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Wu W, Graziano T, Salner A, Chen MH, Judge MP, Cong X, Xu W. Acceptability, Effectiveness, and Roles of mHealth Applications in Supporting Cancer Pain Self-Management: Integrative Review. JMIR Mhealth Uhealth 2024; 12:e53652. [PMID: 39024567 PMCID: PMC11294773 DOI: 10.2196/53652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/22/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Cancer pain remains highly prevalent and persistent throughout survivorship, and it is crucial to investigate the potential of leveraging the advanced features of mobile health (mHealth) apps to empower individuals to self-manage their pain. OBJECTIVE This review aims to comprehensively understand the acceptability, users' experiences, and effectiveness of mHealth apps in supporting cancer pain self-management. METHODS We conducted an integrative review following Souza and Whittemore and Knafl's 6 review processes. Literature was searched in PubMed, Scopus, CINAHL Plus with Full Text, PsycINFO, and Embase, from 2013 to 2023. Keywords including "cancer patients," "pain," "self-management," "mHealth applications," and relevant synonyms were used in the search. The Johns Hopkins research evidence appraisal tool was used to evaluate the quality of eligible studies. A narrative synthesis was conducted to analyze the extracted data. RESULTS A total of 20 studies were included, with the overall quality rated as high (n=15) to good (n=5). Using mHealth apps to monitor and manage pain was acceptable for most patients with cancer. The internal consistency of the mHealth in measuring pain was 0.96. The reported daily assessment or engagement rate ranged from 61.9% to 76.8%. All mHealth apps were designed for multimodal interventions. Participants generally had positive experiences using pain apps, rating them as enjoyable and user-friendly. In addition, 6 studies reported significant improvements in health outcomes, including enhancement in pain remission (severity and intensity), medication adherence, and a reduced frequency of breakthrough pain. The most frequently highlighted roles of mHealth apps included pain monitoring, tracking, reminders, education facilitation, and support coordination. CONCLUSIONS mHealth apps are effective and acceptable in supporting pain self-management. They offer a promising multi-model approach for patients to monitor, track, and manage their pain. These findings provide evidence-based insights for leveraging mHealth apps to support cancer pain self-management. More high-quality studies are needed to examine the effectiveness of digital technology-based interventions for cancer pain self-management and to identify the facilitators and barriers to their implementation in real-world practice.
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Affiliation(s)
- Weizi Wu
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Teresa Graziano
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Andrew Salner
- Hartford HealthCare Cancer Institute, Hartford, CT, United States
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT, United States
| | - Michelle P Judge
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Xiaomei Cong
- Yale School of Nursing, Orange, CT, United States
| | - Wanli Xu
- School of Nursing, University of Connecticut, Storrs, CT, United States
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Kilfoy A, Chu C, Krisnagopal A, Mcatee E, Baek S, Zworth M, Hwang K, Park H, Jibb L. Nurse-led remote digital support for adults with chronic conditions: A systematic synthesis without meta-analysis. J Clin Nurs 2024. [PMID: 38894583 DOI: 10.1111/jocn.17226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024]
Abstract
AIM The systematic review aims to synthesize the literature examining the effectiveness of nurse-led remote digital support on health outcomes in adults with chronic conditions. BACKGROUND Adults with chronic diseases have increased rates of mortality and morbidity and use health care resources at a higher intensity than those without chronic conditions-placing strain on the patient, their caregivers and health systems. Nurse-led digital health disease self-management interventions have potential to improve outcomes for patients with chronic conditions by facilitating care in environments other that the hospital setting. DESIGN AND METHODS We searched PubMed/MEDLINE, Embase, PsycINFO and Cochrane Central databases from inception to 7 December 2022. We included randomized controlled trials assessing the impact of nurse-led remote digital support interventions compared to usual care on health-related outcomes in adults with chronic illness. The Cochrane risk-of-bias tool was used to assess bias in studies. Outcomes were organized into four categories: self-management, clinical outcomes, health care resource use and satisfaction with care. Results are presented narratively based on statistical significance. RESULTS Forty-four papers pertaining to 40 unique studies were included. Interventions most targeted diabetes (n = 11) and cardiovascular disease (n = 8). Websites (n = 10) and mobile applications (n = 10) were the most used digital modalities. Nurses supported patients either in response to incoming patient health data (n = 14), virtual appointment (n = 8), virtual health education (n = 5) or through a combination of these approaches (n = 13). Positive impacts of nurse-led digital chronic disease support were identified in each outcome category. Mobile applications were the most effective digital modality. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE Results show that nurse-led remote digital support interventions significantly improve self-management capacity, clinical health outcomes, health care resource use and satisfaction with care. Such interventions have potential to support overall health for adults with chronic conditions in their home environments.
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Affiliation(s)
- Alicia Kilfoy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Charlene Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- KITE Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Archanaa Krisnagopal
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Enoch Mcatee
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sunny Baek
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Mallory Zworth
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kyobin Hwang
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hyun Park
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
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Paterson C, Kavanagh PS, Bacon R, Turner M, Moore M, Barratt M, Chau M. To understand the experiences, needs, and preferences for supportive care, among children and adolescents (0-19 years) diagnosed with cancer: a systematic review of qualitative studies. J Cancer Surviv 2023:10.1007/s11764-023-01508-9. [PMID: 38151586 DOI: 10.1007/s11764-023-01508-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE This study aimed to understand the experiences, needs, and preferences for supportive care, among children and adolescents (0-19 years) diagnosed with cancer. METHODS A qualitative systematic review has been reported according to PRISMA guidelines. A comprehensive search was conducted across multiple databases (APA PsycINFO, CINAHL, and Medline) and citation searches. Studies were screened according to pre-determined inclusion and exclusion criteria. Methodological quality was evaluated. Findings were extracted in relation to the context of interest of experiences, needs, and preferences of supportive care. Each finding was accompanied by a qualitative verbatim illustration representing the participant's voice. RESULTS 4449 publications were screened, and 44 studies were included. Cancer populations represented in the included studies included lymphoma, leukaemia, brain cancer, sarcomas, and neuroblastoma. Two overarching synthesised findings were identified as (1) coping, caring relationships, communication, and impact of the clinical environment, and (2) experiences of isolation, fear of the unknown, restricted information, and changing self. Children and adolescents articulated that cancer care would be enhanced by developing a sense of control over their body and healthcare, being involved in communication and shared decision-making, and ensuring the clinical environment is age-appropriate. Many experienced a sense of disconnection from the rest of the world (including peers, school, and experiences of prejudice and bullying), and a lack of tailored support and information were identified as key unmet care needs that require further intervention. CONCLUSIONS Children and adolescent who are diagnosed with cancer are a unique and understudied group in oncological survivorship research, with the slowest progress in improvement of care over time. This review will facilitate the development of future interventions and promote the importance of tailored support for children and adolescents at all stages of the cancer journey. IMPLICATIONS FOR CANCER SURVIVORS Children and adolescents continue to experience a range of difficulties despite routine contact with cancer healthcare professionals. Children and adolescents should be carefully assessed about their individual circumstances and preferences for support given the clear implications from this review that "one size" does not fit all.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, Australia.
- Central Adelaide Local Health Network, Adelaide, Australia.
- Robert Gordon University, Aberdeen, Scotland, UK.
- Faculty of Health, University of Canberra, Bruce, ACT, Australia.
