Construction Of An M-Health Based Information Support Program For Women With Breast Cancer During Diagnosis And Treatment Process

[Objective]Breast cancer patients face a variety of physical and psychological challenges during the long diagnosis and treatment process. They urgently need strong, long-term and timely guidance and support from professionals. In the current situation of inadequate and uneven distribution of medical resources, the rapid development of m-health provides a new and efficient solution to this problem. This study aims to explore and understand breast cancer patients'diverse information needs during different stages of diagnosis and treatment.Expert working group discussions and Delphi expert consultations are used to constructing the m-health based information support program for breast cancer patient during diagnosis and treatment process, and software design and development. Thus, with the help of m-health technology,we can better meet breast cancer patients'immediate,personalized information needs, and then promote their rehabilitation.[Method]The study is divided into three parts:1. A preliminary study on mobile information support program for patients with breast cancer(1) A qualitative study method was used to explore the real experience of breast cancer patients, the main contents, preferences and characteristics of their information need in different stages during the treatment and rehabilitation process. Including a3-6 months longitudinal follow-up study of 12 breast cancer patients and focus interviews of 7 supplemental cases of representative breast cancer patients. (2) A WeChat subscription based breast cancer information support pre-test was conducted. Information related to breast cancer diagnosis and treatment was sent to the patients through the WeChat subscription regularly, thus to explore patients' acceptance of m-health based information support method, their habits and information preferences. (3) Combining the results of literature review, qualitative research and WeChat pre-experimental study, and referring related m-health based app on the market, A draft of m-health based information support program was came out.2. Demonstration and revision of mobile information support scheme(1) The expert working group discussion was conducted; a total of 7 experts from medical, nursing and software engineering were included. Experts give their views and advice about the contents of breast cancer patients' information needs and suggestions for the revision of the information support scheme. (2) A Delphi expert consultation was conducted, 20 clinical nursing experts had participated and gave their opinions on the core part of the mobile information support program. Each item of the eight information bank was checked and approved by the experts. (3) Referring to the authoritative guide,expert consensus, clinical education handbook, papers of academic conference and professional books, the concrete contents of the eight information banks were sorted out.3. The final establishment of information support scheme and the initial development of softwareExpert consultations including 5 clinical medical and nursing experts and 3 software engineers were used to revise and optimization the mobile information support scheme and software design. Researcher organized the multi-disciplinary cooperation of the experts to revise and finalize the mobile information support program, and then work with software engineers to design and develop this software.[Results]1. The result of the preliminary study on information support program for patients with breast cancer(1)Breast cancer patients'different information need contents during diagnosis stage,operation stage, adjuvant chemotherapy stage, chemotherapy stage and rehabilitation stage were recognized in the longitudinal follow-up. And patients'information needs contents during radiation therapy stage, endocrine therapy stage and rehabilitation stage,patients 'access to the information and their opinion to these information channels were recognized in the focus interviews. (2) During the one-month WeChat subscription pre-test,there are 24 users followed the subscription. Totally 12 information support messages were delivered and were read 586 times by users. The top three information support messages read by users were How to do self-breast examination, Clinical examination of breast cancer: the imaging examination and Clinical examination of breast cancer: the pathological examination. Some users actively engage in the pre-test and gave some useful feedback and suggestions for the construction and usage of the subscription. (3) The draft of the mobile information support program for breast cancer patients was come out, which includes four modules: self-health management, categorized information support,questionnaire self-evaluation and social psychological support.2. Demonstration and revision of mobile information support scheme(1) The expert working group discussion identified the main modules of the mobile information support program, including self-health management, categorized information support and social psychological support. Also, the experts gave their valuable suggestion for the core part of the mobile information support program: the construction of an information knowledge bank. (2) The construction of breast cancer information knowledge bank: the expert personal authority coefficient is between 0.7-0.95, average expert authority coefficient was 0.86, and the results were credible. Item demonstration of the eight information bank: the first round consultation results showed that the experts'acceptance rate of items was 87%, including modification of three items, merging of 2 items, splitting 3 items and adding 12 items; The second round consultation results showed that the experts'acceptance rate of items was 94%, including modification of three items,splitting 1 items and adding 7 items. After the 2-round e-delphi process, the experts reached consensus on 84-items information bank. (3) Referring to the 84 items of the information knowledge bank one by one, and following the principle of being scientific and easy to read, the concrete contents of eight information bank were sorted out. A total of more than 66 thousands words information support draft was finished.3. Establishment of mobile information support and software developmentThe construction of information support program for breast cancer patients and the demonstration of the concrete contents of each information support item were finished in the expert consultation process. The mobile information support program included three major parts, among which the information knowledge bank based information support is the most important part, and the other two supplementary parts are questionnaire self-evaluation and interaction circle. A login path diagram to fascinate breast cancer patients' use of the app, and the function and interface of the software were designed according to the mobile information support scheme. The software included five function modules: registration and login, personalized information support (main interface),questionnaire self-evaluation, interactive circle, and personal information and settings.[Conclusions]1. Breast cancer patients have different information needs during different stages of diagnosis and treatment process, such as diagnosis stage, operation stage, adjuvant chemotherapy stage, chemotherapy stage and rehabilitation stage. Specialize information support should be provided related to patients'current situation.2. Health care professionals are still the main source and most reliable channel of information support for patients with breast cancer, and information sharing between peers is also of great importance to breast cancer patients. Breast cancer patients now have much more online practice to find relevant information, and WeChat platform becomes an important access for some patient to get information. Using the WeChat subscription to provide professional information support to users can overcome the limitations of time and space.It's easy, economic and efficient.3. In this study, breast cancer patients' information support items of eight different stages,including diagnosis stage,adjuvant chemotherapy stage,operation stage,chemotherapy stage, radiation therapy stage, endocrine therapy stage, targeted therapy stage and rehabilitation stage,was identified and the concrete contents of each item sorted out through expert discussions and consultations.The text, pictures and video materials of information support contents can be used as education materials for breast cancer patients during diagnosis and treatment in clinical.4?The mobile information support program was finalized in this study, including three parts: the information knowledge bank based information support, questionnaire self-evaluation and interaction circle. The major function and modules of the mobile information support software were identified as five parts: registration and login,personalized information support (main interface), questionnaire self-evaluation,interactive circle, and personal information and settings.The software is in the debugging process currently, the practical application and effectiveness test of the software will be carried out in the future study.