| Research background and purpose:Lung cancer is the malignant tumor with the highest incidence and mortality rate in China,and the disease burden is high.It has been confirmed that timely and effective rehabilitation training for postoperative lung cancer patients can speed up their recovery process.With the development of medical technology and the application of accelerated recovery after surgery(ERAS)in clinical practice,patients have shorter hospital stays and fewer opportunities to undergo in-hospital rehabilitation.Continuing care for patients after lung cancer surgery has become a major development trend.The mobile medical platform-based continuing care provides a way for patients to obtain out-of-hospital rehabilitation training,and patients’ willingness to use the mobile medical platform for continuing care has attracted much attention from scholars.Most studies use questionnaires to understand patients’ willingness to use the Continuing Care mHealth platform,and some patients do not understand the Continuing Care mHealth platform,which may lead to patients not being able to fully express their needs.This study intends to establish a simple but core content of the continuity of care WeChat platform for postoperative lung cancer patients,where the core content refers to six rehabilitation training videos authorized by the Chinese Society of Rehabilitation Medicine to provide patients with continuity of care service content related to postoperative rehabilitation training,to explore the basic situation of patients’ use of the continuity of care WeChat platform and its influencing factors,so as to facilitate medical and nursing staff to understand the different To explore the basic situation of patients’ use of the extended care WeChat platform and its influencing factors,in order to facilitate medical and nursing staff to understand the service needs of postoperative lung cancer patients with different personality characteristics of the extended care WeChat platform,so as to promote the development of extended care services.Materials and Methods:Firstly,a We Chat platform applicable to the continuous care of postoperative lung cancer patients was established.The We Chat platform in this study had the core services needed by patients,and the main content of the platform was the rehabilitation training videos provided by the Chinese Society of Rehabilitation Medicine,with six videos,including three respiratory training videos and three limb movement videos.A continuous sampling method was used to select postoperative lung cancer patients who met the inclusion criteria and were seen in a tertiary care hospital from December 2021 to November 2022.One day before discharge,the investigator trained postoperative lung cancer patients one-on-one to use the We Chat platform,and after the training was completed,the investigator assessed the patients to ensure that each patient knew how to use the platform,and collected general patient data(including demographics data,clinical data,and exercise habit questionnaire,of which clinical data were obtained from medical records)as well as the Chinese version of the Chinese-version Strategeis Used by People to Promote Health(C-SUPPH),Functional Assessment of Cancer Therapy-Lung Cancer(FACT-L),M.D.Anderson Symptom Inventory(MDASI)data,and patients were informed that the survey needed to be conducted twice for this study.One month after the patients were discharged from the hospital,the investigator proactively contacted the patients to collect information on the patients’ We Chat platform usage as well as the data of the Functional Assessment of Cancer Therapy-Lung Cancer(FACT-L),M.D.Anderson Symptom Inventory(MDASI)in order to track the patients’ We Chat platform usage and analyze the patients’ We Chat platform usage and the influencing factors.SPSS 26.0 was used to build the database and conduct statistical analysis,and the measurement data were described by mean ± standard deviation;the count data were described by frequency and percentage.One-way analysis and multiple linear regression analysis were used to analyze patients’ willingness to use We Chat platform and its influencing factors after lung cancer surgery,with a two-sided test level of α=0.05.Result:1.A total of 162 postoperative lung cancer patients were included in this study,11 patients were lost because no one answered or refused to answer during the telephone follow-up,and 151 patients were finally included,of whom 69 were male,accounting for 45.7%,and 82 were female,accounting for 54.3%,with an average age of(60.57 ±10.11)years;61 patients with elementary school education,accounting for The majority of patients had histopathological type of non-small cell carcinoma,143 patients,accounting for 94.7%;the most patients had stage I disease,59 patients,accounting for 39.1%;44 