scholarly journals A Mobile App for Thyroid Cancer Patients Aiming to Enhance Their Quality of Life: Protocol for a Quasiexperimental Interventional Pilot Study

10.2196/13409 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e13409 ◽  
Author(s):  
Evanthia Giannoula ◽  
Ioannis Iakovou ◽  
Ioannis Katsikavelas ◽  
Panagiotis Antoniou ◽  
Vasilios Raftopoulos ◽  
...  

Background Thyroid cancer (TC) is one of the fastest growing cancers all over the world. Differentiated thyroid cancer (DTC) is the most frequent subtype of TC. When appropriate treatment is given, the prognosis for the patient is generally excellent. Despite the generally good prognosis of thyroid carcinomas, the symptoms may range from emotional to physical discomfort, depending on the thyroid hormone status, which can severely affect the patient. Moreover, the diagnostic and therapeutic procedures that DTC patients have to undergo, such as thyroidectomy and radioiodine therapy, significantly affect their mental and physical well-being. Often, the physician only addresses the favorable prognosis of DTC compared with other cancer types and neglects to assess issues related to the quality of life (QoL) of the patient; this was the reason we decided to design a mobile app for DTC patients and their caregivers. Objective The aim of this study is to research the feasibility and applicability of an mHealth app tailored to DTC patients, as reflected in their QoL. The main features of the developed app offer access to useful information about thyroid cancer, diagnostic tests, and the appropriate therapy administered to DTC patients. Methods Based on the existing literature, we created an up-to-date information platform regarding TC and especially DTC. In order to develop an effective app that can be implemented in current health care, we designed a section where the patient and physician can keep a medical record in an effort to enable access to such information at any time. Finally, we designed a user-friendly notification program, including pill prescription, follow-up tests, and doctor visit reminders in order to equally facilitate the lives of the patient and physician. Results Having developed this mobile app, we aim to conduct a pilot quasiexperimental interventional trial. Our intention is to enroll at least 30 TC patients and assign them to intervention or control groups. Both groups will receive standard care for treating and monitoring TC, and the intervention group will also receive and use the DTC app. TC patients’ QoL will be assessed for both control and intervention groups in order to examine the effectiveness of the DTC app. QoL will be assessed through the QoL core questionnaire European Organisation for Research and Treatment of Cancer (EORTC) QLQ-THY34 in combination with the EORTC QLQ-C30 questionnaire through quantitative statistical analysis. Conclusions The use of mHealth apps can play a significant role in patient education, disease self-management, remote monitoring of patients, and QoL improvement. However, the main limitation of the majority of existing studies has been the lack of assessing their usefulness as well as the absence of specific instruments to carry out this assessment. In light of those considerations, we developed a mobile app tailored to the needs of DTC patients. Furthermore, we evaluated its contribution to the QoL of the patients by using the EORTC QLQ-THY34 questionnaire, an accurate and safe instrument for the evaluation of the QoL in TC patients, while supporting future planned endeavors in the field. International Registered Report Identifier (IRRID) PRR1-10.2196/13409

2019 ◽  
Author(s):  
Evanthia Giannoula ◽  
Ioannis Iakovou ◽  
Ioannis Katsikavelas ◽  
Panagiotis Antoniou ◽  
Vasilios Raftopoulos ◽  
...  

