Designing a digital health intervention for lung cancer patients requiring surgery: a qualitative, patient-informed exploration of digital technology capability, functionality and design. (Preprint)
Authors: Robinson-Barella Anna , Slight Robert D , Husband Andy K , Slight Sarah P 
Published: September 2023

BACKGROUND

Lifestyle changes made by patients during the perioperative period can impact on the outcomes and success of elective surgeries. However, there remains a limited understanding of how best to support patients during this time, particularly through the use of digital health interventions. Recognising and understanding the potential unmet needs of surgical patients with lung cancer is central to motivating healthier lifestyle change, improving recovery and optimising overall surgical success in the short- and long-term.

OBJECTIVE

This qualitative, patient-informed study aims to understand how digital technologies can support patients undergoing lung cancer surgery to adjust their lifestyle behaviours, and consequently influence their post-operative outcomes. Pre- and post-operative patient perceptions are explored and the findings intend to identify key aspects of digital technology capability, functionality and design that best support this patient group.

METHODS

Semi-structured interviews with pre- and post-operative patients undergoing surgery for lung cancer were conducted between September 2020 and February 2021, via telephone and video call software. Patient perspectives of using digital technologies to complement current surgical care and support with lifestyle behaviour change were discussed. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data, with NVivo (version 12) software facilitating data management. Ethical approval was obtained from the NHS Health Research Authority.

RESULTS

Sixteen participants were interviewed. Three themes were developed from the data regarding the capability, functionality and design of digital technologies to best support the elective perioperative journey. These centred on (1) “getting the technology to tell me, guide me and encourage me”; (2) “help to recover in a better way for my health, mentally”; and (3) “making it a personalised approach and supporting me to reach my goals”. Interventions designed with personalised milestones were found to better guide patients through a structured recovery. Individualised tailoring of preparatory and recovery information was desired by patients with previously high levels of physical activity prior to surgery. Personalised progression-based exercises encouraged physical recovery; game-like rewards and incentives were regarded as motivational for making and sustaining lifestyle change. Video calling and messaging features offered connectivity with peers and clinicians for supported care delivery.

CONCLUSIONS

Specific intervention capability, functionality and design features can provide better, structured support for lung cancer patients across the perioperative journey, and beyond. This work provides much needed evidence relating to the optimal design digital interventions for this patient cohort. Findings from this study suggest a desire for personalised perioperative care, in turn, supporting patients to make health behaviour changes to optimise surgical success. These findings should be used to influence future co-design projects to enable the design and implementation of patient-focused, tailored and targeted digital health technologies within modern healthcare settings.

CLINICALTRIAL

Not applicable.