Richards Rebecca, Kinnersley Paul, Brain Kate, Wood Fiona
MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
Centre for Medical Education, Cardiff University, Cardiff, United Kingdom.
JMIR Cancer. 2021 May 6;7(2):e23671. doi: 10.2196/23671.
Many patients with cancer have unmet information needs during the course of the illness. Smart devices, such as smartphones and tablet computers, provide an opportunity to deliver information to patients remotely. We aim to develop an app intervention to help patients with cancer meet their illness-related information needs in noninpatient settings. In addition to the in-depth exploration of the issues faced by the target users of a potential intervention, it is important to gain an understanding of the context in which the intervention will be used and the potential influences on its adoption. As such, understanding the views of clinicians is key to the successful implementation of this type of app in practice. Additionally, clinicians have an awareness of their patients' needs and can provide further insight into the type of app and features that might be most beneficial.
This study aims to explore cancer clinicians' views on this type of intervention and whether they would support the use of an app in cancer care. Specifically, the perceived acceptability of an app used in consultations, useful app features, the potential benefits and disadvantages of an app, and barriers to app use were explored.
A total of 20 qualitative, semistructured interviews were conducted with 22 clinicians from urological, colorectal, breast, or gynecological cancer clinics across 2 hospitals in South Wales. The interviews were audio recorded, transcribed, and analyzed using thematic analysis.
Clinicians felt that it would be acceptable for patients to use such an app in noninpatient settings, including during consultations. The benefits of this type of app were anticipated to be a more informed patient, an increased sense of control for patients, better doctor-patient communication, and a more efficient and effective consultation. In contrast, an increase in clinicians' workload and poorer communication in consultations, which depended on the included app features, were identified as potential disadvantages. The anticipated barriers to app use included patients' age and prior experience with smart technology, their access to smart devices, the confidentiality of information, and an avoidant coping approach to their condition.
This study suggests that clinicians should support their patients in using an app to help them meet their information needs both at home and during consultations. This study highlights some of the potential barriers for this type of intervention in practice, which could be minimized during the intervention design process.
许多癌症患者在患病过程中有未满足的信息需求。智能手机和平板电脑等智能设备为远程向患者提供信息提供了机会。我们旨在开发一种应用程序干预措施，以帮助癌症患者在非住院环境中满足其与疾病相关的信息需求。除了深入探讨潜在干预措施的目标用户所面临的问题外，了解干预措施将在何种背景下使用以及对其采用的潜在影响也很重要。因此，了解临床医生的观点是在实践中成功实施此类应用程序的关键。此外，临床医生了解患者的需求，并可以进一步深入了解可能最有益的应用程序类型和功能。
本研究旨在探讨癌症临床医生对这类干预措施的看法，以及他们是否支持在癌症护理中使用应用程序。具体而言，探讨了在会诊中使用应用程序的可接受性、有用的应用程序功能、应用程序的潜在益处和缺点以及应用程序使用的障碍。
对南威尔士2家医院的泌尿外科、结直肠癌、乳腺癌或妇科癌症诊所的22名临床医生进行了20次定性半结构化访谈。访谈进行了录音、转录，并采用主题分析法进行分析。
临床医生认为患者在非住院环境中使用此类应用程序是可以接受的，包括在会诊期间。预计这类应用程序的好处是患者更加知情、患者的控制感增强、医患沟通更好以及会诊更高效。相比之下，临床医生工作量的增加以及会诊中沟通不畅（这取决于应用程序的功能）被确定为潜在缺点。预计应用程序使用的障碍包括患者的年龄、对智能技术的先前经验、他们对智能设备的获取、信息的保密性以及对自身病情的回避应对方式。
本研究表明，临床医生应支持患者使用应用程序，以帮助他们在家庭和会诊期间满足信息需求。本研究突出了这类干预措施在实践中的一些潜在障碍，这些障碍在干预设计过程中可以最小化。
