Development of the Web App “Psychosocial Rehabilitation Project App”: Experience Report

1. Introduction

There are approximately more than 10 thousand applications ( apps) developed on mental health in the world [1,2,3]. These are mostly related to cognitive-behavioral therapy techniques to collaborate in the treatment of anxiety and depression in psychiatric patients and few developed to support psychosocial rehabilitation [1,4,5,6,7].

It has been proven that apps based on psychosocial rehabilitation can contribute to the development of autonomy and social functionality, as well as improving the quality of life of psychiatric patients [7]. But applying the Psychosocial Rehabilitation (RP) theory in the practice of mental health professionals is something challenging, as it is complex in relation to its theory, which has also been systematized by the Psychosocial Rehabilitation Project (PRP) [8,9,10,11,12,13,14].

The challenge of applying psychosocial rehabilitation by mental health professionals is amplified by barriers related to the configuration of the Psychosocial Care Network (RAPS) belonging to the Brazilian public health system (SUS), which undermines the process of psychosocial rehabilitation of psychiatric patients, such as the fragmentation of care, disarticulation of health actions mental health, insufficient and unattended communication between mental health professionals [8,10,11,15,16,17].

Therefore, an application (app) for the construction of psychosocial rehabilitation projects, is identified as a technological tool that can computerize and streamline the psychosocial rehabilitation project, optimizing interprofessional communication and integrating RAPS during planning, evaluation, construction, monitoring/monitoring, and (re)evaluation of psychosocial rehabilitation projects carried out by mental health professionals [1,8,18,19].

Therefore, in previous investigations the authors of this work will carry out the theoretical foundation that justifies the development of an app for the construction of psychosocial rehabilitation projects with their therapeutic purpose in supporting mental health professionals in planning, evaluation, construction, monitoring/monitoring, monitoring of psychosocial rehabilitation projects in your work area [20].

And, later, they will build their prototype using Marvel software, called Prototype of the web app “Project Psychosocial Rehabilitation App” – PWAPPR (see link: https://marvelapp.com/prototype/31b02f26), which was based on the prototype requirements obtained through the integrative review of literature and the conduct of focus group interviews with professionals of mental health of the Psychosocial Care Center, also considering suggestions received from the perfection carried out by health professionals during the validation of its content and appearance [21].

The PWAPPR presents 27 screens that graphically represent how the login resources, registration of the mental health professional, presentation of the structure for the construction of a psychosocial rehabilitation project, evaluation, user support and credit of the web app “Psychosocial Rehabilitation Project App” would be. Its content and appearance validation (N=15 mental health professionals) resulted in Content Validity Indexes (CVIs) for objectives, appearance, structure and organization, and relevance by more than 0.90 [21].

Therefore, the general objective of this work is to report the development of the web app “App Project for Psychosocial Rehabilitation”, which puts the development of an app for the construction of mental health rehabilitation projects, specifically in the context of Brazilian public health, if it proves promising as support in the management and care of health professionals mental health to psychiatric patients [5,7,21,22,23,24,25,26].

2. Method

This investigation reports the development of the web app “Project Psychosocial Rehabilitation App”, supporting the experience reporting method [27] and the multimethod approach [28,29,30], following the recommendations of the SRQR [31,32]. The investigation was approved by the Ethics and Research Committee of the School of Nursing of the University of São Paulo (EERP-USP), through the Dictamen del n. 6,605,152 of January 3, 2024 (CAAE: 75372623.5.0000.5393).

Complementing the experience reporting method, the investigation uses the Participant Observation (OP) technique to systematize the data collection. La OP, as suggested by Correia (2009) [33], França et al. (2022) [34] and Mónico et al. (2017) [35], it is a valuable tool to observe, understand and interact with participants during the development and validation of the web app “Project Psychosocial Rehabilitation App” . The records of these observations were carried out in an investigation diary, in the possession of the main investigator, in accordance with the recommendations of Kroef, Gavillon and Ramm (2020) [36].

