A mobile application of a breast cancer e-support program for Chinese women with breast cancer undergoing chemotherapy

Background: Women with breast cancer undergoing chemotherapy suffer from a variety of symptoms such as pain, fatigue, and sleep disturbance, which adversely affect women’s quality of life (QoL) and psychological well-being. These women have frequently reported unmet supportive care needs. Easily accessible and innovative support is lacking. Mobile applications (apps) provide a promising platform to provide knowledge and offer a means to interact with peers or health care professionals when and where needed. Aim: To develop and evaluate the effectiveness of an app-based Breast Cancer Support (BCS) program for Chinese women with breast cancer undergoing chemotherapy on social support, self-efficacy, symptom distress, QoL, and anxiety and depression. Methods: This thesis consists of an introduction, to illustrating the need for an easily accessible and innovative BCS program; an integrative review on the effectiveness of Internet-based interactive program, from which the knowledge gaps generated further justify the development and evaluation of the BCS program; a study protocol to describe the methodology of the BCS program, a descriptive study on the BCS development and validation process, a quantitative study reporting the BCS effectiveness using a multi-center, single-blinded, randomized controlled trial (RCT), and a qualitative study on process evaluation of the BCS program. Results: Our quantitative study demonstrates BCS’s potential for dissemination as an effective and easily accessible intervention to promote women’s self-efficacy, symptom interference, and QoL during chemotherapy. However, these beneficial effects were not sustained at 6 months. The process evaluation supports the quantitative results that the BCS program was useful and feasible. Conclusion: This is the first study of its kind in China to demonstrate the value of an app-based intervention for women with breast cancer undergoing chemotherapy using a rigorous research design. This is crucial because mobile apps are being increasingly utilized as supplementary interventions for individuals when the feasibility of face-to-face interventions are challenged by physical limitations or geographic distance.