title: Feasibility of a mobile and web-based intervention to support self-management in outpatients with cancer pain.
abstract: OBJECTIVE
  Cancer pain is a prevalent and distressing symptom. To enhance self-management in outpatients, a multi-component intervention was developed, integrating patient self-management and professional care through healthcare technology. This article describes feasibility of the intervention in everyday practice.
  
  
  METHODS
  Patients with moderate to severe cancer pain (n = 11) and registered nurses specialized in pain and palliative care (n = 3) participated in a four-week study. The intervention involved daily monitoring, graphical feedback, education, and advice by means of a mobile application for patients and a web application for nurses. Learnability, usability and desirability were measured in patients with a 20-item questionnaire (1-5 scale), higher scores indicating better feasibility. Patients' adherence was based on completion rates from server logs. Single semi-structured interviews with patients and a focus group interview with nurses provided insight into experiences.
  
  
  RESULTS
  Questionnaire findings confirmed learnability (4.8), usability (4.8) and desirability (4.6) of the application for patients. Average completion rates were 76.8% for pain monitoring, 50.4% for medication monitoring and 100% for education sessions. Interviews revealed that patients were pleased with the simplicity of the mobile application and appreciated different components. Nurses agreed upon the added value and were mostly positive about the possibilities of the web application. Patients and nurses provided ideas for improvements relating to the content and technical performance of the intervention.
  
  
  CONCLUSIONS
  Study results demonstrate feasibility of the intervention in everyday practice. Provided that content-related and technical adjustments are made, the intervention enables patients with cancer pain to practice self-management and nurses to remotely support these patients.
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, Maastricht, The Netherlands. Electronic address: l.hochstenbach@maastrichtuniversity.nl.
authors.forename: Laura M J
authors.initials: LM
authors.lastname: Hochstenbach
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, Maastricht, The Netherlands; School of Health and Social Care, Department of Social Work and Health Development, University of Greenwich, London, United Kingdom. Electronic address: s.zwakhalen@maastrichtuniversity.nl.
authors.forename: Sandra M G
authors.initials: SM
authors.lastname: Zwakhalen
authors.affiliation: Department of Patient and Care, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: a.courtens@mumc.nl.
authors.forename: Annemie M
authors.initials: AM
authors.lastname: Courtens
authors.affiliation: School for Mental Health and Neuroscience (MHeNs), Department of Anesthesiology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Anesthesiology, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: maarten.van.kleef@mumc.nl.
authors.forename: Maarten
authors.initials: M
authors.lastname: van Kleef
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, Maastricht, The Netherlands; Research Center Technology in Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands. Electronic address: l.dewitte@maastrichtuniversity.nl.
authors.forename: Luc P
authors.initials: LP
authors.lastname: de Witte
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000072716:Cancer Pain / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D059408:Pain Management; D010349:Patient Compliance; D012648:Self Care; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Feasibility; Neoplasms; Nursing; Outpatients; Pain; Self-management; eHealth