| 1. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Symptoms and self-care strategies during and six months after radiotherapy for prostate cancer : Scoping the perspectives of patients, professionals and literature
- 2016
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 21, s. 139-145
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Under-diagnosed and uncontrolled symptoms in patients with prostate cancer during radiotherapy can have a negative impact on the individual's quality of life. An opportunity for patients to report their symptoms systematically, communicate these symptoms to cancer nurses and to receive self-care advice via an application in an Information and Communication Technology-platform could overcome this risk. The content in the application must precisely capture symptoms that are significant to both patients and health care professionals. Therefore, the aim of the study was to map and describe symptoms and self-care strategies identified by patients with prostate cancer undergoing radiotherapy, by health care professionals caring for these patients, and in the literature.Methods: The study combines data from interviews with patients (n ¼ 8) and health care professionals (n ¼ 10) and a scoping review of the literature (n ¼ 26) focusing on the period during and up to 6 months after radiotherapy.Results: There was a concordance between the patients, health care professionals, and the literature on symptoms during and after radiotherapy. Urinary symptoms, bowel problems, pain, sexual problems, fatigue, anxiety, depression, cognitive impairment and irregular symptoms were commonly described during the initial treatment period. Self-care strategies were rarely described in all three of the sources.Conclusions: The results show which symptoms to regularly assess using an Information and Communication Technology-platform for patients with newly-diagnosed prostate cancer during radiotherapy. The next step is to evaluate the efficacy of using the platform and the accuracy of the selected symptoms and self-care advice included in a smartphone application.
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| 2. |
- Sundberg, Kay, et al.
(författare)
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Feasibility of an interactive ICT-platform for early assessment and management of patient-reported symptoms during radiotherapy for prostate cancer
- 2015
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 19:5, s. 523-528
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to test the feasibility and acceptability of an Information and Communication Technology platform for assessing and managing patient reported symptoms during radiotherapy for prostate cancer.Methods: In cooperation with a health management company, using a patient experience co-design, we developed the platform operated by an interactive application for reporting and managing symptoms in real time. Nine patients diagnosed with prostate cancer and receiving radiotherapy were recruited from two university hospitals in Sweden. Evidence-based symptoms and related self-care advice specific to prostate cancer were implemented in the application based on a literature review and interviews with patients and health care professionals. In the test of the platform the patients reported symptoms, via a mobile phone, daily for two weeks and were afterwards interviewed about their experiences.Results: Overall, the patients found the symptom questionnaire and the self-care advice relevant and the application user friendly. The alert system was activated on several occasions when the symptoms were severe leading to a nurse contact and support so the patients felt safe and well cared for.Conclusions: The platform enabled increased patient involvement and facilitated symptom assessment and communication between the patient and the health care provider. The study's results support further development of the platform, as well as tests in full-scale studies and in other populations.
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| 3. |
- Algilani, Samal, 1981-, et al.
(författare)
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An interactive ICT-platform for early assessment and management of patient-reported concerns among older adults living in ordinary housing : development and feasibility
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 26:11-12, s. 1575-1583
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Tidskriftsartikel (refereegranskat)abstract
- Aim and objectives: To develop and test feasibility and acceptability of an interactive ICT-platform integrated in a tablet for collecting and managing patient reported concerns of older adults in home care.Background: Using different ICT-applications, e.g. interactive tablets for self-assessment of health and health issues, based on health monitoring as well as other somatic and psychiatric monitoring systems may improve quality of life, staff and patient communication and feelings of being reassured. The European Commission hypothesize that introduction of ICT-applications to the older population will enable improved health. However, evidence-based and user-based applications are scarce.Design: The design is underpinned by the Medical Research Council's complex intervention evaluation framework. A mixed-method approach was used combining interviews with older adults and healthcare professionals, and logged quantitative data.Methods: In cooperation with a health management company, a platform operated by an interactive application for reporting and managing health related problems in real time was developed. Eight older adults receiving home care were recruited to test feasibility. They were equipped with the application and reported three times weekly over four weeks, and afterwards interviewed about their experiences. Three nurses caring for them were interviewed. The logged data was extracted as a coded file.Results: The older adults reported as instructed, in total 107 reports (mean 13). The most frequent concerns were pain, fatigue and dizziness. The older adults experienced the application as meaningful with overall positive effects as well as potential benefits for the nurses involved.Conclusions The overall findings in this study indicated high feasibility among older adults using the ICT-platform. The study's results support further development of the platform, as well as tests in full-scale studies and in other populations.Relevance to practice: An ICT-platform increased the older adults' perception of involvement and facilitated communication between the patient and nurses.
