Effects of a smartphone-based self-care health diary for heart transplant recipients: A mixed methods study

Aim: This study evaluated the effectiveness of a smartphone-based self-care health diary based on the Information-Motivation-Behavioral Skills model, designed to enable transplant recipients to self-manage their health and increase their adherence to medical advice.

Background: Heart transplant recipients must take immunosuppressants to prevent rejection for the rest of their lives. As immunosuppressant drugs suppress the immune system, transplant recipients are like individuals battling chronic diseases and must be diligent about self-care to keep healthy.

Methods: This was a quasi-experimental study using a nonequivalent control group pretest-posttest non-synchronized design and mixed methods. The sample comprised of 56 patients, with 28 each in the experimental and control groups. The control group was recruited from May 25-June 19, 2018, and the experimental group from September 1-13, 2018. Self-efficacy and self-care adherence were assessed via questionnaires; user experiences were assessed via interviews after the application was used for 4 weeks.

Results: After four weeks of use, transplant recipients reported significantly higher self-efficacy (F = 55.87, p < 0.001) and self-care adherence (F = 9.68, p = 0.003). Five themes were derived for the user experiences: (1) taking initiative for self-care, (2) utilizing a novel tool for self-care, (3) experiencing obstacles in ongoing self-care, (4) focusing on self-care adherence through the tool, and (5) expecting the application to serve as a personal medical assistant.

Conclusions: The health diary application is expected to motivate heart transplant recipients to perform self-care and improve adherence to medical advice.