scholarly journals Adherence to a Mindfulness and Relaxation Self-Care App for Cancer Patients: Mixed-Methods Feasibility Study

10.2196/11271 ◽  
2018 ◽  
Vol 6 (12) ◽  
pp. e11271 ◽  
Author(s):  
Michael Mikolasek ◽  
Claudia M Witt ◽  
Jürgen Barth
Keyword(s):  
Mixed Methods ◽  
Cancer Patients ◽  
Feasibility Study ◽  
Self Care

scholarly journals Effects and Implementation of a Mindfulness and Relaxation App for Cancer Patients: Mixed-Methods Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Michael Mikolasek ◽  
Claudia Margitta Witt ◽  
Jürgen Barth
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Medical Care ◽  
Cancer Patients ◽  
Feasibility Study ◽  
Health Professionals ◽  
Controlled Trial ◽  
Standard Medical Care ◽  
Related Quality

BACKGROUND A cancer diagnosis and cancer treatment can cause high levels of distress, which is often not sufficiently addressed in standard medical care. Therefore, a variety of supportive non-pharmacological treatments have been suggested to reduce cancer patients’ distress. However, not all patients use those interventions because of limited access or being unaware. To overcome these barriers, mHealth might be a promising way to deliver respective supportive treatments. OBJECTIVE The aim of this study was to evaluate effects and the implementation of a mindfulness and relaxation app intervention for cancer patients as well as patients’ adherence to such an intervention. METHODS In this observational feasibility study with a mixed-methods approach, cancer patients were recruited online and through hospitals in Switzerland. All enrolled patients received access to a mindfulness and relaxation app. Patients completed self-reported outcomes (general health, health-related quality of life, anxiety, depression, distress, mindfulness, and fear of progression) at baseline, week 4, 10, and 20. The frequency of app exercise usage was gathered directly through the app in order to assess the adherence of patients. In addition, we conducted interviews with 5 health professionals for their thoughts on the implementation of the app intervention into standard medical care. We analyzed patients’ self-reported outcomes with linear mixed models (LMM) and qualitative data with content analysis. RESULTS A total of 100 cancer patients (74 female) with a mean age of 53.2 (SD 11.6) participated in the study, of which 25 patients used the app regularly until week 20. LMM analyses revealed an improvement in anxiety (P=.04), distress (P<.001), fatigue (P=.01), sleep disturbance (P=.02), quality of life (P=.03), and mindfulness (P<.001) over the course of 20 weeks. Further LMM analyses revealed a larger improvement of distress (P<.001), a moderate improvement of anxiety (P=.001), and depression (P=.03) in patients with high symptom levels at baseline in the respective domains. The interviews revealed that the health professionals perceived the app as a helpful addition to standard care. They also made suggestions for improvements, which could facilitate the implementation and adherence to such an app. CONCLUSIONS This study indicates that a mindfulness and relaxation app for cancer patients can be a feasible and effective way to deliver a self-care intervention, especially for highly distressed patients. Future studies should investigate if the appeal of the app can be increased with more content and the effectiveness of such an intervention needs to be tested in a randomized controlled trial. CLINICALTRIAL

scholarly journals Adherence to a Mindfulness and Relaxation Self-Care App for Cancer Patients: Mixed-Methods Feasibility Study (Preprint)

2018 ◽  
Author(s):  
Michael Mikolasek ◽  
Claudia M Witt ◽  
Jürgen Barth
Keyword(s):  
Depressive Symptoms ◽  
Mixed Methods ◽  
Cancer Patients ◽  
Proportional Hazards ◽  
Resistance To Change ◽  
Self Care ◽  
Female Gender ◽  
Median Number ◽  
Cox Proportional Hazards ◽  
Openness To Experience

BACKGROUND Cancer is highly prevalent worldwide and can cause high levels of distress in patients, which is often neglected in medical care. Smartphone apps are readily available and therefore seem promising to deliver distress-reducing interventions such as mindfulness and relaxation programs. OBJECTIVE This study aimed to evaluate the feasibility of a mindfulness and relaxation app for cancer patients. We looked at characteristics of participating patients in a mobile health (mHealth) study, including adherence to the app intervention, predictors for adherence, and patients’ feedback regarding the app. METHODS In this prospective observational study with a mixed-methods approach, cancer patients received a mindfulness and relaxation self-care app. Cancer patients were recruited online and through hospitals in Switzerland. We assessed self-reported measures (eg, quality of life, anxiety, depressive symptoms, openness to experience, resistance to change) at baseline, and the app gathered data on patients’ practicing time. With 8 semistructured interviews, we obtained patients’ feedback about the app and recommendations for improvements. We looked at 3 dimensions of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (reach, adoption, and maintenance) and analyzed data for adherence for the first 10 weeks of the app intervention. We report descriptive statistics for patient characteristics and app use. For the prediction of adherence, we used Kaplan-Meier analyses with log-rank tests and a Cox proportional hazards regression. RESULTS Data from 100 cancer patients (74 female) showed that 54 patients were using the app exercises continuously until week 10. In continuous app users, the median number of exercises per week dropped from 4 (interquartile range, IQR 1-7) at week 1 to a median of 2 (IQR 1-4) at week 10. Our analyses revealed 4 significant predictors for better adherence: female gender, higher openness to experience, higher resistance to change, and more depressive symptoms. Interviews revealed that the patients generally were satisfied with the app but also made suggestions on how to improve it. CONCLUSIONS Our study indicates that a mindfulness and relaxation mHealth intervention for cancer patients is feasible with acceptable adherence and largely positive feedback from patients. CLINICALTRIAL German Clinical Trials Register DRKS00010481; https://www.drks.de/drks_web/navigate.do?navigation Id=trial.HTML&TRIAL_ID=DRKS00010481 (Archived by WebCite at http://www.webcitation.org/73xGE1B0P)

