Perceptions regarding smartphone based self-care in patients with chronic heart failure : A focus group interview

만성 심부전 환자의 스마트폰을 활용한 자가관리에 대한 인식 : 포커스 그룹 인터뷰 적용

  • 손연정 (중앙대학교 적십자 간호대학) ;
  • 백경화 (경북보건대학교 간호학부)
  • Received : 2018.07.30
  • Accepted : 2018.09.20
  • Published : 2018.09.28


This study is a qualitative study using focus group interview to explore the perception regarding smartphone use for adhering to self-care in chronic heart failure patients. Eleven patients who were diagnosed with heart failure were included. Three focus groups were held with heart failure patients at an outpatient cardiac care center. The focus group discussions were transcribed verbatim and analyzed using the method of constant comparative analysis. The 12 sub-themes were categorized into 'perception of smartphone use', 'Barriers to smartphone use', and 'Facilitators to smartphone use'. We found that the need to design tailored the messages or health information based on individual preferences. Our findings will be used to develop or design a smartphone based self-care program for patients with heart failure.


Supported by : National Research Foundation of Korea (NRF)


  1. M. I. Cajita, K. T. Gleason & H. R. Han. (2016). A systematic review of mHealth-based heart failure interventions, Journal of Cardiovascular Nursing, 31(3), 10-22. DOI : 10.1097/JCN.0000000000000305.
  2. J. O. Choi. (2012). Trearment of advenced heart failure: beyond medical treatment, Korean Journal of Medicine, 82(6), 658-666. DOI : 10.3904/kjm.2012.82.6.658.
  3. S. C. Inglis, H. Du, H. C. Dennison & P. M. Davidson. (2015). mHealth education intervention in heart failure (protocol), Cochrane Database of Systematic Reviews, 8, 1-14. DOI: 10.1002/14651858.CD011845.
  4. B. Riegel, V. V. Dickson & K. M. Faulkner. (2016). The situation-specific theory of heart failure self-care : revised and updated, Journal of Cardiovascular Nursing, 31(3), 226-235. DOI : 10.1097/JCN.0000000000000244.
  5. L. C. Abromsm, R. Whittaker, C. Free, J. M. van Alstyne & J. M. Schindler-Ruwisch. (2015). Developing and pretesing a text-messaging program for health behavior change : Recommended steps, JMIR Mhealth and Uhealth, 3(4), 1-11. DOI : 10.2196/mhealth.4917.
  6. J. D. Piette et al. (2015). A mobile health intervention supporting heart failure patients and their informal caregivers: A randomized comparative effectiveness trial, Journal of Medical Internet Research, 17(6), 1-18. DOI : 10.2196/jmir.4550.
  7. M. I. Cajita, T. R. Cajita & H. R. Han. (2016). Health literacy and heart failure : A systematic Review, Journal of Cardiovascular Nursing, 31(2), 121-130. DOI : 10.1097/JCN.0000000000000229.
  8. C. L. Gardner et al. (2016). Electronic physiologic and subjective data acquisition in home-dwelling heart failure patients: An assessment of patient use and perception of usability, International Journal of Medical Informatics, 93, 42-48. DOI : 10.1016/j.ijmedinf.2016.06.001.
  9. P. Athilingam, B. A. Jenkins, H. Zumpano & M. A. Labrador. (2018). Mobile technology to improve heart failure outcomes: Aproof of concept paper, Applied Nursing Research, 39, 26-33. DOI : 10.1016/j.apnr.2017.10.018.
  10. M. W. Kreuter & R. J. Wray. (2003). Tailored and targeted health communication: strategies for enhancing information relevance, American Journal of Health Behaviors, 27, 227-232.
  11. T. Dekoekkoek, B. Given, C. W. Given, K. Ridenour, M. Schueller & S. I. Spoelstra. (2015). mHealth SMS text messaging interventions and to promote medication adherence : An integrative review, Journal of Clinical Nuring, 24, 2722-2735, DOI : 10.1111/jocn.12918.
