scholarly journals A Stress Management App Intervention for Cancer Survivors: Design, Development, and Usability Testing (Preprint)

2018 ◽  
Author(s):  
Elin Børøsund ◽  
Jelena Mirkovic ◽  
Matthew M Clark ◽  
Shawna L Ehlers ◽  
Michael A Andrykowski ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Stress Management ◽  
Development Process ◽  
Usability Testing ◽  
Evidence Based ◽  
Care Providers ◽  
Design And Development ◽  
Management Intervention ◽  
Stress Management Intervention ◽  
Management Interventions

BACKGROUND Distress is prevalent in cancer survivors. Stress management interventions can reduce distress and improve quality of life for cancer patients, but many people with cancer are unfortunately not offered or able to attend such in-person stress management interventions. OBJECTIVE The objective of this study was to develop an evidence-based stress management intervention for patients living with cancer that can be delivered electronically with wide reach and dissemination. This paper describes the design and development process of a technology-based stress management intervention for cancer survivors, including the exploration phase, intervention content development, iterative software development (including design, development, and formative evaluation of low- and high-level prototypes), and security and privacy considerations. METHODS Design and development processes were iterative and performed in close collaboration with key stakeholders (N=48). In the exploration phase, identifying needs and requirements for the intervention, 28 participants gave input, including male and female cancer survivors (n=11) representing a wide age range (31-81 years) and cancer diagnoses, healthcare providers (n=8) including psychosocial oncology experts, and eHealth experts (n=9) including information technology design and developers. To ensure user involvement in each phase various user-centered design and service design methods were included, such as interviews, usability testing, and think aloud processes. Overall, participants were involved usability testing in the software development and formative evaluation phase, including cancer survivors (n=6), healthy volunteers (n=7), health care providers (n=2), and eHealth experts (n=5). Intervention content was developed by stress management experts based on well-known cognitive behavioral stress management strategies and adjusted to electronic format through multiple iterations with stakeholders. Privacy and security issues were considered throughout. RESULTS The design and development process identified a variety of stakeholder requirements. Cancer survivors preferred stress management through a mobile app rather than through a personal computer (PC) and identified usefulness, easy access, user friendliness, use of easily understandable language, and many brief sections rather than longer ones as important components of the intervention. These requirements were also supported by recommendations from health care providers and eHealth experts. The final intervention was named StressProffen and the hospital Privacy and Security Protection Committee was part of the final intervention approval to also ensure anchoring in the hospital organization. CONCLUSIONS Interventions, even evidence-based, have little impact if not actively used. This study illustrates how user-centered design and service design can be applied to identify and incorporate essential stakeholder aspects in the entire design and development process. In combination with evidence-based concepts, this process facilitated development of a stress management intervention truly designed for the end users, in this case, cancer survivors. CLINICALTRIAL ClinicalTrials.gov NCT02939612; https://clinicaltrials.gov/ct2/show/NCT02939612 (Archived at WebCite at http://www.webcitation.org/71l9HcfcB)

scholarly journals A User-Centered Approach to an Evidence-Based Electronic Health Pain Management Intervention for People With Chronic Pain: Design and Development of EPIO

10.2196/15889 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e15889 ◽  
Author(s):  
Ingrid Konstanse Ledel Solem ◽  
Cecilie Varsi ◽  
Hilde Eide ◽  
Olöf Birna Kristjansdottir ◽  
Elin Børøsund ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Development Process ◽  
Evidence Based ◽  
Care Providers ◽  
Design And Development ◽  
Management Intervention ◽  
Intervention Content ◽  
Stakeholder Input ◽  
User Centered

Background Chronic pain conditions are complicated and challenging to live with. Electronic health (eHealth) interventions show promise in helping people cope with chronic illness, including pain. The success of these interventions depends not only on the technology and intervention content but also on the users’ acceptance and adherence. Involving all stakeholders (eg, patients, spouses, health care providers, designers, software developers, and researchers) and exploring their input and preferences in the design and development process is an important step toward developing meaningful interventions and possibly strengthening treatment outcomes. Objective The aim of this study was to design and develop a user-centered, evidence-based eHealth self-management intervention for people with chronic pain. Methods The study employed a multidisciplinary and user-centered design approach. Overall, 20 stakeholders from the project team (ie, 7 researchers, 5 editors, 7 software developers, and 1 user representative), together with 33 external stakeholders (ie, 12 health care providers, 1 health care manger, 1 eHealth research psychologist, and 17 patients with chronic pain and 2 of their spouses) participated in a user-centered development process that included workshops, intervention content development, and usability testing. Intervention content was developed and finalized based on existing evidence, stakeholder input, and user testing. Stakeholder input was examined through qualitative analyses with rapid and in-depth analysis approaches. Results Analyses from stakeholder input identified themes including a need for reliable, trustworthy, and evidence-based content, personalization, options for feedback, behavioral tracking, and self-assessment/registration as factors to include in the intervention. Evidence-based intervention content development resulted in one face-to-face introduction session and 9 app-based educational and exercise-based modules. Usability testing provided further insight into how to optimize the design of the intervention to the user group, identifying accessibility and a simple design to be essential. Conclusions The design and development process of eHealth interventions should strive to combine well-known evidence-based concepts with stakeholder input. This study, designing and developing the pain management intervention EPIO, illustrates how a stakeholder-centered design approach can provide essential input in the development of an eHealth self-management intervention for people with chronic pain. Trial Registration ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104

scholarly journals Pilot testing an app-based stress management intervention for cancer survivors