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| 4. |
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| 5. |
- Christiansen, Mats, 1972-
(författare)
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Patient experiences and the influence on health literacy and self-care using mHealth to manage symptoms during radiotherapy for prostate cancer
- 2019
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- 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.
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| 6. |
- Ehrsson, Ylva Tiblom, et al.
(författare)
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Head and neck cancer patients' perceptions of quality of life and how it is affected by the disease and enteral tube feeding during treatment
- 2015
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 120:4, s. 280-289
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore individual quality of life in patients with head and neck cancer from diagnosis up to 3 months after termination of radiotherapy.RESEARCH QUESTIONS: 1) Which areas in life are important to quality of life, and which are influenced by the disease and by having oral or enteral nutrition; and 2) Which areas in life are influenced by having a nasogastric feeding tube (NGT) or a percutaneous endoscopic gastrostomy (PEG) tube?MATERIAL AND METHODS: Data were collected in 36 patients. Semi-structured interviews were conducted using an extended version of the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) and analysed with content analysis.RESULTS: Negative and positive experiences of quality of life in general were about relation to family, own health, and leisure activities. Negative impacts on physical, psychological, existential and social problems, but also positive experiences are described by the patients related to the disease. More than half expressed eating-related problems. Enteral nutrition entailed negative and positive experiences, and no greater variations were described by the patients with NGT or PEG tube. Overall, there were interindividual variations.CONCLUSIONS: The patients' perception of general or disease-related quality of life was not affected by whether they had enteral nutrition or not. From the patients' perspective neither of the two feeding tubes (NGT or PEG) was clearly in favour. We suggest that more studies are needed on how the choice of enteral feeding tube can be evidence-based, and incorporating the patients' perspective.
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| 7. |
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| 8. |
- Faag, Carina, 1970-
(författare)
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A comprehensive nurse-led intervention for patients with peripheral vestibular disorders : the feasibility and benefits
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Dizziness and balance problems are common symptoms at all ages, the symptoms are more common in women than in men and increases with age. Several studies clearly demonstrate that peripheral vestibular disorders symptoms may lead to the patients reporting functional consequences of a physical, mental and social character. The overall aim of this thesis was to investigate the efficacy and feasibility of an intervention for patients with peripheral vestibular disorders that contains patient education in groups in combination with individual support. The study is a randomized controlled trial (RCT). Thirty-six patients participated in the study: the intervention group (n = 18), who received the intervention and standard care, and patients in a control group (n = 18), who received standard care. The intervention includes a patient education program and individualized nursing support during a six-month period. Outcomes were collected by self-assessment questionnaires about dizziness-related symptoms, well-being, sense of coherence, and self-care measured at baseline before randomization and at six and nine months later. All patients were also instructed to complete a diary where they recorded symptoms that arose during an episode of dizziness. The main results show that the patients who received the intervention rated statistically significant fewer vertigo-related symptoms and a higher sense of coherence than the control group at the ninemonth follow-up. The intervention was feasible and seems to support the patients to manage symptoms. The effects were small and must be considered in relation to the efforts of the intervention. Confirmative studies are warranted.
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| 9. |
- Faag, Carina, et al.
(författare)
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Feasibility and Effects of a Nursing Intervention for Patients with Peripheral Vestibular Disorders
- 2017
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Ingår i: Rehabilitation Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0278-4807 .- 2048-7940. ; 42:5, s. 274-281
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore the feasibility and possible outcomes of a nursing intervention in patients with peripheral vestibular disorders. Design: A randomized controlled trial (RCT). Methods: Thirty-six patients participated in the study: the intervention group (n = 18), who received the intervention, and patients in a control group (n = 18), who received standard care. The intervention includes patient education and individualized nursing support during a 6-month rehabilitation period. Outcomes were symptoms, well-being, sense of coherence, and self-care measured at baseline before randomization and at 6 and 9 months later. Findings: At the 9-month follow up, the patients who received the intervention rated significantly fewer vertigo-related symptoms and a higher sense of coherence than the control group. Conclusion: The intervention was feasible and seems to support the patients to manage symptoms, but confirmative studies are warranted. Clinical Relevance: Patient education in combination with individual support may be beneficial to help patients with peripheral disorders during their rehabilitation.
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| 10. |
- Fjell, Maria, et al.
