Abstract

Background The majority of new cancer cases are expected to be diagnosed in low- and middle-income countries (LMICs) by 2025, and 65% of cancer deaths currently occur in LMICs. Treatment adherence, patient monitoring, and follow-up are essential to cancer care but are often not possible in these settings. Out Patient (OP) Care, a smartphone application (app) developed to fill this gap, texts appointment reminders to patients and electronically stores medical records confidentially.

Objectives This study aims to present the development of this app and evaluate its usability and feasibility as defined by provider and patient experiences in the context of a multidisciplinary cancer clinic in Gaborone, Botswana.

Methods OP Care was piloted at a multidisciplinary team gynecologic oncology clinic in Gaborone, Botswana. The app was developed through an iterative process with feedback from clinic staff and physicians. The usability was evaluated using a cross-sectional survey. All staff members in the gynecologic oncology clinic, which typically consists of one doctor and four nurses, as well as a portion of the staff in the (Princess Marina Hospital general) oncology ward used the app. All providers using the app were surveyed, along with all patients who attended the gynecologic oncology clinic during the 3-week survey period. Staff demographics, reactions, and opinions on usability, as well as patients' reactions to the appointment reminders were collected. Agreement to the ease-of-usability statements was recorded on a 1 (not at all) to 7 (extremely so) scale. Primary outcomes were the app's usability and the feasibility of text reminders from the patient's perspective.

Results Nine staff and 15 patients were surveyed. Staff included three doctors and six nurses and encompassed all of the staff in the gynecologic oncology clinic as well as a portion of the general oncology ward. All surveyed staff owned a smartphone and used a computer at home. Most (78%) staff did not feel that OP Care would increase their work burden and were willing to use the app if implemented permanently (median: 6; interquartile range [IQR]: 1). Seventeen out of the nineteen usability questions, such as “I feel comfortable using this system,” scored a median of 6, corresponding to “very much so.” Patients reported that the reminder text messages were helpful (median: 6; IQR: 1) and preferred the text reminders to be in Setswana (median: 7; IQR: 1).

Conclusion High usability scores indicate that the app can be scaled up to usage in this clinic and others. Although patients appreciate OP Care, the option for call and text reminders in Setswana is indicated.

Publication History

Received: 09 January 2020

Accepted: 05 May 2020

Publication Date:
24 August 2020 (online)

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

中文翻译：

---

用于跟踪博茨瓦纳哈博罗内肿瘤患者的智能手机应用程序的开发和可用性。

摘要

背景技术 预计到2025年，大多数新的癌症病例将在低收入和中等收入国家（LMIC）进行诊断，目前，有65％的癌症死亡病例发生在LMIC中。治疗依从性，患者监测和随访对于癌症护理至关重要，但在这些情况下通常是不可能的。Out Patient（OP）Care是一款为弥补这一空白而开发的智能手机应用程序（app），可向患者发送约会提醒并以电子方式秘密存储病历。

目标 这项研究旨在介绍该应用程序的开发，并根据在博茨瓦纳哈博罗内的多学科癌症诊所中提供者和患者的经验来评估其可用性和可行性。

方法 OP Care在博茨瓦纳哈博罗内的一个多学科团队妇科肿瘤诊所进行了试点。该应用程序是通过迭代过程开发的，并得到了诊所工作人员和医生的反馈。使用横断面评估来评估可用性。妇科肿瘤诊所的所有工作人员（通常由一名医生和四名护士组成）以及（公主码头医院普通科）肿瘤病房的部分工作人员都使用了该应用程序。对使用该应用程序的所有提供者以及在3周的调查期内就诊于妇科肿瘤诊所的所有患者进行了调查。收集了人员统计数据，对可用性的反应和意见，以及患者对约会提醒的反应。对易用性声明的同意以1（根本没有）到7（极其如此）的等级记录。从患者的角度来看，主要结果是该应用程序的可用性和文本提示的可行性。

结果对 9名员工和15例患者进行了调查。工作人员包括三名医生和六名护士，并涵盖了妇科肿瘤诊所的所有人员以及普通肿瘤病房的一部分。所有接受调查的员工都拥有智能手机，在家中使用电脑。大多数（78％）的员工并不认为OP Care会增加工作负担，如果永久实施，他们不愿意使用该应用程序（中位数：6；四分位间距[IQR]：1）。在19个可用性问题中，有17个（例如“我对使用此系统感到满意”）的中位数为6，相当于“非常”。患者报告说，提醒文字消息是有帮助的（中位数：6； IQR：1），并希望将文字提醒内容设置在Setswana（中位数：7； IQR：1）。

结论 高可用性得分表明该应用程序可以按比例扩展到该诊所和其他应用程序中的使用情况。尽管患者喜欢OP护理，但在Setswana中显示了呼叫和文本提醒选项。

出版历史

收到：2020年1月9日

接受：2020年5月5日

发布日期：
2020年8月24日（在线）

©2020年。Thieme。版权所有。

Georg Thieme Verlag KG
斯图加特·纽约