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, Zahra Mohammadzadeh2 , Mohammadreza Saeidnia3 , Amir Mahmoodzadeh4 , Neda Ghorbani5 , Mohammad Hasanzadeh 6
2- Department of Health Information Technology,Department of Health Information Technology, Urmia University of Medical Sciences, Urmia, Iran Urmia, Iran
3- Department of Hematology, Shiraz University of Medical Sciences, Shiraz, Iran
4- Department of Clinical Biochemistry, Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Cellular & Molecular, Qom Branch, Islamic Azad University, Qom, Iran
6- Professor, Department of Knowledge and Information Sciences, Tarbiat Modares University, Tehran, Iran , hasanzadeh@modares.ac.ir
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Self-care is a practice in which people use the knowledge, their skill and ability as a resource to maintain and improve their health (1). Self-care is a laborious process that requires time and energy to perform the action. Implementation of this action depends on the internal (cognitive, physical, emotional and behavioral) and external (environment and society) capacities (2,3). Self-care is one of the emerging operational strategies for the management and prevention of communicable infectious diseases. According to research, it results in increased energy and positive emotions, reducing stress, physical health feeling, increasing the self-confidence and enthusiasm and consequently, could improve the level of health of the community (4-7). According to the findings of similar research greater awareness of communicable diseases leads to better self-care (8,9). Several articles in different countries have focused on the use of smartphones self-care software for the management of communicable infectious diseases (10,11). Self-care is a voluntary activity that performs to provide, maintain and promote a healthy community (12). Therefore, Self-care includes activities that are applicable by each person (13) and could cause continuous assurance and long-term follow up of self-care activities (14).
Given the prevalence of corona-virus disease (COVID-19) as a chronic disease and the importance of self-care in its prevention, providing self-care services can be an important achievement for the community and also given the widespread use of smartphones software and the low-cost of this technology, the use of smartphones self-care system is increasing in this area (15).
In addition to save time and expenses, it has an important role in managing and providing care for the prevention of corona-virus (COVID-19). In recent years development of smartphones software has led to the application of this software in a variety of health areas (16). Using this software has been a considerable help in management and prevention of chronic and communicable diseases in developed countries (17,18).
Due to the lack of self-care software for the management and prevention of infectious diseases and lack of self-care software to prevent corona-virus disease (COVID-19) in Iran it is important to address this issue.
The purpose of this study was to identify the requirements for a smartphones self-care system to prevent corona-virus (COVID-19).
Search strategy and study selection
This descriptive study was conducted in two stages in the year 2020. The first stage of the study focused on identifying requirements of smartphones self-care system for coronavirus disease 2019 (COVID-19). The keywords Mobile, Self-care, Mobile health, Prevention Requirements, Minimum data set Self-Management Strategies, Smart Phone, corona-virus disease 2019 (COVID-19) and Acute disease were searched using AND operators in databases of PubMed, Scopus, the web of Science, science direct, Google Scholar and ProQuest. Review and original articles with self-care, corona-virus and corona-virus (COVID-19) topics published between 2001 and 2020 were checked. According to the mentioned criteria, we tried to gather as many articles as possible. A total of 246 articles were identified of which 195 were eliminated due to lack of inclusion criteria, being repeated or overlapped. Finally, 30 articles were selected (15, 16, 18-45).
In the second stage, using obtained data while checking similar articles, a questionnaire was designed for validation and choosing the requirements for designing a smartphones self-care system to prevent Corona-virus infection. The questionnaire included 4 parts and 56 questions (Demographic data; 8 questions, Clinical requirements; 12 questions, Self-care strategy and Technical characteristics; 12 questions) and it was designed based on five degrees Likert scale (from totally agree to completely disagree). The reliability of the questionnaire was calculated as 0.85 by Cronbach's alpha coefficient. The software’s validity was also verified by infectious diseases specialists and health information management professors. The current research sample size has consisted of infectious diseases specialists, experienced nurses in patient education who were occupied in Urmia University of Medical Sciences that due to sample size limitation, the sampling process was not performed and the whole of the individuals were included in the study (22 individuals). Inclusion criteria were personal satisfaction, volunteering and completing all the questions in the questionnaire, and answering the questionnaire incompletely or incomplete answers were considered as cases of removing people from the study. The questionnaire was distributed between individuals and 20 questionnaires were collected after fulfillment. At this stage, the questionnaire’s choices were scored from 1 to 5 (Totally agree: 5, I agree: 4, I don't think: 3, I disagree: 2, and I completely disagree: 1). Then, each of the identified data elements and attributes were considered to be significant only if the infectious disease specialists had achieved at least a mean of 2.5 or more. Finally, the mean values given to each data element were calculated and the related descriptive tables were drawn. Data was analyzed using SPSS software version 22 (SPSS Inc., Chicago, Ill., USA).
