uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Adherence to Report and Patient Perception of an Interactive App for Managing Symptoms During Radiotherapy for Prostate Cancer: Descriptive Study of Logged and Interview Data.
Karolinska Institutet.ORCID iD: 0000-0001-6185-9618
Show others and affiliations
2017 (English)In: JMIR Cancer, ISSN 2369-1999, Vol. 3, no 2, article id e18Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients undergoing radiotherapy for prostate cancer experience symptoms related to both the cancer itself and its treatment, and it is evident that patients with prostate cancer have unmet supportive care needs related to their disease. Over the past decade, there has been an increase in the amount of research within the field of mobile health and the use of apps as tools for managing illness. The main challenge is to develop a mobile technology to its full potential of being interactive in real time. The interactive app Interaktor, which aims to identify and manage symptoms in real time includes (1) a function for patients' assessment of the occurrence, frequency, and distress of symptoms; (2) a connection to a monitoring Web interface; (3) a risk assessment model that sends alerts via text message to health care providers; (4) continuous access to evidence-based self-care advice and links to relevant websites for more information; and (5) graphs for the patients and health care providers to view the history of symptom reporting.

OBJECTIVE: The aim of the study was to investigate user behavior, adherence to reporting, and the patients' experiences of using Interaktor during radiotherapy for localized advanced prostate cancer.

METHODS: The patients were instructed to report daily during the time of treatment and then for an additional 3 weeks. Logged data from patients' use of the app were analyzed with descriptive statistics. Interview data about experiences of using the app were analyzed with content analysis.

RESULTS: A total of 66 patients participated in the study. Logged data showed that adherence to daily reporting of symptoms was high (87%). The patients used all the symptoms included in the app. Of the reports, 15.6% generated alerts to the health care providers. Overall, the patients found that it was easy and not particularly time-consuming to send a daily report, and many described it as becoming a routine. Reporting symptoms facilitated reflection on their symptoms and gave them a sense of security. Few technological problems were reported.

CONCLUSIONS: The use of Interaktor increased patients' sense of security and their reflections on their own well-being and thereby served as a supportive tool for the self-management of symptoms during treatment of prostate cancer. Some further development of the app's content might be beneficial for future use.

Place, publisher, year, edition, pages
2017. Vol. 3, no 2, article id e18
Keywords [en]
mHealth, mobile apps, prostate cancer, symptom assessment
National Category
Nursing
Research subject
Oncology
Identifiers
URN: urn:nbn:se:uu:diva-394312DOI: 10.2196/cancer.7599PubMedID: 29089290OAI: oai:DiVA.org:uu-394312DiVA, id: diva2:1358547
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2019-10-10
In thesis
1. Patient experiences and the influence on health literacy and self-care using mHealth to manage symptoms during radiotherapy for prostate cancer
Open this publication in new window or tab >>Patient experiences and the influence on health literacy and self-care using mHealth to manage symptoms during radiotherapy for prostate cancer
2019 (English)Licentiate thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2019
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-394313 (URN)978-91-7831-300-6 (ISBN)
Presentation
2019-02-22, H2 Grön, Alfred Nobels allé 23, Huddinge, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2019-10-08 Created: 2019-10-07 Last updated: 2019-10-11Bibliographically approved
2. Patient experiences and the influence on health literacy and self-care using mHealth to manage symptoms during radiotherapy for prostate cancer
Open this publication in new window or tab >>Patient experiences and the influence on health literacy and self-care using mHealth to manage symptoms during radiotherapy for prostate cancer
2019 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Prostate cancer is a diagnosis that can affect the men’s quality of life both due to the symptoms related to the disease and the treatment the men receive. Treatment with radiotherapy for prostate cancer in Sweden takes place at outpatient clinics, where the patient visits daily for radiotherapy and then returns home. Most of the time the patient is experiencing the symptoms and side-effects at home without health-care professionals easily accessible. To facilitate person-centered care and improve clinical management when hospital care is moving to outpatient care, the app (Interaktor) for smartphones and tablets was developed. Using patient-reported outcomes (PRO), the app was intended to identify symptoms early, assess them in real time, and provide symptom-management support during radiotherapy for prostate cancer.   

Aims: The overall objective of the intervention described in this thesis, was to facilitate symptom management for patients with prostate cancer assisted with an interactive app during radiotherapy treatment.

Methods:  The two studies included in this thesis come from one trial. A descriptive investigation evaluated the intervention group’s use and perception of the using the app, and a quasi-experimental investigation compared those using the app with a historical control group not using the app to evaluate the effect on health literacy and self-care agency. The patients (n=130) were recruited consecutively from two university hospitals in Sweden between April 2012 and October 2013. The intervention group (n=66) had access to the app during 5-7 weeks of radiotherapy and three additional weeks. The intervention group’s use of the app was logged. Health literacy was measured  using the Swedish Functional Health Literacy Scale (FHL) and the Swedish Communicative and Critical Health Literacy Scale (CCHL), and the Appraisal of Self-care Agency scale, version A (patient’s assessment) (ASA-A) for self-care agency. Transcribed notes from phone or face-to-face interviews about participants’ experiences of using and reporting in the app were analyzed.

Results: In the intervention group using the app, adherence to daily reports was 87% (Md 92%, 16-100%), and generated 3,536 reports. All listed symptoms were used, where the most common being: urinary urgency, fatigue, hot flushes, and difficulties in urinating. A total of 1,566 alerts were generated, with 1/3 being severe (red alert). The app was reported in the interviews as easy to use, the reporting became routine; to report facilitated reflection over symptoms, the symptoms were relevant although some found that nuancing severity was hard. Using the app was reported as providing a sense of security. Substantial portions of the participants showed inadequate FHL and CCHL at baseline for both groups. CCHL changed significantly for the intervention group from baseline to three months after ended treatment (p = 0.050). Functional health literacy and self-care agency did not reveal any statistically significant differences over time for either group. 

Conclusions: The conclusions to draw from this thesis are that an mHealth intervention, the app Interaktor, served as a supportive tool for the patients to assess and manage symptoms during the radiotherapy for prostate cancer. The intervention provided the patients with a sense of safety, increased awareness of own well-being and a significant improvement in communicative and critical health literacy was found. 

The portions of inadequate levels of health literacy reported leave substantial groups of patients more vulnerable in assessing and managing symptoms when treated with radiotherapy for prostate cancer. Although health literacy levels include notable portions of patients in this study that have inadequate levels of both functional and communicative and critical health literacy, the adherence of using the app was high.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institet, 2019
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-394927 (URN)978-91-7831-300-6 (ISBN)
Presentation
2019-02-22, Hörsal 2 Grön, Alfred Nobels allé 23, Huddinge, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2019-10-25 Created: 2019-10-10 Last updated: 2019-10-25Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Christiansen, Mats
Nursing

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 12 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf