Famcare: Mobile Application On Palliative Care For Filipino Caregivers

“Famcare: Mobile Application on Palliative Care for Filipino Caregivers”

Winifredo Licop

Doctor of Philosophy in Nursing Education, Olivarez College Tagaytay, Philippines

DOI: https://dx.doi.org/10.47772/IJRISS.2025.9010139

Received: 06 January 2025; Accepted: 10 January 2025; Published: 07 February 2025

ABSTRACT

Caregiver at the palliative care not only benefits the client, but also the health care system, and they should have access to high-quality, evidencebased interventions. Moreover, Health care faces several challenges, such as funding limitations, large geographic distances that make such resources often more costly for rural patients. t is a general premise that information technology (IT) can address these challenges and enhance home health care services.  The main objective of this study is to develop a mobile app on palliative care in the android operating system for Filipino Caregivers. The researcher utilized the ADDIE framework or known as Analysis- Design- Develop, Implement, and evaluate to develop the mobile application:

The mobile application has the following features 1. With backward compatibility that can run with the minimum android OS of Ice cream sandwich 2. Palliative Care Awareness and Education. 3. List of Palliative care facilities and HIV treatment 4. With mobile utility medication manager, contact list, vital signs record, record manager, pain assessment. Two pilot test was done with the Caregiver end-user with a weighted mean of 3.73 or excellent and with the technical expert in IT with the weighted mean of 3.85 or excellent. The study recommended testing the effectiveness of the mobile app, translate to Filipino dialect, and enhance the feature, aesthetics of the mobile application.

INTRODUCTION

Caregiving is described as a natural process, something built out of love but also driven by a sense of duty and obligation (Henriksson, Carlander, & Arestedt, 2013). Family members are typically the first caregivers for patients; while they may be willing to take on this role, they often find it difficult to express their own needs, especially when prioritizing the patient’s well-being (Effer, Tiun, & Li, 2010).

Being a family caregiver can present significant physical, emotional, and social challenges. The responsibilities involved are often demanding and constantly evolving (Henriksson, Carlander, & Arestedt, 2013). Despite the need for high-quality care, family members are often unprepared to monitor disease progression, make treatment decisions, or manage complex caregiving tasks. Unprepared caregivers may experience serious adverse effects, such as anxiety and burnout (Goldsmith & Ragan, 2017).

Family members, friends, and unpaid caregivers provide primary palliative care and are considered the frontline providers of much of the care received by adults and children (Henriksson & Arestedt, 2013; Reinhard, Institute of Medicine). Caregiver responsibilities include critical symptom management, prognosis discussions, care planning, advanced care preparation, and documentation (Quill & Abernethy, 2013). Specific tasks range from providing companionship and handling household chores to assisting with personal care and daily living activities. Caregivers are also involved in complex medical decision-making (Schulz, 2016; Quill & Abernethy, 2013).

Primary care at the end of life benefits not only the patient but also the healthcare system. Continuity of care is associated with fewer avoidable hospitalizations, reduced emergency department visits, and improved quality of life. However, many patients and family caregivers report feeling neglected by nurses and physicians during critical moments, particularly at the end of life (Selseira & Forman, 2019).

Healthcare faces several challenges, including funding limitations, vast geographic distances that make resources difficult to access for rural patients, and workforce distribution issues that create barriers to healthcare services. Information technology (IT) has the potential to address these challenges and improve healthcare delivery. Advances in telecommunications, web-based solutions, mobile applications, and social networking tools can enhance healthcare accessibility and education. The integration of IT can lead to a fundamental redesign of care processes through electronic communication. Caregivers should have access to high-quality, evidence-based interventions designed to mitigate potential adverse health effects (Schulz, 2016).

METHODOLOGY

According to Richey and Klein, (2005) developmental studies often are planned in phases a  Type 1  developmental studies may have an analysis phase, design phase, a development phase, and a try-out and evaluation phase. Another organization of a Type 1 study would include phases directed toward first analysis, then prototype development and testing, and finally prototype revision and retesting.