Based on the findings of the first stage of the study, the requirements for a smartphones self-care system for the prevention of corona-virus (COVID-19) were determined in the area of "demographic data requirements, clinical requirements, self-care strategies, and technical capabilities." According to the findings of the first step, 13 data elements for demographical requirements, 9 elements for clinical requirements, 8 technical characteristic requirements and 8 elements of the system self-care strategies were identified.
Based on the findings of the second stage of the investigation, from the data elements and characteristics identified in the first stage, 5 data elements for demographic requirements, 11 elements for clinical requirements, 5 elements for self-care strategies requirements and 11 elements for technical characteristics were selected.
The mean scores assigned by the infectious disease specialists to the identified requirements and selected items for each of the 4 parts (demographic, clinical information, self-care strategies, and technical characteristics) are presented in Table 1.
Table 1. Requirements for self-management system and average scores assigned by specialists
| Demographic data | Mean | Self-care strategy | Mean | Clinical requirements | Mean | Technical characteristics | Mean |
| Age | 4.5 | Motivate Yourself (Thinking Positive) |
4.5 | Dry and frequent coughing | 5 | Communication with health units (remote monitoring) | 5 |
| Gender | 4.6 | Personal hygiene | 4.4 | difficulty breathing | 5 | Educational messages | 5 |
| Location | 4.3 | Exercise | 4.2 | Ague | 5 | Contact with doctor | 5 |
| Tel. number | 4.1 | Healthy diet | 4.1 | Sore throat | 4.9 | Get news from valid sources | 5 |
| BMI | 3.8 | General recommendations | 3.9 | runny nose | 4.8 | Diet reminder | 4.5 |
| _ | _ | _ | _ | Tiredness and weakness | 4.5 | Exercise reminder | 4.5 |
| _ | _ | _ | _ | joint's pain | 4.2 | Motivational message | 4.5 |
| _ | _ | _ | _ | Diarrhea |
4.1 | Text messaging | 4.4 |
| _ | _ | _ | _ | Nocturnal sweat | 3.8 | Security Requirements | 4.3 |
| _ | _ | _ | _ | Pneumonia | 3.8 | online | 4.2 |
| _ | _ | _ | _ | Weight Loss | 3.7 | User-friendly | 4.1 |
Based on obtained results from the first stage of the present study, four demographic areas (with 5 data elements), Clinical requirements (with 11 data elements), Self-care strategies (with 5 data elements), Technical characteristics (with 11 data elements) were identified to design a smartphones software system to prevent corona-virus disease (COVID-19).
According to the infectious diseases specialists, 8 data elements were selected in the present study for the demographic area that was consistent with the results of Nematollahi et al.
They concluded that in designing and operating a comprehensive information management system for chronic and acute diseases the mechanism of enrollment of their full demographic information should be considered (46). A total of 11 data elements were also selected according to the infectious diseases specialists in the clinical field, which was in agreement with the result of the study by Jank JG et al. They concluded that the most common clinical symptoms of corona-virus (COVID-19) patients are fatigue, cough, fever, and digestive symptoms (20,21). In the self-care strategies context, 5 data elements were selected according to the specialists that were consistent with the research by Fernandez et al. They supported the children's self-care and their families suffering from a contagious infectious disease that self-care strategies have been achieved included evaluations, counseling, care and accompaniment (47). Similar researches emphasizing on self-care strategies for acute and chronic conditions have highlighted the importance of improving the lifestyle of self-care programs, which could help to ameliorate their health status and increase their motivation and ability to participate in treatment plans (48,49). The technical characteristics area was completed with 11 data elements selected by infectious disease specialists. In a similar study, Henry and Moore illustrated that the smartphones self-care could be fruitful in this context through present punctual reminders and people participation in related activities (50).
The study was conducted to identify the requirements of a mobile-based self-care system to prevent COVID-19. The results of the research indicated that the data elements of communication with health and medical units (remote monitoring), educational messages, communication with the doctor and receiving news from reputable sources are among the technical requirements with a very high range and an average of 5. These have drawn the research community's attention to the importance of technical requirements which could be an important requirement to prevent COVID-19. Dry and frequent coughing, shortness of breath, fever and chills were other very important data elements with a very high spectrum and an average of 5 among the important and significant clinical requirements of the research community. It should be noted that the weight loss element with an average of 3.7 of the set of clinical requirements elements had the lowest average and the rest of the data elements of all identified requirements had an average above 3.7, which shows the high importance of each of these data elements.
Applying the requirements and suggested strategies in the present study can improve self-care skills to prevent corona-virus, symptoms management, motivate and reduce stress, increase personal hygiene and communication with health care providers.
Suggestions: It is recommended to perform future investigations to develop and evaluate self-care system to prevent corona-virus (COVID-19).
The authors would like to thank all the professors and staff of the Virology Research Center of Masih Daneshvari Hospital and Urmia University of Medical Sciences who assisted us in this study.
Authors declared no conflict of interests.
Received: 2020/03/13 | Accepted: 2020/04/30 | ePublished: 2020/05/12
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