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Evaluating effects of a mobile health application in reducing patients' care needs and improving quality of life after oral cancer surgery. (Preprint)


 BACKGROUND
 Oral cancer patients experience different degrees of comorbidity after medical and surgical treatment and also must face psychological distress and uncertainty during the disease course. Patients may encounter physical function obstacles, psychosocial issues and diminishing quality of life. Poorer quality of life creates a higher demand for care, greater demand for health information, and increased psychological needs, care support, medical communication needs, and assistance with physical functioning and activities of daily life.
 
 
 OBJECTIVE
 This study aimed to investigate the use of a mobile health application to provide information and education for patients after undergoing oral cancer surgery, and to evaluate changes in care needs and quality of life after the intervention.
 
 
 METHODS
 A convenience sample of 100 patients with postoperative oral cancer was recruited from Far Eastern Memorial Hospital (New Taipei City, Taiwan) between March 2017 and December 2017. Patients were divided into two groups: an experimental group (n=50) receiving an education and information intervention from a mobile health application and a control group (n=50) receiving standard care and nursing guidance. The mobile health application was used from discharge to three months after oral cancer surgery. Patients’ data were collected using a self-administered structured questionnaire. Data were analyzed using logistic regression analysis.
 
 
 RESULTS
 At baseline, overall scores for quality of life in the experimental and control groups were 32.15 and 28.99, respectively; after 3 months of education/information intervention via mobile health application, the overall scores for quality of life were 24.91 and 24.63, respectively, but without statistical significance. Among patients’ care needs, the physiological needs decreased significantly in the experimental group after the intervention compared with those of the control group (p=0.015). Multivariate linear regression indicated that physiological needs also decreased significantly in the experimental group compared with the control group after adjusting for age and sex (p=0.022). Acceptability of the APP by patients was measured by use intentions, perceived usefulness and perceived ease of use. At baseline, mean experimental group scores were 2.54 for use intentions, 2.52 for perceptual usefulness, and 2.32 for perceived ease of use, with no significant differences with control group scores. After 3 months intervention, experimental group scores for use intentions, perceived usefulness and perceived ease of use were 3.02, 2.95, and 3.01, respectively, representing significant increases in each after APP intervention (p<0.01).
 
 
 CONCLUSIONS
 The mobile health application intervention improves quality of life and reduces physiological needs significantly in patients with postoperative oral cancer, and use of the device was readily accepted. These findings may constitute an empirical basis for postoperative care delivered by healthcare practitioners. Results of this study suggest that mobile health applications can be incorporated easily into routine care of oral cancer patients to provide medical information conveniently and improve patients’ self-management and quality of life.
