3 results on '"Mikolasek, Michael"'
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2. Improvements in Health Might Contradict Adherence to Mobile Health Interventions: Findings from a Self-Care Cancer App Study.
- Author
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Siebenhüner, Alexander R., Mikolasek, Michael, Witt, Claudia M., and Barth, Jürgen
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TREATMENT of psychological stress , *CANCER patient psychology , *STATISTICS , *SCIENTIFIC observation , *ANALYSIS of variance , *MOBILE apps , *QUALITY of life , *CHI-squared test , *KAPLAN-Meier estimator , *RESEARCH funding , *PATIENT compliance , *DATA analysis software , *DATA analysis , *HEALTH self-care , *TELEMEDICINE , *LONGITUDINAL method - Abstract
Background: Cancer patients often suffer from high levels of distress. Mobile health (mHealth) applications might be an innovative way to deliver mindfulness and relaxation interventions for cancer patients. However, data about the implementation of apps in health care are lacking. Adherence to mHealth interventions is an important indicator for a successful implementation and might be needed to maximize treatment effects. However, the decrease in distress might reduce the motivation of patients to engage in such self-care tools in the long run. Therefore, the aim of this analysis was to investigate the association between the course of distress over time and the adherence to a relaxation self-care app in cancer patients. Methods: We developed an app for cancer patients (CanRelax) and 83 patients who participated in the prospective observational study used the app at least once. The evaluation was guided by the RE-AIM framework, and this analysis focused on the implementation of the app. Patients were grouped into five subgroups according to their course of distress over 10 weeks (Distress Thermometer). These subgroups of patients were compared with each other to identify different user groups. Findings: About half of the patients were adherent over 10 weeks. However, a decrease in distress was associated with lower adherence to the app intervention, whereas patients with moderate distress or an increase in distress showed more adherence. Conclusion: Adherence to an app intervention might be also driven by patients' distress level. A decrease in distress might reduce patients' motivation to continue with a self-care intervention. The interplay between adherence and treatment outcomes should be explored in upcoming mHealth trials to get a better understanding for the implementation of such interventions. Encouraging patients to continue self-care interventions is a major challenge in integrative medicine if they are delivered digitally. The Clinical Trial Registration number: DRKS00010481. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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3. Adherence to a Mindfulness and Relaxation Self-Care App for Cancer Patients: Mixed-Methods Feasibility Study
- Author
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Jürgen Barth, Claudia M. Witt, Michael Mikolasek, University of Zurich, and Mikolasek, Michael
- Subjects
medicine.medical_specialty ,Mindfulness ,mindfulness ,Psychological intervention ,Health Informatics ,610 Medicine & health ,Information technology ,patient compliance ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,relaxation ,mobile app ,Medicine ,cancer ,030212 general & internal medicine ,mHealth ,2718 Health Informatics ,Original Paper ,business.industry ,T58.5-58.64 ,Clinical trial ,Distress ,10034 Institute of Complementary Medicine ,030220 oncology & carcinogenesis ,Physical therapy ,Anxiety ,Observational study ,medicine.symptom ,Public aspects of medicine ,RA1-1270 ,business - Abstract
BackgroundCancer is highly prevalent worldwide and can cause high levels of distress in patients, which is often neglected in medical care. Smartphone apps are readily available and therefore seem promising to deliver distress-reducing interventions such as mindfulness and relaxation programs. ObjectiveThis study aimed to evaluate the feasibility of a mindfulness and relaxation app for cancer patients. We looked at characteristics of participating patients in a mobile health (mHealth) study, including adherence to the app intervention, predictors for adherence, and patients’ feedback regarding the app. MethodsIn this prospective observational study with a mixed-methods approach, cancer patients received a mindfulness and relaxation self-care app. Cancer patients were recruited online and through hospitals in Switzerland. We assessed self-reported measures (eg, quality of life, anxiety, depressive symptoms, openness to experience, resistance to change) at baseline, and the app gathered data on patients’ practicing time. With 8 semistructured interviews, we obtained patients’ feedback about the app and recommendations for improvements. We looked at 3 dimensions of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (reach, adoption, and maintenance) and analyzed data for adherence for the first 10 weeks of the app intervention. We report descriptive statistics for patient characteristics and app use. For the prediction of adherence, we used Kaplan-Meier analyses with log-rank tests and a Cox proportional hazards regression. ResultsData from 100 cancer patients (74 female) showed that 54 patients were using the app exercises continuously until week 10. In continuous app users, the median number of exercises per week dropped from 4 (interquartile range, IQR 1-7) at week 1 to a median of 2 (IQR 1-4) at week 10. Our analyses revealed 4 significant predictors for better adherence: female gender, higher openness to experience, higher resistance to change, and more depressive symptoms. Interviews revealed that the patients generally were satisfied with the app but also made suggestions on how to improve it. ConclusionsOur study indicates that a mindfulness and relaxation mHealth intervention for cancer patients is feasible with acceptable adherence and largely positive feedback from patients. Trial RegistrationGerman Clinical Trials Register DRKS00010481; https://www.drks.de/drks_web/navigate.do?navigation Id=trial.HTML&TRIAL_ID=DRKS00010481 (Archived by WebCite at http://www.webcitation.org/73xGE1B0P)
- Published
- 2018
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