(författare)
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Patients’ experiences of using an interactive appduring treatment for breast cancer
- 2018
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Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 27:s1, s. s20-
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To evaluate patients' experiences of using an interactive app for reporting symptoms during neoadjuvant chemotherapy treatment for breast cancer.Methods: The research project is a multicenter Randomized Controlled Trial with a mixed method approach. The content of the interactive app (Interaktor) was developed from the perspective of patients, health care professionals and literature. It is made for use in a smart device including a 14‐symptom questionnaire based on a risk assessment model, which generates alerts to a nurse at the clinic if symptoms are severe. Patients have continuous access to self‐care advice and can follow their symptoms in graphs. The study includes patients recruited from two university hospitals in Sweden, 75 using the app during treatment in comparison to control group (n = 75) with standard care routines. Data was collected between 2015 and 2017 including logged data, interviews with patients and nurses concerning experiences of using the app and participation in care. Outcomes were collected at three time points by questionnaires including symptom distress, health literacy, perceptions of individualized care, sense of coherence and quality of life. Analysis of outcome data is currently ongoing.Results: Results: including logged data showed an 80% adherence to reporting in the app. A total of 16.299 symptoms were reported during the study period and the most frequent symptoms reported were fatigue, sleeping difficulties, pain, nausea, sadness and oral discomfort. Results: from interviews showed that patients using the app noted that it was easy to use with few technical problems. They considered the app as a source for information with the self‐care advice, helping them manage symptoms. Knowing that nurses at the clinic monitored them, led to a feeling of being looked after and cared for. The app was an easy way of getting in contact with the health care if symptoms were severe, which increased the interaction with caregivers, leading to a feeling of security, personalized and participatory care.Conclusions: Using the app during treatment for breast cancer can facilitate management of symptoms, participatory and individualized care.
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| 11. |
- Gustavell, Tina, et al.
(författare)
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Symptoms and self-care following pancreaticoduodenectomy : Perspectives from patients and healthcare professionals - Foundation for an interactive ICT application
- 2017
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 26, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- PurposePoor prognosis and a problematic recovery period after pancreaticoduodenectomy means that patients may benefit from early detection of symptoms and support for self-management. Interactive Information and Communication Technology tools can be used for this purpose, but the content needs to be relevant to patients as well as healthcare professionals. To facilitate development of the content of an application for this purpose, the aim of this study was to explore common symptoms and self-care in the first six months after pancreaticoduodenectomy, as identified by patients and healthcare professionals.MethodData were collected through individual interviews with patients (n = 14), along with two focus group interviews and one individual interview with healthcare professionals (n = 10). Data were analysed using qualitative content analysis.ResultsCommon symptoms after surgery were those related to eating, bowel function and emotional wellbeing, along with fatigue and pain. Some self-care activities and advice were mentioned in the interviews. The patients often experienced a lack of advice on self-care at discharge.ConclusionsThe results render knowledge of the symptoms it is important to be aware of and to assess regularly after pancreaticoduodenectomy. The results also contribute to knowledge about specific self-care related to these symptoms, even though it was not extensively described, and further research is needed to define evidence-based self-care advice.
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| 12. |
- Göransson, Carina, 1967-, et al.
(författare)
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Perspectives of health and self-care among older persons-To be implemented in an interactive information and communication technology-platform
- 2017
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Ingår i: Journal of Clinical Nursing. - Chichester : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 26:23-24, s. 4745-4755
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Tidskriftsartikel (refereegranskat)abstract
- AIM AND OBJECTIVES: To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves.BACKGROUND: The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals.DESIGN: Descriptive qualitative design.METHODS: This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis.RESULTS: Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons.CONCLUSIONS: The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research.RELEVANCE TO CLINICAL PRACTICE: Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing.
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| 13. |
- Göransson, Carina, 1967-, et al.
(författare)
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Testing an app for reporting health concerns-Experiences from older people and home care nurses
- 2018
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Ingår i: International Journal of Older People Nursing. - Hoboken : Wiley-Blackwell. - 1748-3735 .- 1748-3743. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To explore the experiences of using an app among older people with home-based health care and their nurses. Background: Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed. Design: Explorative qualitative design. Methods: For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis. Results: The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement. Conclusions: The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future. Implications for practice: The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care. © 2017 John Wiley & Sons Ltd
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| 14. |
- Holmefur, Marie, 1968-, et al.