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - M Turner
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - M Moore
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - M Barratt
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - M Chau
- South Australia Medical Imaging, Flinders Medical Centre, Adelaide, Australia
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Jibb LA, Sivaratnam S, Hashemi E, Chu CH, Nathan PC, Chartrand J, Alberts NM, Masama T, Pease HG, Torres LB, Cortes HG, Zworth M, Kuczynski S, Fortier MA. Parent and clinician perceptions and recommendations on a pediatric cancer pain management app: A qualitative co-design study. PLOS DIGITAL HEALTH 2023; 2:e0000169. [PMID: 38019890 PMCID: PMC10686487 DOI: 10.1371/journal.pdig.0000169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 10/14/2023] [Indexed: 12/01/2023]
Abstract
Pain is one of the most prevalent and burdensome pediatric cancer symptoms for young children and their families. A significant proportion of pain episodes are experienced in environments where management options are limited, including at home. Digital innovations such as apps may have positive impacts on pain outcomes for young children in these environments. Our overall aim is to co-design such an app and the objective of this study was to explore the perceptions of children's parents about app utility, needed system features, and challenges. We recruited parents of young children with cancer and multidisciplinary pediatric oncology clinicians from two pediatric cancer care centers to participate in audio-recorded, semi-structured, co-design interviews. We conducted interviews structured around technology acceptance and family caregiving theories until data saturation was reached. Audio-recordings were then transcribed, coded, and analyzed using thematic analysis. Forty-two participants took part in the process. Participants endorsed the concept of an app as a useful, safe, and convenient way to engage caregivers in managing their young child's pain. Overall, the app was valued as a means to provide real-time, multimodal informational and procedural pain support to parents, while also reducing the emotional burden of pain care. Recommendations for intervention design included accessibility-focused features, comprehensive symptom tracking, and embedded scientific- and clinically-sound symptom assessments and management advice. Predicted challenges to app use included the workload burden it may place on parents and clinicians. The insights gathered will inform the design principles of our future childhood cancer pain digital research.
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Affiliation(s)
- Lindsay A. Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Surabhi Sivaratnam
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Elham Hashemi
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Charlene H. Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Paul C. Nathan
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Julie Chartrand
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Tatenda Masama
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Hannah G. Pease
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
| | - Lessley B. Torres
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
- Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, California, United States of America
- UCI Center on Stress and Health, University of California Irvine, Irvine, California, United States of America
| | - Haydee G. Cortes
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
- Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, California, United States of America
- UCI Center on Stress and Health, University of California Irvine, Irvine, California, United States of America
| | - Mallory Zworth
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Susan Kuczynski
- Ontario Parents Advocating for Children with Cancer, Toronto, Canada
| | - Michelle A. Fortier
- Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States of America
- Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, California, United States of America
- UCI Center on Stress and Health, University of California Irvine, Irvine, California, United States of America
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Kilfoy A, Panesar P, Hashemi E, Masama T, Pereira M, Liu W, Alexander S, Korenblum C, Jibb LA. "It just made me feel better": qualitative examination of the implementation of a novel virtual psychosocial support program for adolescents with cancer. Support Care Cancer 2023; 31:610. [PMID: 37792141 DOI: 10.1007/s00520-023-08054-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented the novel, virtual, weekly Teens4Teens peer support group and patient education program. We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program, its feasibility, acceptability, and perceived impact. METHODS We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis. RESULTS We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens, and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programming in pediatric cancer care, provided lessons on how best to build and apply such a program, and highlighted the value of the program for both adolescents' and clinicians' acceptability, feasibility, and perceived utility. CONCLUSION Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming, such as Teens4Teens, is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families. This study has potential to provide researchers and clinicians with valuable information about the content, design, and delivery of virtual peer support programming for adolescents with cancer.
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Affiliation(s)
- A Kilfoy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - P Panesar
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, ON, Hamilton, L8S 4L8, Canada
| | - E Hashemi
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - T Masama
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
| | - M Pereira
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - W Liu
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - S Alexander
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, ON, Toronto, M5S 1A8, Canada
| | - C Korenblum
- Department of Supportive Care, University Health Network, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M6G 2C4, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, ON, Toronto, M5S 1A8, Canada
- Division of Adolescent Medicine, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
| | - L A Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada.
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada.
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
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Carter M, Manworren RC, Stinson JN. Commentary: Pediatric Pain Measurement, Assessment, and Evaluation. Semin Pediatr Neurol 2023; 47:101074. [PMID: 37919028 DOI: 10.1016/j.spen.2023.101074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 11/04/2023]
Abstract
PEDIATRIC PAIN MEASUREMENT, ASSESSMENT, AND EVALUATION Renee C.B. Manworren, Jennifer Stinson Seminars in Pediatric Neurology Volume 23, Issue 3, August 2016, Pages 189-200 Assessment provides the foundation for diagnosis, selection of treatments, and evaluation of treatment effectiveness for pediatric patients with acute, recurrent, and chronic pain. Extensive research has resulted in the availability of a number of valid, reliable, and recommended tools for assessing children's pain. Yet, evidence suggests children's pain is still not optimally measured or treated. In this article, we provide an overview of pain evaluation for premature neonates to adolescents. The difference between pain assessment and measurement is highlighted; and the key steps to follow are identified. Information about self report and behavioral pain assessment tools appropriate for children are provided; and fac tors to be considered when choosing a specific 1 are outlined. Finally, we preview future approaches to personalized pain medicine in pediatrics that include harnessing the use of potential digital health technologies and genomics.
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Affiliation(s)
- Michela Carter
- Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Renee Cb Manworren
- Nursing Research & Professional Practice, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL; College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX.
| | - Jennifer N Stinson
- Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Chen W, Huang J, Cui Z, Wang L, Dong L, Ying W, Zhang Y. The efficacy of telemedicine for pain management in patients with cancer: a systematic review and meta-analysis. Ther Adv Chronic Dis 2023; 14:20406223231153097. [PMID: 36815091 PMCID: PMC9940183 DOI: 10.1177/20406223231153097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/10/2023] [Indexed: 02/19/2023] Open
Abstract
Background Pain is the most common cancer-related symptom, but it is often undertreated. Telemedicine is widely used in cancer treatment, but its effectiveness is uncertain. Objective We aimed to evaluate the impact of telemedicine intervention on pain in patients with cancer. Design Methodological quality and risk-of-bias evaluation were conducted, and the sources of heterogeneity were explored through subgroup analysis and sensitivity analysis. Data Sources and Methods PubMed, Embase, Web of Science, Cochrane Library, and clinical trial databases were searched up to 16 August 2022. Randomized controlled trials of the impact of telemedicine intervention regarding pain in patients with cancer were included, and the results related to pain were extracted. Results Twenty-one randomized controlled trials were selected from 1810 articles. A total of 1454 patients received telemedicine interventions, and 2213 received conventional medical services. Telemedical intervention had a positive effect on improving pain intensity [standard mean deviation (SMD) = -0.28, 95% confidence interval (CI): -0.49 to -0.06, p = 0.01] and pain interference (SMD = -0.41, 95% CI: -0.54 to -0.28, p < 0.00001), with statistical difference between the two groups. The subgroup analysis results showed that the telemedicine subgroup based on an application (SMD = -0.54, 95% CI: -0.91 to -0.18, p = 0.004) and the subgroup with intervention time ⩾ 6 months (SMD = -0.33, 95% CI: -0.52 to -0.13, p = 0.001), both demonstrated significant improvement regarding pain intensity, with significant statistical difference between the two groups. When the follow-up time was ⩾ 6 months, there was no significant difference (SMD = -0.24, 95% CI: -0.55 to 0.07, p = 0.13). Conclusion Compared with conventional medical services, telemedicine intervention can improve the pain of patients with cancer and is effective and acceptable regarding symptom monitoring. Integrating telemedicine interventions into cancer pain management may be a feasible option. But its long-term effects still need to be confirmed with more high-quality randomized controlled trials in the future. Registration https://www.crd.york.ac.uk/PROSPERO/; CRD42022361990.