BACKGROUND Thyroid cancer (TC) is one of the fastest growing cancers all over the world. Differentiated thyroid cancer (DTC) is the most frequent subtype of TC. When appropriate treatment is given, the prognosis for the patient is generally excellent. Despite the generally good prognosis of thyroid carcinomas, the symptoms may range from emotional to physical discomfort, depending on the thyroid hormone status, which can severely affect the patient. Moreover, the diagnostic and therapeutic procedures that DTC patients have to undergo, such as thyroidectomy and radioiodine therapy, significantly affect their mental and physical well-being. Often, the physician only addresses the favorable prognosis of DTC compared with other cancer types and neglects to assess issues related to the quality of life (QoL) of the patient; this was the reason we decided to design a mobile app for DTC patients and their caregivers. OBJECTIVE The aim of this study is to research the feasibility and applicability of an mHealth app tailored to DTC patients, as reflected in their QoL. The main features of the developed app offer access to useful information about thyroid cancer, diagnostic tests, and the appropriate therapy administered to DTC patients. METHODS Based on the existing literature, we created an up-to-date information platform regarding TC and especially DTC. In order to develop an effective app that can be implemented in current health care, we designed a section where the patient and physician can keep a medical record in an effort to enable access to such information at any time. Finally, we designed a user-friendly notification program, including pill prescription, follow-up tests, and doctor visit reminders in order to equally facilitate the lives of the patient and physician. RESULTS Having developed this mobile app, we aim to conduct a pilot quasiexperimental interventional trial. Our intention is to enroll at least 30 TC patients and assign them to intervention or control groups. Both groups will receive standard care for treating and monitoring TC, and the intervention group will also receive and use the DTC app. TC patients’ QoL will be assessed for both control and intervention groups in order to examine the effectiveness of the DTC app. QoL will be assessed through the QoL core questionnaire European Organisation for Research and Treatment of Cancer (EORTC) QLQ-THY34 in combination with the EORTC QLQ-C30 questionnaire through quantitative statistical analysis. CONCLUSIONS The use of mHealth apps can play a significant role in patient education, disease self-management, remote monitoring of patients, and QoL improvement. However, the main limitation of the majority of existing studies has been the lack of assessing their usefulness as well as the absence of specific instruments to carry out this assessment. In light of those considerations, we developed a mobile app tailored to the needs of DTC patients. Furthermore, we evaluated its contribution to the QoL of the patients by using the EORTC QLQ-THY34 questionnaire, an accurate and safe instrument for the evaluation of the QoL in TC patients, while supporting future planned endeavors in the field. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/13409


Author(s):  
Vera Arsenyeva ◽  
Boris Martynov ◽  
Gennadiy Bulyshchenko ◽  
Dmitriy Svistov ◽  
Boris Gaydar ◽  
...  

Gliomas make up about 8 cases per 100,000 population and the number of patients with this disease is only increasing. There can be not only various types of neurological deficits among the symptoms, but also personal and emotional changes, that seriously affects the quality of life. The modern model of health care includes not only recovery of the patient’s physical functions, but also his or her psychosocial well-being. In particular, the assessment and study of the characteristics of health-related quality of life, as well as cognitive functions in patients with gliomas, is increasingly recognized as an important criterion when considering the effectiveness of treatment. To date, the features of health related quality of life and cognitive functions of patients with epilepsy and acute cerebral circulation disorders have been studied sufficiently, and, as a result, techniques have been developed that accurately assess the QOL and CF in patients with these diseases. These are QOLIE-31 and QOLIE-AD-48 questionnaires for patients with epilepsy. This is the National Institutes of Health Stroke Scale (NIHSS), Orgogozo stroke scale (OSS), World Federation of Neurological Surgeons (WFNS) scale for the clinical assessment of subarachnoid hemorrhage (SAH) for patients with acute cerebrovascular accident. At the same time, there are no generally accepted methods for assessing quality of life and neurocognitive functions that are sensitive to changes in the condition of patients with gliomas in the early postoperative period by the time of discharge from the hospital. As a result, there is no systematic information on the dynamics of the quality of life of such patients, their neurocognitive functioning. The purpose of this article was to study the literature on QOL and CF in patients affected by neurological and neurosurgical disorders for the further selection of optimal methods for assessing dynamics of the condition of patients with glial brain tumors before and after surgery. At the moment, such requirements are only partially met by the EORTC QLQ-C30 questionnaire and its application EORTC QLQ-BN20.


