Fjell Maria, Langius-Eklöf Ann, Nilsson Marie, Sundberg Kay
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
JMIR Nurs. 2022 Aug 11;5(1):e39983. doi: 10.2196/39983.
Neoadjuvant chemotherapy (NACT) is often recommended for patients with breast cancer with more aggressive tumor characteristics. As with all chemotherapies, they can cause substantially disturbing symptoms. Most patients receive their treatment as outpatients, which means that they must take responsibility for self-care and management of symptoms at home for a long period. Patients with breast cancer undergoing chemotherapy may not receive sufficient support for management of treatment-related symptoms. For patients undergoing NACT, it has been concluded that information and supportive needs are not always met. In our previous study, the use of mobile health to support patients with breast cancer undergoing NACT reduced symptoms during treatment with the support of an interactive app. Therefore, it is important to investigate how patients experience their care and explore any specific contribution that the app may have brought in care.
This study aims to explore patients' experiences of care with or without the support of an interactive app during NACT for breast cancer.
This qualitative study was part of a larger randomized controlled trial and included 40 individual face-to-face interviews conducted with patients in both intervention and control groups after the end of NACT. The interviews were audio recorded, and the data were analyzed inductively using thematic analysis.
No major differences in experience of care were observed between the groups. A total of 4 overarching themes emerged. In the first theme, The health care context, patients described care as assessible, although sometimes there was a lack of time and continuity with nurses. In the second theme, Being a recipient of care, it emerged that the patients experienced a warm and positive atmosphere at the clinics. In the third theme, Taking an active role as a patient, patients described being active in searching for information and various ways of participation in their own care. In the fourth theme, The value of the app, patients who had used the app experienced it as a complementary source of information, creating a sense of security. Using the app provided patients with the support of being contacted by a nurse if needed, enabled self-care, and facilitated the planning of daily activities.
Overall, patients' experiences of care were similar and mostly positive. However, for patients using the app, it provided additional support for information and self-care and enhanced participation in their own care. The easy access to a nurse gave patients a sense of security. The findings suggest integrating an interactive app as a complement to standard care to support patients with breast cancer during treatment.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-DOI: 10.1186/s12885-017-3450-y.
新辅助化疗（NACT）通常推荐用于具有更具侵袭性肿瘤特征的乳腺癌患者。与所有化疗一样，它们会引起严重困扰的症状。大多数患者作为门诊病人接受治疗，这意味着他们必须长期在家中负责自我护理和症状管理。接受化疗的乳腺癌患者在治疗相关症状的管理方面可能得不到足够的支持。对于接受NACT的患者，已经得出结论，信息和支持需求并不总是得到满足。在我们之前的研究中，使用移动健康技术通过一款交互式应用程序的支持，在治疗期间减轻了接受NACT的乳腺癌患者的症状。因此，调查患者如何体验他们的护理并探索该应用程序在护理中可能带来的任何具体贡献非常重要。
本研究旨在探索乳腺癌患者在接受NACT期间，在有或没有交互式应用程序支持的情况下的护理体验。
这项定性研究是一项更大规模随机对照试验的一部分，包括在NACT结束后对干预组和对照组的患者进行40次个人面对面访谈。访谈进行了录音，并使用主题分析法对数据进行归纳分析。
两组在护理体验方面未观察到重大差异。共出现了4个总体主题。在第一个主题“医疗保健环境”中，患者将护理描述为可及的，尽管有时与护士相处缺乏时间和连续性。在第二个主题“作为护理接受者”中，发现患者在诊所体验到温暖和积极的氛围。在第三个主题“作为患者发挥积极作用”中，患者描述自己积极寻找信息并以各种方式参与自身护理。在第四个主题“应用程序的价值”中，使用该应用程序的患者将其体验为一种补充信息来源，营造了一种安全感。使用该应用程序使患者在需要时能得到护士联系的支持，实现了自我护理，并促进了日常活动的规划。
总体而言，患者的护理体验相似且大多是积极的。然而，对于使用该应用程序的患者，它为信息和自我护理提供了额外支持，并增强了他们对自身护理的参与度。容易联系到护士给患者带来了安全感。研究结果表明，将交互式应用程序作为标准护理的补充，以在治疗期间支持乳腺癌患者。
国际注册报告标识符（IRRID）：RR2-DOI：10.1186/s12885-017-3450-y。
