Requirements of mobile-based self-management application for patients with gastric cancer: specialists and patients perspective (Preprint)

Delphi technique for design and content validation by experts of a mobile app for self-care of breast cancer-related lymphedema

INTRODUCTION

Breast cancer-related lymphedema (BCRL) is a complication that requires lifelong control, with patients taking responsibility for self-care. Mobile applications (apps) can be an effective health education strategy to help manage BCRL by promoting collaborative learning environments in physical therapy. The objective of this study was to design and validate the content for the development of a mobile application for self-care in the health of the BCRL.

METHODS

The Delphi technique was used through two rounds with data collection instruments using Research Electronic Data Capture (REDCap) and consensus was obtained among a group of experts regarding the content.

RESULTS

Thirty experts participated in the first round to suggest content and 11 content menus, and 48 sub-content menus were suggested. The second round included 19 experts to validate the content. The content validity coefficient values were considered good, both for clarity and relevance (CVCt = 0.93) and for the relevance (CVCt = 0.92) of the contents, with the CVCt of the scale being 0.92, giving its content validity according to the analysis methods used in this research.

CONCLUSION

The Delphi technique helped to obtain a consensus that the content is clear, relevant, and pertinent. The results indicate that the application will be a useful and effective tool, offering the necessary functionality to guide these patients' self-care, and is ready for development.

IMPLICATIONS FOR CANCER SURVIVORS

This app will assist in proactive prevention before BCRL diagnosis, provide comprehensive knowledge and information during the treatment process for diagnosed patients, and support long-term self-management, while enhancing the learning of education provided to them by healthcare professionals such as physiotherapists.

iCare - a self-directed, interactive online program to improve health and wellbeing for people living with upper gastrointestinal or hepato-pancreato-biliary cancers, and their informal carers: the study protocol for a Phase II randomised controlled trial

BACKGROUND

Up to 70% of people diagnosed with upper gastrointestinal (GI) tract or hepato-pancreato-biliary (HPB) cancers experience substantial reductions in quality of life (QoL), including high distress levels, pain, fatigue, sleep disturbances, weight loss and difficulty swallowing. With few advocacy groups and support systems for adults with upper GI or HPB cancers (i.e. pancreas, liver, stomach, bile duct and oesophageal) and their carers, online supportive care programs may represent an alternate cost-effective mechanism to support this patient group and carers. iCare is a self-directed, interactive, online program that provides information, resources, and psychological packages to patients and their carers from the treatment phase of their condition. The inception and development of iCare has been driven by consumers, advocacy groups, government and health professionals. The aims of this study are to determine the feasibility and acceptability of iCare, examine preliminary efficacy on health-related QoL and carer burden at 3- and 6-months post enrolment, and the potential cost-effectiveness of iCare, from health and societal perspectives, for both patients and carers.

METHODS AND ANALYSIS

A Phase II randomised controlled trial. Overall, 162 people with newly diagnosed upper GI or HPB cancers and 162 carers will be recruited via the Upper GI Cancer Registry, online advertisements, or hospital clinics. Patients and carers will be randomly allocated (1:1) to the iCare program or usual care. Participant assessments will be at enrolment, 3- and 6-months later. The primary outcomes are i) feasibility, measured by eligibility, recruitment, response and attrition rates, and ii) acceptability, measured by engagement with iCare (frequency of logins, time spent using iCare, and use of features over the intervention period). Secondary outcomes are patient changes in QoL and unmet needs, and carer burden, unmet needs and QoL. Linear mixed models will be fitted to obtain preliminary estimates of efficacy and variability for secondary outcomes. The economic analysis will include a cost-consequences analysis where all outcomes will be compared with costs.

DISCUSSION

iCare provides a potential model of supportive care to improve QoL, unmet needs and burden of disease among people living with upper GI or HPB cancers and their carers.

AUSTRALIAN AND NEW ZEALAND CLINICAL TRIALS REGISTRY

ACTRN12623001185651. This protocol reflects Version #1 26 April 2023.