The ADDIE model is the generic process traditionally used by instructional designers and training developers. The five phases—Analysis, Design, Development, Implementation, and Evaluation—represent a dynamic, flexible guideline for building practical training and performance support tools. (Instructional Design.org, 2019)

Two (2) palliative nurses and two (2) clinical instructor participated the one on one consultation and using and three mobile phone for follow  up and clarification, that fit from the criteria in terms of experience (3 years and above) and for clinical instructor with Masters degree in Nursing, three consultation was done from May to July 2020 for the analysis phase of the study in relation to the contents and utilities of the Fam Care mobile application in android system.  IT programmer/ developer is the expert in the designing and development of the mobile application in palliative care in collaboration with the researcher. IT programmer evaluates the program for functionality and smooth interface of the mobile app in the selected program for the android mobile platform. System developer have all the criteria set by the researcher. The IT specialist have a technical knowledge in developing a mobile application, with Masters degree in Information Technology

Purposive sampling using the snowball technique was employed in selecting the participants for the end-users as evaluators of the mobile software application in palliative care. Fifteen Caregivers were selected based on the following criteria

Data Gathering Procedure

Understanding the end-user and their needs is the starting point of any design project may it be instruction design or mobile app development, this means observing and engaging with end-users in order to comprehend them on a mental and emotional level (Carefoundry, 2019).

Analysis phase

The integrative review determines current knowledge about a specific topic because it is carried out to identify, analyze and synthesize results of independent studies on the same subject, thus contributing to a possible benefit on the quality of care delivered to patients. It is noted worth mentioning that the use of integrative review impacts not only in the development of policies, protocols, and procedures but also in a critical assessment that the daily practice demands.

Quality Score

Fifteen studies were compiled, organized by date retrieved from the search engine, using ProQuest, and were analyzed based on the inclusion criteria. The integrative review begins with the summary of findings and continues with an analysis of the data collected from the included studies. The data is examined, and the conclusion is drawn based on the pattern found in the literature. After the initial selection of the literature the researcher utilized Joanna Briggs Critical analysis tools to analyze the literature depends on the research design or methodology of the fifteen (15) literature.

Twelve (12) out of 15 or eighty percent (80%) got a perfect score while the remaining three (3) the score less than the perfect score, but in an acceptable range in term.

Design

The second phase of the ADDIE model is the design phase in which the researcher needs collaboration from other experts in information technology and a programmer/ system developer for mobile application.  In this phase, the design and the program that was utilized will be identified based from the intended user and the blueprint of what mobile app will look like for the third phase as well as the projection of expenses and budget of time and the backward compatibility. The design phase started from July to August 2019 where the researcher discusses to the system developer or the SME in Information technology the content of the mobile app and if the mobile app utilities are possible to include in the system of FamCare for the formative evaluation phase.

Development

The development phase is where the realization of the 2^nd phase, where all the contents and design embedded in the mobile application and evaluated by the developer and the researcher.

Implementation and Summative Evaluation

Implementation is the 4^th phase in which pilot testing is done, and the end-user evaluated the said android application, after 2 weeks of testing the FamCare App, using the adapted and modified ISO 9126 software survey tool questionnaire for the following indicators such as Functionality, usability, reliability efficiency, maintainability and portability and content as a summative Evaluation. Mean and Frequency are the statistical treatment utilized in analyzing the result of the evaluation.

RESULT AND DISCUSSION

Analysis Phase

1^st step Interview with the end user

The researcher interviewed five (5) end-users for possible content and utilities that are included in the mobile app. One-on-one interview via face-to-face interview and phone interview follow up for clarification and follow up question was done to ensure that all information is correct. During the interview, the end-user recommends medication reminders as one of the utility of the mobile app that will alarm when the medication is due and facilities of care available in the Philippines.

2^nd step Integrative Review Result Identified Themes

The focus of the integrative review was to identify the needs of the caregivers and the needs of the patient care in the areas of palliative care that will be included in the content of the mobile application. Four themes emerged from the data analysis that consists of the needs of the following, 1. Palliative Care Awareness and Education, 2.  Continuity of Care, 3. Holistic Care 3, 4. Open communication to the palliative health care team.

