Journal of Medical Systems

, 42:254 | Cite as

Patient Satisfaction with Mobile Health (mHealth) Application for Exercise Intervention in Breast Cancer Survivors

  • Hannah Lee
  • Kyeong Eun Uhm
  • In Yae Cheong
  • Ji Sung Yoo
  • Seung Hyun Chung
  • Yong Hyun Park
  • Ji Youl Lee
  • Ji Hye HwangEmail author
Mobile & Wireless Health
Part of the following topical collections:
  1. Mobile & Wireless Health


This study aimed to assess user satisfaction with mobile health (mHealth) application in breast cancer survivors after a 12-week exercise program and provide developers with reference points for mHealth applications from the perspective of patients and physicians. This is a retrospective review of prospectively collected multicenter data of 88 breast cancer survivors who carried out a 12-week exercise program via smartphone application with pedometer. Personalized programs including aerobic and resistance exercise were prescribed by physiatrists. Also, telephone counseling was performed at the 3rd and 9th week. All patients completed the user satisfaction questionnaire at the end of the intervention. The mean achievement rates of aerobic and resistance exercise for 12 weeks were 78.8 and 71.3%, respectively. The mean score of overall satisfaction rated on the 5-point Likert scale was 4.22 ± 0.73. When the patients were grouped according to age, the overall satisfaction score increased significantly with age (P = 0.040). Also, the satisfaction scores of patients with radiotherapy were significantly higher than patients without radiotherapy (P = 0.001). In terms of system characteristics, the most satisfying was data transmission accuracy (4.32 ± 0.74). In addition, patients were very satisfied with telephone counseling (4.55 ± 0.62). The results suggest the direction of mHealth should go to meet the detailed requirements of the specific user group as a more targeted approach. In addition, if a mutual feedback platform can be implanted in mHealth applications, it will increase user loyalty and make mHealth a more available motivational technology in our lives.


Mobile health Breast cancer Survivorship Rehabilitation Exercise Application 



This research was supported by the National Information Society Agency (NIA) funded by the Ministry of Science, ICT and Future Planning (Smart After Care Service for Cancer and Cardiac Disease).