(författare)
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Measurement properties of the 13-item sense of coherence scale using Rasch analysis
- 2015
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Ingår i: Quality of Life Research. - : Springer Netherlands. - 0962-9343 .- 1573-2649. ; 24:6, s. 1455-1463
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The sense of coherence (SOC) scale is widely used and has an extensive history in research. The psychometric properties of the SOC scale have been investigated using classic test theory, but modern test theory enables a more multifaceted investigation of the properties of the SOC scale. The aim of this study was to explore the measurement properties of the SOC scale using the Rasch measurement model.Methods: SOC questionnaires from a sample of 623 healthy adults were analysed using Rasch analysis. Aspects analysed were rating scale functioning, item fit, unidimensionality, differential item functioning (DIF), targeting, and reliability.Results: Rating scale analysis showed that the seven scale steps were not utilized in the intended manner and that a shortening to five categories would be beneficial. Twelve out of the 13 items showed acceptable goodness-of-fit and 43 % of the variance was explained by the SOC dimension in the principal components analysis. There was no DIF between subgroups in the sample. The items were well targeted to the sample SOC level with no ceiling or floor effects. Item and person reliability were good and the person separation index was 2.05 indicating that the scale can separate three different levels of SOC, which corresponds well to its theoretical base.Conclusions: The SOC scale is generally well functioning; however, the three components of SOC seem to influence the PCA results. The scale would benefit from a reduction from seven to five scale steps, which would need to be investigated further.
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| 15. |
- Hälleberg Nyman, Maria, 1968-, et al.
(författare)
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Patients' Perspective on Participation in Care With or Without the Support of a Smartphone App During Radiotherapy for Prostate Cancer : Qualitative Study
- 2017
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 5:7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with prostate cancer are often cared for as outpatients during radiotherapy, which can be an aggravating circumstance for patient participation. There is a need to evaluate whether an interactive smartphone app could enable participation in care, specifically during treatment for prostate cancer. The interactive app (Interaktor) used in this study is developed in codesign with patients and health care professionals; it includes daily reports of symptoms, a risk assessment model, evidence-based self-care advice, along with the provision of immediate access to clinicians.OBJECTIVE: The aim of this study was to explore how patients with prostate cancer perceived their participation with or without the support of the smartphone app during radiotherapy.METHODS: A total of 28 prostate cancer patients receiving adjuvant radiotherapy were interviewed about their perceived participation in their own care. All the patients interviewed in this study participated in an intervention study where the control group received standard care that comprised having access to a contact nurse to turn to with any concerns during their treatment. In addition to standard care, the patients in the intervention group received the app downloaded in a smartphone. The patients' age ranged between 57 and 77 years; 17 patients used the smartphone app. The interviews were analyzed with directed qualitative content analysis.RESULTS: The four dimensions of patient participation, which include mutual participation, fight for participation, requirement for participation, and participation in getting basic needs satisfied, were confirmed as valid perspectives in the interviews with the patients with prostate cancer, irrespective of whether they used the smartphone app. However, the patients who had used the smartphone app described it as a facilitating factor, especially for mutual participation.CONCLUSIONS: Using innovative ways to communicate with patients, such as an interactive app for symptom management with contact with health care in real time, can successfully help achieve increased patient participation in care.
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| 16. |
- Langius-Eklöf, Ann, et al.
(författare)
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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.
- 2017
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Ingår i: JMIR Cancer. - : JMIR Publications Inc.. - 2369-1999. ; 3:2
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 17. |
- Langius-Eklöf, Ann, et al.
(författare)
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Effects of an interactive mHealth innovation for early detection of patient-reported symptom distress with focus on participatory care : protocol for a study based on prospective, randomised, controlled trials in patients with prostate and breast cancer.
- 2017
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cancer patients are predominantly treated as out-patients and as they often experience difficult symptoms and side effects it is important to facilitate and improve patient-clinician communication to support symptom management and self-care. Although the number of projects within supportive cancer care evaluating mobile health is increasing, few evidence-based interventions are described in the literature and thus there is a need for good quality clinical studies with a randomised design and sufficient power to guide future implementations. An interactive information and communications technology platform, including a smartphone/computer tablet app for reporting symptoms during cancer treatment was created in collaboration with a company specialising in health care management. The aim of this paper is to evaluate the effects of using the platform for patients with breast cancer during neo adjuvant chemotherapy treatment and patients with locally advanced prostate cancer during curative radiotherapy treatment. The main hypothesis is that the use of the platform will improve clinical management, reduce costs, and promote safe and participatory care.METHOD: The study is a prospective, randomised, controlled trial for each patient group and it is based on repeated measurements. Patients are consecutively included and randomised. The intervention groups report symptoms via the app daily, during treatment and up to three weeks after end of treatment, as a complement to standard care. Patients in the control groups receive standard care alone. Outcomes targeted are symptom burden, quality of life, health literacy (capacity to understand and communicate health needs and promote healthy behaviours), disease progress and health care costs. Data will be collected before and after treatment by questionnaires, registers, medical records and biomarkers. Lastly, participants will be interviewed about participatory and meaningful care.DISCUSSION: Results will generate knowledge to enhance understanding about how to develop person-centred care using mobile technology. Supporting patients' involvement in their care to identify problems early, promotes more timely initiation of necessary treatment. This can benefit patients treated outside the hospital setting in regard to maintaining their safety.CLINICAL TRIAL REGISTRATION: June 12 2015 NCT02477137 (Prostate cancer) and June 12 2015 NCT02479607 (Breast cancer).
