Personal face-to-face visits for breast cancer patients with physicians or other care providers may soon be successfully complemented by a smartphone, person-centered app. A PhD student’s preliminary evaluation of breast cancer patients finds a newly developed e-support app can be useful to women being treated for breast cancer in helping them manage symptoms, medication, and chemotherapy and side effects, and providing general support in dealing with the illness.
A thesis by Filipa Ventura, a PhD candidate at the University of Gothenburg’s Sahlgrenska Academy in Gothenburg, Sweden, describes development and preliminarily evaluation of an interactive smartphone app that provides e-support for self-care.
Ventura’s thesis, “Person-centred e-support. Foundations for the development of nursing interventions in outpatient cancer care,” explains how the app, called “Care Expert,” has been developed specifically for women undergoing breast cancer treatment and incorporates self-assessment functions for both health and quality of life, self-monitoring of symptoms and status, self-validation, and direct reporting to the patient’s contact nurse.
Scientifically Based Advice
“Care Expert” provides patients with support during sometimes arduous cancer treatment, enabling them to quickly detect and identify symptoms and side effects of therapy and provide them with scientifically based self-care advice tailored to each patient’s specific needs. Patients are also provided the option of contacting their healthcare team via personal messages written in the app. Ventura said in a Gothenburg University release that this sort of continuous, customized support is especially significant when it compliments early-stage breast cancer treatment, which is usually conducted in outpatient cancer care settings.
Assurance of Support
Ventura’s evaluation finds that women using the Care Expert app experienced an increased assurance of support in having continuous access to their healthcare team through using the app. She says that a major advantage with the prototype app is its integration of the perspectives of patients and the healthcare teams, which she regards as key to the success of e-support applications.
Her thesis explores foundations of person-centred e-support for women undergoing treatment for early-stage breast cancer, and is designed to enhance the knowledge base on how nursing interventions in the form of interactive health communication applications like Care Support might assist support tailored to the needs and preferences of the patient in shifting the cancer care context from inpatient to outpatient settings.
Focus on the Whole Person
One of the individual studies addressed in Ventura’s thesis is a multi-center, randomized, controlled trial conducted to evaluate the impact of a computer-based educational program on health self-efficacy, healthcare participation, anxiety, and depression of 226 women undergoing treatment for early-stage breast cancer who participated.
She says multi-level modeling revealed no statistically significant improvement in outcomes, indicating that information on diagnosis and treatment received via computer-based programs is insufficient to support womens’ ability to cope with their personal circumstances during cancer treatment, or to increase self-participation in the healing process.
She observes that a number of smartphone apps have been developed to provide e-support to cancer patients during treatment, but says Care Expert is the first that has been designed based on principles of person-centered care, in which the focus is on the whole person rather than their disease diagnosis.
Need for Support
In order for e-support to meet a patient’s needs, Ventura said, the patient needs to be involved from the very beginning of diagnosis and treatment, otherwise there is a significant risk that the app will more likely not be used, or if it is, will increase the patient’s burden rather than being supportive.
Another study profiled in the thesis explored early-stage development of a Care Expert person-centerd e-supportive system app prototype and its usability for women undergoing chemotherapy for early-stage breast cancer. Subjective assessment and diagnostic evaluation of the prototype were conducted in four individual usability sessions, with the prototype’s supportive communication functions perceived by women to support their self-driven and cooperative agencies.
Ventura says that integration of the results suggests interactive health communication applications have potential to complement care in meeting women’s supportive needs. However, she cautions that the exclusive provision of reliable and evidence-based information via a computer-based program is not enough, and that integration of person-centered dimensions and user involvement early on in the development process may be key to ensuring effectiveness of the application.
Ventura’s thesis concludes that women undergoing breast cancer treatment — even highly resourceful individuals — will inevitably need support, the adequate provision of which will assist them in handling the disease and managing treatment consequences, while strengthening their personal motivation to actively participate in the care and treatment of their cancer.
As a result, person-centred e-supportive systems may bridge the communication gap between hospital settings and patients’ homes by fostering a reciprocal partnership in care that acknowledges and reinforces patients’ expertise and agency.
Ventura defended her thesis “Person-centered e-support. Foundations for the development of nursing interventions in outpatient cancer care” on Feb. 11.