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Mock, V., Frangakis, C., Davidson, N. E., Ropka, M. E., Pickett, M., Poniatowski, B., Stewart, K. J., Cameron, L., Zawacki, K., and Podewils, L. J., Exercise manages fatigue during breast cancer treatment: A randomized controlled trial. Psycho-Oncology 14(6):464–477, 2005.CrossRefGoogle Scholar
  2. 2.
    Kirshbaum, M. N., A review of the benefits of whole body exercise during and after treatment for breast cancer. J. Clin. Nurs. 16(1):104–121, 2007.CrossRefGoogle Scholar
  3. 3.
    Singh, B., Spence, R. R., Steele, M. L., Sandler, C. X., Peake, J. M., and Hayes, S. C., A systematic review and meta-analysis of the safety, feasibility and effect of exercise in women with stage II+ breast cancer. Arch. Phys. Med. Rehabil., 2018.Google Scholar
  4. 4.
    Courneya, K. S., Exercise in cancer survivors: An overview of research. Med. Sci. Sports Exerc. 35(11):1846–1852, 2003.CrossRefGoogle Scholar
  5. 5.
    Marmot, M., Atinmo, T., Byers, T., Chen, J., Hirohata, T., Jackson, A., James, W., Kolonel, L., Kumanyika, S., and Leitzmann, C., Food, nutrition, physical activity, and the prevention of cancer: a global perspective, 2007.Google Scholar
  6. 6.
    Turner, R. R., Steed, L., Quirk, H., Greasley, R. U., Saxton, J. M., Taylor, S. J., Rosario, D. J., Thaha, M. A., and Bourke, L., Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst. Rev. 9:CD010192, 2018.PubMedGoogle Scholar
  7. 7.
    Siegel, R. L., Miller, K. D., and Jemal, A., Cancer statistics, 2016. CA Cancer J. Clin. 66(1):7–30, 2016.CrossRefGoogle Scholar
  8. 8.
    Holmes, M. D., Chen, W. Y., Feskanich, D., Kroenke, C. H., and Colditz, G. A., Physical activity and survival after breast cancer diagnosis. JAMA 293(20):2479–2486, 2005.CrossRefGoogle Scholar
  9. 9.
    McNeely, M. L., Campbell, K. L., Rowe, B. H., Klassen, T. P., Mackey, J. R., and Courneya, K. S., Effects of exercise on breast cancer patients and survivors: A systematic review and meta-analysis. Can. Med. Assoc. J. 175(1):34–41, 2006.CrossRefGoogle Scholar
  10. 10.
    Dieli-Conwright, C. M., and Orozco, B. Z., Exercise after breast cancer treatment: Current perspectives. Breast Cancer: Targets and Therapy. 7:353–362, 2015.Google Scholar
  11. 11.
    Leong, S. P., Shen, Z.-Z., Liu, T.-J., Agarwal, G., Tajima, T., Paik, N.-S., Sandelin, K., Derossis, A., Cody, H., and Foulkes, W. D., Is breast cancer the same disease in Asian and Western countries? World J. Surg. 34(10):2308–2324, 2010.CrossRefGoogle Scholar
  12. 12.
    Arrington, A. K., Goldstein, L., Kruper, L., Vito, C., Yim, J., and Chen, S. L., Life expectancy after curative-intent treatment of breast cancer: Impact on long-term follow-up care. Am. Surg. 80(6):604–609, 2014.PubMedGoogle Scholar
  13. 13.
    Martinez-Perez, B., de la Torre-Diez, I., and Lopez-Coronado, M., Mobile health applications for the most prevalent conditions by the World Health Organization: Review and analysis. J. Med. Internet Res. 15(6):e120, 2013.CrossRefGoogle Scholar
  14. 14.
    Fox, S., and Duggan, M., Pew Research Center's Internet & American Life Project. 2013. Mobile Health, 2012.Google Scholar
  15. 15.
    Carter, M. C., Burley, V. J., Nykjaer, C., and Cade, J. E., Adherence to a smartphone application for weight loss compared to website and paper diary: Pilot randomized controlled trial. J. Med. Internet Res. 15(4):e32, 2013.CrossRefGoogle Scholar
  16. 16.
    Gustafson, D. H., McTavish, F. M., Chih, M. Y., Atwood, A. K., Johnson, R. A., Boyle, M. G., Levy, M. S., Driscoll, H., Chisholm, S. M., Dillenburg, L., Isham, A., and Shah, D., A smartphone application to support recovery from alcoholism: A randomized clinical trial. JAMA Psychiatry 71(5):566–572, 2014.CrossRefGoogle Scholar
  17. 17.