Therefore, the web app “Project Psychosocial Rehabilitation App” was developed by Technology and Information (TIC) professionals, based on guidelines adapted from the APA (2021) [37] together with recommendations from the Martinez-Martin study; Greely; Cho (2021) [38], described Box 1, along with adjustments and changes for improvements made in the prototype, the PWAPPR, which was carried out in the Marvel software, as presented in a previously published study [21]:

In this way, in virtual meetings and video calls on Google Meet and text messages on Whatsapp, the main researcher and ICT professionals will discuss, in a collaborative and highly participatory context, with the objective of creating, the PWAPPR, aesthetically pleasing, simple, coherent and adapted to the technological support of a mental health application, without forgetting the recommendations defined in it Box 1. Which are displayed lower, in Box 2:

3. Results

A report of the experience in the development of the web app “Psychosocial Rehabilitation Project App” is presented.

3.1. Starting with the Adaptation of the Web App Prototype “Psychosocial Rehabilitation Project App”

The web app “Psychosocial Rehabilitation Project App” appears as an incipient technological project, born with the desire to help mental health professionals in the construction of psychosocial rehabilitation projects in a dynamic, easy way, retrieving information and, mainly, with the ability to optimize interprofessional communication around a care network structured, so that psychosocial rehabilitation is carried out in a real way.

In this context, the web app is understood as an application developed with the lowest costs of incipient research projects, in comparison with applications developed for the Android or iOS operating systems, being a resource accessible through a link without hardware restrictions or the user’s mobile operating system.

(...) The last applications that people have done (...) have been in this line of thinking, as “projects” are involved without financial cumulus, they are easier to achieve when it comes to maintenance costs. (...) And on the web app, you can have them available in one place, where the person accesses via a link, but from her cell phone it appears... that she is accessing an application (Technological Development Supervisor).

For the development of the web app “Project Psychosocial Rehabilitation App”, it was necessary, in addition to the researcher understanding the web app, to explain and “translate” in a collaborative, informal and cordial language, the PWAPPR to its developers, to clarify their doubts regarding this prototype and the functionalities demonstrated.

- This is stupid. When “inserting the new psychosocial rehabilitation project”, are the psychosocial rehabilitation projects for patients? (Developer 1). - Yes, my patients. But in the sense (...) that, for example, when carrying out a psychosocial rehabilitation project, by “inserting the new psychosocial rehabilitation project” (...), the mental health professional is inserting this project that is about the patient, and the idea is that it will appear, the patient, his name and the project that is in construction or completed (Principal Researcher). - Ya see! So does the patient represent a psychosocial rehabilitation project? (Developer 1). - This is a psychosocial rehabilitation project for each patient (…) ... (Principal Researcher).

These conversations oriented towards the understanding of the PAPRP, and subsequently, the development of the web app “App Proyecto Rehabilitation Psychosocial” were marked by collaborative work and interactions with the exchange of knowledge, professional experiences, and mutual learning between the main researcher and developers, in order to connect the theory and practice of mental health to the technological resources and functions of the web app “Psychosocial Rehabilitation Project App”, with explanations of the resources and technological elements by the developers, and how the psychosocial rehabilitation project is operationalized/conceptualized by the researcher.

- This small screen here, (called the name of the main researcher), is called Drawer. What is the Drawer? The Drawer is when the person or healthcare professional clicks on their photo. Then this screen appears, slides vertically and the user profile information appears (...). (Developer 1).

(…)

- (...) (The) Psychosocial Rehabilitation Project, is not limited to what is happening, but is also macro, in establishing goals and interventions for psychosocial rehabilitation and quality of life of the patient. (…) ... (Principal Researcher).

However, there are moments of difficulties in making the app ’s functionalities useful and coherent with the needs of mental health professionals presented by the main researcher, such as conflicting questions about when to require the CPF (Brazilian person identification document) as a requirement for the professional registration of psychiatric patients.

