Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 17, 2020
Date Accepted: Mar 12, 2020
Using an Interactive App for Symptom Reporting and Management Following Pancreatic Cancer Surgery Facilitates Person-Centered Care: A Descriptive Study
ABSTRACT
Background:
Pancreatic and periampullary cancers are rare but has high mortality rates. The only hope for cure is surgical removal of the tumor. Following pancreatic surgery, the patients have a great deal of responsibility for managing their symptoms. Patients report a lack of sufficient knowledge of self-care and unmet supportive care needs. This necessitates having a healthcare system responsive to these needs and healthcare professionals who pay close attention to symptoms. Person-centered care is widely encouraged and means a shift from a model in which the patient is the passive object of care to a model involving the patient as an active participant in their own care. To address the challenges in care following pancreatic cancer surgery, an interactive app (Interaktor) was developed in which patients regularly report symptoms and receive support in self-care. The app has shown to reduce patients’ symptom burden and to increase their self-care activity levels following pancreaticoduodenectomy due to cancer.
Objective:
The aim of the study was to describe how patients used the app Interaktor following pancreaticoduodenectomy due to cancer and their experience of doing so.
Methods:
A total of 115 patients were invited to use Interaktor for six months following pancreaticoduodenectomy. Of those, 35 declined, 8 dropped-out and 46 did not meet the inclusion criteria after surgery, leaving 26 patients to be included in the analysis. The patients were instructed to report symptoms daily through the app for up to six months following surgery. In case of alerting symptoms, they were contacted by their nurse. Data on reported symptoms, alerts and viewed self-care advice were logged and analyzed with descriptive statistics. Also, the patients were interviewed about their experiences and the data were analyzed using thematic analysis.
Results:
The patients’ median adherence to symptom reporting was 82%. Fatigue and pain were the most reported occurring symptoms. Twenty-four patients reported alerting symptoms and the most common alert was fever. There were variations in how many times the patients had viewed the self-care advice (range 3-181). The most commonly viewed advice concerned pancreatic enzyme supplements. Through the interviews the overarching theme “Being seen as a person” with three sub-themes; “Getting your voice heard”, “Having access to an extended arm of healthcare”, and “Learning about own health” were identified.
Conclusions:
Interaktor proved to be well accepted. It made patients feel reassured at home and offered support for self-care. The app facilitated person-centered care by its multiple features targeting individual supportive care needs and enabled participation in own care. This supports our recent studies showing that patients using the app had less symptom burden and higher self-care activity levels than those only getting standard care.
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