Seminars in oncology nursing · 2026
The Effect of a Mobile Health Application Developed Based on Transformative Learning Theory on Grief Reaction and Posttraumatic Growth in Women Diagnosed with Breast Cancer.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Alkaş Serap, Yaman Sözbir Şengül
Аннотация
OBJECTIVES: This study aimed to examine the associations between counseling and supportive care delivered through a nurse-led mobile health application, theoretically informed by Mezirow's Transformative Learning Theory, and changes in grief-related emotional responses and posttraumatic growth among women diagnosed with breast cancer.
METHODS: This single-center, parallel-group randomized controlled trial included 56 women who had completed mastectomy and were at the beginning of the survivorship period. A mobile application titled Breast Cancer Support (BCS) was developed, and women in the intervention group used the application for eight weeks. Grief-related responses were measured using the Psychological Responses to Grief Before Loss of Health Scale, and posttraumatic growth was assessed using the Posttraumatic Growth Inventory (PTGI).
RESULTS: The intervention group demonstrated significantly greater improvements in Positive Attitude Toward Illness scores at post-test and follow-up compared with the control group (P < .05; 95% CI: -1.195 to -0.120), with significant group × time interaction effects (P < .001). Although unadjusted PTGI scores did not significantly differ between groups (P > .05), ANCOVA analyses adjusting for baseline scores indicated significant between-group differences at post-test and follow-up (P < .001; partial η² = .707; 95% CI: 65.191-69.269).
CONCLUSIONS: The findings provide preliminary evidence of associations between a nurse-led, theory-informed mobile health intervention and changes in grief-related emotional responses and posttraumatic growth during breast cancer survivorship. Transformative Learning Theory served as a guiding framework for intervention design rather than as an empirically measured outcome, and the results should not be interpreted as evidence that transformative learning occurred.
IMPLICATIONS FOR NURSING PRACTICE: Theory-informed mobile health applications may represent a feasible and accessible approach to delivering supportive care during the post-treatment period. Nurses may facilitate patient engagement with such tools by supporting access to informational and reflective resources; however, further rigorous trials are required before conclusions regarding effectiveness or routine implementation can be drawn.
METHODS: This single-center, parallel-group randomized controlled trial included 56 women who had completed mastectomy and were at the beginning of the survivorship period. A mobile application titled Breast Cancer Support (BCS) was developed, and women in the intervention group used the application for eight weeks. Grief-related responses were measured using the Psychological Responses to Grief Before Loss of Health Scale, and posttraumatic growth was assessed using the Posttraumatic Growth Inventory (PTGI).
RESULTS: The intervention group demonstrated significantly greater improvements in Positive Attitude Toward Illness scores at post-test and follow-up compared with the control group (P < .05; 95% CI: -1.195 to -0.120), with significant group × time interaction effects (P < .001). Although unadjusted PTGI scores did not significantly differ between groups (P > .05), ANCOVA analyses adjusting for baseline scores indicated significant between-group differences at post-test and follow-up (P < .001; partial η² = .707; 95% CI: 65.191-69.269).
CONCLUSIONS: The findings provide preliminary evidence of associations between a nurse-led, theory-informed mobile health intervention and changes in grief-related emotional responses and posttraumatic growth during breast cancer survivorship. Transformative Learning Theory served as a guiding framework for intervention design rather than as an empirically measured outcome, and the results should not be interpreted as evidence that transformative learning occurred.
IMPLICATIONS FOR NURSING PRACTICE: Theory-informed mobile health applications may represent a feasible and accessible approach to delivering supportive care during the post-treatment period. Nurses may facilitate patient engagement with such tools by supporting access to informational and reflective resources; however, further rigorous trials are required before conclusions regarding effectiveness or routine implementation can be drawn.