Theme 1 Palliative Care Awareness and Education

Palliative Care awareness and education are defined as the needs of the family caregiver to access the right information of what is palliative care, prognosis., treatment to combat the misconception and stigma. Health Education is always part of the nursing responsibility in all areas, may it be in the community or the hospital or facilities, as imparting knowledge empower family and may result in the patient to have active participation in the whole process of treatment/ intervention of palliative care until the end.

Table 1 Coding Matrix for Palliative Care Awareness and Education

One theme that emerges from the data analysis is the palliative care awareness and education that was discussed by Silveira et al. (2012), Zimmerman et al. (2016, Hudson, P., & Aranda, S. (2014), Armstrong et al. (2019), Iyer et, al (2019. Lack of palliative care public awareness and education as stated by the different studies included in the literature are hindrances in accessing early palliative care (WHO, 2019), maybe due to the various factors such as misconception about palliative care; example given that palliative care is for cancer patient only (WHO, 2019), Negative attitudes and strong stigma or misconception on the said care (Zimmerman et al., 2016), lack of education and training of the health care professional (Pagulong, 2015), add to the Filipino culture of delayed seeking medical help (Aeur, Sarol Jr, Tanner and Weiss, 2001) and the attitude of “Bahala Na” when facing chronic illness (Stanford, 2019, Bigby, 2003; Mc Laughlin, 1998; Vance, 1995).

The study of Armstrong et al. (2019) discussed the lack of information about hospice care and how can it help, resulting in late referral and misconception of hospice care about hastening death. Ventura et al. (2014) and Uribe et al. (2019) cited that patients and caregivers wanted more information about the illness, often about managing their lives and making decisions, and how the condition would progress. Zimmerman et al. (2016) stated that paramount to early access and integration of palliative care is through strengthening health and palliative care education (Uribe et al., 2019), within and outside the health care service (Santo Lima et al. 2019) awareness of the palliative care program and facilities that cater to the individual needs under this care with the primary goal of increasing the quality of remaining time of the client.

Based on the first theme identified in integrative review “palliative care awareness and education,” the researcher includes the following content on the android system software; Definition and differentiation of Palliative care, end of life care, and hospice care. Breaking the myth of Palliative care, Dying with dignity, preparation for home-care. The android software is not meant to be the substitute of a palliative health care team such as the nurse and the doctor and avoid misuse of the system for selfdiagnosis, but technology is one platform that a nurse can use to impart knowledge, increase understanding and awareness about palliative care, correct the misconceptions and encourage the family caregiver to consult a physician and early access to palliative care services and treatment.

Theme 2: Continuity of Care

Continuity of Care defined as the continuation of care from facilities or hospital to home setting as the family becomes the primary care provider. This need for skills in assisting the client in meeting daily activities of daily living and symptom management at home.

Table 2 Coding Matrix for Continuity of Care

The second theme that emerged from the data analysis is the need for continuity of care, cited by four studies namely Tarberg et al. (2019) Santo Lima et al. (2019) Ghosh (2019), Uribe et al. (2019). The paradigm shifts from family or loved one to primary caregivers who assist and meet the client’s activity of daily living and other needs. Family caregivers who provide home-based care may feel unprepared for the role and often neglect their own needs (Stajduhar & Davies, 2005; Talberg et al. 2019). Coordination of care was central in providing timely and robust end-of-life care.

Continuity of care also means gathering all the necessary information about the patient’s history, status, and prognosis, as well as arranging referrals to other providers, providing medications, and accessing community services (Ventura et al., 2014). Knowledge of the patient’s health status, ability to respond appropriately to patient and family needs, such as pain and emotional issues (Silveira et al., 2019) and knowledge and information about the essential care patient was cited by Uribe et al. (2019). Dela Vega et al. (2018) Family caregivers need education, support, and supervision that empower them to tailor their care to the needs of the patient. The need to information to assist the client for practical skills in helping or attending their activities of daily living is also included in the system such as practical skills infection, giving oral medication, bed bath, exercise as well as some advanced skills that need proper training from the nurse such as NGT feeding among others was also included in the android content.

Added to the information within the system are the facilities in hospice care from the website of Hospice group of the Philippines official website with the name of the facilities/organization and their contact number and address or location and the HIV testing and treatment centre by DOH based on the Department Memorandum no. 2018- 0031 for those patients who are willing to have an HIV test and wanted to avail of a free ARV medication. This information is crucial in the continuity of care for the patient who has needs and utilizes the resources within the community or at least the nearest facilities or treatment.

The android system includes utilities that may generate necessary health information about the client’s health. Among the utilities include the patient information sheet, vital signs reports, and pain assessment scale to ensure that day -to day information is kept within the system, and the health care provider in the community know necessary for medical and health intervention appropriate to the clients need. Medication reminder was also added to the utilities as part of the pain management system and continuity of care.

Theme 3 Holistic Care

Holistic care pertains to addressing the needs of the patient as a person, not just focusing on the physical facet but also attending the needs such as emotional, social, and spiritual needs.

Table 3 Coding Matrix for Holistic Care

Table 3 studies that cluster under the holistic care. Palliative care as many studies shows that nurses and health care provider must not only focus on the symptom management and physical aspect but also address other human dimensions such as social, spiritual, emotional and financial needs of the client and the family caregiver.

The study of Galatsch et al. (2019) focus on the identification of physical symptoms experienced by the patient and observed by the Caregiver, this include, severe pain,/ discomfort, insomnia, vomiting, unable to eat or swallow, dehydration. Ventura et al. (2014) discussed some of the unmet needs of both family carers and patient, as they are unable to attend and practice their religious belief, and mingle with friends due to fear of death and future event. Silveira et al. (2019) cited emotional and group support and counselling needs; the necessity to talk about their feeling about the situation. Study of Uribe et al. (2019) point out the need of the caregivers for emotional support to accept the disease and face each part of the process and financial support not only to cover the patient’s needs but also the caregiver needs when they become a full-time primary caregiver.

The android system includes holistic care as a response to the identified themes. Every patient has its unique needs and may not cover all the necessary information because of a vast body of knowledge about the said topic. Some information includes physical aspect of care needs comprise of basic symptom management, from pain assessment and pain control, non-pain management such as nutritional needs among others—stage of Grieving by dr. Ross was explained for emotional needs in each phase the client and the caregiver experience during this process and non-specified spiritual needs.

Theme 4: Open Communication

Open communication means constant contact with the health care provider, especially in times of need during home care delivery.

Table 4 Coding Matrix for Open Communication

Regular communication with the palliative health care team lacks as cited by four authors. For both patients and caregivers, this may lead to anxiety as to who should be communicated in times of uncertainty (Ventura et al., 2019) resulted in the feeling of abandonment (Silveira et al. (2012). The concern with communication may lead to poor continuity of care (Ventura et al., 2019). Advances in telecommunications, web solutions, mobile application and social networking tools have the potential to support health care delivery and education. The use of Information Technology can lead to a fundamental redesign of home care processes based on the purpose and integration of electronic communication. Caregivers should have access to high-quality, evidence-based interventions designed to mitigate or prevent adverse health effects (Schulz, 2016). Open communication between the attending physician, patient, and family regarding the patient’s wishes in terms of treatment and end-of-life care appears to improve the dignified death as perceived by family caregivers based on the study of van Gennip et al. (2013)

In line with the themes, the researcher focusses on the use of technology within the capabilities of the mobile function, such as a list of contact for the health care team capable of calling health care providers. Journal and documentation of everyday activities, just like the nurse’s notes in the patient chart.

Formative Evaluation Phase

According to the ADDIE framework, in every phase, there must be an evaluation at the end that will be carried out to the next stage. The researcher consulted four (4) Subject matter experts in palliative care; two are Filipino nurses who work in palliative care facilities here and abroad, and two (20 clinical Instructors. Face to face consultation was done with three or more meetings depends on the availability of the SME. The first meeting discussed the informed consent and the objective of the study. Once they are willing to be a subject matter expert, they were given the topic and content based on the integrative review and ask for their suggestions and recommendation that need to add or omit in the content.

Content of the Mobile application for Filipino Caregivers

Based on the combined result of the integrative review and formative evaluation of the four SME in palliative care, the following are the list of content in palliative care that was included in the android system for Filipino Caregiver.

