Usability of the ´Beter Voorbereid´ eHealth application in adults prior to major elective surgery

Abstract

Aim Improving lifestyle risk factors, such as physical inactivity, nutrition, smoking or alcohol consumption, prior to major surgery can enhance postoperative recovery. The mobile eHealth application ‘Beter Voorbereid’ was developed to help patients improve their lifestyle by offering information, advice and exercises tailored to the patients’ needs. The aim of this pilot study was to evaluate the usability of the ‘Beter Voorbereid’ app in patients undergoing major elective surgery. Methods A concurrent triangulation mixed methods design was used to evaluate the usability in two hospitals in the Netherlands. Patients were recruited at the day of their preoperative screening. The System Usability Scale was used to quantify usability (range 0-100). Semi-structured interviews were conducted by telephone to gain detailed insights. Results The app was used by 23 men and 28 women. Their median(interquartile range) age was 56(43; 64). The System Usability Scale was completed by 32 subjects (62,7%). The mean±standard deviation of the System Usability score was 68,2±18,3, which is marginally acceptable. The interviews were conducted with 6 men and 6 women, between 25 and 77 of age. Qualitative analysis suggested that the login procedure was difficult, but the app itself was easy to use. The exercises did not always match the interviewees’ level of physical fitness. Interviewees who used the app two to three weeks preoperatively were the most motivated, most satisfied and succeeded in changing their lifestyle before surgery. Conclusion The “Beter Voorbereid” app is a promising eHealth tool, but some improvements are necessary. The main areas for improvement are the login procedure, variety in difficulty levels of the exercises and optimizing the timing of first use of the app. Clinical Relevance The interviewees described the lifestyle changes they made as an added value to their postoperative recovery. After improvements of the app are made, a full-scale RCT will be conducted to evaluate the effectiveness of the app on postoperative physical recovery.