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| 18. |
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| 19. |
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| 20. |
- Mattsson, Susanne, 1978-
(författare)
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Health-related Internet use and screening for emotional distress in people with cancer
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate the preferences and incentives for using Internet-delivered support among people with cancer and to develop and test a generic questionnaire measuring health-related Internet use, the Health Online Support Questionnaire (HOSQ). Another aim was to examine the psychometric properties of the online-administered Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale (VAS) regarding anxiety and depression in psychosocial screening among people with cancer, in comparisons with the longer instruments Montgomery Åsberg Depression Rating Scale – Self-report (MADRS-S) and the State Trait Anxiety Inventory – State (STAI-S).Study I was a correlational and descriptive study on the development and psychometric properties of the HOSQ. Study II was a cross-sectional and descriptive study on health related Internet use in patients with cancer. Study III was a cross-sectional and descriptive study examining preferences for psychological treatments. Study IV was a psychometric comparison study of two short instruments and two longer instruments measuring anxiety and depression.Findings from study I showed that the HOSQ might be a reliable and valid instrument for measuring the use of online support for people with health problems. Results ought to be replicated though in larger and other groups to confirm the results for different diagnoses. Findings from study II confirmed results from other studies showing that people with cancer turn to the Internet for informational support that enables them to influence their care and to stay in touch with friends and relatives. Demographical differences regarding the uptake of Internet-based support remains, which indicates a need for research on how to bridge this digital gap. In study III, we found that a large majority preferred psychological treatment face to face whereas Internet-based interventions were reported as the preferred choice by a minority. Findings from the content analysis suggest that Internet-based interventions have specific advantages that may facilitate help-seeking among some individuals and some disadvantages that may be perceived as barriers. Initiatives to increase treatment acceptability may benefit from addressing the advantages and disadvantages reported in this study. In study IV we found that the use of the short and ultrashort tools HADS and VAS identified anxiety and depression in patients with cancer with high accuracy in comparisons with the longer instruments.In conclusion, online screening with the HADS and VAS may be a suitable initial method to identify anxiety and depression in patients with cancer. There is still a large proportion of patients who lack the interest or eHealth literacy to use health-related support on the Internet. By learning more about the barriers, use and perception of eHealth and Internet-based interventions, adequate support may be offered.
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| 21. |
- Sundberg, Kay, et al.
(författare)
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Early detection and management of symptoms using an interactive smartphone application (Interaktor) during radiotherapy for prostate cancer
- 2017
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 25:7, s. 2195-2204
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Patients undergoing radiotherapy for prostate cancer suffer from a variety of symptoms which influence health-related quality of life. We have developed an application (Interaktor) for smartphones and tablets for early detection, reporting and management of symptoms, and concerns during treatment for prostate cancer. The study evaluates the effect on symptom burden and quality of life when using the application for real-time symptom assessment and management during radiotherapy for localized prostate cancer.Methods: A non-randomized controlled study was used at two university hospitals in Sweden where 64 patients constituted a control group and 66 patients made up an intervention group. The intervention group was asked to report symptoms via the application daily during the treatment as well as 3 weeks after. The EORTC QLQ-C30 and its module PR25 and the Sense of Coherence questionnaire were administered at three time points in both groups.Results: The intervention group rated significantly lower levels of fatigue and nausea at the end of radiotherapy. Moreover, they had significantly less burden in emotional functioning, insomnia, and urinary-related symptoms at the end of treatment as well as 3 months later compared with the control group. In the multivariate analyses, with education and sense of coherence as covariates, the intervention group still significantly rated emotional functioning (p = 0.007), insomnia (p = 0.017), and urinary-related symptoms (p = 0.008) as better than the control group at T2.Conclusion: Study findings suggest that Interaktor could be an efficient mHealth tool for facilitating supportive care needs during cancer treatment.
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