The content of palliative care software comes from the existing body of knowledge about palliative care from different sources. From printed books and online sources, articles, e-books, among others. Caregiver Booklet: A guide for a patient, family member and community caregivers by WHO (n.d), Palliative Care: Symptom management and end-of-life care: Integrated Management of Adolescent and Adult and Illness by WHO (2004), A Handbook of Palliative Care in Africa by African Palliative Care Association (2010) are the e-books that significantly contribute to the Palliative Awareness and Education, misconception and breaking the myth from the different website such as Medline (2019)

Caregivers’ skills were a pattern to the book of Zucker’s (2010) Essential book for Caregiver and Fundamental of Nursing by Kozier (2010). While Holistic Care in Psychological needs content comes from the book of Videbek (2017) Mental Health Nursing. The content of the book does not just copy the entire content of one source to another but need to consider many factors. The researcher considers the end-user some of the content especially content from the Nursing books and website are too technical or use medical jargon that only professionals can understand; that is why the content underwent an English critique to lessen this problem.

Design

Mobile app installation

Design is the process of planning and designing the system. Build a master plan that needs to follow to the next stage. The design is based on the first phase, which is the analysis phase, after identifying the content using the integrative review and the result from the formative evaluation. The researcher collaborates with the Information or system developer during the designing and developing stage. The designing period commences from June to July 2019. In this stage, budgeting and blueprint creation of the android application is part of this stage.

A virtual studio is a software of choice for the mobile application tool development. According to the system developer, the said software has the following advantage The backward compatibility was designed to cater to all android user’s older version 2011 to present, especially caregivers who owned low end to high-end price android owner without having an issue of compatibility because of continuously updating of the android system.

Figure 1 System Architecture of the mobile application Family Care

Figure 3 shows the architectural design of the whole system and how the android application work. The Home module or the patient information is the center of the android system as all the user input from the different module will reflect on the Home module such as the name of the patient, number of medications reminder, number of journal entry, number of health care contact number and latest vital signs. The FamCare android system home was designed to ensure that the end-user and health care provider view all and most recent information of patients upon login.

The SME in palliative care expenses was amounting worth 3,00 pesos worth of gift and food expenses during the formative analysis phase. These expenses are the cost for the food and gift as the researcher use of time during the consultation. The original budget for the SME in palliative care is 7,000 for the professional fee and gift pesos, but only four experts were consulted out of five, while one SME is a religious figure who refuses to accept gift and payment while the rest refuse to accept cash payment.

Aesthetic Design

During the designing phase, the end-user recommended an interface that can easily understood and user- friendly with minimizing assistance or none at all from the developer. The FamCare Mobile app interface was designed to easily navigate the content and its utilities by positioning the list of topic and utilities at the left side corner of the mobile app. FamCare mobile app on the Android system was designed to be minimalist. According to Hunter (2020), A minimalist design is simple, easy to understand and only contains necessary elements to remove any complexity in the app  Incorporating white space is also known as the negative space that does not have any colour. This blank space is essential for developing contrast, adding structure and focusing on the various design elements. FamCare background all over the mobile app may it be in the context of palliative care or utilities dominate white space background. this is why the FamCare mobile app uses minimal design to achieve this particular goal.

Development

Figure 2 Build. Gradle of the application

Figure above shows the build Gradle of the mobile app upon instalment. The minimum SDK version for the use is API 15 – Ice Cream Sandwich. This is based on a synced Gradle of the application. This means that the form is known to run on the minimum Android ICS. This build Gradle was used for technical evaluation during the formative evaluation. The mobile application on palliative care can run an operating system from Ice cream sandwich up to the latest Operating system of android.

Table 5 Mobile App Development progress

Table 5 shows the mobile app development progress or in technical term the system change log or history of development stage from the selection of the program used for the android system up to the last content. The development process is iterative and putting the design into reality. The researcher and the system developer started working on the development phase from July to November of 2019, adding each component into the system, adding and removing the parts that are not working within the system. The researcher and the developer meet two to three times a month or depend upon the need to test the system from basic errors and mechanics of the system, other means of communication was also utilized for clarification such as SMS, e-mail for the technicalities on both Health care field and Information technology; such as inquiry about the system or the content of the palliative care. Examining the content is not flicking through it – it is a systematic check on the accuracy of the material and the utility of the navigation.

