An eHealth Application in Head and Neck Cancer Survivorship Care: Health Care Professionals' Perspectives

Abstract

BackgroundAlthough many cancer survivors could benefit from supportive care, they often do not utilize such services. Previous studies have shown that patient-reported outcomes (PROs) could be a solution to meet cancer survivors’ needs, for example through an eHealth application that monitors quality of life and provides personalized advice and supportive care options. In order to develop an effective application that can successfully be implemented in current health care, it is important to include health care professionals in the development process.ObjectiveThe aim of this study was to investigate health care professionals’ perspectives toward follow-up care and an eHealth application, OncoKompas, in follow-up cancer care that monitors quality of life via PROs, followed by automatically generated tailored feedback and personalized advice on supportive care.MethodsHealth care professionals involved in head and neck cancer care (N=11) were interviewed on current follow-up care and the anticipated value of the proposed eHealth application (Step 1). A prototype of the eHealth application, OncoKompas, was developed (Step 2). Cognitive walkthroughs were conducted among health care professionals (N=21) to investigate perceived usability (Step 3). Interviews were recorded, transcribed verbatim, and analyzed by 2 coders.ResultsHealth care professionals indicated several barriers in current follow-up care including difficulties in detecting symptoms, patients’ perceived need for supportive care, and a lack of time to encourage survivors to obtain supportive care. Health care professionals expected the eHealth application to be of added value. The cognitive walkthroughs demonstrated that health care professionals emphasized the importance of tailoring care. They considered the navigation structure of OncoKompas to be complex. Health care professionals differed in their opinion toward the best strategy to implement the application in clinical practice but indicated that it should be incorporated in the HNC cancer care pathway to ensure all survivors would benefit.ConclusionsHealth care professionals experienced several barriers in directing patients to supportive care. They were positive toward the development and implementation of an eHealth application and expected it could support survivors in obtaining supportive care tailored to their needs. The cognitive walkthroughs revealed several points for optimizing the application prototype and developing an efficient implementation strategy. Including health care professionals in an early phase of a participatory design approach is valuable in developing an eHealth application and an implementation strategy meeting stakeholders’ needs.

‘Oncokompas’, a web-based self-management application to support patient activation and optimal supportive care: a feasibility study among breast cancer survivors

“…To ensure sustainable usage, Oncokompas is developed following an iterative participatory design [12,23,25,26], meaning that we strive for constant optimization of Oncokompas while involving cancer survivors and healthcare professionals (HCPs) in each step of the development process. First, a needs assessment was conducted among BC and head-and neck cancer (HNC) survivors and HCPs [12,25]. Next, usability of a prototype of Oncokompas was tested by HNC survivors in two iterative cycles and HCPs participated in cognitive walkthroughs [27].…”

Neuro-oncology family caregivers’ view on keeping track of care issues using eHealth systems: it’s a question of time

“…The same semi-structured interview schedule from our previous publication was used [ 12 ]. To summarize, the main topics were (1) experiences with supportive care provision and unmet supportive care needs; (2) thoughts and suggestions regarding keeping track of care issues, including frequency, timing and format; (3) attitudes toward and conditions for use of different paper-based (the Distress Thermometer [ 15 ]) and eHealth instruments (Oncoquest [ 16 ] and Oncokompas [ 17 ]) to track care issues over time. Although these instruments are all patient-oriented, we felt these were suitable examples to show caregivers because they rely on technology in various degrees: from no technology being used with the distress thermometer (DT), to Oncoquest (OQ) which is part computer-based and part comprised of personal contact, to Oncokompas (OK) which is completely computer-based.…”

<b>Diagnósticos de enfermagem em pacientes com câncer de cabeça e pescoço em tratamento ambulatorial / Nursing diagnosis in patients with head and neck cancer in ambulatorial treatment<b>

“…No domínio sexualidade foi identificado que 63% dos pacientes apresentavam como indicador clínico alteração na atividade sexual e dificuldade na atividade sexual, seja relacionado ao interesse ou ao prazer sexual. Estudo mostra que a sexualidade, apesar de não ser um tema muito abordado em pacientes com câncer, causa profundos impactos funcionais e sociais, devido a perda da função de órgãos como lábios e língua, o que pode gerar efeitos profundos em beijar, assim como na excitabilidade sexual e na realização do sexo oral (20) .…”

“…Visto a preocupação com a influência do humor no âmbito do tratamento de uma pessoa com câncer, sociedades americanas determinaram o uso do termo distress para conceituar o estresse emocional vivenciado pelo paciente oncológico. Pela sua importância clínica, esse sofrimento emocional tem sido considerado o sexto sinal vital para esse grupo de pacientes, sendo necessária sua identificação, documentação e manejo (20) , uma vez que o mesmo tem sido associado a menor satisfação do paciente com os cuidados de saúde, menor qualidade de vida, e redução da sobrevida (21,22) .…”