Development of a mobile health application for patients with liver cirrhosis and the effect of the application on patient activation, self-efficacy, and quality of life

Objective: The aim of this study was to develop a mobile health application (ReLiver-N App [Rehabilitation of Liver by Nurse Application]) for patients with liver cirrhosis and to determine the effect of the application on patient activation, self-efficacy, and quality of life. Methods: The study consisted of two stages: a methodological and randomized controlled trial. In the first stage, a web-based mobile health application (ReLiver-N App) was developed for patients with liver cirrhosis. The second stage of the study was carried out between October 2022 and May 2023 with 52 patients with liver cirrhosis by using the Patient Activation Measure, Self-efficacy for Managing Chronic Disease 6-item Scale, and Chronic Liver Disease Questionnaire. Patients in the intervention (ReLiver-N App) group received comprehensive health education and patient activation practices via the ReLiver-N App and were followed up by text messages once a week. Patients in the ReLiver-N App and active control groups completed the measurements for patient activation practice for 12 weeks. The data were evaluated using descriptive statistics, t-tests, Student's t-tests, variance, and regression analyses. Results: A statistically significant difference was found between the post-test mean scores of the ReLiver-N App and active control groups in terms of patient activation, self-efficacy, and quality of life (p<0.01). The ReLiver-N App group participated in patient activation practices at a rate of 70.8% and the active control group at a rate of 36.0%. At the end of this study 65.4% of the patients in the ReLiver-N App group and 15.4% of the patients in the active control group had an patient activity level of "3." Conclusion: Mobile educational content and patient activation practices aimed at increasing participation in self-care increased the level of activation, self-efficacy, and quality of life of patients with liver cirrhosis. It is recommended that the use of comprehensive educational content and patient activation practices in the care process of patients be generalized. Keywords: liver cirrhosis, nursing care, patient activation, self-efficacy, quality of life.