the effects of a nurse-led mhealth program for symptom self-management of breast cancer patients undergoing chemotherapy

Conditions: Breast Cancer; Chemotherapeutic Toxicity

Summary: breast cancer (bc) survivors will experience multiple symptoms following chemotherapy. during the pandemic of covid-19, the closure of clinics and fear of infection lead to bc patients' challenges in self-managing their multiple symptoms in home settings. mobile health (mhealth), without time and space limitation, plays a positive role in supporting self-management and treatment compliance. however, previous mhealth self-management studies did not report sustained beneficial effects with physician-led supervision. in oncology practice, the nurse-led model of patient self-management for breast cancer has been placed on greater emphasis. accordingly, an innovative nurse-led supervised mhealth program was designed to support self-management for bc patients undergoing chemotherapy. this pilot study aims to examine the feasibility and acceptability of a nurse-led mhealth-based self-management program for bc patients receiving chemotherapy, in order to provide evidence for conducting a definitive trial. the feasibility outcomes of the pilot study include subject eligibility rate, recruitment rate, and retention rate. the efficacy outcomes relate to self-efficacy (primary outcome), symptom distress and frequency, as well as health-related quality of life, and healthcare utilisation. the qualitative outcomes encompass patient- and provider-users' perceptions of the app usability and subjects' experiences of engaging in the pilot study.

this nurse-led mhealth symptom self-management program is composed of one core intervention 'mchemotherapy', one pre-chemotherapy consultation, and two follow-up visits. mchemotherapy will be specifically utilized to facilitate symptom self-management for breast cancer patients covering chemotherapy. the objectives of the pilot study are: (i) to develop an evidence-based nurse-led mhealth guideline for self-management of chemotherapy-related symptoms; (ii) to determine the usability of a nurse-led mobile application; (iii) to pilot the methodological procedures of the randomized controlled trial; (iv) to determine enrollment rate, the eligibility rate, retention rate, and dropout rate during the preliminary rct participant recruitment and follow-up process; (v) to preliminarily test the effectiveness of this program on self-efficacy, qol, symptom distress and symptom frequency, as well as healthcare utilization; (vi) to identify the participants' perceptions and acceptability of the pilot study; (vii) to provide suggestions and implications for a future multicentre large-scale rct examining the definite effects of nurse-led mhealth self-management guidelines on self-efficacy, qol, symptom distress and symptom frequency in cancer patients undergoing chemotherapy. the pilot study aims to examine the following null hypotheses of efficacy outcomes: the bc patients in the mhealth group will demonstrate no difference in self-efficacy, quality of life, symptom distress and symptom frequency, as well as healthcare utilization after completing the chemotherapy at week 3 and week 6 when compared to the bc patients in the control group.

Eligibility criteria:
inclusion criteria: * people who are 18 years or above * newly diagnosed with breast cancer * commencing chemotherapy and being prescribed with four cycles of a chemotherapy regimen * mobile phone and wechat® users (a mobile application of shenzhen city's tencent computer system co. ltd.) * wi-fi or 4g network users * able to read and write chinese exclusion criteria: * people who are pregnant * have been diagnosed with terminal-stage breast cancer (i.e., stage iv) * have a history of chemotherapy * have been prescribed with targeted therapy within three weeks of completing the chemotherapy * have documented mental disorders * have already engaged in other mhealth studies

Keywords: nurse-led mhealth self-management breast cancer chemotherapy