JMIR Publications

ABSTRACT

Background:

Patients with breast cancer who have more aggressive tumor characteristics are often recommended neoadjuvant chemotherapy, which is given before surgery. The main purpose of the treatment is to reduce tumor size and provide valuable prognostic information of the treatment’s effectiveness. As with all chemotherapy, it can cause substantial disturbing physical and psychological symptoms. Most patients undergoing chemotherapy receive their treatment as outpatients, which means they must take responsibility for self-care and management of symptoms at home for a long period of time. Studies have shown that patients with breast cancer undergoing chemotherapy may not receive sufficient support in managing treatment-related symptoms. For patients undergoing neoadjuvant chemotherapy, such studies are few, but it has been concluded that information and supportive needs are not always met. The use of mHealth to support patients with cancer has grown and a previous study has shown reduced symptoms during treatment by the support of an interactive app. Therefore, it is important to investigate how patients with breast cancer undergoing neoadjuvant chemotherapy experience their care as well as explore any specific contribution the app may have brought in the care.

Objective:

The objective of this study was to explore the patients’ experiences of care with or without the support of an interactive app during neoadjuvant chemotherapy for breast cancer.

Methods:

This qualitative study was part of a larger randomized controlled trial and includes 40 individual face-to-face interviews conducted with patients after end of neoadjuvant chemotherapy. The interviews were audio recorded and data was analyzed inductively using thematic analysis.

Results:

The analysis resulted in four overarching themes: “The healthcare context”, which was overall described as accessible, although lack of time and continuity with nurses were mentioned. In the theme “Being a recipient of care”, it emerged that the patients experienced a warm and positive atmosphere at the clinics. In the third theme “Taking an active role as a patient”, patients described being active themselves in searching for information and various ways of participation in their own care were stated. In the fourth theme, “The value of the app”, patients who had used the app experienced it as a complementary source of information creating a sense of security. Using the app gave patients added support of being contacted by a nurse if needed, enabled self-care, and facilitated planning of daily activities.

Conclusions:

Overall the patients were satisfied with care. The extra support for information and self-care provided by the use of the app enhanced participation in their own care and the easy access to a nurse gave them a sense of security. The findings suggest integrating an interactive app as a complement to support patients with breast cancer during treatment. Clinical Trial: ClinicalTrials.gov NCT02479607