2021 ◽  
pp. JDNP-D-20-00078
Author(s):  
Sybilla Myers ◽  
Christopher Kennedy

BackgroundPerceived health-related quality of life (HRQOL) is fundamental to well-being and is a meaningful way to measure physical and mental health.Local ProblemNo standard method exists for measuring perceived HRQOL during the COVID-19 pandemic in participants as they attempt to improve their self-determined wellness goals. An implementation plan that considers the social distancing limitations imposed can be used to predict an individual’s likelihood of long-term success.MethodsDuring the four, 2-week plan-do-study-act (PDSA) cycles, the Social Cognitive Theory model informed the implementation of the four core interventions. To guide iterative changes, the data was analyzed through Excel and run charts.InterventionsThe four core interventions were the shared decision-making tool (SDMT), health mobile app tool (HMAT), wellness tracker tool (WTT), and the team engagement plan.ResultsAmong 28 participants, perceived quality of life increased by 70%, engagement in shared decision-making increased to 82%, app use and confidence increased to 85%, and goal attainment reached 81%.ConclusionsThe SDMT, health app, and wellness tracker created a methodical plan of accountability for increasing participant wellness. The contextual barrier of the COVID-19 pandemic added a negative wellness burden which was mitigated by creating a patient-centered culture of wellness.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Figueras-Puigderrajols ◽  
A Ballesteros ◽  
D Guerra

Abstract Study question The present study aims to explore infertility-related psychosocial outcomes, including fertility quality of life (QoL), as well as anxiety and depression levels, in women diagnosed with infertility. Summary answer Differences on fertility-related QoL appeared when comparing treatment types (gamete donation vs own gamete). Furthermore, statistically significant associations were found between QoL and anxious-depressive symptomatology. What is known already Those who wish to have children and do not achieve their objective just like other peers can see their goals and expectations with pessimism, generating concern and a series of negative emotions. Several psychological implications of infertility have been described, such as increased levels of stress, anxiety, depression, decreased self-esteem, mood and hope, or poor relationship adjustment. The emotional impact of infertility in people’s life cycle can be so strong that reducing it only to biological aspects would lead to a dangerous situation of neglect. For this reason, QoL assessment in ART becomes an important need. Study design, size, duration FertiQol stands as the most widely used tool to assess infertility-related QoL, overcoming the limitations of other instruments that only target specific medical conditions. The present is a multi-site cross-sectional study over patients with infertility (n = 104), aiming to explore their fertility-QoL, as well as their anxiety and depression levels, which are symptoms that have been previously associated.Questionnaire administration, and sociodemographic and medical data gathering took place between January 2019 and December 2020. Participants/materials, setting, methods Participants were 104 female patients (M.age= 39.8) undergoing or expecting a fertility treatment. The FertiQol Spanish version was administered through mobile app, and its paper version distributed at medical/psychological appointments. QoL was self-reported through FertiQol, assessing the influence of infertility problems in various areas (e.g. impact on self-esteem, emotions, general health, family, partners, social relationships, work, life projects...). Additionally, HADS (Hospital Anxiety and Depression Scale) was provided as a measurement of anxiety and depression levels. Main results and the role of chance Regarding treatments, 50.6% of participants were currently undergoing gamete donation while 44.3% were undergoing treatments that involved using their own gametes. After comparing QoL between these treatment types, results showed that patients who underwent egg donation, compared to those who used their own eggs, reported statistically significantly lower scores of QoL in the Social Subscale (p = .03), but not in the other psychological outcomes. Also, statistically significant negative correlations were found between HADS and all core FertiQol subscales (p< .05). Results are consistent with previous studies showing similar associations between fertility QoL and anxiety and depression, as well as with increased psychological negative implications of gamete donation. The majority of participants reported non-pathological scores of anxiety and depression when considering the cut off value of 8 for HADS, thus suggesting the presence of a relatively healthy sample. The number of treatments that patients had previously taken and the years of infertility were not associated with any of the psychological variables. Limitations, reasons for caution Some limitations to consider are presence of co-morbid diagnosis, differences in medication, or patient’s cultural backgrounds.Also, conclusions should be interpreted cautiously since the design doesn’t allow causal inferences. Further investigations should consider a continuous assessment to explore changes in psychological well-being at different points of intervention, specially with gamete donation. Wider implications of the findings: The great advantage we’ve seen so far when using FertiQol is the possibility to identify more accurately the true impact on other aspects of patient’s well-being besides the emotional area.ART professionals, including psychologists and counselors,will have more information within a small amount of time about QoL when using this tool. Trial registration number 1503-BCN–019-DG


2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Cohen MV ◽  
◽  
de Fátima Teixeira P ◽  
Vaisman M ◽  
Vaisman F ◽  
...  