scholarly journals Reamed intramedullary nailing versus circular frame external fixation for segmental tibial fractures (STIFF-F): a mixed methods feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Caroline B. Hing ◽  
Elizabeth Tutton ◽  
Toby O. Smith ◽  
Molly Glaze ◽  
Jamie R. Stokes ◽  
...  
Keyword(s):  
Mixed Methods ◽  
External Fixation ◽  
Intramedullary Nailing ◽  
Feasibility Study ◽  
Online Survey ◽  
Tibial Fracture ◽  
Tibial Fractures ◽  
Circular Frame ◽  
Pilot Rct ◽  
Randomised Controlled

Abstract Background Segmental tibial fractures are fractures in two or more areas of the tibial diaphysis resulting in a separate intercalary segment of the bone. Surgical fixation is recommended for patients with segmental tibial fractures as non-operative treatment outcomes are poor. The most common surgical interventions are intramedullary nailing (IMN) and circular frame external fixation (CFEF), but evidence about which is better is of poor quality. An adequately powered randomised controlled trial (RCT) to determine optimum treatment is required. STIFF-F aimed to assess the feasibility of a multicentre RCT comparing IMN with CFEF for segmental tibial fracture. Methods STIFF-F was a mixed-methods feasibility study comprising a pilot RCT conducted at six UK Major Trauma Centres, qualitative interviews drawing on Phenomenology and an online survey of rehabilitation. The primary outcome was recruitment rate. Patients, 16 years and over, with a segmental tibial fracture (open or closed) deemed suitable for IMN or CFEF were eligible to participate. Randomisation was stratified by site using random permuted blocks of varying sizes. Participant or assessor blinding was not possible. Interviews were undertaken with patients about their experience of injury, treatment, recovery and participation. Staff were interviewed to identify contextual factors affecting trial processes, their experience of recruitment and the treatment pathway. An online survey was developed to understand the rehabilitation context of the treatments. Results Eleven patients were screened and three recruited to the pilot RCT. Nineteen staff and four patients participated in interviews, and 11 physiotherapists responded to the survey. This study found the following: (i) segmental tibial fractures were rarer than anticipated, (ii) the complexity of the injury, study setup times and surgeon treatment preferences impeded recruitment, (iii) recovery from a segmental tibial fracture is challenging, and rehabilitation protocols are inconsistent and (iv) despite the difficulty recruiting, staff valued this research question and strived to find a way forward. Conclusion The proposed multicentre RCT comparing IMN with CFEF is not feasible. This study highlighted the difficulty of recruiting patients to an RCT of a complex rare injury over a short time period. Trial registration The study was registered with the International Standard Randomised Controlled Trials Number Registry: ISRCTN11229660

Self-Care for Nurse Leaders in Acute Care Environment Reduces Perceived Stress: A Mixed-Methods Pilot Study Merits Further Investigation

2017 ◽  
Vol 36 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Susan Mac Leod Dyess ◽  
Angela S. Prestia ◽  
Doren-Elyse Marquit ◽  
David Newman
Keyword(s):  
Mixed Methods ◽  
Acute Care ◽  
Perceived Stress ◽  
Repeated Measures ◽  
Self Care ◽  
Nurse Leaders ◽  
Future Research ◽  
Care Practice ◽  
Meditation Practice ◽  
Significant Drop

Acute care practice settings are stressful. Nurse leaders face stressful demands of numerous competing priorities. Some nurse leaders experience unmanageable stress, but success requires self-care. This article presents a repeated measures intervention design study using mixed methods to investigate a self-care simple meditation practice for nurse leaders. Themes and subthemes emerged in association with the three data collection points: at baseline (pretest), after 6 weeks, and after 12 weeks (posttest) from introduction of the self-care simple meditation practice. An analysis of variance yielded a statistically significant drop in perceived stress at 6 weeks and again at 12 weeks. Conducting future research is merited.

Sign in / Sign up

Export Citation Format

Share Document