JMIR Publications

ABSTRACT

Background:

Moyamoya disease (MMD) is a known progressive obstructive cerebrovascular disorder. Monitoring and managing mood and stress are critical for patients with MMD as it is related to clinical outcomes. The ecological momentary assessment (EMA) method is a longitudinal study design by which time-varying variables can be assessed sensitively in a natural environment. The EMA method may help elucidate momentary fluctuations and changes in psychological dimensions such as mood and stress over time.

Objective:

This study aimed to describe and predict relationships in between-person differences and within-person fluctuation of mood and stress using the EMA method combined with a mobile phone application.

Methods:

Participants older than 18 years were recruited from a tertiary hospital in Seoul, Korea between July 2018 and January 2019. The PsyMate scale for negative affect (NA) and positive affect (PA) and the Trier Inventory for Chronic Stress Scale were uploaded on a patient’s mobile phone. Using a mobile application, data were collected four times a day for 7 days. Pearson’s correlations and mixed modelling were used to predict relationships between repeatedly measured variables at both the between-person and within-person levels.

Results:

: The mean age of the 93 participants was 40.59 (±10.06) years; 66 (71.0%) were female, and 71 (76.3%) were married. Participants provided 1,929 (74.08%) responses out of a possible 2,604. The mean momentary NA and PA values were 2.15 (±1.12) and 4.70 (±1.31) out of 7, respectively. The momentary stress value was 2.03 (±.68) out of 5. Momentary NA, PA, and stress were inter-correlated (P< .01) and varied over time in relation to momentary variables. Common factors associated with momentary NA and PA at the within-person and between-person levels were “being alone,” “eating/drinking,” “resting,” and “being at the hospital.” Common predictors associated with momentary stress at both levels were “resting,” “during the weekend,” “at the office,” and “time of the day.”

Conclusions:

The EMA method using a mobile phone application demonstrated its ability to capture changes of mood and stress in various environmental contexts in patients with MMD. The results could provide baseline information for developing interventions to manage the negative mood and stress of patients with MMD based on the identified predictors affecting mood and stress at two different levels.