Development and Feasibility of a Smartphone Application for Promoting Healthy Heart Behaviors Following Open-Heart Surgery: A Mixed-Method Pilot Study

Abstract

Background/Objectives: Adherence to healthy behaviors after open-heart surgery is crucial for recovery and long-term health. Traditional patient education methods can be enhanced by using technology to improve engagement and self-care. This study aimed to develop and assess the feasibility of the "Term-Jai" smartphone application for promoting healthy heart behaviors in open-heart surgery patients. Methods: The "Term-Jai" psychological theory-based application was tested quantitatively and qualitatively over a 30-day period with 13 patients (age 44-78 years) following open-heart surgery between November 2023 and March 2024. Participant engagement, healthy behaviors, user experience, and usability were assessed using the System Usability Scale (SUS), satisfaction ratings, healthy behavior questionnaires, and semi-structured interviews. Results: The application was feasible, with 70% of participants remaining engaged during the intervention. The average SUS score was 80.2 ± 10.3, indicating good usability. Participants found the application's information useful, clear, and easy to understand, showing improvements in health behaviors following application usage. The qualitative analysis highlighted the application's intuitive design and potential for supporting cardiac rehabilitation. High satisfaction scores suggested its effectiveness despite some barriers to application usage around technical support and personalized exercise progression. Conclusions: The "Term-Jai" application is a promising tool for promoting healthy behaviors in patients following open-heart surgery. The application shows good usability and participant satisfaction, indicating its potential for broader implementation after further refinements.

Keywords: cardiac rehabilitation; health behavior; mobile applications; postoperative care; telemedicine.

Figure 1

CONSORT flow diagram for a single-group pilot study.

Figure 2

The screenshots of “Term-Jai” smartphone app. (a) The home screen displays the user’s profile and exercise progression, including an illustration of a growing tree and a percentage of completion; (b) The educational sessions feature video and audio media covering fundamental knowledge about cardiovascular diseases, risk factors, and cardiac rehabilitation (CR); (c) The workout section includes today’s session and a summary of exercise activity; (d) exercise session; (e) green circle appears each day upon exercise completion, and users receive a trophy after completing five sessions per week.