Implementation

Implementation commenced last December 10 – 17, 2019, with three IT experts and fifteen end-users. Pilot testing defined as a type of Software Testing that validates a component of the mobile app or the entire system under a real-time working condition. It checks the primary functionality of the system before going into production. In Pilot testing, a carefully chosen group of end-users try the app under test and provide the feedback before the full deployment of the system. In other words, it means to conduct a rehearsal for the usability test that follows. Pilot Testing helps in the early detection of bugs in the System (Guru99, 2019).

Three experts in IT, test the android application in terms of Reliability, portability maintainability, and security using the modified MARS evaluation tool, while fifteen end-users were selected during the pilot testing of the android application in palliative care, purposive sampling and snowball technique were utilized in choosing the participants

Evaluation

Mobile application pilot test result from IT/technical expert

Table 6 Pilot test result from the technical expert/ IT

Table 6 shows the result of the pilot testing done by the three IT technical experts with the general weighted average of 3.85 with the verbal interpretation of excellent. Both Efficiency and Portability areas got the highest score of 4.00, or excellent while Usability got the lowest rating among the five areas with the score or 3.66 with the verbal interpretation of excellent.

The mobile app on palliative care has only 30 MB or 30,000 kilobytes size during the pilot testing and consume little space in terms of mobile memory consumption. According to pcloudy (2017), Android devices mostly run on phones with limited memory; a more significant memory consumption resulted in many leaks; the app runs out of available memory. This triggers more frequent Garbage Collector events that paralyze the device (Stop-the-world GC events) by almost stopping the rendering of UI and processing of events. This leads to an Out of Memory Exception and translates to the user as the app being unresponsive.

On the other hand, usability got the lowest score among the areas of pilot testing of the mobile application with the weighted mean of 3.66 with the verbal interpretation of excellent. The program is attractive and interesting; it motivates users to continue using the program got the 3.00 weighted mean and the lowest score among the question. The design of the mobile application approach is the minimalist design with a white background; this is to maintain the small memory consumption. The said result and recommendation were forwarded to the system developer to enhance the identified weakness of the app.

Summative Evaluation from the Caregiver end-user result

Table 7 Pilot test result from the Caregiver end user

Table 7 shows the result of the pilot test for the mobile app on palliative care evaluate by the family caregiver or the end-user, with an overall weighted mean of 3.73 with the verbal interpretation of “Excellent” based on the weighted scale range. Among the MARS evaluation tool, the areas of Information Quality got the highest weighted mean of 3.83 with the verbal interpretation of excellent. The content of the mobile application about palliative care awareness and education is the identified need during the integrative review in the analysis stage. Palliative care Application (app)can pave the way for promoting the patients’ knowledge and thus cultivating their quality of life, which, in turn, can deliver proper care at the end of the patients ‘life (Salimian et al., 2019).

Aesthetic got the lowest weighted mean among the areas with a score of 3.62 with a verbal interpretation of “excellent”. Adding graphics, choosing colours and deciding on fonts has a significant bearing on how engaging the course content is. The careful selection of these elements allows presenting the content in a manner that will appeal to the intended user (Strizver, 2019; Quigley, 2019). Question about the Layout: The placement of the controls and icons are well-thought-of got the weighted mean of 3.40 with a verbal interpretation of “excellent” and one of the recommendations of the end-user is to add back button function to return to the previous module or dashboard for easy access rather than use the main interface to access other parts of the system. he said recommendation will be included at the final version of the mobile application.

DISCUSSION

The aim of the study is to develop a mobile application on android devices with backward compatibility specifically designed for Filipino Caregiver caring for their love ones or relative with Palliative condition. The researcher adhered to the structured process of ADDIE model. Analysis, Design, Develop and Evaluate that follow the characteristics of developmental research design.to develop an output intended to the end user need.

During analysis phase fifteen literature were included in an integrative review to extract the identified needs of the caregiver in Palliative Care.  One on one interview with five (5) Caregivers were conducted for their suggestion and recommendation in terms of the information and utilities that were included within the mobile app. Four nursing experts in palliative care were consulted for the evaluation of the analysis phase.