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Affiliation(s)
| | | | | | - Lei Wang
- Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Liang Dong
- Department of Information, Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Weifeng Ying
- Department of Information, Affiliated Hospital of Jiaxing University, Jiaxing, China
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Ren Y. Effect Evaluation of Mental Nursing in Nursing of Young Cancer Patients Based on Big Data. Front Public Health 2022; 10:888183. [PMID: 35570897 PMCID: PMC9099006 DOI: 10.3389/fpubh.2022.888183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
The field of mental health nursing has always been special, dynamic, and flexible in terms of enhancing individuals' quality of life. Mental health nursing is all about caring for individuals with mental health disorders with the aim of helping them recover from illness, thereby improving their living conditions. Health Education of mental nursing emphasizes on providing special care to patients and optimally fulfills the clinical outcomes of the patients. It has been widely accepted that mental illness negatively influences the well-being of individuals, irrespective of their age, origin, demography, social status, and economic status. Young patients diagnosed with cancer report that they have a poor quality of life, as they undergo several physical and psychological needs, especially after the surgery and other cancer-related treatments. Thus, this study aims to examine the effect of mental health nursing on nursing young patients with cancer, based on the big data. Thus, the study conducts longitudinal analysis of the data gathered from the young patients with cancer, monitored by mental health nurse, with advanced practice nurse (APN) interventions. Results of the study stated that APN interventions positively impacted the physical as well as psychological needs of the research subjects. Mental nursing interventions resulted in positive clinical outcomes of the patients.
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Karataş N, Kaya A, İşler Dalgıç A. The effectiveness of user-focused mobile health applications in paediatric chronic disease management: A systematic review. J Pediatr Nurs 2022; 63:e149-e156. [PMID: 34598848 DOI: 10.1016/j.pedn.2021.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/19/2022]
Abstract
PROBLEM This systematic review aims to evaluate the effectiveness of user-focused mobile health (mHealth) applications in paediatric chronic disease management. ELIGIBILITY CRITERIA Articles were included under the Population Intervention Comparator Outcome Study (PICOS) design framework for (P) children with a chronic disease, (I) mHealth user-focused apps, (C) usual care/control groups, (O) health outcomes related to chronic diseases, and (S) randomised controlled trials. This study followed the guidelines provided by Cochrane, Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and Mobile Health Evidence Reporting and Assessment. SAMPLE A comprehensive literature search screening was conducted via CINAHL, PubMed, CENTRAL, ELSEVIER, SAGE, Science Direct, Scopus, Taylor Francis, WoS, and IEEE XPLORE from inception to November 15, 2020. RESULTS The review included seven articles, which combined provided data for a total of 755 children. The effects of the mHealth applications on the investigated 31 unique outcomes of five chronic paediatric diseases were mixed, ranging from effective to no effect. The risk of bias in the included studies was mostly either high or concerning according to Risk of Bias tool 2.0. The mobile apps that were evaluated were not standalone apps but were designed to interact with and provide data to healthcare providers. CONCLUSION Some mHealth interventions in this systematic review produced clinically meaningful and statistically relevant reductions in health outcomes related to chronic disease management. However, based on the available data, it is not possible to make definitive conclusions concerning the preferred target population of the interventions. IMPLICATION mHealth apps may be beneficial in improving selected patient outcomes in chronic disease management. Our results may assist the digital health services of hospitals, paediatric nurses who are interested in mHealth, and children who have a chronic disease.
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Affiliation(s)
- Nimet Karataş
- Pediatric Nursing Department, Faculty of Nursing, Akdeniz University Antalya, Turkey.
| | - Ayla Kaya
- Pediatric Nursing Department, Faculty of Nursing, Akdeniz University Antalya, Turkey.
| | - Ayşegül İşler Dalgıç
- Pediatric Nursing Department, Faculty of Nursing, Akdeniz University Antalya, Turkey.
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Jibb LA, Ameringer S, Macpherson CF, Sivaratnam S. The Symptom Experience in Pediatric Cancer: Current Conceptualizations and Future Directions. Curr Oncol Rep 2022; 24:443-450. [PMID: 35150393 DOI: 10.1007/s11912-022-01222-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW We aimed to review the recent research on the childhood cancer symptom experience pertaining to socioeconomic factors, biology and genetics, growth and development, family psychosocial dynamics, and social and treating environments to begin to formulate recommendations for a personalized approach to symptom management. RECENT FINDINGS Cancer symptoms are common and distressing in children and negatively impact child and family quality of life. Many interacting factors influence children's cancer symptoms experiences, including the assessment and management of such symptoms. This paper highlights several gaps in the research related to the cancer symptom experience including routine symptom assessment, the impact of socioeconomic, biological, and genetic factors on symptoms, and the establishment of effective symptom management partnerships with families. Based on our findings, we provide recommendations related to that research which is ready to be implemented into clinical practice and areas for needed future efforts.
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Affiliation(s)
- Lindsay A Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, M5T 1P8, Toronto, Canada. .,Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, M5G 0A4, Canada.
| | | | | | - Surabhi Sivaratnam
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, M5G 0A4, Canada.,Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, Hamilton, L8S 4K1, Canada
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The Pediatric Cancer Survivors' User Experiences With Digital Health Interventions: A Systematic Review of Qualitative Data. Cancer Nurs 2021; 45:E68-E82. [PMID: 34870939 DOI: 10.1097/ncc.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence suggests that digital health interventions are feasible and acceptable in pediatric cancer survivors. Efforts to synthesize user experiences, however, are limited. OBJECTIVE The aim of this study was to systematically identify, appraise, and synthesize qualitative evidence on the user experiences of pediatric cancer survivors participating in digital health interventions. METHODS We searched 4 databases to identify studies with qualitative data of the digital health intervention user experiences from childhood, adolescent, and young adult pediatric cancer survivors, published from the databases' inception to January 31, 2020. Studies that met inclusion criteria were selected and reviewed for quality. The extracted data were analyzed by thematic synthesis. RESULTS Sixteen articles met the inclusion criteria. Two analytic themes emerged, each with 3 descriptive themes: (1) the favorable experience of using digital health interventions, including "knowing about oneself and one's cancer," "connecting with others in a trustworthy and safe way," and "getting empowered and rewarded"; and (2) the challenges of using digital health interventions, including "challenges from the content of the program," "technology challenges," and "user challenges." CONCLUSIONS This systematic review supports the value of digital health interventions as an acceptable and convenient approach for delivering care to pediatric cancer survivors. It is essential to understand the users' positive experiences and challenges to customize interventions and achieve positive health outcomes. IMPLICATIONS FOR PRACTICE Nurses can contribute to the development and implementation of digital health interventions for pediatric cancer survivors through advocacy, navigation, feedback, and multidisciplinary collaboration. We recommended system-level support in modifying and developing relevant workflows or practice guidelines for implementation.