    Kirwan, M., Vandelanotte, C., Fenning, A., and Duncan, M. J., Diabetes self-management smartphone application for adults with type 1 diabetes: Randomized controlled trial. J. Med. Internet Res. 15(11):e235, 2013.CrossRefGoogle Scholar
  18. 18.
    Logan, A. G., Transforming hypertension management using Mobile health technology for telemonitoring and self-care support. Can. J. Cardiol. 29(5):579–585, 2013.CrossRefGoogle Scholar
  19. 19.
    Nussbaum, R., Kelly, C., Quinby, E., Mac, A., Parmanto, B., and Dicianno, B. E., A systematic review of mobile health applications in rehabilitation. Arch. Phys. Med. Rehabil., 2018.Google Scholar
  20. 20.
    Gubbi, J., Buyya, R., Marusic, S., and Palaniswami, M., Internet of things (IoT): A vision, architectural elements, and future directions. Futur. Gener. Comput. Syst. 29(7):1645–1660, 2013.CrossRefGoogle Scholar
  21. 21.
    Istepanian, R. S. H., Sungoor, A., Faisal, A., and Philip, N., Internet of m-health things “m-IoT”. Assisted Living 2011, IET Seminar, pp. 1–3.Google Scholar
  22. 22.
    McPherson, K., Steel, C. M., and Dixon, J. M., ABC of breast diseases. Breast cancer-epidemiology, risk factors, and genetics. BMJ 321(7261):624–628, 2000.CrossRefGoogle Scholar
  23. 23.
    Maggard, M. A., O'Connell, J. B., Lane, K. E., Liu, J. H., Etzioni, D. A., and Ko, C. Y., Do young breast cancer patients have worse outcomes? J. Surg. Res. 113(1):109–113, 2003.CrossRefGoogle Scholar
  24. 24.
    McCarroll, M. L., Armbruster, S., Pohle-Krauza, R. J., Lyzen, A. M., Min, S., Nash, D. W., Roulette, G. D., Andrews, S. J., and von Gruenigen, V. E., Feasibility of a lifestyle intervention for overweight/obese endometrial and breast cancer survivors using an interactive mobile application. Gynecol. Oncol. 137(3):508–515, 2015.CrossRefGoogle Scholar
  25. 25.
    Bravo, C., O’Donoghue, C., Kaplan, C. P., Luce, J., and Ozanne, E., Can mHealth improve risk assessment in underserved populations? Acceptability of a breast health questionnaire app in ethnically diverse, older, low-income women. J. Health Dispar. Res. Pract. 7(4):6, 2014.Google Scholar
  26. 26.
    Quintiliani, L. M., Mann, D. M., Puputti, M., Quinn, E., and Bowen, D. J., Pilot and feasibility test of a Mobile health-supported behavioral counseling intervention for weight management among breast cancer survivors. JMIR Cancer 2(1):e4, 2016.CrossRefGoogle Scholar
  27. 27.
    Uhm, K. E., Yoo, J. S., Chung, S. H., Lee, J. D., Lee, I., Kim, J. I., Lee, S. K., Nam, S. J., Park, Y. H., Lee, J. Y., and Hwang, J. H., Effects of exercise intervention in breast cancer patients: Is mobile health (mHealth) with pedometer more effective than conventional program using brochure? Breast Cancer Res. Treat. 161(3):443–452, 2017.CrossRefGoogle Scholar
  28. 28.
    Riffenburg, K. M., and Spartano, N. L., Physical activity and weight maintenance: The utility of wearable devices and mobile health technology in research and clinical settings. Curr. Opin. Endocrinol. Diabetes Obes. 25(5):310–314, 2018.Google Scholar
  29. 29.
    Eakin, E. G., Lawler, S. P., Winkler, E. A., and Hayes, S. C., A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer: Exercise for health. Ann. Behav. Med. 43(2):229–238, 2012.CrossRefGoogle Scholar
  30. 30.
    Bohannon, R. W., Wang, Y. C., and Gershon, R. C., Two-minute walk test performance by adults 18 to 85 years: Normative values, reliability, and responsiveness. Arch. Phys. Med. Rehabil. 96(3):472–477, 2015.CrossRefGoogle Scholar
  31. 31.
    Chun, M. Y., Validity and reliability of korean version of international physical activity questionnaire short form in the elderly. Korean J. Fam. Med. 33(3):144–151, 2012.CrossRefGoogle Scholar
  32. 32.
    IPAQ Research committee, guidelines for data processing and analysis of the international physical activity questionnaire (IPAQ) – Short and long forms, 2005.Google Scholar
  33. 33.
    Misra, S., New report finds more than 165,000 mobile health apps now available, takes close look at characteristics & use. (accessed 17 February 2017).