Background: Low risk thyroid cancer can be treated with lobectomy or total thyroidectomy. Studies have shown that the risk of recurrence does not differ between the two surgeries, although there are higher rates of complications with total thyroidectomy. Our study aimed to find if there were differences in quality of life and thyroid function in the two treatments. Methods: Low risk DTC survivors answered three QoL questionnaires (EQ5D3L, SF36, and EORTC QLQ C30) and had their thyroid function evaluated. Results: Twenty-six lobectomy patients and 101 total thyroidectomy were included. Hypoparathyroidism occurred more in the total thyroidectomy, and TSH was more likely to be on target (0.5-2.0) in lobectomy. There was no difference between groups regarding QoL, but there was a significant difference regarding thyroid function. In SF36 form, TSH off target led to more physical limitations, pain, less vitality, and worse social aspects. Abnormal total T3 level was associated with pain, less vitality, and worse mental health. In the EORTC QLQ C30, off target TSH led to worse role functioning, fatigue, and nausea. EQ5D form showed that worse utility index was found when TT3 was not in normal range. Conclusion: This study showed there was a difference among thyroid function, specially TSH depending on type of surgery. When uncontrolled, TSH was associated with worse aspects of the quality of life. Therefore, lobectomy patients have a better thyroid function control and less surgical complications which might have an impact in some aspects of the quality of life when compared to total thyroidectomy.


Author(s):  
Romina Nemecek ◽  
Patrick Huber ◽  
Sophie Schur ◽  
Eva Masel ◽  
Stefanie Porkert ◽  
...  

Patients with advanced cancer have a substantial symptom burden, which deteriorates their quality of life. Palliative care improves well-being of patients and their family caregivers. Within the scope of a controlled pilot study, a user-friendly telepresence system is developed, which enables patients and family caregivers to send a direct request to a palliative care team. Additionally, a specially tailored database is developed, which contains up to date patient information. Twenty patients with advanced non-small cell lung cancer are consecutively assigned in a control and an intervention group. The intervention group receives the telemedically augmented care, whereas the control group receives standard care. The primary goal of this chapter is to determine the usability and feasibility; the secondary goal is the assessment of the intervention's impact on quality of life and the number of unscheduled hospital admissions. To sum up, telemedically supported ambulatory palliative care may synergistically help to improve safety and quality of life.


2020 ◽  
Vol 134 ◽  
pp. 104003 ◽  
Author(s):  
Jael Lorca-Cabrera ◽  
Carme Grau ◽  
Rut Martí-Arques ◽  
Laia Raigal-Aran ◽  
Anna Falcó-Pegueroles ◽  
...  

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5584-5584
Author(s):  
Debora Capelli ◽  
Liviana Giostra ◽  
Denise Maravalle ◽  
Pietro Leoni ◽  
Attilio Olivieri