- You probably wouldn’t link the project, because you didn’t have anyone registered yet, but you would link the patients (…) together with the healthcare professional (Developer 1). - It’s worth it, but here, how, for example, if you haven’t had the first contact with the patient, who will be the first person to enter this CPF? (…), and then we may have a problem of not getting the registration... (Principal Researcher). - You can leave that there. To (…) then you do it, no?, maybe… (Developer 2).

The meetings and meetings of clarification and understanding of the PWAPPR culminated in the definition of the appearance and functioning requirements for the development of the web app “Project Psychosocial Rehabilitation App”, structured in Box 3, but required the provision of the main researcher to allow its changes and refinement, when it was important judgment by developers.

(...) - So that we can talk about the requirements... (...) then (...) about the design of the application. If we change the design, but we keep all the features, is it fine? (Developer 1). (…) - No problem! (Principal Researcher). - Perfect, then. So, at Home we can see it as a presentation of the app (...). (...). This button here from Start, would it be like a beginning for the videos? - (Developer 1). - This part was just to show (…) (give) the Start... Now I’m thinking that it doesn’t make sense… (…). Let’s go back to home (that) (…) fell very good. Let’s go solo to cut. Let’s make a video alone. Because then we don’t have much information… (…) (Principal Researcher).

The requirements (Board 3) were synthesized didactically between three major elements: screens, functions and data base, structuring the web app “Psychosocial Rehabilitation Project App”. With the objective of integrating the construction of psychosocial rehabilitation projects by mental health professionals.

- (...) This is a psychosocial rehabilitation project for each patient, (...), so each patient will have a psychosocial rehabilitation project, (...), which (...) (has) this structure (...): patient data, situational diagnosis, goals, interventions, pacts, case study agenda and evaluation (Principal Researcher). - (Y) (...) the (...) evolution is (...) an important category because I am going to be able, (...) to refill all of it (...), it is as if this evolution was a general record of the follow-up of this patient... (Developer 1).

(…)

-(...) So here we have a compartment of patient information, as if we were generating reports. This format, do you think it would be in PDF? How do you imagine it? (Developer 1). - I had imagined a link opening (via) the internet or it could be a PDF, there was no problem (Principal Researcher). - Of course, I understand (Developer 1). - This search is to (...) enter the patient direction, which are the psychiatric patient support network devices, (...)... All according to your PRP and programmed and managed by the mental health professional (Principal Researcher).

Next, Box 3 is presented, which details the functionalities and appearance of the web app “Psychosocial Rehabilitation Project App”. Meeting the essential requirements for its construction and development. Integrating the construction and management of psychosocial rehabilitation projects by mental health professionals, with a focus on psychosocial rehabilitation.

Therefore, the developers present the instructional design for the development of the web app “Project Psychosocial Rehabilitation App” (Figure 1), which adjusts to your appearance and functionality requirements (Box 3), encompassing the changes in perfection and improvement made in meetings and interactions/meetings virtual.

This design guides and facilitates expert technicians in the development of the web app “Psychosocial Rehabilitation Project App”, serving as a reference for the creation of its screens and technological resources, and reducing the development time of this application.

-(...) Here is a high-fidelity prototype. So, you can use it as if it were really the application. What you can’t, for example, in a field, you can’t write on it, precisely because it’s a prototype, you know?, it doesn’t have that type of function. For example, profile, go out, you can see the flow, how it is, (...) here we have the shadow of things, we have the cards (Figure 7). (...) We cream the screen, we cream its function. And here, for example, this is a screen that is under construction, now we are at the beginning, you take so many details of this, we will start working first (...) (Developer 1).

Based on the instructional design for developing the web app “App project for psychosocial rehabilitation” presented previously, which facilitated the construction of the web app, the development of the web app “Psychosocial Rehabilitation Project App” was carried out, using the most suitable technologies for its execution. In this sense, the continuation will detail the technological characteristics that support its functionality and efficiency.