  12. Y. K. Bartlett et al. (2014). The SMART personalized self-management system for congestive heart failure: results of a realist evaluation, BMC Medical Informatics & Decision Making, 14, 1-13. DOI : 10.1186/s12911-014-0109-3.
  13. T. M. Ruppar, P. S. Cooper, D. R. Mehr, J. M. Delgado & J. M. Dunbar-Jacob. (2016). Medication adherence interventions improve heart failure mortality and readmission rates : Systematic review and meta-analysis of controlled trials, Journal of American Heart Association, 5(6), 1-19. DOI : 10.1161/JAHA.115.002606.
  14. J. Polisena, K. Tran, K. Cimon, B. Hutton, S. McGill & K.Palmer. (2010). Home telemonitoring for congestive heart failure: A systematic review and meta-analysis, Journal of Telemedicine and Telecare, 16(2), 68-76. DOI : 10.1258/jtt.2009.090406.
  15. M. Y. Kim, Y. H. Kang, D. L. Jung & G. J. Lee. (2013). Older adults' smart phone use and access to health information, Journal of Qualitative Research, 14(1), 13-22.
  16. S. J. Kim, H. J. Kim, K. J. Lee, S. O. Lee. (1999). Focus group research methodology, Seoul : Hyunmoonsa.
  17. R. A. Krueger & M. A. Casey. (2009). Focus groups: A practical guide for applied research, Thousand Oaks, CA : Sage.
  18. I. S. Yang. (2016). Influence of social support and negative emotional status on self-care adherence in symptomatic patients with heart failure, Korean Journal of Adult Nursing, 28(3), 302-313. DOI : 7475/kjan.2016.28.3.302.
  19. J. W. Lee. (2010). Information gap status analysis proposal, Seoul : National Information Society Agency.
  20. S. H. Jung & W. T. Kim. (2014). A study on improvement of smartphone use for seniors: improvement plans in perspectives of bodily perception and understanding of terms, concepts and technologies, Design Convergence Study, 13,(2), 279-295.
  21. D. R. Kim, K. H. Kang, B, L. Lee & K. H. Kim. (2018). A study on the experience of loneliness in elderly living alone: focus group interview, Journal of the Korea Convergence Socity, 9(4), 85-91. DOI : 10.15207/JKCS.2018.9.4.085.
  22. H. N. Lim, B. L. Lee, T. H. Cha & K. H. Kim. A. (2018). A study on the experience of daily life and chronic disease management of elderly living alone : focus group interview, Journal of the Korea Convergence Society, 9(4), 111-118. DOI : 10.15207/JKCS.2018.9.4.111.
  23. H. K. Jin & H. J. Lee. (2016). The effects of reinforced walking exercise on dyspnea-fatigue symptoms, daily activities, walking ability, and health related quality of life in heast failure patients, Korean Journal of Adults Nursing, 28(3), 266-278. DOI : 10.7475/kjan.2016.28.3.266.
  24. M. J. Kim & M. J. Kim. (2016). Concept analysis of volition for health behavior practice in patients with chronic disease, Journal of Korean Academy Nursing, 46(5), 687-696. DOI : 10.4040/jkan.2016.46.5.687.
  25. A. E. Rogers et al. (2000). Knowledge and communication difficulties for patients with chronic heart failure: qualitative study, BMJ, 321(7261), 605-607.
  26. L. Hjelmfors, A. Sandgren, A. Stromberg., J. Martensson, T. Jaarsma & M. Friedrichsen. (2018). I was told that I would not die from heart failure: Patient perceptions of prognosis communication, Applied Nursing Research, 41, 41-45. DOI : 10.1016/j.apnr.2018.03.007.
  27. M. Fry et al. (2016). The implications of living with heart failure; the impact on everyday life, family support, co-morbidities and access to healthcare: a secondary qualitative analysis, BMC Family Practice, 17(1), 139-146. DOI : 10.1186/s12875-016-0537-5.
  28. J. Xu et al. (2018). Heart failure rehospitali zation and delayed decision making: the impact of self-care and depression, Journal of Cardiovascular Nursing, 33(1), 30-39. DOI : 10.1097/JCN.0000000000000423.