Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore.
National University Health System, Singapore, Singapore.
J Med Internet Res. 2021 Dec 7;23(12):e31917. doi: 10.2196/31917.
Elective colorectal cancer (CRC) surgeries offer enhanced surgical outcomes but demand high self-efficacy in prehabilitation and competency in self-care and disease management postsurgery. Conventional strategies to meet perioperative needs have not been pragmatic, and there remains a pressing need for novel technologies that could improve health outcomes.
The aim of this paper was to describe the development of a smartphone-based interactive CRC self-management enhancement psychosocial program (iCanManage) in order to improve health outcomes among patients who undergo elective CRC surgeries and their family caregivers.
A multidisciplinary international team comprising physicians, specialist nurses, a psychologist, software engineers, academic researchers, cancer survivors, patient ambassadors, and ostomy care medical equipment suppliers was formed to facilitate the development of this patient-centric digital solution. The process occurred in several stages: (1) review of current practice through clinic visits and on-site observations; (2) review of literature and findings from preliminary studies; (3) content development grounded in an underpinning theory; (4) integration of support services; and (5) optimizing user experience through improving interface aesthetics and customization. In our study, 5 participants with CRC performed preliminary assessments on the quality of the developed solution using the 20-item user version of the Mobile App Rating Scale (uMARS), which had good psychometric properties.
Based on the collected uMARS data, the smartphone app was rated highly for functionality, aesthetics, information quality, and perceived impact, and moderately for engagement and subjective quality. Several limiting factors such as poor agility in the adoption of digital technology and low eHealth literacy were identified despite efforts to promote engagement and ensure ease of use of the mobile app. To overcome such barriers, additional app-training sessions, an instruction manual, and regular telephone calls will be incorporated into the iCanManage program during the trial period.
This form of multidisciplinary collaboration is advantageous as it can potentially streamline existing care paths and allow the delivery of more holistic care to the CRC population during the perioperative period. Should the program be found to be effective and sustainable, hospitals adopting this digital solution may achieve better resource allocation and reduce overall health care costs in the long run.
ClinicalTrials.gov NCT04159363; https://clinicaltrials.gov/ct2/show/NCT04159363.
择期结直肠癌（CRC）手术提供了更好的手术结果，但需要在术前康复中具有高度的自我效能感，并且在术后具有自我护理和疾病管理能力。满足围手术期需求的传统策略并不实用，因此仍然迫切需要能够改善健康结果的新技术。
本文旨在描述一种基于智能手机的交互式 CRC 自我管理增强心理社会程序（iCanManage）的开发，以改善接受择期 CRC 手术的患者及其家庭照顾者的健康结果。
一个由医生、专科护士、心理学家、软件工程师、学术研究人员、癌症幸存者、患者大使和造口护理医疗器械供应商组成的多学科国际团队成立，以促进这一以患者为中心的数字解决方案的开发。该过程分几个阶段进行：（1）通过临床访问和现场观察审查当前实践；（2）审查文献和初步研究结果；（3）基于基础理论进行内容开发；（4）整合支持服务；（5）通过改善界面美学和定制化来优化用户体验。在我们的研究中，5 名 CRC 患者使用 20 项移动应用程序评级量表（uMARS）的用户版本对开发解决方案的质量进行了初步评估，该量表具有良好的心理测量学特性。
基于收集到的 uMARS 数据，智能手机应用程序在功能、美学、信息质量和感知影响方面的评分较高，在参与度和主观质量方面的评分中等。尽管努力促进参与度并确保移动应用程序易于使用，但仍发现了一些限制因素，例如对数字技术的采用缺乏灵活性和电子健康素养较低。为了克服这些障碍，在试验期间，将为 iCanManage 计划增加额外的应用程序培训课程、使用说明书和定期电话访问。
这种形式的多学科合作具有优势，因为它有可能简化现有的护理路径，并允许在围手术期为 CRC 人群提供更全面的护理。如果该计划被证明有效且可持续，采用这种数字解决方案的医院可能会在长期内实现更好的资源分配和降低整体医疗保健成本。
ClinicalTrials.gov NCT04159363；https://clinicaltrials.gov/ct2/show/NCT04159363。