3.2. Getting to Know The Web App “Psychosocial Rehabilitation Project App”

The application “Psychosocial Rehabilitation Project App” was developed using Flutter, a Google framework that allows the creation of native applications for multiple platforms from a single code, standing out for generating modern, high-performance interfaces. The programming language used was Dart, which is distinguished by its simplicity, efficiency and support for asynchronous programming, guaranteeing fluidity and performance. Data storage is carried out using Firebase, specifically using Cloud Firestore, a non-relational database that offers flexibility and scalability [22,26].

El Storage is used to store files, such as photos and documents, directly in the cloud. Authentication takes care of the login and user registration, as well as email/passwords. El Functions allows you to automate tasks, such as sending emails automatically when a user registers. App Check helps protect the application against unauthorized access, ensuring greater security and Hosting serves to host websites and applications, making them available online quickly.

Furthermore, Firebase provides additional features such as user authentication and notification sending. The combination of these technologies allows the development of an efficient, safe and easy to maintain solution, satisfying the dynamic needs of the web app “Psychosocial Rehabilitation Project App” allowing the construction and management of psychosocial rehabilitation projects by mental health professionals during the psychosocial rehabilitation process in their context’s labors [22,26].

Therefore, the screens of the web app “Psychosocial Rehabilitation Project App”, which in accordance with the appearance, functionality and database requirements, demonstrated in box 3, have a screen for mental health professional login (e-mail and password), “Resource Bar” for the function: “Home”, “Projects”, “Evolution” and “Resources”.

“Home”: Help tool, Video on psychosocial rehabilitation project and Psychosocial rehabilitation advice.

“Projects”: Function to search for projects by patient name and button for “Add Proyecto” (New project).

“Evolution”: Screen that demonstrates the projects by photos, by clicking on the professional you can see the evolutions over time and add new developments.

“Resources”: Edit Profile, Help and Support, Term of Use, Technical Information, Developments and Thanks.

In particular, the “Help and Support” resource, the professional can access references on mental health, legislation, search for mental health services through the patient’s direction, record productivity with codes of procedures available and standardized by the Brazilian Ministry of Health [53,54].

Below are the screens and functionalities of the web application. Due to trade name/commercial reasons, it has been renamed “App Reabilita Psicossocial” (formerly “Psychosocial Rehabilitation Project App” (Figure 2).

4. Discussion

App’s due to their natural omnipresent nature in the daily lives of users [23], must be easy to use, flexible and have simple and intuitive interfaces, adapting to the user’s professional or social environment [55]. Web apps, in particular, are recommended for their compatibility with different operating systems, accessible through a link [25].

Developing a web app to optimize the functions of mental health professionals can increase acceptance, commitment, use and satisfaction with its use and usability [23,24]. Studies highlight the importance of the interactive participation of the main researcher, as a means of unity between users and developers [22,23,56,57], demanding flexibility and interpersonal skills, co-design, commitment and collaboration [58].

The participation of mental health professionals as co-designers, under the leadership of the main researcher, guarantees that the app in development is aligned with the desired therapeutic purpose [59], promoting an environment of continuous collaboration and interdisciplinary work [60].

The translation of the needs of mental health professionals into an app, such as the web app “Psychosocial Rehabilitation Project App”, is a complex challenge [58]. The Principal Researcher must prioritize horizontal dialogue, collaboration, understanding and empathy, to be understood by the developers. These, in turn, require high unconditional understanding, empathy and active listening, to minimize “failures in translation”.

It is crucial to understand the justifying theory and purpose of the web app “Psychosocial Rehabilitation Project App”: the construction and direction of the psychosocial rehabilitation project for mental health professionals in their work context, in a dynamic and effective way [8,13,61]. This guarantees long-term user acceptability, usability and commitment [23,24].

The development of a web app in mental health involves human interaction aimed at “real life”, guided by practical rationality and permeated by socio-technical aspects such as cordial dialogue and collaborative attitudes [61]. The data collection technique used, participant observation not systematized, enabled the freedom to observe, collaborate and actively participate in the development of the web app [33,34,35], motivated to contribute with theoretical and practical knowledge, and professional experiences, as well. how to learn from technology professionals [8,13,27].