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12
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Geraghty AWA, Roberts LC, Stanford R, Hill JC, Yoganantham D, Little P, Foster NE, Hay EM, Yardley L. Exploring Patients' Experiences of Internet-Based Self-Management Support for Low Back Pain in Primary Care. PAIN MEDICINE 2021; 21:1806-1817. [PMID: 31841156 PMCID: PMC7553019 DOI: 10.1093/pm/pnz312] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective We explored patients’ experiences of using Internet-based self-management support for low back pain (LBP) in primary care, with and without physiotherapist telephone guidance. Design Exploratory descriptive qualitative study using thematic analysis, nested within a randomized feasibility trial. Methods Patients with LBP who participated in a feasibility trial of the SupportBack Internet intervention (ISRCTN: 31034004) were invited to take part in semistructured telephone interviews after the three-month intervention period (a convenience sample from within the trial population). Fifteen participants took part (age range = 36–87 years, 66.7% female, characteristics representative of the trial population). Data were analyzed thematically. Results Analysis resulted in the development of six themes (subthemes in parentheses): Perceptions of SupportBack’s design (Clarity and ease of use, Variety and range of information provided, Need for specificity and flexibility), Engaging with the SupportBack intervention, Promoting positive thought processes (Reassurance, Awareness of self-management), Managing behavior with SupportBack (Motivation and goal setting, Using activity as a pain management strategy, Preferences for walking or gentle back exercises), Feeling supported by telephone physiotherapists (Provision of reassurances and clarity, Physiotherapists are motivating), Severity and comorbidity as barriers (Preexisting condition or severity acting as a barrier, Less useful for mild low back pain). Conclusions The Internet intervention SupportBack appeared to feasibly support self-management of LBP. Reassurance and ongoing support to implement behavioral changes were central to reported benefits. The addition of physiotherapist telephone support further enhanced the patient experience and the potential utility of the intervention.
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Affiliation(s)
- Adam W A Geraghty
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Lisa C Roberts
- School of Health Sciences, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rosie Stanford
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Jonathan C Hill
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Newcastle, UK
| | - Dinesh Yoganantham
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Paul Little
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Nadine E Foster
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Newcastle, UK
| | - Elaine M Hay
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Newcastle, UK
| | - Lucy Yardley
- School of Psychological Science, University of Bristol, Bristol, UK.,Department of Psychology, University of Southampton, Southampton, UK
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13
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Abel KM, Bee P, Gega L, Gellatly J, Kolade A, Hunter D, Callender C, Carter LA, Meacock R, Bower P, Stanley N, Calam R, Wolpert M, Stewart P, Emsley R, Holt K, Linklater H, Douglas S, Stokes-Crossley B, Green J. An intervention to improve the quality of life in children of parents with serious mental illness: the Young SMILES feasibility RCT. Health Technol Assess 2020; 24:1-136. [PMID: 33196410 DOI: 10.3310/hta24590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Quality of life for children and adolescents living with serious parental mental illness can be impaired, but evidence-based interventions to improve it are scarce. OBJECTIVE Co-production of a child-centred intervention [called Young Simplifying Mental Illness plus Life Enhancement Skills (SMILES)] to improve the health-related quality of life of children and adolescents living with serious parental mental illness, and evaluating its acceptability and feasibility for delivery in NHS and community settings. DESIGN Qualitative and co-production methods informed the development of the intervention (Phase I). A feasibility randomised controlled trial was designed to compare Young SMILES with treatment as usual (Phase II). Semistructured qualitative interviews were used to explore acceptability among children and adolescents living with their parents, who had serious mental illness, and their parents. A mixture of semistructured qualitative interviews and focus group research was used to examine feasibility among Young SMILES facilitators and referrers/non-referrers. SETTING Randomisation was conducted after baseline measures were collected by the study co-ordinator, ensuring that the blinding of the statistician and research team was maintained to reduce detection bias. PARTICIPANTS Phase I: 14 children and adolescents living with serious parental mental illness, seven parents and 31 practitioners from social, educational and health-related sectors. Phase II: 40 children and adolescents living with serious parental mental illness, 33 parents, five referrers/non-referrers and 16 Young SMILES facilitators. INTERVENTION Young SMILES was delivered at two sites: (1) Warrington, supported by the National Society for the Prevention of Cruelty to Children (NSPCC), and (2) Newcastle, supported by the NHS and Barnardo's. An eight-session weekly group programme was delivered, with four to six children and adolescents living with serious parental mental illness per age-appropriate group (6-11 and 12-16 years). At week 4, a five-session parallel weekly programme was offered to the parents/carers. Sessions lasted 2 hours each and focused on improving mental health literacy, child-parent communication and children's problem-solving skills. MAIN OUTCOME MEASURES Phase ll children and parents completed questionnaires at randomisation and then again at 4 and 6 months post randomisation. Quality of life was self-reported by children and proxy-reported by parents using the Paediatric Quality of Life questionnaire and KIDSCREEN. Semistructured interviews with parents (n = 14) and children (n = 17) who participated in the Young SMILES groups gathered information about their motivation to sign up to the study, their experiences of participating in the group sessions, and their perceived changes in themselves and their family members following intervention. Further interviews with individual referrers (n = 5) gathered information about challenges to recruitment and randomisation. Two focus groups (n = 16) with practitioners who facilitated the intervention explored their views of the format and content of the Young SMILES manual and their suggestions for changes. RESULTS A total of 35 families were recruited: 20 were randomly allocated to Young SMILES group and 15 to treatment as usual. Of those, 28 families [15/20 (75%) in the intervention group and 13/15 (87%) in the control group] gave follow-up data at the primary end point (4 months post baseline). Participating children had high adherence to the intervention and high completion rates of the questionnaires. Children and adolescents living with their parents, who had serious mental illness, and their parents were mainly very positive and enthusiastic about Young SMILES, both of whom invoked the benefits of peer support and insight into parental difficulties. Although facilitators regarded Young SMILES as a meaningful and distinctive intervention having great potential, referrers identified several barriers to referring families to the study. One harm was reported by a parent, which was dealt with by the research team and the NSPCC in accordance with the standard operating procedures. LIMITATIONS The findings from our feasibility study are not sufficient to recommend a fully powered trial of Young SMILES in the near future. Although it was feasible to randomise children and adolescents living with serious parental mental illness of different ages to standardised, time-limited groups in both NHS and non-NHS settings, an intervention like Young SMILES is unlikely to address underlying core components of the vulnerability that children and adolescents living with serious parental mental illness express as a population over time. CONCLUSIONS Young SMILES was widely valued as unique in filling a recognised gap in need. Outcome measures in future studies of interventions for children and adolescents living with serious parental mental illness are more likely to capture change in individual risk factors for reduced quality of life by considering their unmet need, rather than on an aggregate construct of health-related quality of life overall, which may not reflect these young people's needs. FUTURE WORK A public health approach to intervention might be best. Most children and adolescents living with serious parental mental illness remain well most of the time, so, although their absolute risks are low across outcomes (and most will remain resilient most of the time), consistent population estimates find their relative risk to be high compared with unexposed children. A public health approach to intervention needs to be both tailored to the particular needs of children and adolescents living with serious parental mental illness and agile to these needs so that it can respond to fluctuations over time. TRIAL REGISTRATION Current Controlled Trials ISRCTN36865046. FUNDING This project was funded by the National Institute of Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 59. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kathryn M Abel
