Dataset Information

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.

SUBMITTER: Brennan L

PROVIDER: S-EPMC7424492 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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

Brennan Louise L Kessie Threase T Caulfield Brian B

JMIR mHealth and uHealth 20200729 7

<h4>Background</h4>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 specifi ...[more]

PMID: 32687476

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Project description:IntroductionLumbar discectomy is a widely used surgical procedure internationally with the majority of patients experiencing significant benefit. However, approximately 20% of patients report suboptimal functional recovery and quality of life. The impact and meaning of the surgical experience from the patients' perspective are not fully understood. Furthermore, there is limited evidence guiding postoperative management with significant clinical practice variation and it is unclear if current postoperative support is valued, beneficial or meets patients' needs and expectations. This study aims to address the evidence gap by moving beyond current knowledge to gain insight into the lived experiences relating to patients' lumbar discectomy surgery journey. Results will inform more meaningful and specific care, thus, enhance rehabilitation and outcomes.Methods and analysisA qualitative investigation using interpretative phenomenology analysis (IPA) will provide a flexible inductive research approach. A purposive sample (n=20) of patients undergoing primary discectomy will be recruited from one UK NHS secondary care centre. Semi-structured interviews will be conducted postsurgery discharge. A topic guide, developed from the literature and our previous work with input from two patient co-investigators, will guide interviews with the flexibility to explore interesting or patient-specific points raised. Providing longitudinal data, patients will keep weekly diaries capturing experiences and change over time throughout 12 months following surgery. A second interview will be completed 1?year postsurgery with its topic guide informed by initial findings. This combination of patient interviews and diaries will capture patients' attitudes and beliefs regarding surgery and recovery, facilitators and barriers to progress, experiences regarding return to activities/function and interactions with healthcare professionals. The rich density of data will be thematically analysed in accordance with IPA, supported by NVivo software.Ethics and disseminationEthical approval has been granted by the London-Bloomsbury Research Ethics Committee (18/LO/0459; IRAS 241345). Conclusions will be disseminated through conferences and peer-reviewed journals.

Project description:IntroductionThere has been a 65% increase in lumbar spinal fusion surgery (LSFS) worldwide over the last 13 years, with costs of £26 million to the UK National Health Service annually. Patient dissatisfaction with outcome and persistent pain and disability incurs further costs. Three trials provide low-quality evidence for the role of physiotherapy. Our UK surveys investigating physiotherapy/surgeon practice concluded rehabilitation should be tailored to the individual patient owing to considerable clinical heterogeneity. This study will explore the perceptions of patients who undergo LSFS to inform precision rehabilitation.Methods and analysisA qualitative study, using interpretive phenomenological analysis, will recruit a purposive sample (n=40) to ensure patterns of similarity and difference in their journeys can be explored. In-depth semistructured interviews will be undertaken following discharge from hospital and at 12 months postsurgery. Patients' preoperative and postoperative experiences, underlying attitudes and beliefs towards the surgical intervention, facilitators and barriers to recovery, adherence to advice and physiotherapy, experiences of rehabilitation and return to normal function/activity/work will be explored. A 12-month patient diary will provide real time access to patient data, capturing a weekly record of life as lived, including symptoms, medication, experiences of stages of recovery, rehabilitation adherence, healthcare professional appointments, attitudes, their feelings and experiences throughout their journey. Data will be analysed in a number of stages in accordance with interpretive phenomenological analysis, supported using NVivo software. Analysis of the first interviews and patient diaries will afford a rich density of data to build an overall understanding of the patients' lived experiences, informing the 12-month interview. Strategies (eg, reflexivity) will ensure trustworthiness.Ethics and disseminationThe study has ethical approval (IRAS 223283). Findings will ensure that patient-driven data inform precision rehabilitation by understanding the patient journey. Findings will be disseminated through peer-reviewed journals and conferences.

Dataset Information

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

Publications

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

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