  34. 34.
    Glynn, L. G., Hayes, P. S., Casey, M., Glynn, F., Alvarez-Iglesias, A., Newell, J., G, O. L., Heaney, D., O'Donnell, M., and Murphy, A. W., Effectiveness of a smartphone application to promote physical activity in primary care: The SMART MOVE randomised controlled trial. Br. J. Gen. Pract. 64(624):e384–e391, 2014.CrossRefGoogle Scholar
  35. 35.
    Moran, J., Kelly, G., Haberlin, C., Mockler, D., and Broderick, J., The use of eHealth to promote physical activity in people with mental health conditions: A systematic review. HRB Open Research. 1:5, 2018.CrossRefGoogle Scholar
  36. 36.
    Bonn, S. E., Alexandrou, C., Steiner, K. H., Wiklander, K., Östenson, C.-G., Löf, M., and Lagerros, Y. T., App-technology to increase physical activity among patients with diabetes type 2-the DiaCert-study, a randomized controlled trial. BMC Public Health. 18(1):119, 2018.CrossRefGoogle Scholar
  37. 37.
    Ogilvie, D., Foster, C. E., Rothnie, H., Cavill, N., Hamilton, V., Fitzsimons, C. F., Mutrie, N., and Scottish Physical Activity Research, C, Interventions to promote walking: Systematic review. BMJ 334(7605):1204, 2007.CrossRefGoogle Scholar
  38. 38.
    Comulada, W. S., Swendeman, D., Koussa, M. K., Mindry, D., Medich, M., Estrin, D., Mercer, N., and Ramanathan, N., Adherence to self-monitoring healthy lifestyle behaviours through mobile phone-based ecological momentary assessments and photographic food records over 6 months in mostly ethnic minority mothers. Public Health Nutr. 21(4):679–688, 2018.CrossRefGoogle Scholar
  39. 39.
    Højris, I., Andersen, J., Overgaard, M., and Overgaard, J., Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone. Acta Oncol. 39(3):355–372, 2000.CrossRefGoogle Scholar
  40. 40.
    Senkus-Konefka, E., and Jassem, J., Complications of breast-cancer radiotherapy. Clin. Oncol. (R. Coll. Radiol.) 18(3):229–235, 2006.CrossRefGoogle Scholar
  41. 41.
    Bentzen, S. M., and Dische, S., Morbidity related to axillary irradiation in the treatment of breast cancer. Acta Oncol. 39(3):337–347, 2000.CrossRefGoogle Scholar
  42. 42.
    Fitzpatrick, R., Surveys of patients satisfaction: I--important general considerations. BMJ 302(6781):887–889, 1991.CrossRefGoogle Scholar
  43. 43.
    Chae, Y. M., Lee, J. H., Ho, S. H., Kim, H. J., Jun, K. H., and Won, J. U., Patient satisfaction with telemedicine in home health services for the elderly. Int. J. Med. Inform. 61(2–3):167–173, 2001.CrossRefGoogle Scholar
  44. 44.
    Aljasir, B., and Alghamdi, M. S., Patient satisfaction with mobile clinic services in a remote rural area of Saudi Arabia. East Mediterr. Health J. 16(10):1085–1090, 2010.CrossRefGoogle Scholar
  45. 45.
    Patrick, K., Griswold, W. G., Raab, F., and Intille, S. S., Health and the mobile phone. Am. J. Prev. Med. 35(2):177–181, 2008.CrossRefGoogle Scholar
  46. 46.
    Patro, B. K., Kumar, R., Goswami, A., Nongkynrih, B., Pandav, C. S., and U. G. Study Group, Community perception and client satisfaction about the primary health care services in an urban resettlement colony of New Delhi. Indian J. Community Med. 33(4):250–254, 2008.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Hannah Lee
    • 1
  • Kyeong Eun Uhm
    • 2
  • In Yae Cheong
    • 1
  • Ji Sung Yoo
    • 3
  • Seung Hyun Chung
    • 3
  • Yong Hyun Park
    • 4
  • Ji Youl Lee
    • 4
  • Ji Hye Hwang
    • 1
    Email author
  1. 1.Department of Physical and Rehabilitation Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Rehabilitation MedicineKonkuk University School of MedicineSeoulSouth Korea
  3. 3.Department of Rehabilitation MedicineNational Cancer CenterGoyang-siSouth Korea
  4. 4.Department of Urology, Seoul St. Mary’s HospitalThe Catholic University of Korea College of MedicineSeoulSouth Korea

Personalised recommendations