- Centre for Women's Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Penny Bee
- Division of Nursing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Lina Gega
- Department of Health Sciences, University of York, York, UK.,Hull York Medical School, University of York, York, UK
| | - Judith Gellatly
- Centre for Women's Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Division of Nursing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Adekeye Kolade
- Centre for Women's Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Diane Hunter
- National Society for the Prevention of Cruelty to Children, London, UK
| | - Craig Callender
- Northumberland Tyne and Wear NHS Foundation Trust, St Nicholas Hospital, Newcastle upon Tyne, UK
| | - Lesley-Anne Carter
- Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester, UK
| | - Rachel Meacock
- Manchester Centre for Health Economics, University of Manchester, Manchester, UK
| | - Peter Bower
- National Primary Care Research and Development Centre, University of Manchester, Manchester, UK
| | - Nicky Stanley
- School of Social Work, University of Central Lancashire, Preston, UK
| | - Rachel Calam
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Miranda Wolpert
- Evidence Based Practice Unit, University College London, London, UK.,Anna Freud Centre, London, UK
| | - Paul Stewart
- National Society for the Prevention of Cruelty to Children, London, UK
| | - Richard Emsley
- Department for Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kim Holt
- Department of Social Work, Education and Community Wellbeing, University of Northumbria, Newcastle upon Tyne, UK
| | - Holly Linklater
- Department of Education and Inclusive Pedagogy, University of Edinburgh, Edinburgh, UK
| | - Simon Douglas
- Northumberland Tyne and Wear NHS Foundation Trust, St Nicholas Hospital, Newcastle upon Tyne, UK
| | - Bryony Stokes-Crossley
- Northumberland Tyne and Wear NHS Foundation Trust, St Nicholas Hospital, Newcastle upon Tyne, UK
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
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Lau N, Waldbaum S, Parigoris R, O'Daffer A, Walsh C, Colt SF, Yi-Frazier JP, Palermo TM, McCauley E, Rosenberg AR. eHealth and mHealth Psychosocial Interventions for Youths With Chronic Illnesses: Systematic Review. JMIR Pediatr Parent 2020; 3:e22329. [PMID: 33075743 PMCID: PMC7685926 DOI: 10.2196/22329] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/02/2020] [Accepted: 10/16/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND An estimated 12.8% of children and adolescents experience chronic health conditions that lead to poor quality of life, adjustment and coping issues, and concurrent mental health problems. Digital health deployment of psychosocial interventions to support youth with chronic illness has become increasingly popular with the advent of the technological advances in the digital age. OBJECTIVE Our objectives were to systematically review published efficacy studies of eHealth and mHealth (mobile health) psychosocial interventions for youths with chronic illnesses and review intervention theory and treatment components. METHODS PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched for studies published from 2008 to 2019 of eHealth and mHealth psychosocial interventions designed for children and adolescents with chronic illnesses in which efficacy outcomes were reported. We excluded studies of interventions for caregivers, healthy youth, disease and medication management, and telehealth interventions that function solely as a platform to connect patients to providers via phone, text, or videoconference. RESULTS We screened 2551 articles and 133 relevant full-text articles. Sixteen efficacy studies with psychosocial and health outcomes representing 12 unique interventions met the inclusion criteria. Of the included studies, 12 were randomized controlled trials and 4 were prospective cohort studies with no comparison group. Most interventions were based in cognitive behavioral theory and designed as eHealth interventions; only 2 were designed as mHealth interventions. All but 2 interventions provided access to support staff via text, phone, email, or discussion forums. The significant heterogeneity in intervention content, intervention structure, medical diagnoses, and outcomes precluded meta-analysis. For example, measurement time points ranged from immediately postcompletion of the mHealth program to 18 months later, and we identified 39 unique outcomes of interest. The majority of included studies (11/16, 69%) reported significant changes in measured health and/or psychosocial posttreatment outcomes, with small to large effect sizes. CONCLUSIONS Although the available literature on the efficacy of eHealth and mHealth psychosocial interventions for youth with chronic illnesses is limited, preliminary research suggests some evidence of positive treatment responses. Future studies should continue to evaluate whether digital health platforms may be a viable alternative model of delivery to traditional face-to-face approaches.
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Affiliation(s)
- Nancy Lau
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Shayna Waldbaum
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Ryan Parigoris
- Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Alison O'Daffer
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Casey Walsh
- Department of Health Services, University of Washington, Seattle, WA, United States
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Susannah F Colt
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Elizabeth McCauley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Abby R Rosenberg
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, United States
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
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15
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Blower S, Swallow V, Maturana C, Stones S, Phillips R, Dimitri P, Marshman Z, Knapp P, Dean A, Higgins S, Kellar I, Curtis P, Mills N, Martin-Kerry J. Children and young people's concerns and needs relating to their use of health technology to self-manage long-term conditions: a scoping review. Arch Dis Child 2020; 105:1093-1104. [PMID: 32444448 PMCID: PMC7588410 DOI: 10.1136/archdischild-2020-319103] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of patient-facing health technologies to manage long-term conditions is increasing; however, children and young people may have particular concerns or needs before deciding to use different health technologies. AIMS To identify children and young people's reported concerns or needs in relation to using health technologies to self-manage long-term conditions. METHODS A scoping review was conducted. We searched MEDLINE, PsycINFO and CINAHL in February 2019. Searches were limited to papers published between January 2008 and February 2019. We included any health technology used to manage long-term conditions. A thematic synthesis of the data from the included studies was undertaken. We engaged children with long-term conditions (and parents) to support review design, interpretation of findings and development of recommendations. RESULTS Thirty-eight journal articles were included, describing concerns or needs expressed by n=970 children and/or young people aged 5-18 years. Most included studies were undertaken in high-income countries with children aged 11 years and older. Studies examined concerns with mobile applications (n=14), internet (n=9), social media (n=3), interactive online treatment programmes (n=3), telehealth (n=1), devices (n=3) or a combination (n=5). Children and young people's main concerns were labelling and identity; accessibility; privacy and reliability; and trustworthiness of information. DISCUSSION This review highlights important concerns that children and young people may have before using technology to self-manage their long-term condition. In future, research should involve children and young people throughout the development of technology, from identifying their unmet needs through to design and evaluation of interventions.