The design stage is where the author collaborated with SME IT experts to design the mobile app based from the drawn conclusion in the previous phase. Architectural design was done during this phase and became the blueprint of the next stage which is the Development stage. It is where the developer and the researcher created a prototype mobile app that will run in any android device. A total of 11 tests were done to evaluate the system for any errors and lags from July to December 2019 before the pilot test.

Purposive sampling was used to select the end user during the implementation stage. Fifteen (15) Caregivers and three (3) IT experts participated during implementation for a week last December 2019, and evaluated the said output using the Modified and adapted MARS based from the ISO 9126 known as Software Quality characteristics. The result of the evaluation of the technical expert has a GWA of 3.85 while the end- users have a GWA of 3.73. A total of 30 megabytes or 30,000 kilobytes is the file size of the mobile app upon download in APK format ready to install the system for android smartphone devices only. Four themes emerged from the data analysis during integrative review that consists of the needs of the caregiver, 1. Palliative Care Awareness and Education, 2.  Continuity of Care, 3. Holistic Care 3, 4. Open communication to the palliative health care team. Interviewed with the caregiver suggest the need of the following utilities vital signs monitoring, record keeping, pain management, medication reminder.

A virtual studio is computer software of choice by the system developer for its functionality and backward compatibility during the design and develops stage of the mobile application known as FamCare. Aesthetic, expenses, target end-user time and file size are the factors considered to shift the output from hybrid mobile app to mobile app dedicated for android mobile devices user only as the one limitation of the mobile app

Pilot test was done last December 2019 with a total of seven days or 1 week from December 1- December 17 with fifteen caregiver and three technical experts in Information technology is considered necessary and mandatory. Modified and adapted survey was utilized using MARS (Mobile App Rating Scale) with verbal interpretation of excellent in both end user. Improvement was done to the mobile app based from lowest score such as Usability, Aesthetic and add other features based from the comments and suggestion of the end – user and was included in the final output such as back button and easy navigation, End- user Agreement for the protection of the end-user and the developer.

Mobile app can be a potent alternative for caregivers of patients on palliative care as reference for caregiving knowledge and skills as well as a tool for documentation used and available for both the caregiver and the health care Team attending to the patient. The app has the potential for upgrade and updates

The study recommended the following based from the result of the study such as 1. Strengthen the palliative awareness program in the community. 2. Make known the available resources for palliative care program. 3. Increase social support and group support for palliative care. 4 Translate the content from a different dialect in the Philippines such as Tagalog, Cebuano, Ilocano. 5. Additional content in the holistic care that discusses culturally sensitive care for Filipino people, 6. Test for the quasi-experimental studies to measure the effectiveness of the mobile application system 7. Enhance the aesthetic and layout or overall design and background of the mobile application to enhance learner engagement on the mobile app. 8. Include the suggestion and recommendation in terms of more content, usability, utilities in the final version of the mobile app. 9. Expand the palliative care awareness and education content that focuses on children and last develop a hybrid application that can run on both IOS and Android OS smartphones that will cater to all smartphone users.

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 CURRICULUM VITAE

Dr. Winifredo E. Licop, R.N.

Address           E. Aguinaldo Highway Brgy. San Jose Tagaytay City

 Office no:       (046) 860- 2301 loc. 106

Contact No:     09222586235

E-mail add       rhedlicop@gmail.com

Educational Background

PhD in Nursing Education major in Leadership and Management

St. Paul University Manila

May 2020

Master of Arts in Nursing Major in Nursing Administration

The Philippine Women’s University

June 2016

Bachelor of Science in Nursing

Luna Goco Colleges

2005

Highschool

Abada College

1997

Elementary

Sta Rita Elementary School

1994

National Licensure Examination/Eligibility

Qualification Certification

Research And Publication (for the last five years Only.)

Professional Organization

Community Services (for the last five years Only)

Achievement And Awards

Personal Information

Date of Birth   :           May 14, 1981

Religion                      : Roman Catholic

Nationality                  : Filipino

Civil Status                 : Single

Heights                        :5’7”

Talents                        : Singing

Hobbies                       : Reading books and listening to Audiobook