The Effect of Mobile Education on Anxiety and Activities of Daily Living

The study was designed as a prospective, two-arm (1:1), randomized controlled interventional study.

The study officially commenced in September 2021 with the development of the e-mobile intervention. During the preparatory phase (September 2021-February 2022), educational content was developed according to the Life Model, expert evaluations were completed, the mobile application was developed with the support of software engineers and graphic designers, pilot testing was conducted, and sample size calculations were performed.

Participant recruitment and data collection were conducted in the general surgery clinic of a university hospital between March and November 2022.

The sample consisted of patients who underwent partial thyroidectomy due to benign thyroid disease, were between 18 and 65 years of age, were able to communicate, used Android-based smartphones, and agreed to participate in the study.

A pilot study was conducted before the main trial, and sample size was determined using a priori power analysis. A total of 68 participants were included in the study and randomized into intervention and control groups.

The intervention group received Life Model-based e-mobile education in addition to standard discharge protocols. The e-mobile application was developed by the researchers with the support of software engineers and graphic designers. Educational content was structured according to the Activities of Daily Living Model developed by Roper, Logan, and Tierney. The application included information related to the preoperative, postoperative, and home-care periods, educational materials, frequently asked questions, questionnaires, reminder functions, and a messaging system.

The control group received standard discharge protocols only during the study period. After completion of the study, participants in the control group were provided access to the educational material.

Data were collected using the Personal Information Form, State-Trait Anxiety Inventory (STAI), and Activities of Daily Living Assessment and Monitoring Form. Trait anxiety was assessed preoperatively. State anxiety and activities of daily living were assessed on postoperative days 3, 7, and 10.

The primary objective of the study was to evaluate the effect of e-mobile education on anxiety levels following thyroidectomy. The secondary objective was to evaluate its effect on activities of daily living during the postoperative recovery period.

Inclusion criteria

• Planned thyroidectomy for benign thyroid disease
• Hospitalized at least one day before surgery
• Aged between 18 and 65 years
• Able to communicate in Turkish
• Conscious and oriented to person, place, and time
• No psychiatric disorder
• No hearing, speech, or visual impairment
• Undergoing partial thyroidectomy, lobectomy, or total thyroidectomy under general anesthesia
• Possession and use of an Android-based smartphone
• Willing to participate and provide written informed consent

Exclusion criteria

• Presence of psychiatric disorders
• Hearing, speech, or visual impairment
• Refusal to provide informed consent
• Withdrawal from the study after enrollment
• Failure to use the e-mobile application after allocation to the intervention group
• Employment in a health-related profession
• Cancellation of surgery for any reason
• Inability to be contacted during the follow-up period