The Effect of a Mobile Health Application Developed Based on Transformative Learning Theory on Grief Reaction and...

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.

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).

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).

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.

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.