Construction And Evaluation Of Self-management Support Module Based On Mobile-Health For Lung Cancer Patients

BackgroundLung cancer is the most commonly diagnosed cancer both in China and worldwide.Lung cancer patients have self-management support needs for symptom management,role adjustment and emotion management during the long process of treatment and rehabilitation.Long-term and timely professional support is required to meet the supportive care needs.In the context of limited and unevenly distributed medical resources,the rapid development of mobile health has opened a new and potentially effective approach to alleviate the supply-demand imbalance.ObjectiveThe first aim of this study is to develop self-management support modules for lung cancer patients.The second aim is to design mobile health platform for the application of the modules and test its feasibility and applicability.This study is significant to provide timely and personalized self-management support for lung cancer patients,thereby enhancing patients' self-management competence and quality of life.MethodThis study has two phases,and phase one was composed of two steps:1.Phase one(Step one): Study on the self-management support framework for lung cancer patients:(1)Literature research method: comprehensive literature review has been conducted to explore lung cancer patients' primary supportive care needs.(2)Qualitative study: a semi-structured interview has been conducted with 15 lung cancer patients to further identify self-management supportive needs during the stage of treatment and rehabilitation,and their preference for mobile health platforms.2.Phase one(Step two): Construction and revision of symptom self-management support module for lung cancer patients:(1)Based on the framework of “symptom self-management module for lung cancer patients”,the researcher cited evidence from corresponding guidelines,literature,professional books and official websites to expand the detailed content of modules,using principles of scientificity,legibility and practicability.(2)Delphi expert consultation method: a total of 13 clinical and nursing experts have been invited for the two rounds of expert consultation to justify and revise the detailed content items.3.Phase two: Preliminary development and trial operation of lung cancer patient self-management support platform(1)Based on the final symptom self-management module for lung cancer patients,the researcher meet periodically with the software engineer to discuss and design the platform.In consideration of patients' preference and the research resource,WeChat public account “symptom self-management” has been preliminarily published.(2)A total of 13 lung cancer patients has been invited to test the platform for 2weeks.Feasibility and applicability of the platform was evaluated.Results1.Preliminary findings of the symptom self-management support framework for lung cancer patients(1)A total of 18 studies was included for the literature review.Key supportive care needs extracted included symptom management needs,emotional management needs,social support needs,medical information needs,and role adaptation needs.Commonly reported symptoms include fatigue,pain,cough,dyspnea and nausea.This step resulted in the construction of the initial framework for self-management support of lung cancer patients,including five common symptom management modules,role management module and emotional management module.(2)Qualitative study extracted six themes: professional support,Chinese medicine treatment,personal support,family support and peer support,and platform preference and preference.It was found that lung cancer patients have beenexperiencing unmet supportive care needs.Limited self-management knowledge and skills impeded their self-support.Lack of sustainable platform stopped them from getting continuous support from professionals and peers.Patients reported the common use of traditional Chinese medicine but without clear intention and information resource.2.Construction and revision of the symptom self-management support module content for lung cancer patients(1)Using the framework developed in the previous step,the detailed content of self-management support module for lung cancer patients have been sorted out.This step resulted in the beta version of “Symptom Self-Management Modules for Lung Cancer Patients”,including 61,000 words and 8 level one indicators,34 level two indicators,157 level three indicators.(2)The expert evaluation of the lung cancer patients self-management support module resulted in the authoritative coefficient of 0.895,0.858 for two rounds respectively,indicating a credible result.The first expert evaluation round showed that the expert recognized 67% of the entries.As a result,15 entries were deleted,32 entries were added,and 8 entries were modified for improvement.The second round of results showed that experts recognized 96% of the items,and the expert comments included the deletion of 6 items,modification of 3 items,and adding of 1 item.After two rounds of expert consultation,a total of 175 entries were finalized.This step resulted in the online version of “Symptom Self-Management Modules for Lung Cancer Patients”.3.Preliminary and trial operation results of the symptom self-management support platform for lung cancer patients(1)The platform was finally developed in the form of public account,including“symptom management”,“emotion and role management” and “my”.The "Symptom Management" section includes five common symptom modules,and the "My" section includes four sections: "Registration","Interaction","Help",and "Investigation".(2)The total frequency of content browsing of the public account for 13 patients within 2 weeks was 670 times,and the per capita account was 26 times/week.Usefeedback questionnaire showed that the platform had high compliance and acceptability.The cancer self-management efficacy questionnaire and the lung cancer patient quality of life scale were used to test the potential effectiveness of the platform based modules.The difference of scores between the pre-and post-using the platform showed an upward trend,but without statistically significant difference(P>0.05).ConclusionsThe study has shown that lung cancer patients have a variety of supportive care needs after discharge,professional information support needs are particularly prominent,as well as insufficient self-management skills and no sustainable peer support platform.Evaluated by experts and patient applicability,the “symptom self-management” public account based on evidence-based and patient needs showed its preliminary applicability and feasibility.