| Author: | Shi, Nuo |
| Title: | The effects of a nurse-led mHealth program for symptom self-management of breast cancer patients undergoing chemotherapy in Shanghai : a randomized controlled pilot study |
| Advisors: | Wong, Arkers (SN) Wong, Frances (SN) |
| Degree: | DHSc |
| Year: | 2023 |
| Subject: | Mobile apps Breast -- Cancer -- Patients Nurse and patient Telecommunication in medicine Hong Kong Polytechnic University -- Dissertations |
| Department: | Faculty of Health and Social Sciences |
| Pages: | xxvi, 396 pages : color illustrations |
| Language: | English |
| Abstract: | Background Due to the closure of clinics and the lack of opportunities in meeting healthcare professionals, breast cancer (BC) patients undergoing chemotherapy, like other chronic disease patients, encountered more challenges than usual during the COVID-19 pandemic. To tackle these challenges, there was an increase in the number of mHealth programs offered to this group of patients, but their rate of adherence to app usage has remained low. Aims The objectives of this pilot study were: (1) to examine the feasibility of the study, (2) to determine the preliminary effects of this program on self-efficacy (primary outcome), quality of life (QoL), symptom burden, and healthcare utilization in patients with BC who are receiving chemotherapy, and (3) to explore the perceptions of the participants and nurses of engagement with this program. Methods In this single-blinded randomized controlled pilot trial, BC patients who commenced chemotherapy were recruited in a university-affiliated hospital. Ninety-six participants were randomly allocated to either an mChemotherapy group (n=48) or a control group (n=48). The intervention group engaged in a six-week self-regulation activity and received nurse-led social support via the mChemotherapy app. The mChemotherapy app was composed of six components: self-monitoring, consultation, alerts, reminders, my prescriptions, and knowledge base. The control group received routine care plus a placebo app. The data analysis was conducted following the Intention-to-Treat principle. The Generalized Estimating Equation (GEE) was adopted. Thematic analysis was utilized to analyze and categorize the transcripts from the focus group interviews. Data collection was conducted at baseline, week 3, and week 6. Results A total of 96 participants were enrolled from 16 May to 23 August 2022.. Six of them withdrew from the study intervention (6.3%). The average rate of adherence to app usage increased from 4.8% to 51.2%, and the average score for the perceived usability of the app was 83.75. In terms of both the total and sub-scale self-efficacy scores, no significant between-group and interaction effects were noted in the intervention and control groups over the six-week period. At week 6, the mChemotherapy group reported a significantly lower symptom burden (95% CI [0.31 to 15.75], p=.042) and significantly better physical well-being than the controls (95% CI [0.40 to 5.80], p=.024). The participants exhibited a positive attitude towards the experience of using the app and expressed their intention to use it to deal with chemotherapy-related symptoms. A number of barriers (such as older age) and facilitators (social support and native high-adherence) to adherence to app usage were identified from the group interviews. Conclusions This six-week nurse-led self-management program via an mHealth app was found to be feasible to improve the adherence rate of app usage. This program showed preliminary effectiveness at improving the QoL and symptom burden of BC patients during chemotherapy, although there may not have been significant between-group and group*time effects on self-efficacy. Nurses can utilize this mChemotherapy program to facilitate patient self-management of symptoms during chemotherapy. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 7295.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 19.17 MB | Adobe PDF | View/Open |
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