a of the instrument was .92, and the subscales ranged from .74 to .85. Conclusion The developed scale for nursing professional pride shows validity and reliability. The significance of this study is the development of an instrument capable of measuring nursing professional pride. To verify the relevance of this instrument, conducting comparative studies is suggested.

OBJECTIVES: The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. METHODS: This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. RESULTS: We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. CONCLUSIONS: The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system.
Concept Formation ; Electronics ; Electrons ; Evidence-Based Practice ; Medical Records Systems, Computerized ; Nursing Assessment ; Nursing Records ; Perinatal Care ; Semantics

OBJECTIVES: The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. METHODS: This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. RESULTS: We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. CONCLUSIONS: The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system.
Concept Formation ; Electronics ; Electrons ; Evidence-Based Practice ; Medical Records Systems, Computerized ; Nursing Assessment ; Nursing Records ; Perinatal Care ; Semantics

OBJECTIVES: This study analyzed smartphone obesity-management applications developed in Korea and the quality of the information that they provide. METHODS: Obesity-management smartphone applications were searched using the keywords 'obesity + management,' 'weight + management,' 'weight + loss,' 'weight + exercise,' 'weight + diet,' 'weight + calories,' and 'diet,' with a search application programming interface (provided by Apple) between September 23 and September 27, 2013. These applications were then classified according to their main purpose, type of interventions used, price, type of developer, and user ratings. The information quality of the applications was analyzed using the Silberg scale. RESULTS: In total, 148 smartphone applications for obesity management were found. The main purpose of most of these applications (70.95%) was to provide information regarding weight control. The most frequently used intervention (34.62%) was to provide information on exercise management. More than half of the applications (58.78%) were free of charge. The mean of users' rating of these applications was 3.68 out of 5. The quality of information provided by these applications was evaluated as 4.55 out of 9: specifically, 1.79 out of 3 for authorship, 0.22 out of 2 for attribution, 1.29 out of 2 for disclosure, and 1.25 out of 2 for currency. Only three of the applications (2.88%) had a score on the Silberg scale greater than or equal to 7 points. CONCLUSIONS: The findings of this study suggest that the quality of information provided by smartphone applications in the healthcare domain urgently need to be evaluated to prevent users being misinformed by these applications.
Authorship ; Delivery of Health Care ; Disclosure ; Korea ; Mobile Health Units ; Obesity ; Telemedicine ; Weight Loss

Electronic Health Records (EHRs)-based surveillance systems are being actively developed for detecting adverse drug reactions (ADRs), but this is being hindered by the difficulty of extracting data from unstructured records. This study performed the analysis of ADRs from nursing notes for drug safety surveillance using the temporal difference method in reinforcement learning (TD learning).

Anaphylaxis ; Asia ; Beer ; Child ; Eating ; Food Hypersensitivity ; Hordeum ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Korea ; Medical Records ; Pediatrics ; Phenotype ; Respiratory System ; Retrospective Studies ; Sensitivity and Specificity ; Triticum ; Wheat Hypersensitivity

BACKGROUND: Barley is a grain that is consumed in various forms in Asia. Studies on barley allergy are limited to a few case reports about hypersensitivity reactions to beer, but there is no barley allergy study in children. This study aimed to identify the phenotype and immunologic findings in Korean children with barley allergy. METHODS: Forty-two participants with a history of ingesting barley who underwent serum specific immunoglobulin E to barley (barley-sIgE) assay at the Department of Pediatrics in Ajou Medical Center were enrolled through a retrospective analysis of medical records from March 2008 to February 2018. The demographic characteristics, symptoms, and immunologic parameters of the patients were assessed. RESULTS: Twenty subjects presented with clinical barley allergy (B-allergic group), and 22 were atopic controls without allergic reactions after the ingestion of barley (B-tolerant group). The median ages of the B-allergic and B-tolerant groups were 1 and 3 years, respectively. In the B-allergic group, the cutaneous system (90.0%) was most frequently affected, followed by the respiratory system (40.0%). Anaphylaxis was observed in 35.0% of the B-allergic group. The median level of barley-sIgE was 13.90 kU(A)/L (range, 0.14–101.00 kU(A)/L) in the B-allergic group, and this value was significantly higher (P < 0.001) than that of the B-tolerant group (0.30 kU(A)/L; range, 0.01–24.40 kU(A)/L), with an optimal cutoff level of 1.24 kU(A)/L (sensitivity, 85.0%; specificity, 86.4%). A positive correlation was found between the serum levels of barley-sIgE and wheat-sIgE in the B-allergic group with clinical wheat allergy. CONCLUSION Barley is an important allergen for children in Korea. This study showed the clinical characteristics of barley allergy and suggested optimal cut-off levels of barley-sIgE for clinical barley allergy. Clinically, cross-reactivity or co-sensitization is often observed between barley and wheat.