Systematic review: Effect of mobile applications on college students with depressive symptoms.

AIM: To evaluate the effects of mobile applications (apps) on college students with depressive symptoms. DESIGN: Depression among college students is a school health issue, although little is known regarding effective app-based interventions for managing depressive symptoms. This review follows the concept of (1) theoretical guidance framework on app design, (2) app-based intervention study design and (3) effect of app-based interventions. DATA SOURCES: Cochrane Library, CINAHL Plus with Full Text and PubMed were searched in October 2022. METHODS: English-language reports of app-based interventions for college students with depressive symptoms. Quality appraisal and data extraction of selected articles was conducted by two independent reviewers using the mixed methods appraisal tool. Data synthesis using core outcome and findings of intervention. RESULTS: Five studies have shown that depressive symptoms significantly decreased after app use, specifically indicating the effects that occur in 4 weeks. Although four studies have applied the theoretical framework to the app design, the findings showed the low implementation of the intervention activities as originally designed and at the specified dosage and difficulty in understanding the processes through which the intervention resolves the depressive symptoms. CONCLUSION: App-based intervention can decrease depressive symptoms; furthermore, 4 weeks was the time point at which the changes were expected to occur. However, the theory-based app design for the depression population was rarely related, and studies clearly explaining the intervention measures, intervention dosage and duration required to achieve effectiveness are needed. IMPACT: This study provides the synthesis of evidence-based app interventions to manage depressive symptoms to zoom in on different views and we suggest using the applications for at least 4 weeks before changes are expected to occur. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement in this study.

Effects of mHealth-based interventions on health literacy and related factors: A systematic review.

AIMS: To evaluate the effects of mobile health (mHealth)-based interventions on health literacy and related factors. BACKGROUND: Few reviews exist on the effects of mHealth-based interventions on the improvement and changes in health literacy and related factors. EVALUATION: A systematic review was conducted using the Mixed Methods Appraisal Tool to evaluate the quality of articles. RESULTS: Outcome variables included eHealth literacy, mHealth literacy and health literacy. Two studies showed that health literacy was significantly enhanced after mHealth application use, particularly among those with low education and health literacy levels. Two articles reported that health information seeking and health information appraisal improved after mHealth-based interventions, thereby increasing health literacy levels. In one article, no significant relationship was found between health literacy levels and mHealth literacy. CONCLUSION: mHealth can enhance health literacy; furthermore, mobile applications effectively improve patient health literacy. However, measurement tools used for evaluating health literacy indicators are inconsistent, with the concept and components of these tools being not specifically designed for evaluating health literacy indicators. IMPLICATIONS FOR NURSING MANAGEMENT: To successfully and effectively overcome health problems in diverse clinical settings, the theory-based mHealth services should be adopted while considering their intensity, frequency, duration and credibility.

Patient willingness to undergo a two-week free trial of a telemedicine service for coronary artery disease after coronary intervention: A mixed-methods study.

AIM: To understand the factors affecting willingness to use telemedicine in patients with coronary artery disease after coronary intervention. BACKGROUND: Telemedicine is a relatively new service provided to discharged patients in Taiwan, therefore, public acceptance is low. METHOD: This mixed-methods study conducted between January and June 2014 used convenience sampling. In total, 140 patients were offered a two-week free trial of telemedicine services before hospital discharge. Participants completed structured questionnaires and answered semi-structured qualitative questions related to willingness to use telemedicine services. RESULTS: Patients' willingness to use telemedicine was not significantly correlated with experience using technology, perceived ease of use or computer self-efficacy; instead, it was based on trust in the hospital staff, opinions of the staff and ongoing support from the case manager. Reasons for their lack of willingness to use the service were mainly related to diseases, technology/equipment and environmental factors. CONCLUSION: Staff support through telephonic tracking and real-time feedback can increase willingness to use telemedicine. IMPLICATIONS FOR NURSING MANAGEMENT: Case managers can collect necessary personal information and offer the patients 24-hr services as a monitor, an instructor and a companion, thereby accommodating more patients, building value and strengthening telemedicine services.