Efficacy of a Mobile App for Assisting in the Self-management of Patients with Breast Cancer on Self-efficacy: A Non-randomized Intervention Trial (Preprint)

Abstract

BACKGROUND Numerous mobile apps have been developed and applied to patients with cancer. However, a comprehensive app targeted at breast cancer patients that integrates evidence-based medical information, psychological support, and schedule management using multidisciplinary medical approaches remains absent. OBJECTIVE To investigate whether a mobile app designed to assist the self-management of patients with breast cancer is feasible and positively affects their self-efficacy and other psychological aspects. METHODS The Cancer Manager® (CAMA®; HuDIT, Seoul, Korea) was developed to assist in the self-management of patients with breast cancer and survivors according to cancer trajectory. Its functionalities include providing evidence-based digitalized information created by experts, managing patients’ medication and medical appointment schedules, and providing a delayed question-and-answer system for patients to query healthcare professionals. In this non-randomized intervention trial, we analyzed data from 66 patients with breast cancer divided into an experimental group (CAMA group, n=34) and a control group (treatment as usual [TAU] group, n=32). Outcome measures included the Korean version of the Cancer Survivor Self-Efficacy Scale (CS-SES-K), the Korean version of the Mini-Mental Adjustment to Cancer Scale (K-Mini-MAC), World Health Organization Quality of Life Brief Version (WHOQOL-BREF), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Menopause Emotional Symptoms Questionnaire (MESQ). A user satisfaction survey was also conducted. RESULTS Throughout the intervention period, the CAMA group (vs. TAU group) demonstrated significant improvements in the CS-SES-K subscale of Seeking help and support (F=5.09, P=.03), WHOQOL subscale of Psychological well-being (F=5.48, P=.02), K-Mini-MAC subscale of Anxious preoccupation (F=5.49, P=.02), K-Mini-MAC subscale of Positive attitude (F=5.44, P=.02), PHQ-9 (F=4.83, P=.03), GAD-7 (F=5.48, P=.02), and MESQ (F=4.30, P=.04). Changes in the K-Mini-MAC subscale of Anxious preoccupation scores were positively correlated with changes in the PHQ-9 (r=.46, P=.007) and GAD-7 (r=.41, P=.02) and negatively correlated with changes in the K-Mini-MAC subscale of Positive attitude (r=-.36, P=.04). Changes in the PHQ-9 were positively correlated with changes in the GAD-7 (r=.66, P<.001) and MESQ (r=.35, P=.04). The user satisfaction survey offered insights into the CAMA® app’s positive impact, trust-building outcomes, and opportunities for enhancement, such as the inclusion of communication tools and continued content enrichment. CONCLUSIONS The mobile app for assisting in the self-management of patients with breast cancer, CAMA®, was deemed as being feasible and effective for increasing self-efficacy for seeking help and support, positive attitude toward cancer, and psychological well-being. Additionally, the app decreased anxious preoccupation toward cancer, depressive mood, anxiety, and menopausal emotional symptoms. CLINICALTRIAL Clinical Research Information Service KCT0007917; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=23348&search_page=L