JMIR Cancer最新文献

Background: Individuals undergoing cancer treatment often face a high symptom burden that impairs quality of life. Exercise and mind-body therapies have been shown to reduce symptoms but are underused. We developed a digital exercise and mind-body therapy program that effectively reduces symptoms while overcoming in-person delivery barriers. Understanding patient experiences can inform treatment mechanisms and guide digital health interventions in cancer care.

Objective: This study aimed to explore patient experiences with Integrative Medicine at Home (IM@Home), a 12-week live digital program delivering exercise and mind-body therapies tailored to the needs of individuals undergoing cancer treatment.

Methods: This qualitative study was embedded in a randomized clinical basket trial (NCT05053230) evaluating the effects of IM@Home versus enhanced usual care on symptoms and acute health care utilization in adults with solid tumors undergoing active treatment and experiencing moderate or greater fatigue. Using maximum variation sampling, 20 participants were selected for semistructured interviews. Interviews explored participants' experiences with the program, its impact on outcomes, unmet needs, and suggestions for improvement. Transcripts were analyzed using a combined inductive and deductive thematic analysis.

Results: Twenty participants (mean age 63, SD 9.6 years; 18/20, 90% female) were interviewed. Five major themes emerged: (1) IM@Home alleviated symptom burden and supported symptom self-management; (2) IM@Home facilitated social support and information exchange; (3) IM@Home offered a flexible, tailored program in a group setting; (4) IM@Home facilitated accessible, cost-effective support; and (5) recommendations for program enhancement. IM@Home was perceived as an accessible, flexible, and supportive program that promoted physical and emotional well-being during treatment.

Conclusions: IM@Home demonstrates a promising model for delivering integrative supportive care during cancer treatment. Findings highlight patient-valued features such as real-time guidance, tailored content, and community support. These insights can inform future implementation, integration into clinical care, and efforts to enhance digital mind-body interventions in oncology.

Trial registration: ClinicalTrials.gov NCT05053230; https://www.clinicaltrials.gov/study/NCT05053230.

International registered report identifier (irrid): RR2-10.1038/s41746-024-01387-z.

Background: Barriers to eHealth use include lack of technological infrastructure, resistance to change, and inequities in access. However, patterns of access to and use of eHealth tools in people being treated for cancer have not been fully described in the literature.

Objective: Our aim was to describe the patterns of access to and use of eHealth tools among outpatients receiving treatment for hematological malignancies and solid tumors.

Methods: We conducted a cross-sectional multicenter study using a survey offered to patients aged over 18 years receiving outpatient treatment for hematological malignancies or solid tumors at 4 teaching hospitals in Madrid, Spain, between February 1, 2021, and November 30, 2021. The survey instrument featured questions about patients' demographic and social characteristics, cancer diagnosis, use of information and communication technology (ICT), use and opinions of the Patient Portal, and changes in ICT use during the COVID-19 pandemic. To study the relationship between the different variables, 2-tailed Student t tests or ANOVA were used for variables with normal distribution, and the Mann-Whitney or Kruskal-Wallis tests were used for variables with nonnormal distribution. Statistical analyses were performed using SPSS (version 25; IBM Corp) for Windows.

Results: In total, 200 patients were included in our study. Median age was 60 (range 21-87) years. A total of 130 (65%) patients presented with hematological malignancies. Most (n=181, 90.5%) patients considered that eHealth tools might help to improve communication with the medical team during their treatment. Retired participants (28.6% vs 71.4%; P<.001), those older than 60 years (26% vs 74%; P<.001), and those without higher education (2.6% vs 97.4%; P<.001) showed significantly lower rates of internet use, with no observed sex-related differences. A total of 177 (88.5%) patients found the Patient Portal useful, and 140 (70%) reported increased use of ICT due to the COVID-19 pandemic.

Conclusions: Most (177/200, 88.5%) patients viewed eHealth tools as useful and believed that it was helpful to improve communication with their care team. However, notable gaps in the use of eHealth were observed in certain groups of patients, with significant differences in use due to age, education, and employment status. Strategies to identify subgroups at risk for unequal access to digital health, as well as to facilitate access and use, are warranted.