Patient Experiences of Rehabilitation and the Potential for an mHealth System with Biofeedback After Breast Cancer Surgery: Qualitative Study

Abstract

Background Physiotherapy-led home rehabilitation after breast cancer surgery can protect against the development of upper limb dysfunction and other disabling consequences of surgery. A variety of barriers can limit physical rehabilitation outcomes, and patients may benefit from more support during this time. Mobile health (mHealth) systems can assist patients during rehabilitation by providing exercise support, biofeedback, and information. Before designing mHealth systems for a specific population, developers must first engage with users to understand their experiences and needs. Objective The aims of this study were to explore patients’ rehabilitation experiences and unmet needs during home rehabilitation after breast cancer surgery and to understand their experiences of mHealth technology and the requirements they desire from an mHealth system. Methods This was the first stage of a user-centered design process for an mHealth system. We interviewed 10 breast cancer survivors under the two main topics of “Rehabilitation” and “Technology” and performed a thematic analysis on the interview data. Results Discussions regarding rehabilitation focused on the acute and long-term consequences of surgery; unmet needs and lack of support; self-driven rehabilitation; and visions for high-quality rehabilitation. Regarding technology, participants reported a lack of mHealth options for this clinical context and using non-cancer–specific applications and wearables. Participants requested an mHealth tool from a reliable source that provides exercise support. Conclusions There are unmet needs surrounding access to physiotherapy, information, and support during home rehabilitation after breast cancer surgery that could be addressed with an mHealth system. Breast cancer survivors are open to using an mHealth system and require that it comes from a reliable source and focuses on supporting exercise performance.

People with cancer and their family caregivers’ personal experience of using supportive eHealth technology: A narrative review

“…eHealth technology was valued for its role in helping users learn about the cancer experience. Participants with cancer found that information provided through eHealth echoed the advice of their healthcare team and standard care, which helped them understand the language around cancer or address their knowledge gaps regarding information they did not initially understand, potentially due to feeling overwhelmed (Brennan et al, 2020;Gustavell et al, 2020;Hauffman et al, 2020;Ownsworth et al, 2020;Ure et al, 2020). A number of studies highlighted that eHealth enabled people with cancer and family caregivers to prepare for hospital visits, navigate the healthcare system and engage more efficiently with the clinical team (Hauffman et al, 2020;Mohsen et al, 2021;Song et al, 2015).…”

“…This sense of connection was also evident in Moshen and colleagues' ( 2021) study of people with cancer and their access to education and personal medical information using eHealth technology. Despite this connection, a resounding sentiment was evident regarding how participants did not want eHealth technology to replace their in-person, face-to-face contact with their healthcare team (Brennan et al, 2020;Dalby et al, 2021;Ownsworth et al, 2020). People with cancer cited that technology may inhibit their ability to detail their individual experienced issues (Dalby et al, 2021;Drott et al, 2016;Crafoord et al, 2020), telephone conversations can feel rushed or encounter language/accent comprehension difficulties (Dalby et al, 2021), written contact with healthcare professionals lack of body language and verbal nuances (Högberg et al, 2015) and pertinent topics may require further discussion such as fear of cancer recurrence (Drott et al, 2016;Smith et al, 2020a) which may be overlooked using technology.…”

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

“…Despite the multitude of digital solutions available, many fail to meet patient and provider expectations-with their use and uptake hindered by ethical issues such as privacy and security of data, disease management, and communication [5]. Involving technology end users in cocreation approaches has been acknowledged as a possible strategy to design digital interventions that meet both the patient and provider needs [6,7].…”

Evaluation of two mobile health apps for patients with breast cancer using the Mobile Application Rating Scale

“…One used a qualitative approach and focus group methodology to collect user needs and preferences for the content and features of a mobile app for arm and shoulder exercises after breast cancer treatment (34). Another similar qualitative research study using semi-structured interviews with breast cancer survivors explored user experiences and needs regarding rehabilitation and technology (35).…”