Beutter Chantal N L, Zeller Katharina, Martens Uwe M, Pfleiderer Bettina, Fegeler Christian
MOLIT Institute gGmbH, Heilbronn, Germany.
Clinic for Radiology, University of Münster, Münster, Germany.
JMIR Cancer. 2023 Sep 26;9:e44985. doi: 10.2196/44985.
The treatment for cancer can have a negative impact not only on physical well-being but also on mental health and the quality of life (QoL). Health apps enable the monitoring of different parameters, but to date, there are only few that support patients with cancer and none that focuses on the assessment of QoL. Furthermore, patients as stakeholders are often only integrated at the late stage of the development process, if at all.
The aim of this research was to develop and evaluate a smartphone app (Lion-App) to enable patients with cancer to autonomously measure the QoL with an iterative, user-centered approach.
Patients with cancer were involved in a 3-stage process from conceptualization to the point when the app was available on the tester's private device. First, focus groups with members (N=21) of cancer support groups were conducted to understand their expectations and needs. Thereafter, individual tests were performed. After developing a prototype that incorporated findings from the focus groups, a second test cycle was conducted, followed by a beta test lasting 2 months. In our app, the QoL can be assessed via a patient diary and an integrated questionnaire. Through all stages, usability was evaluated using the modular extended version of the User Experience Questionnaire (UEQ+), including the calculation of a key performance indicator (KPI). If possible, the impact of sex on the results was evaluated. As part of the beta test, usage rates as well as age-dependent differences were also assessed.
A total of 21 participants took part in the initial 3 focus groups. In the subsequent usability testing (N=18), 17 (94%) participants rated their impression through the UEQ+, with a mean KPI of 2.12 (SD 0.64, range: -3 to 3). In the second usability test (N=14), the mean KPI increased to 2.28 (SD=0.49). In the beta test, the usage rate of 19 participants was evaluated, of whom 14 (74%) also answered the UEQ+ (mean KPI 1.78, SD 0.84). An influence of age on the number of questionnaire responses in Lion-App was observed, with a decrease in responses with increasing age (P=.02). Sex-dependent analyses were only possible for the first usability test and the beta test. The main adjustments based on user feedback were a restructuring of the diary as well as integration of a shorter questionnaire to assess the QoL.
The iterative, user-centered approach for development and usability testing resulted in positive evaluations of Lion-App. Our app was rated as suitable for everyday use to monitor the QoL of patients with cancer. Initial results indicated that the sex and age of participants seem to play only a minor role.
癌症治疗不仅会对身体健康产生负面影响，还会影响心理健康和生活质量（QoL）。健康应用程序能够监测不同参数，但迄今为止，支持癌症患者的应用程序很少，且没有专注于生活质量评估的应用程序。此外，作为利益相关者的患者在开发过程中往往只是在后期才被纳入，甚至根本没有被纳入。
本研究的目的是开发并评估一款智能手机应用程序（Lion-App），使癌症患者能够采用迭代的、以用户为中心的方法自主测量生活质量。
癌症患者参与了从概念化到应用程序在测试人员私人设备上可用这一过程的三个阶段。首先，与癌症支持小组的成员（N = 21）进行焦点小组讨论，以了解他们的期望和需求。此后，进行了个体测试。在开发出纳入焦点小组研究结果的原型后，进行了第二个测试周期，随后进行了为期2个月的beta测试。在我们的应用程序中，可以通过患者日记和综合问卷来评估生活质量。在所有阶段，使用用户体验问卷（UEQ+）的模块化扩展版本评估可用性，包括计算关键绩效指标（KPI）。如果可能，评估性别对结果的影响。作为beta测试的一部分，还评估了使用率以及年龄相关差异。
共有21名参与者参加了最初的3个焦点小组。在随后的可用性测试（N = 18）中，17名（94%）参与者通过UEQ+对他们的印象进行了评分，平均KPI为2.12（标准差0.64，范围：-3至3）。在第二次可用性测试（N = 14）中，平均KPI提高到2.28（标准差 = 0.49）。在beta测试中，评估了19名参与者的使用率，其中14名（74%）也回答了UEQ+（平均KPI 1.78，标准差0.84）。观察到年龄对Lion-App中问卷回复数量有影响，随着年龄增长回复数量减少（P = 0.02）。仅在第一次可用性测试和beta测试中进行了性别相关分析。根据用户反馈进行的主要调整是对日记进行重新组织以及整合一份更简短的问卷来评估生活质量。
迭代的以用户为中心的开发和可用性测试方法对Lion-App产生了积极评价。我们的应用程序被评为适合日常使用，以监测癌症患者的生活质量。初步结果表明，参与者的性别和年龄似乎只起很小的作用。