The process of mutual and collaborative learning, although rewarding, is challenging, especially for the Principal Researcher, when experiencing contact with resources and technological tools that are rarely addressed in their professional training.

The creation of the prototype of the app, followed by its development by technology professionals, demonstrates the increasing participation and collaboration of researchers with training in mental health, contributing to the contextualization and applicability of the app to professional practice [26], and aligning it with its purpose, as it construction and management of psychosocial rehabilitation projects by mental health professionals [59].

The perfection changes made in the web app “Psychosocial Rehabilitation Project App” focused on the appearance, layout and organization, seeking a coherent app with technological support, and little content, which is linked to the theoretical structure of the psychosocial rehabilitation project [8,13,24].

Studies corroborate the need for modifications to the prototype, covering screen layout, functional requirements [26], content, layout/aesthetics/design, appearance and functionalities [23,62]. Other studies focused on content for theoretical support, pleasant appearance with colorful icons [24], accessibility and applicability to the professional environment of mental health workers [22].

The studies also confirm that changes in the prototype are necessary throughout the development process, whenever researchers and developers consider it important [26].

The web app “Psychosocial Rehabilitation Project App” is aligned with the needs of mental health professionals with resources that facilitate and support clinical decision-making, streamlining diagnosis, patient registration, information storage and data storage [25]. However, the author warns about the importance of data privacy [25], corroborated by other studies that emphasize responsibility for data security [1,24,40,63,64,65].

5. Conclusion

The development of the web app “Psychosocial Rehabilitation Project App” represents a significant contribution to the field of mental health, offering a technological tool designed to optimize the construction and management of psychosocial rehabilitation projects by mental health professionals. This process was characterized by a collaborative approach, where the main researcher acted as a bridge between the practical needs of mental health professionals during the management and construction of psychosocial rehabilitation projects, and the technical capabilities of technology professionals.

Throughout the investigation, horizontal dialogue and mutual empathy were crucial to translating the complexity of the psychosocial rehabilitation project into coherent and usable functionalities within the professional environment. The adjustments made in the instructional design of development, as well as in its functionalities and technological resources, specifically in the web app “Psychosocial Rehabilitation Project App”, highlight the importance of adaptability during all stages of development, ensuring that the web app reflects both the technical demands and the theoretical and therapeutic purposes aligned with methodological support for the psychosocial rehabilitation project.

The active participation of the Principal Researcher allowed for a synergy between theory and practice, which ensured that the web app “Psychosocial Rehabilitation Project App” on the ground was functional, but also aligned with the real needs of mental health professionals during the psychosocial rehabilitation process. This reinforces certain previous findings in literature, which highlight how co-design and interdisciplinary collaboration increase acceptance, commitment and usability of mental health technologies.

Furthermore, the web app “Psychosocial Rehabilitation Project App”, which can be accessed from any device with an internet connection, presents itself as an inclusive and versatile technological solution, suitable for the work context of mental health professionals in the continuous process of systematizing the psychosocial rehabilitation project.

On the other hand, concerns regarding the security and privacy of patient data emerge as fundamental challenges that demand constant attention from researchers and technology professionals, and especially from mental health professionals who in the future will be users of the web app “Psychosocial Rehabilitation Project App”.

A limitation of this work was that, despite the development process having been very collaborative, taking into account the needs of mental health professionals, a field implementation was not carried out that allowed us to observe the effectiveness, usability and continued acceptance of the web app “Psychosocial Rehabilitation Project App”. This gap suggests the need for future studies that involve its implementation in mental health work contexts specifically in relation to psychosocial rehabilitation to evaluate its effectiveness over a short and long term.

Finally, the “Psychosocial Rehabilitation Project App” on the ground offers an innovative and applicable tool in the professional environment, which also exemplifies how interdisciplinary collaboration, and the integration of knowledge can overcome the challenges associated with the development of technologies in mental health. This study, therefore, opens new possibilities for future investigations that continue to prioritize empathy, adaptability and ethics in technological products with innovative potential and aimed at improving the quality of life of patients and professional practice in mental health.