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Objectives: Ecological momentary assessment (EMA) methods are known to have validity for capturing momentary changes in variables over time. However, data quality relies on the completion rates, which are influenced by both participants’ characteristics and study designs. This study applied an EMA method using a mobile application to assess momentary moods and stress levels in patients with Moyamoya disease to examine variables associated with EMA completion rates. Methods: Adults with Moyamoya disease were recruited from a tertiary hospital in Seoul. Patients with cognitive impairment were excluded. The EMA survey was loaded as a mobile application onto the participants’ personal smartphones. Notifications were sent at semi-random intervals four times a day for seven consecutive days. Daily completion rates were calculated as the percentage of completed responses per day; overall completion rates were calculated as the proportion of completed responses per total of the 28 scheduled measures in the study and assessed through a descriptive analysis, t-test, ANOVA, and regression analysis, with mixed modeling to identify the point at which the daily completion rate significantly decreased. Results: A total of 98 participants responded (mean age, 41.00 ± 10.30 years; 69.4% female; 75.5% married). The overall completion rate was 70.66%, with no gender or age differences found. The daily completion rate decreased significantly after day 5 (p = 0.029). Conclusions: Obtaining a good completion rate is essential for quality data in EMA methods. Strategic approaches to a study design should be established to encourage participants throughout a study to improve completion rates.
Objectives: This study aimed to describe the process of utilizing a mobile application for ecological momentary assessment (EMA) to collect data on stress and mood in daily life setting. Methods: A mobile application for the Android operating system was developed and installed with a set of questions regarding momentary mood and stress into a smartphone of a participant. The application sets alarms at semi-random intervals in 60-minute blocks, four times a day for 7 days. After obtaining all momentary affect and stress, the questions to assess the usability of the mobile EMA application were also administered. Results: The data were collected from 97 police officers working in Gyeonggi Province of South Korea. The mean completion rate was 60.0% ranging from 3.5% to 100%. The means of positive and negative affect were 18.34 of 28 and 19.09 of 63. The mean stress was 17.92 of 40. Participants responded that the mobile application correctly measured their affect (4.34 ± 0.83) and stress (4.48 ± 0.62) of 5-point Likert scale. Conclusions: Our study investigated the process of utilizing a mobile application to assess momentary affect and stress at repeated times. We found challenges regarding adherence to the research protocol, such as completion and delay of answering after alarm notification. Despite this inherent issue of adherence to the research protocol, the EMA still has advantages of reducing recall bias and assessing the actual moment of interest at multiple time points that improves ecological validity.
Ecological momentary assessment (EMA) is a method that captures the current experience and behavior of subjects in real time in a natural environment. The data collected by EMA reveals alterations according to the time and context of experience and action. The Trier Inventory for Chronic Stress (TICS) is a tool that measures momentary stress, and is capable of measuring stress experienced in real life. This study was undertaken to verify the validity and reliability after translating the short form TICS into a Korean version. Totally, 89 police officers working at the police station in the capital participated in this study. The mobile application developed for this study was installed on their smartphones, and data were collected four times a day for seven consecutive days. Confirmatory factor analysis and content validity index (CVI) was applied to test the validity, and concurrent validity was evaluated by correlating with the occupational stress score. The model was validated by confirmatory factor analysis, and we obtained good reliabilities (I-CVI=0.83-1, RMSEA=0.104, SRMR=0.104, CFI=0.948, TLI=0.919, Cronbach's alpha=0.839). Our findings indicate the reliability, and validate use of the Korean tool for measuring momentary stress. 생태순간평가(Ecological momentary assessment)는 대상자의 현재 경험과 행동을 일상생활 환경에서 실시간으로 반복 측정하는 연구방법으로 수집된 자료를 통해 시간과 맥락에 따른 경험과 행동의 변화를 알 수 있다. Trier Inventory for Chronic Stress (TICS)는 순간 스트레스를 측정하기 위한 도구로써 대상자가 일상생활에서 경험하는 스트레스를 측정할 수 있다. 본 연구의 목적은 축약형 TICS를 한국판으로 번역 후 생태순간평가를 적용하여 수집된 자료로 타당도와 신뢰도를 검증하고자 함이다. 연구대상은 수도권 지역에 위치한 경찰서, 지구대에 근무하는 89명의 경찰공무원으로 본 연구를 위해 개발된 순간 스트레스 측정 애플리케이션을 대상자 소지의 스마트폰에 설치하도록 하였다. 자료 수집은 1명의 대상자당 총 7일간 하루 4번 순간 스트레스 설문을 통해 수집하였고, 자료 분석은 수집된 총 1163회의 순간 설문 자료를 이용하여 분석하였다. 타당도 검증은 전문가 타당도 분석, 확인적 요인 분석, 한국인 직무 스트레스 점수와 상관관계 분석으로 하였고 신뢰도 검증은 Cronbach’s α 값을 확인하였다. 연구 결과 순간 스트레스 측정 도구의 타당도와 내적 일관성 신뢰도는 도구로 활용하기 적합한 수준이었다(I-CVI=.83-1, RMSEA=.104, SRMR=.104, CFI=.948, TLI=.919, Cronbach’s α =.839). 따라서 본 도구는 대상자의 순간 스트레스 측정에 유용하게 사용될 수 있을 것이다.
This study was designed to distinguish by the characteristic difference and the degree of symptoms such as fatigue, pain, coping to pain, and efficacy on pain, and to offer descriptive data for nursing intervention for improving coping ability to pain along each characteristics of disease in chronic arthritis and systemic lupus erythematosus. The subjects were 135 outpatients in the hospital for rheumatic disease in H-University, Seoul. The data were collected by structural questionnaire, from April 29 to June 29, 1999. The results were that the fatigue score was high in the OA patients while the RA patients and SLE patients experienced middle range of fatigue score, but which was not statistically different. Although the RA patients felt higher pain than other diseases, they have well coped with their pain than the others. In efficacy on pain the SLE patients had higher score than others but all of the disease showed lower score. No statistically significant difference among the three croup was recorded in efficacy on pain. Therefore, pain management in the RA patients was primary nursing intervention because they felt severe pain and have well coped with pain while they had lower pain efficacy score than the others. It is also important that fatigue management and coping strategies on pain for the OA patients and SLE patients are specially supportive in the nursing intervention.