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Affiliation(s)
- Sarah Blower
- Department of Health Sciences, University of York, York, UK
| | - Veronica Swallow
- College of Health, Wellbeing & Life Sciences, Sheffield Hallam University, Sheffield, South Yorkshire, UK
| | - Camila Maturana
- York Trials Unit, University of York, York, North Yorkshire, UK
| | - Simon Stones
- School of Healthcare, University of Leeds, Leeds, West Yorkshire, UK
| | - Robert Phillips
- Centre for Reviews and Dissemination, University of York, York, North Yorkshire, UK
| | - Paul Dimitri
- NIHR Children and Young People MedTech Cooperative, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, Sheffield, UK
| | - Zoe Marshman
- School of Clinical Dentistry, The University of Sheffield, Sheffield, Sheffield, UK
| | - Peter Knapp
- Department of Health Sciences and Hull York Medical School, University of York, York, North Yorkshire, UK
| | - Alexandra Dean
- York Trials Unit, University of York, York, North Yorkshire, UK
| | | | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - Penny Curtis
- School of Nursing and Midwifery, The University of Sheffield, Sheffield, Sheffield, UK
| | - Nathaniel Mills
- NIHR Children and Young People MedTech Co-operative and NIHR Devices for Dignity MedTech Co-operative, Sheffield Children's NHS Trust, Sheffield, UK
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16
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Hoffmann A, Faust-Christmann CA, Zolynski G, Bleser G. Toward Gamified Pain Management Apps: Mobile Application Rating Scale-Based Quality Assessment of Pain-Mentor's First Prototype Through an Expert Study. JMIR Form Res 2020; 4:e13170. [PMID: 32452803 PMCID: PMC7284405 DOI: 10.2196/13170] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 01/01/2023] Open
Abstract
Background The use of health apps to support the treatment of chronic pain is gaining importance. Most available pain management apps are still lacking in content quality and quantity as their developers neither involve health experts to ensure target group suitability nor use gamification to engage and motivate the user. To close this gap, we aimed to develop a gamified pain management app, Pain-Mentor. Objective To determine whether medical professionals would approve of Pain-Mentor’s concept and content, this study aimed to evaluate the quality of the app’s first prototype with experts from the field of chronic pain management and to discover necessary improvements. Methods A total of 11 health professionals with a background in chronic pain treatment and 2 mobile health experts participated in this study. Each expert first received a detailed presentation of the app. Afterward, they tested Pain-Mentor and then rated its quality using the mobile application rating scale (MARS) in a semistructured interview. Results The experts found the app to be of excellent general (mean 4.54, SD 0.55) and subjective quality (mean 4.57, SD 0.43). The app-specific section was rated as good (mean 4.38, SD 0.75). Overall, the experts approved of the app’s content, namely, pain and stress management techniques, behavior change techniques, and gamification. They believed that the use of gamification in Pain-Mentor positively influences the patients’ motivation and engagement and thus has the potential to promote the learning of pain management techniques. Moreover, applying the MARS in a semistructured interview provided in-depth insight into the ratings and concrete suggestions for improvement. Conclusions The experts rated Pain-Mentor to be of excellent quality. It can be concluded that experts perceived the use of gamification in this pain management app in a positive manner. This showed that combining pain management with gamification did not negatively affect the app’s integrity. This study was therefore a promising first step in the development of Pain-Mentor.
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Affiliation(s)
- Alexandra Hoffmann
- Junior Research Group wearHEALTH, Department of Computer Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Corinna A Faust-Christmann
- Junior Research Group wearHEALTH, Department of Computer Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Gregor Zolynski
- Junior Research Group wearHEALTH, Department of Computer Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Gabriele Bleser
- Junior Research Group wearHEALTH, Department of Computer Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
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17
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Jibb L, Nathan PC, Breakey V, Fernandez C, Johnston D, Lewis V, McKillop S, Patel S, Sabapathy C, Strahlendorf C, Victor JC, Moretti ME, Nguyen C, Hundert A, Cassiani C, El-Khechen Richandi G, Insull H, Hamilton R, Fang G, Kuczynski S, Stinson J. Pain Squad+ smartphone app to support real-time pain treatment for adolescents with cancer: protocol for a randomised controlled trial. BMJ Open 2020; 10:e037251. [PMID: 32184315 PMCID: PMC7076249 DOI: 10.1136/bmjopen-2020-037251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Pain negatively affects the health-related quality of life (HRQL) of adolescents with cancer. The Pain Squad+ smartphone-based application (app), has been developed to provide adolescents with real-time pain self-management support. The app uses a validated pain assessment and personalised pain treatment advice with centralised decision support via a registered nurse to enable real-time pain treatment in all settings. The algorithm informing pain treatment advice is evidence-based and expert-vetted. This trial will longitudinally evaluate the impact of Pain Squad+, with or without the addition of nurse support, on adolescent health and cost outcomes. METHODS AND ANALYSIS This will be a pragmatic, multicentre, waitlist controlled, 3-arm parallel-group superiority randomised trial with 1:1:1 allocation enrolling 74 adolescents with cancer per arm from nine cancer centres. Participants will be 12 to 18 years, English-speaking and with ≥3/10 pain. Exclusion criteria are significant comorbidities, end-of-life status or enrolment in a concurrent pain study. The primary aim is to determine the effect of Pain Squad+, with and without nurse support, on pain intensity in adolescents with cancer, when compared with a waitlist control group. The secondary aims are to determine the immediate and sustained effect over time of using Pain Squad+, with and without nurse support, as per prospective outcome measurements of pain interference, HRQL, pain self-efficacy and cost. Linear mixed models with baseline scores as a covariate will be used. Qualitative interviews with adolescents from all trial arms will be conducted and analysed. ETHICS AND DISSEMINATION This trial is approved by the Hospital for Sick Children Research Ethics Board. Results will provide data to guide adolescents with cancer and healthcare teams in treating pain. Dissemination will occur through partnerships with stakeholder groups, scientific meetings, publications, mass media releases and consumer detailing. TRIAL REGISTRATION NUMBER NCT03632343 (ClinicalTrials.gov).
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Affiliation(s)
- Lindsay Jibb
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Paul C Nathan
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Vicky Breakey
- Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Conrad Fernandez
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Hematology/Oncology, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Donna Johnston
- Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Victor Lewis
- Division of Hematology/Oncology, Alberta Children's Hospital, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sarah McKillop
- Division of Hematology/Oncology, Stollery Children's Hospital, Edmonton, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Serina Patel
- Division of Hematology/Oncology, London Health Sciences Centre Children's Hospital, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Christine Sabapathy
- Division of Hematology/Oncology, Montreal Children's Hospital, Montreal, Quebec, Canada
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Caron Strahlendorf
- Division of Hematology/Oncology, BC Children's Hospital, Vancouver, BC, Canada
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - J Charles Victor
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Myla E Moretti
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cynthia Nguyen
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amos Hundert
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Celia Cassiani
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Hayley Insull
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Rachel Hamilton
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Geoffrey Fang
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Susan Kuczynski
- Ontario Parents Advocating for Children with Cancer, Toronto, Ontario, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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18
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Digital interventions for adolescent and young adult cancer survivors. Curr Opin Support Palliat Care 2020; 14:51-59. [DOI: 10.1097/spc.0000000000000480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Almeida AF, Rocha NP, Silva AG. Methodological Quality of Manuscripts Reporting on the Usability of Mobile Applications for Pain Assessment and Management: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E785. [PMID: 32012674 PMCID: PMC7038093 DOI: 10.3390/ijerph17030785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/16/2020] [Accepted: 01/24/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND There has been increasing use of mobile mHealth applications, including pain assessment and pain self-management apps. The usability of mHealth applications has vital importance as it affects the quality of apps. Thus, usability assessment with methodological rigor is essential to minimize errors and undesirable consequences, as well as to increase user acceptance. OBJECTIVE this study aimed to synthesize and evaluate existing studies on the assessment of the usability of pain-related apps using a newly developed scale. METHODS an electronic search was conducted in several databases, combining relevant keywords. Then titles and abstracts were screened against inclusion and exclusion criteria. The eligible studies were retrieved and independently screened for inclusion by two authors. Disagreements were resolved by discussion until consensus was reached. RESULTS a total of 31 articles were eligible for inclusion. Quality assessment revealed that most manuscripts did not assess usability using valid instruments or triangulation of methods of usability assessment. Most manuscripts also failed to assess the three domains of usability (effectiveness, efficiency and satisfaction). CONCLUSIONS future studies should consider existing guidelines on usability assessment design, development and assessment of pain-related apps.
