Background: Patients with malignant pleural mesothelioma (MPM) have a life-limiting illness and short prognosis and experience many debilitating symptoms from early in the illness. Innovations such as remote symptom monitoring are needed to enable patients to maintain wellbeing and manage symptoms in a proactive and timely manner. The Advanced Symptom Management System (ASyMS) has been successfully used to monitor symptoms associated with cancer. Objective: This study aimed to determine the feasibility and acceptability of using an ASyMS adapted for use by patients with MPM, called ASyMSmeso, enabling the remote monitoring of symptoms using a smartphone. Methods: This was a convergent mixed methods study using patient-reported outcome measures (PROMs) at key time points over a period of 2-3 months with 18 patients. The Sheffield Profile for Assessment and Referral for Care (SPARC), Technology Acceptance Model (TAM) measure for eHealth, and Lung Cancer Symptom Scale-Mesothelioma (LCSS-Meso) were the PROMs used in the study. Patients were also asked to complete a daily symptom questionnaire on a smartphone throughout the study. At the end of the study, semistructured interviews with 11 health professionals, 8 patients, and 3 carers were conducted to collect their experience with using ASyMSmeso. Results: Eighteen patients with MPM agreed to participate in the study (33.3% response rate). The completion rates of study PROMs were high (97.2%-100%), and completion rates of the daily symptom questionnaire were also high, at 88.5%. There were no significant changes in quality of life, as measured by LCSS-Meso. There were statistically significant improvements in the SPARC psychological need domain (P=.049) and in the “Usefulness” domain of the TAM (P=.022). End-of-study interviews identified that both patients and clinicians found the system quick and easy to use. For patients, in particular, the system provided reassurance about symptom experience and the feeling of being listened to. The clinicians largely viewed the system as feasible and acceptable, and areas that were mentioned included the early management of symptoms and connectivity between patients and clinicians, leading to enhanced communication. Conclusions: This study demonstrates that remote monitoring and management of symptoms of people with MPM using a mobile phone are feasible and acceptable. The evidence supports future trials using remote symptom monitoring to support patients with MPM at home.

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中文翻译：

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恶性胸膜间皮瘤 (ASyMSmeso) 患者的高级症状管理系统：混合方法研究


背景：恶性胸膜间皮瘤 (MPM) 患者是一种生命有限的疾病，预后短，并且从疾病早期就会出现许多使人衰弱的症状。需要远程症状监测等创新，使患者能够保持健康并主动及时地管理症状。高级症状管理系统 (ASyMS) 已成功用于监测与癌症相关的症状。目的：本研究旨在确定使用适合 MPM 患者使用的 ASyMS（称为 ASyMSmeso）的可行性和可接受性，该 ASyMS 能够使用智能手机远程监测症状。方法：这是一项收敛混合方法研究，使用 18 名患者在 2-3 个月的关键时间点进行的患者报告结果测量 (PROM)。研究中使用的 PROM 包括谢菲尔德评估和转介护理档案 (SPARC)、电子健康技术接受模型 (TAM) 衡量标准以及肺癌症状量表-间皮瘤 (LCSS-Meso)。在整个研究过程中，患者还被要求在智能手机上完成每日症状调查问卷。研究结束时，我们对 11 名卫生专业人员、8 名患者和 3 名护理人员进行了半结构化访谈，以收集他们使用 ASyMSmeso 的经验。结果：18 名 MPM 患者同意参加该研究（响应率为 33.3%）。研究PROM的完成率很高（97.2%-100%），每日症状问卷的完成率也很高，为88.5%。根据 LCSS-Meso 的测量，生活质量没有显着变化。 SPARC 心理需求领域 (P=.049) 和 TAM 的“有用性”领域 (P=.022) 取得了统计上显着的改善。 研究结束采访表明，患者和临床医生都发现该系统快速且易于使用。特别是对于患者来说，该系统让他们对症状体验和被倾听的感觉感到放心。临床医生在很大程度上认为该系统是可行和可接受的，提到的领域包括症状的早期管理以及患者和临床医生之间的联系，从而加强沟通。结论：本研究表明，使用手机远程监测和管理 MPM 患者的症状是可行且可接受的。这些证据支持未来使用远程症状监测来支持 MPM 患者在家的试验。


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