Development And Clinical Application Of Self-management Application Program For Gynecological Malignant Tumor Chemotherapy Intermittent Chemotherapy-related Nausea And Vomiting Symptoms

Background:Chemotherapy-induced nausea and vomiting(CINV)is one of the most common side effects of chemotherapy.Gynecologic malignant tumor patient's during intermission of chemotherapy is affected by the delayed CINV.Therefore,Patients in intermission of chemotherapy are in urgent need of a series of follow-up treatment.The shortcoming of the traditional telephone follow-up such as lack of targeted,time-limited and unclear level is gradually highlighted.Objective:To establish the CINV Mobile Symptom Self-management System(CMSM)in patients during intermission of chemotherapy and applied to the clinic.Methods:Firstly we used the literature method and Delphi method to form interventions and tactics involved in CINV mobile symptom self-management system about malignant tumor during intermission of chemotherapy.At the same time,we formed a functional outline of APP based on the patients demand investigation.Secondly convenience sampling was adopted to select 140 malignant tumor patients during intermission of chemotherapy from Peking Union Medical College Hospital gynecology ward,during September,2016 to July,2017.Data from three chemotherapy intervals were collected.The effect and availability of the application were evaluated by the MAT scale and the FLIE scale.Results:During the stage of application establishment,2 more items were added,and 41 items were used to form the decision-making module in the application.Through the investigation of the functional requirements of smart phone application in 350 patients diagnosed with malignant tumor,in the requirements of the eight functional modules the top three were:application function(score:4.36±1.02),professional consultation(score:4.2811.61),medication guidance(score:4.14±1.10);in each functional requirement the top three were:protection of privacy(score:4.53±10.90),CINV dietary guidelines(score:4.39±0.93),the content from the authorities(score:4.38±1.03).In clinical application stage,the results showed that:(1)the incidence rate of CINV was not affected by CMSM application;(2)acute CINV had significant difference between the two groups in the first two chemotherapy intervals,and there was no significant difference between the third chemotherapy interval,the delayed CINV and FLIE were different in three intermittent periods;(3)the satisfaction of nurse follow-up in the study group was higher than that in the control group(t=-3.191,P=0.002).There was significant difference in the time(t=78.207,P=0.000;t=83.367,P=0.000;t=81.498,P=0.000)between nurses collecting patients' follow-up data.Conclusions:For the patients during chemotherapy intermission,the general demand of smart phone based CINV non-medicine interventional application reached a high level.Compared with the traditional telephone follow-up,the smart phone had better effects on management of CINV symptoms,especial the effect of control of delayed CINV symptoms and improvement of quality of life.At the same time,the smart phone saved a lot of time for follow-up,reduced the pressure of nurses' labor and improved follow-up efficiency.