Psychological mobile app for patients with acute myeloid leukemia: A pilot randomized clinical trial

Abstract

Background Patients with acute myeloid leukemia (AML) experience a substantial decline in quality of life (QoL) and mood during their hospitalization for intensive chemotherapy, yet few interventions have been developed to enhance patient‐reported outcomes during treatment. Methods We conducted a pilot randomized trial (ClinicalTrials.gov identifier NCT03372291) of DREAMLAND, a psychological mobile application for patients with a new diagnosis of AML who are receiving intensive chemotherapy. Patients were randomly assigned to DREAMLAND or usual care. DREAMLAND included four required modules focused on: (1) supportive psychotherapy to help patients deal with the initial shock of diagnosis, (2) psychoeducation to manage illness expectations, (3) psychosocial skill‐building to promote effective coping, and (4) self‐care. The primary end point was feasibility, which was defined as ≥60% of eligible patients enrolling and 60% of those enrolled completing ≥60% of the required modules. We assessed patient QoL (the Functional Assessment of Cancer Therapy–Leukemia), psychological distress (the Hospital Anxiety and Depression Scale and the Patient Health Questionnaire‐9), symptom burden (the Edmonton Symptom Assessment Scale), and self‐efficacy (the Cancer Self‐Efficacy Scale) at baseline and at day 20 after postchemotherapy. Results We enrolled 60 of 90 eligible patients (66.7%), and 62.1% completed ≥75% of the intervention modules. At day 20 after chemotherapy, patients who were randomized to DREAMLAND reported improved QoL scores (132.06 vs. 110.72; p =.001), lower anxiety symptoms (3.54 vs. 5.64; p = .010) and depression symptoms (Hospital Anxiety and Depression Scale: 4.76 vs. 6.29; p = .121; Patient Health Questionnaire‐9: 4.62 vs. 8.35; p < .001), and improved symptom burden (24.89 vs. 40.60; p = .007) and self‐efficacy (151.84 vs. 135.43; p = .004) compared with the usual care group. Conclusions A psychological mobile application for patients with newly diagnosed AML is feasible to integrate during hospitalization for intensive chemotherapy and may improve QoL, mood, symptom burden, and self‐efficacy.

Structural Model Presentation of Quality of Life for the Elderly Based on Self-Care with the Mediating Role of Social Support

“…In short, self-care significantly influences changes in the social support variable and increases it, ultimately leading to an improvement in the quality of life of the elderly. This conclusion is corroborated by other related prior research (Ahmadi & Valizadeh, 2021;Ardouin et al, 2023;Badpar et al, 2019;El-Jawahri et al, 2023;Ferrari et al, 2017;Fung et al, 2021;Lindsay et al, 2011;Maddi, 2015;Moulaei et al, 2022;Park et al, 2021;Saeidi et al, 2021;Zal et al, 2022), which validate and confirm the findings of this research.…”

Development of Quality of Life in Adolescents and Young Adults With Cancer Using a Patient Support Smartphone App: Prepost Interventional Study

“…The results in our study mirror the findings of others related to the association between smartphone app use and QoL in young patients with cancer. The pilot randomized clinical trial by El-Jawari et al [ 37 ] found that their psychological smartphone app for young, newly diagnosed patients with acute myeloid leukemia showed significant improvement in QoL (Functional Assessment of Cancer Therapy-Leukemia) and self-efficacy (Cancer Self-Efficacy Scale) and a decrease in symptom burden (Edmonton Symptom Assessment Scale) in patients using the smartphone app compared to the patients receiving standard care. Additionally, the meta-analysis by Siew et al [ 38 ] demonstrated that social media–based interventions significantly improved QoL and anxiety symptoms among patients with cancer.…”

Investigating the role of coping strategies, personality traits and mindfulness with self-care in leukemia patients

“…The questionnaire questions assess the individual's confidence in performing self-care tasks, and the total score ranges from 29 to 145. This tool is self-reported and its internal consistency was reported using Cronbach's alpha as 0.94 (El-Jawahri et al, 2023;Soleymany & Sarifi, 2023).…”

“…Research results indicate that having a psychological program in cancer patients is significantly related to selfcare, increased efficiency, symptom improvement, and life quality (El-Jawahri et al, 2023).…”