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Affiliation(s)
- Ana F. Almeida
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Campus Universitário de Santiago, 3810-193 Aveiro, Portugal (N.P.R.)
| | - Nelson P. Rocha
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Campus Universitário de Santiago, 3810-193 Aveiro, Portugal (N.P.R.)
- Department of Medical Sciences, Universidade de Aveiro - Edifício 30, Agras do Crasto - Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Anabela G. Silva
- School of Health Sciences, Universidade de Aveiro - Edifício 30, Agras do Crasto - Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
- Center for Health Technology and Services Research, Universidade de Aveiro (CINTESIS.UA), Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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20
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Vo V, Auroy L, Sarradon-Eck A. Patients' Perceptions of mHealth Apps: Meta-Ethnographic Review of Qualitative Studies. JMIR Mhealth Uhealth 2019; 7:e13817. [PMID: 31293246 PMCID: PMC6652126 DOI: 10.2196/13817] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/09/2019] [Accepted: 05/27/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mobile phones and tablets are being increasingly integrated into the daily lives of many people worldwide. Mobile health (mHealth) apps have promising possibilities for optimizing health systems, improving care and health, and reducing health disparities. However, health care apps often seem to be underused after being downloaded. OBJECTIVE The aim of this paper is to reach a better understanding of people's perceptions, beliefs, and experience of mHealth apps as well as to determine how highly they appreciate these tools. METHODS A systematic review was carried out on qualitative studies published in English, on patients' perception of mHealth apps between January 2013 and June 2018. Data extracted from these articles were synthesized using a meta-ethnographic approach and an interpretative method. RESULTS A total of 356 articles were selected for screening, and 43 of them met the inclusion criteria. Most of the articles included populations inhabiting developed countries and were published during the last 2 years, and most of the apps on which they focused were designed to help patients with chronic diseases. In this review, we present the strengths and weaknesses of using mHealth apps from the patients' point of view. The strengths can be categorized into two main aspects: engaging patients in their own health care and increasing patient empowerment. The weaknesses pointed out by the participants focus on four main topics: trustworthiness, appropriateness, personalization, and accessibility of these tools. CONCLUSIONS Although many of the patients included in the studies reviewed considered mHealth apps as a useful complementary tool, some major problems arise in their optimal use, including the need for more closely tailored designs, the cost of these apps, the validity of the information delivered, and security and privacy issues. Many of these issues could be resolved with more support from health providers. In addition, it would be worth developing standards to ensure that these apps provide patients accurate evidence-based information.
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Affiliation(s)
- VanAnh Vo
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Lola Auroy
- Université Grenoble Alpes, Centre National de la Recherche Scientifique, Sciences Po Grenoble, Pacte, Grenoble, France
| | - Aline Sarradon-Eck
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Institut de Recherche pour le Développement, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,Institut Paoli-Calmettes, CanBios UMR1252, Marseille, France
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21
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Mehdizadeh H, Asadi F, Mehrvar A, Nazemi E, Emami H. Smartphone apps to help children and adolescents with cancer and their families: a scoping review. Acta Oncol 2019; 58:1003-1014. [PMID: 30915872 DOI: 10.1080/0284186x.2019.1588474] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Considering the importance of empowering patients and their families by providing appropriate information and education, it seems smartphone apps provide a good opportunity for this group. The purpose of this review was to identify studies which used smartphone apps to help children and adolescents with cancer and their families. Method: Arksey and O'Malley's framework was employed in this review. To examine the evidence on the design and use of smartphone apps for the target group, PubMed, Embase, Scopus and Web of Science databases were searched from 2007 to November 2018. Results: Twenty-four articles met the inclusion criteria, with 33% being conducted in the USA and 21% in Canada. Moreover, in 20 studies (83%), app was specifically designed for children and adolescents, with only three studies (13%) for parents and one study (4%) for both. The main modules of smartphone apps in these studies included symptom assessment (90%), provision of information and education (74%), communication with caregivers (57%), social support (30%) and calendar and reminder (21%). Conclusions: Due to the easy access to smartphones without a costly infrastructure compared to landline phones, the use of mobile health (m-Health) has become a suitable method of providing healthcare services, especially for cancer. Use of smartphone apps, increases patient and families' access to reliable and suitable education and information regarding the disease. Thus, healthcare policy-makers in developing or underdeveloped countries can exploit the health-related potentials of m-Health following the experience of developed countries.
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Affiliation(s)
- Hamed Mehdizadeh
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center (MAHAK-HORC), MAHAK Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Eslam Nazemi
- Department of Electrical and Computer Engineering, Shahid Beheshti University, Tehran, Iran
| | - Hassan Emami
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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22
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Jibb LA, Stacey D, Carley M, Davis A, Graham ID, Green E, Jolicoeur L, Kuziemsky C, Ludwig C, Truant T. Research priorities for the pan-Canadian Oncology Symptom Triage and Remote Support practice guides: a modified nominal group consensus. Curr Oncol 2019; 26:173-182. [PMID: 31285662 PMCID: PMC6588050 DOI: 10.3747/co.26.4247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction The pan-Canadian Oncology Symptom Triage and Remote Support (costars) team is studying how to improve the quality and consistency of cancer symptom management. Methods A 1-day invitational meeting was held 24 October 2017 in Ottawa, Ontario, to review the current evidence from costars projects and to establish research priorities for a future largescale implementation study. The meeting included 36 participants who were clinicians from adult oncology, pediatric oncology, and homecare; policymakers from national, provincial, and regional organizations; researchers; and a patient. Half the day involved summarizing evidence from four costars studies and experiences with implementing the costars symptom practice guides. The second half of the day used a modified nominal group technique to generate research questions within small groups, presentation of research questions to all participants, and two rounds of voting to reach consensus on research priorities. Results Participants proposed 4 research categories:■ User-centred augmentation to enhance usability (for example, designing a mobile costars solution)■ Outcome measurement (for example, determining key competencies for clinicians)■ Regular renewal of costars to keep pace with evolving evidence (for example, updates for novel therapies)■ Integration into clinical practice (for example, meaningful engagement of patients and caregivers in study design). Conclusions Across categories, the top 3 priorities were effect on health services use, competency development, and a mobile costars solution. Future research will address identified priorities, reflecting the needs and perspectives of diverse stakeholders. Stakeholder collaboration will continue to guide our approach to operationalizing this priority research agenda.
