Furness Kate, Huggins Catherine Elizabeth, Truby Helen, Croagh Daniel, Haines Terry Peter
Monash Health, Nutrition and Dietetics, Monash Medical Centre, Melbourne, Australia.
School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
JMIR Form Res. 2021 Mar 12;5(3):e23979. doi: 10.2196/23979.
Adults diagnosed with cancers of the stomach, esophagus, and pancreas are at high risk of malnutrition. In many hospital-based health care settings, there is a lack of systems in place to provide the early and intensive nutritional support that is required by these high-risk cancer patients. Our research team conducted a 3-arm parallel randomized controlled trial to test the provision of an early and intensive nutrition intervention to patients with upper gastrointestinal cancers using a synchronous telephone-based delivery approach versus an asynchronous mobile app-based approach delivered using an iPad compared with a control group to address this issue.
This study aims to explore the overall acceptability of an early and intensive eHealth nutrition intervention delivered either via a synchronous telephone-based approach or an asynchronous mobile app-based approach.
Patients who were newly diagnosed with upper gastrointestinal cancer and who consented to participate in a nutrition intervention were recruited. In-depth, semistructured qualitative interviews were conducted by telephone and transcribed verbatim. Data were analyzed using deductive thematic analysis using the Theoretical Framework of Acceptability in NVivo Pro 12 Plus.
A total of 20 participants were interviewed, 10 from each intervention group (synchronous or asynchronous delivery). Four major themes emerged from the qualitative synthesis: participants' self-efficacy, low levels of burden, and intervention comprehension were required for intervention effectiveness and positive affect; participants sought a sense of support and security through relationship building and rapport with their dietitian; knowledge acquisition and learning-enabled empowerment through self-management; and convenience, flexibility, and bridging the gap to hard-to-reach individuals.
Features of eHealth models of nutrition care delivered via telephone and mobile app can be acceptable to those undergoing treatment for upper gastrointestinal cancer. Convenience, knowledge acquisition, improved self-management, and support were key benefits for the participants. Future interventions should focus on home-based interventions delivered with simple, easy-to-use technology. Providing participants with a choice of intervention delivery mode (synchronous or asynchronous) and allowing them to make individual choices that align to their individual values and capabilities may support improved outcomes.
Australian and New Zealand Clinical Trial Registry (ACTRN) 12617000152325; https://tinyurl.com/p3kxd37b.
被诊断患有胃癌、食管癌和胰腺癌的成年人存在营养不良的高风险。在许多基于医院的医疗保健环境中，缺乏为这些高风险癌症患者提供所需的早期和强化营养支持的系统。我们的研究团队进行了一项三臂平行随机对照试验，以测试使用基于同步电话的交付方式与使用iPad的基于异步移动应用程序的方式向患有上消化道癌症的患者提供早期和强化营养干预，并与对照组进行比较，以解决这一问题。
本研究旨在探讨通过基于同步电话的方法或基于异步移动应用程序的方法提供的早期和强化电子健康营养干预的总体可接受性。
招募新诊断为上消化道癌症并同意参加营养干预的患者。通过电话进行深入的半结构化定性访谈，并逐字转录。使用NVivo Pro 12 Plus中的可接受性理论框架进行演绎主题分析来分析数据。
共采访了20名参与者，每个干预组（同步或异步交付）各10名。定性综合分析得出了四个主要主题：干预效果和积极影响需要参与者的自我效能感、低负担水平和对干预的理解；参与者通过与营养师建立关系和融洽关系来寻求支持和安全感；知识获取和学习通过自我管理实现赋权；以及便利性、灵活性和缩小与难以接触到的个体之间的差距。
通过电话和移动应用程序提供的电子健康营养护理模式的特点对于接受上消化道癌症治疗的人来说可能是可以接受的。便利性、知识获取、自我管理的改善和支持是参与者的关键益处。未来的干预措施应侧重于使用简单易用技术的家庭干预。为参与者提供干预交付模式（同步或异步）的选择，并允许他们做出符合其个人价值观和能力的个人选择，可能有助于改善结果。
澳大利亚和新西兰临床试验注册中心（ACTRN）12617000152325；https://tinyurl.com/p3kxd37b 。