patients had local metastasis,accounting for 29.1%;83 patients had other combined diseases,accounting for 55.5%;hypertension was the most common type of combined disease,56 patients,accounting for 37.5%.Among the combined diseases,hypertension was the most common type of disease,with 56 patients,accounting for 37.1%.2.The results of training and assessment on the use of WeChat platform for postoperative patients with lung cancer showed that 151 patients were instructed to use WeChat platform in this study,and 135 patients were instructed directly by the patients themselves,accounting for 89.4%;138 patients were able to master the use of the platform through one training,accounting for 91.4%;when the patients were assessed on the use of the platform,133 patients In the assessment of patients’ use of the platform,133 patients passed the assessment for one time,accounting for 88.1%.3.One month after lung cancer postoperative patients were discharged from the hospital,the follow-up results showed that the maximum number of times patients used the continuity of care WeChat platform was 18,the minimum number of times was 1,and the average number of times was(5.64±5.16).The largest number of patients,92,or 60.9%,used the WeChat platform for less than 0.5h each time.After ensuring that 151 postoperative lung cancer patients were aware of and would use the WeChat public platform to continue care services,without supervision and intervention,30 patients had a high willingness to use it after one month,accounting for 19.9%;46 patients had a moderate willingness to use it,accounting for 30.5%;and 75 patients had a low willingness to use it,accounting for 49.6%.The reasons why patients did not insist on using it mainly included:having other exercise programs(62 times),fear of wound pulling pain(38 times),not daring to exercise with obvious complications(34 times),not liking exercise(22 times)and not having time to exercise(15 times).4.The total self-efficacy score of postoperative lung cancer patients was(85.19 ±11.67),and the scores of each dimension were:self-stress reduction(30.56±4.24),self-decision making(9.26±1.56),and positive attitude(45.41±6.81).10 patients with self-efficacy scores lower than 65(6.6%)were postoperative lung cancer patients,and the self-efficacy score of 66-102 accounted for 123 patients(81.5%),and 18 patients with self-efficacy scores higher than 103(11.9%).The difference in willingness to use the WeChat platform among patients with different self-efficacy was statistically significant(2=7.157,P<0.05),and those with high self-efficacy had higher willingness to use the WeChat platform than those with low self-efficacy.5.In this study,there were 118 lung cancer patients with exercise habits,accounting for 78.14%,and 33 patients without exercise habits,accounting for 21.86%.Among the 118 patients with exercise habit,48 patients(40.7%)had lower willingness to use,and among the 33 patients without exercise habit,27 patients(81.8%)had lower willingness to use,and the difference between the two groups was statistically significant(χ 2=17.469,P<0.001),and patients with exercise habit had higher willingness to use WeChat platform.6.A binary logistic regression analysis was performed using the willingness of postoperative lung cancer patients to use the WeChat public platform for continuity of care as an outcome indicator,and the results showed that exercise habits,comorbid diseases,literacy and self-efficacy were independent influencing factors for the willingness of postoperative lung cancer patients to use the WeChat fair platform.7.The total quality of life score of postoperative lung cancer patients before discharge was(81.75±13.57),and the total quality of life score after one month of discharge was(97.60 ± 10.68),and the difference between the two groups was statistically significant(t=13.182,P<0.001);there was a correlation between the willingness of postoperative lung cancer patients to use WeChat platform and the improvement of their symptoms,and the correlation coefficient r=0.289,and there was no correlation between the willingness of postoperative lung cancer patients to use the WeChat platform and their improvement in quality of life.8.The frequency of pushing services of WeChat platform most preferred by postoperative lung cancer patients was 3-4 times a week,accounting for 47.7%;the top two types of services provided by WeChat platform preferred by postoperative lung cancer patients were:providing personalized dietary exercise program and disease-related knowledge,accounting for 62.9%and 56.3%,respectively;postoperative lung cancer patients preferred WeChat platform to Post-operative lung cancer patients preferred the WeChat platform to provide content in the form of videos,accounting for 96.7%. |
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