Eunjoo Jeon

Development of an Obesity Management Ontology Based on the Nursing Process for the Mobile-Device Domain

Background Lifestyle modification is the most important factor in the management of obesity. It is therefore essential to enhance client participation in voluntary and continuous weight control. Objective The aim of this study was to develop an obesity management ontology for application in the mobile-device domain. We considered the concepts of client participation in behavioral modification for obesity management and focused on minimizing the amount of information exchange between the application and the database when providing tailored interventions. Methods An obesity management ontology was developed in seven phases: (1) defining the scope of obesity management, (2) selecting a foundational ontology, (3) extracting the concepts, (4) assigning relationships between these concepts, (5) evaluating representative layers of ontology content, (6) representing the ontology formally with Protégé, and (7) developing a prototype application for obesity management. Results Behavioral interventions, dietary advice, and physical activity were proposed as obesity management strategies. The nursing process was selected as a foundation of ontology, representing the obesity management process. We extracted 127 concepts, which included assessment data (eg, sex, body mass index, and waist circumference), inferred data to represent nursing diagnoses and evaluations (eg, degree of and reason for obesity, and success or failure of lifestyle modifications), and implementation (eg, education and advice). The relationship linking concepts were “part of”, “instance of”, “derives of”, “derives into”, “has plan”, “followed by”, and “has intention”. The concepts and relationships were formally represented using Protégé. The evaluation score of the obesity management ontology was 4.5 out of 5. An Android-based obesity management application comprising both agent and client parts was developed. Conclusions We have developed an ontology for representing obesity management with the nursing process as a foundation of ontology.

Factors Affecting Acceptance of Smartphone Application for Management of Obesity

Objectives The factors affecting the acceptance of mobile obesity-management applications (apps) by the public were analyzed using a mobile healthcare system (MHS) technology acceptance model (TAM). Methods The subjects who participated in this study were Android smartphone users who had an intent to manage their weight. They used the obesity-management app for two weeks, and then completed an 18-item survey designed to determine the factors influencing the acceptance of the app. Three questions were asked pertaining to each of the following six factors: compatibility, self-efficacy, technical support and training, perceived usefulness, perceived ease of use, and behavior regarding intention to use. Cronbachs alpha was used to assess the reliability of the scales. Pathway analysis was also performed to evaluate the MHS acceptance model. Results A total of 94 subjects participated in this study. The results indicate that compatibility, perceived usefulness, and perceived ease of use significantly affected the behavioral intention to use the mobile obesity-management app. Technical support and training also significantly affected the perceived ease of use; however, the hypotheses that self-efficacy affects perceived usefulness and perceived ease of use were not supported in this study. Conclusions This is the first attempt to analyze the factors influencing mobile obesity-management app acceptance using a TAM. Further studies should cover not only obesity but also other chronic diseases and should analyze the factors affecting the acceptance of apps among healthcare consumers in general.

Maltosyl-erythritol, a Major Transglycosylation Product of Erythritol by Bacillus stearothermophilus Maltogenic Amylase

This study was done to modify erythritol to change its physicochemical and sensory properties. Erythritol, a four-carbon sugar alcohol, was transglycosylated by Bacillus stearothermophilus maltogenic amylase with maltotriose as a donor molecule. The presence of various transglycosylation products of erythritol was confirmed by TLC and high performance ion exchange chromatography (HPIC). The major transfer product was purified by gel filtration chromatography on Bio-Gel P-2. Examination by LC-MS, matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF-MS), and 13C NMR showed that the major transfer product was maltosyl-erythritol. Results of 13C NMR of maltosyl-erythritol suggested that linkage was formed between the C1 carbon of glucose unit in maltose and either one of the two carbon atoms of the terminal hydroxyl groups of erythritol, so that a mixture of 1-O- and 4-O-α-maltosyl-erythritol was produced. The sweetness of maltosyl-erythritol was about 40% that of sucrose, and its negative sensory properties were less than those of erythritol.

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System.

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system.

Nursing Informatics Research Priorities for the Future: Recommendations from an International Survey.

We present one part of the results of an international survey exploring current and future nursing informatics (NI) research trends. The study was conducted by the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA-NISIG) Student Working Group. Based on findings from this cross-sectional study, we identified future NI research priorities. We used snowball sampling technique to reach respondents from academia and practice. Data were collected between August and September 2015. Altogether, 373 responses from 44 countries were analyzed. The identified top ten NI trends were big data science, standardized terminologies (clinical evaluation/implementation), education and competencies, clinical decision support, mobile health, usability, patient safety, data exchange and interoperability, patient engagement, and clinical quality measures. Acknowledging these research priorities can enhance successful future development of NI to better support clinicians and promote health internationally.

Current Trends in Nursing Informatics: Results of an International Survey.

Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice.

Development of the IMB Model and an Evidence-Based Diabetes Self-management Mobile Application

Objectives This study developed a diabetes self-management mobile application based on the information-motivation-behavioral skills (IMB) model, evidence extracted from clinical practice guidelines, and requirements identified through focus group interviews (FGIs) with diabetes patients. Methods We developed a diabetes self-management (DSM) app in accordance with the following four stages of the system development life cycle. The functional and knowledge requirements of the users were extracted through FGIs with 19 diabetes patients. A system diagram, data models, a database, an algorithm, screens, and menus were designed. An Android app and server with an SSL protocol were developed. The DSM app algorithm and heuristics, as well as the usability of the DSM app were evaluated, and then the DSM app was modified based on heuristics and usability evaluation. Results A total of 11 requirement themes were identified through the FGIs. Sixteen functions and 49 knowledge rules were extracted. The system diagram consisted of a client part and server part, 78 data models, a database with 10 tables, an algorithm, and a menu structure with 6 main menus, and 40 user screens were developed. The DSM app was Android version 4.4 or higher for Bluetooth connectivity. The proficiency and efficiency scores of the algorithm were 90.96% and 92.39%, respectively. Fifteen issues were revealed through the heuristic evaluation, and the app was modified to address three of these issues. It was also modified to address five comments received by the researchers through the usability evaluation. Conclusions The DSM app was developed based on behavioral change theory through IMB models. It was designed to be evidence-based, user-centered, and effective. It remains necessary to fully evaluate the effect of the DSM app on the DSM behavior changes of diabetes patients.

Current Status of Nursing Informatics Education in Korea

Objectives This study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea. Methods A set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via email and the postal service. Nursing schools offering nursing informatics were further asked to send their syllabuses. The subjects taught were analyzed using nursing informatics competency categories and other responses were tailed using descriptive statistics. Results A total of 72 schools (35.3%) responded to the survey, of which 38 reported that they offered nursing informatics courses in their undergraduate nursing programs. Nursing informatics courses at 11 schools were taught by a professor with a degree majoring in nursing informatics. Computer technology was the most frequently taught subject (27 schools), followed by information systems used for practice (25 schools). The faculty efficacy was 3.76 ± 0.86 (out of 5). The most frequently reported barrier to teaching nursing informatics (n = 9) was lack of awareness of the importance of nursing informatics. Training and educational opportunities was the most requested additional support. Conclusions Nursing informatics education has increased during the last decade in Korea. However, the proportions of faculty with degrees in nursing informatics and number of schools offering nursing informatics courses have not increased much. Thus, a greater focus is needed on training faculty and developing the courses.