JMIR Publications

ABSTRACT

Background:

Quality of life (QoL) is an important surgical outcome, commonly assessed through self-reports, and has the potential to be enhanced by objective information from personal technologies like smartphone apps and wearables. Understanding patient perspectives on this application of personal technologies is scarce.

Objective:

We aimed at identifying operational aspects of smartphones- and wearables-based assessments, as well human factors that may influence the acceptability of already owned (smartphone) or new (wearable) technologies by patients for pre-post-surgery QoL assessments.

Methods:

In total we involved 41 patients who either had had surgery or were scheduled for it through purposive sampling at three different healthcare centres (Switzerland, USA, and UK). Patients belonged to either one of three populations undergoing surgical procedures on degenerative cervical myelopathy, liver transplant, and total hip replacement. We interviewed them for their perceptions of QoL, their use of smartphone and smartphone apps and wearables, with particular attention to use towards their health self-management, and their attitudes of the potential for the use of such technologies for their pre-post-surgery quality of life assessments.

Results:

Assessment of pain, fatigue, sleep and autonomy in daily living, and especially an increased ability to engage in physical activity were discussed by all the patients as important physical functioning outcomes to be assessed pre-post-surgery. Majority of the patients consider that none of the existing or future personal technologies can replace an assessment conducted by their healthcare practitioner. Most of the patients do not currently use any of the smartphone apps or wearables, i.e., never even considered using them or tried and dropped them after a short period of use. These patients express that wearables like smart watches and bracelets are too expensive and, having too many features, too complex and difficult to operate. A small subset of patients who use some of these technologies, especially smartphone apps, noted their potential advantages, such as being able to seamlessly measure their physical functioning correlated to their health changes, especially sleep and physical activity, and share the data with their practitioners. That, in turn, may increase their sense of self-efficacy, and their motivation to health self-management.

Conclusions:

Given a mostly negative attitude of patients towards wearables, we discuss the use of smartphone-based automated logging of physical functioning (sleep and physical activity) instead. Such a logging may be less accurate than a dedicated wearable, but it may be accurate enough to measure their pre-post surgery physical functioning changes. Additionally, a smartphone has the advantage of being already well integrated into the daily life of patients from perspective of its functionality and the patients’ routines, contrary to wearable devices, would have been provided to the patients in the context of pre-post surgery clinical care and require additional attention for their continuous wear, charging, and data synchronization, amongst the others.