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Affiliation(s)
- L A Jibb
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON
| | - D Stacey
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON
| | - M Carley
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON
| | - A Davis
- Washington State University College of Nursing, Vancouver, WA, U.S.A
| | - I D Graham
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON
| | - E Green
- The Ottawa Hospital, Cancer Program, Ottawa, ON
| | - L Jolicoeur
- The Ottawa Hospital, Cancer Program, Ottawa, ON
| | - C Kuziemsky
- Telfer School of Management, University of Ottawa, Ottawa, ON
| | | | - T Truant
- BC Cancer, Education and Innovation, Vancouver, BC
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23
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Yang J, Weng L, Chen Z, Cai H, Lin X, Hu Z, Li N, Lin B, Zheng B, Zhuang Q, Du B, Zheng Z, Liu M. Development and Testing of a Mobile App for Pain Management Among Cancer Patients Discharged From Hospital Treatment: Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e12542. [PMID: 31144672 PMCID: PMC6658226 DOI: 10.2196/12542] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/24/2019] [Accepted: 03/25/2019] [Indexed: 01/19/2023] Open
Abstract
Background The incidence of cancer pain increases in discharged patients because of discontinued standard treatments and reductions in medication adherence. Motivated by the need for better pain management in discharged patients, we developed a mobile phone app (Pain Guard) to provide continuous treatment information and feedback to discharged cancer patients suffering from pain. Objective The aim was to design, construct, and test the Pain Guard app in patients managing cancer pain, evaluate the total remission rate of pain and the improvement in quality of life (QoL) to improve pain management for cancer pain patients, and assess patient acceptance of the app. Methods This randomized controlled double-arm study involved 58 patients with cancer pain symptoms. Participants were randomly assigned to a group receiving care through the Pain Guard app (n=31) or to a control group (n=27) who received only traditional pharmaceutical care. In a pretest, participants were rated using a baseline cancer pain assessment and QoL evaluation. During treatment, the consumption levels of analgesic drugs were recorded every week. After a 4-week study period, another round of cancer pain assessment and QoL evaluation was conducted. The system’s usability, feasibility, app compliance, and satisfaction were also assessed. Our primary outcome was remission rate of pain, and secondary outcomes were medication adherence, improvements in QoL, frequency of breakthrough cancer pain (BTcP), incidence of adverse reactions, and satisfaction of patients. Results All participants (N=58) successfully completed the study. There were no significant differences in baseline pain scores or baseline QoL scores between groups. At the end of the study, the rate of pain remission in the trial group was significantly higher than that in the control group (P<.001). The frequency of BTcP in the app group was considerably lower than that in the control group (P<.001). The rate of medication adherence in the trial group was considerably higher than that in the control group (P<.001). Improvements in global QoL scores in the trial group were also significantly higher than those in the control group (P<.001). The incidence of adverse reactions in the trial group (7/31) was lower than that in the control group (12/27), especially constipation, with significant differences (P=.01). The 31 participants in the trial group completed a satisfaction survey regarding Pain Guard: 23 (74%) indicated that they were satisfied with receiving pharmaceutical care by Pain Guard, 5 (16%) indicated that they were somewhat satisfied, 2 (6%) indicated neutral feelings, and 1 (3%) indicated that they were somewhat dissatisfied; no participants indicated that they were very dissatisfied. Conclusions Pain Guard was effective for the management of pain in discharged patients with cancer pain, and its operability was effective and easily accepted by patients. Trial Registration Chinese Clinical Trials Registry ChiCTR1800016066; http://www.chictr.org.cn/showproj.aspx?proj=27153
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Affiliation(s)
- Jing Yang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Lizhu Weng
- School of Pharmacy, Fujian Medical University, Fuzhou, China.,Department of Pharmacy, Xiamen Maternity and Child Care Hospital, Xiamen, China
| | - Zhikui Chen
- Department of Ultrasound, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China
| | - Hongfu Cai
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Xiaoyan Lin
- Department of Oncology, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China
| | - Zhijian Hu
- Department of Information, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China
| | - Na Li
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Bijuan Lin
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Bin Zheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Qian Zhuang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Bin Du
- Department of Oncology, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China
| | - Zhiyuan Zheng
- School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
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24
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Hunter JF, Kain ZN, Fortier MA. Pain relief in the palm of your hand: Harnessing mobile health to manage pediatric pain. Paediatr Anaesth 2019; 29:120-124. [PMID: 30444558 DOI: 10.1111/pan.13547] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 11/04/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Abstract
The development and implementation of mobile health (mHealth) interventions provide an opportunity for more optimal management of pediatric pain in the home setting. Leveraging the popularity, mobility, and technological capabilities of digital mobile devices may reduce pediatric pain. Several mHealth applications have already been developed that target the reduction of acute and chronic pediatric pain by digitally delivering intervention strategies in an engaging manner, accumulating pain assessment data, facilitating patient-provider communication, and providing interactive training. Although several mHealth programs have begun to make strides in the management of pediatric pain, there are still many more possibilities for improvement as greater development and adoption of mHealth practices is on the horizon. Recommendations are provided that advocate for continued advancement of pediatric pain mHealth implementation with an emphasis on robust scientific evaluation, a structured approach to development and design elements that enhance engagement. Increased awareness about the positive influence of mHealth along with the encouragement of researchers and healthcare providers to promote and develop mHealth programs has the potential to transform pediatric pain management. This merger of evidence-based pain management strategies and digital technology positions pediatric mHealth to have a profound impact by effectively augmenting standard of care and benefiting healthcare providers, parents, and especially children in need.
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Affiliation(s)
- John F Hunter
- Department of Psychological Science, University of California, Irvine, California
| | - Zeev N Kain
- Center on Stress & Health, School of Medicine, University of California-Irvine, Irvine, California.,Department of Anesthesiology and Perioperative Care, University of California-Irvine, Irvine, California.,Department of Pediatrics, Children's Hospital of Orange County, Orange, California.,Yale Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
| | - Michelle A Fortier
- Center on Stress & Health, School of Medicine, University of California-Irvine, Irvine, California.,Department of Anesthesiology and Perioperative Care, University of California-Irvine, Irvine, California.,Sue & Bill Gross School of Nursing, University of California-Irvine, Irvine, California.,Department of Pediatric Psychology, Children's Hospital of Orange County, Orange, California
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25
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Lindsay S, Kolne K, Cagliostro E. Electronic Mentoring Programs and Interventions for Children and Youth With Disabilities: Systematic Review. JMIR Pediatr Parent 2018; 1:e11679. [PMID: 31518310 PMCID: PMC6716434 DOI: 10.2196/11679] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 09/08/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Children and youth with disabilities experience many challenges in their development, including higher risk of poor self-esteem, fewer friendships, and social isolation. Electronic mentoring is a potentially viable approach for youth with disabilities to access social and peer support within a format that reduces physical barriers to accessing mentors. OBJECTIVE Our objective was to synthesize and review the literature on the impact of electronic mentoring for children and youth with disabilities. METHODS We conducted a systematic review, completing comprehensive searches of 7 databases from 1993 to May 2018. We selected articles for inclusion that were peer-reviewed publications, had a sample of children or youth with disabilities (≤25 years of age), and had empirical findings with at least one outcome focusing on the impact of electronic mentoring. Two reviewers independently applied the inclusion criteria, extracted the data, and rated the study quality before discussing the findings. RESULTS In the 25 studies meeting our inclusion criteria, 897 participants (aged 12-26, mean 17.4 years) were represented across 6 countries. Although the outcomes varied across the studies, of 11 studies testing significance, 9 (81%) reported a significant improvement in at least one of the following: career decision making, self-determination, self-advocacy, self-confidence, self-management, social skills, attitude toward disability, and coping with daily life. The electronic mentoring interventions varied in their delivery format and involved 1 or more of the following: interactive websites, virtual environment, email, mobile apps, Skype video calls, and phone calls. A total of 13 studies involved one-to-one mentoring, 6 had group-based mentoring, and 6 had a combination of both. CONCLUSIONS The evidence in this review suggests it is possible that electronic mentoring is effective for children and youth with disabilities. More rigorously designed studies are needed to understand the impact and effective components of electronic mentoring interventions.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Kendall Kolne
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Elaine Cagliostro
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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