Abstract Late effects and quality of life (QoL) in Acute Myeloid Leukemia (AML) long term adult survivors represent an unexplored field of interest. We prospectively evaluated late effects and dynamic QoL in 44 and 29 cured AML patients (17 <60 years, and 12 >60 years), treated at our department between 1997 and 2010 (7 Allogeneic, 16 Autologous Transplant, 21 chemotherapy alone). We administered EORTC QLQ-C30 and FACT-AN questionnaires at two different time points with a median interval of 29 months (range: 12-34 months). We stratifyed QoL scores by age at diagnosis, performance status (PS), Sorror Index, kind of leukemia treatment, comorbidity at diagnosis. We observed a worsening of emotional (-9.03; p= 0.04) and cognitive (-6.94; p= 0.05) EORTC scale scores, while FACTG (+2.9; p=0.03), emotional (+1.1; p= 0.04) and Functional (+2.25; p=0.001) well being FACT scores increased. Multivariate analysis showed that older patients had worse EORTC QLQ-C30 physical and emotional scale scores and higher values of pain symptoms in comparison to younger counterpart, with RR of 20.1 (p = 0.001), 22.7 ( p <0.04) and 18.4 (p=0.03) respectively. Elderly patients also had lower Total Outcome Index and FACT-An subscale scores (RR: 11.9, p= 0.02; and 8.77, p= 0.04 respectively). Sorror index > 2 was related to lower EORTC QLQ-C30 social scale and dyspnea scores (RR: 32.5; p=0.001 and 21.7; p=0.001 respectively) and FACT-An functional well being values (RR=3.9; p=0.001). We evaluated late effects occurring in 44 patients, since the third month after the end of treatment, with a median follow-up of 70 months (range: 12-166 months). The most frequent grade II-IV late toxicity was cardiac (3 arythmia, 9 cardiomyopathy) with 89% incidence in patients with Sorror HCT-CI score>2 at diagnosis vs 8.8% in the remaining patients and 0%, 20% and 55.5% in patients receiving respectively Daunorubicin, Idarubicin and at least two different anthracyclines. Sorror Index>2 was the only factor significantly predicting cardiotoxicity at the multivariate analysis with a RR of 82.7 (p=0.001). Twelve patients developped a transient hemochromatosis secondary to transfusions, treated with phlebotomy in 3 cases. Three patients (2 males and 1 female) had been fertile; all female patients developped menopause after Transplant. Four patients had secondary neoplasia consisting of Multiple Myeloma, breast cancer, myelodisplasia and axillary sarcoma. Our study underlines the role of Sorror Index at diagnosis in defining patients eligibility to cardio-prophylactic therapy. The analysis of larger series of cured AML patients are strongly needed in order to define guidelines for reducing long term treatment AML toxicity. Disclosures No relevant conflicts of interest to declare.


2007 ◽  
Vol 25 (28) ◽  
pp. 4387-4395 ◽  
Author(s):  
Alyson B. Moadel ◽  
Chirag Shah ◽  
Judith Wylie-Rosett ◽  
Melanie S. Harris ◽  
Sapana R. Patel ◽  
...  

Purpose This study examines the impact of yoga, including physical poses, breathing, and meditation exercises, on quality of life (QOL), fatigue, distressed mood, and spiritual well-being among a multiethnic sample of breast cancer patients. Patients and Methods One hundred twenty-eight patients (42% African American, 31% Hispanic) recruited from an urban cancer center were randomly assigned (2:1 ratio) to a 12-week yoga intervention (n = 84) or a 12-week waitlist control group (n = 44). Changes in QOL (eg, Functional Assessment of Cancer Therapy) from before random assignment (T1) to the 3-month follow-up (T3) were examined; predictors of adherence were also assessed. Nearly half of all patients were receiving medical treatment. Results Regression analyses indicated that the control group had a greater decrease in social well-being compared with the intervention group after controlling for baseline social well-being and covariates (P < .0001). Secondary analyses of 71 patients not receiving chemotherapy during the intervention period indicated favorable outcomes for the intervention group compared with the control group in overall QOL (P < .008), emotional well-being (P < .015), social well-being (P < .004), spiritual well-being (P < .009), and distressed mood (P < .031). Sixty-nine percent of intervention participants attended classes (mean number of classes attended by active class participants = 7.00 ± 3.80), with lower adherence associated with increased fatigue (P < .001), radiotherapy (P < .0001), younger age (P < .008), and no antiestrogen therapy (P < .02). Conclusion Despite limited adherence, this intent-to-treat analysis suggests that yoga is associated with beneficial effects on social functioning among a medically diverse sample of breast cancer survivors. Among patients not receiving chemotherapy, yoga appears to enhance emotional well-being and mood and may serve to buffer deterioration in both overall and specific domains of QOL.


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