2019 ◽  
Vol 10 (3) ◽  
pp. 770-780 ◽  
Author(s):  
Elin Børøsund ◽  
Cecilie Varsi ◽  
Matthew M Clark ◽  
Shawna L Ehlers ◽  
Michael A Andrykowski ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Stress Management ◽  
Depression Scale ◽  
Well Being ◽  
Management Tool ◽  
Anxiety And Depression ◽  
Post Intervention ◽  
Management Intervention ◽  
Stress Management Intervention ◽  
Management Interventions

Abstract Psychosocial eHealth intervention programs for cancer survivors are still in their infancy, with inconsistent findings so far in the scientific literature. The aim of this study was to explore system use, usefulness, ease of use, and preliminary effects of Stress Proffen, an app-based cognitive-behavioral stress management intervention for patients with cancer. A feasibility pilot project tested the intervention with cancer survivors (N = 25). The intervention contained (a) one face-to-face introduction session, (b) 10 app-based modules with stress management educational material and exercises, and (c) one follow-up phone call. Post-intervention interviews were conducted and user log-data were extracted. Outcome measures—Perceived Stress Scale (PSS), Anxiety and Depression (Hospital Anxiety and Depression Scale [HADS]), Health-Related Quality of Life (HRQoL; SF-36), and Self-Regulatory Fatigue (SRF-18)—were completed at baseline and post-intervention. Participants were primarily women (84%), age 34–71 (mean 48) and represented a variety of cancer diagnoses (majority breast cancer: 40%). Twenty-two participants completed all (pre–post) questionnaires. Sixteen participants (67%) completed at least 7 of 10 modules within the 8-week study period. Post-intervention interviews described StressProffen as providing a new, appreciated, and easily accessible stress management tool for the cancer survivors. Dependent/paired t-tests showed significant pre–post intervention effects with significant decrease in stress (p = .008), anxiety (p = .019), and self-regulatory fatigue (p = .025), and improved HRQoL (Role Physical, General Health, Vitality, and Role Emotional, all p’s <.01). App-based stress management interventions such as StressProffen can provide appreciated support for cancer survivors, should be easy to use, can provide significant stress reduction, and improve emotional well-being. Further testing in a randomized controlled trial is warranted and is in progress. Clinicaltrials.gov: NCT0293961.

scholarly journals Does a Community-Based Stress Management Intervention Affect Psychological Adaptation Among Underserved Black Breast Cancer Survivors?

2014 ◽  
Vol 2014 (50) ◽  
pp. 315-322 ◽  
Author(s):  
Suzanne C. Lechner ◽  
Nicole E. Whitehead ◽  
Sara Vargas ◽  
Debra W. Annane ◽  
Belinda R. Robertson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Stress Management ◽  
Breast Cancer Survivors ◽  
Psychological Adaptation ◽  
Community Based ◽  
Management Intervention ◽  
Stress Management Intervention

scholarly journals Results from a randomized controlled trial testing StressProffen ; an application‐based stress‐management intervention for cancer survivors

2020 ◽  
Vol 9 (11) ◽  
pp. 3775-3785 ◽  
Author(s):  
Elin Børøsund ◽  
Shawna L. Ehlers ◽  
Cecilie Varsi ◽  
Matthew M. Clark ◽  
Michael A. Andrykowski ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cancer Survivors ◽  
Stress Management ◽  
Controlled Trial ◽  
Management Intervention ◽  
Randomized Controlled ◽  
Stress Management Intervention ◽  
Trial Testing

Not Just Tools to Handle It: A Qualitative Study of Nursing Students’ Experiences From Participating in a Cognitive Behavioral Stress Management Intervention

2019 ◽  
Vol 46 (6) ◽  
pp. 922-929
Author(s):  
Ulrik Terp ◽  
Birgitta Bisholt ◽  
Fredrik Hjärthag
Keyword(s):  
Nursing Students ◽  
Stress Management ◽  
Qualitative Content Analysis ◽  
Management Training ◽  
Nurse Education ◽  
Cognitive Behavioral ◽  
Stress Management Training ◽  
Management Intervention ◽  
Stress Management Intervention ◽  
Management Interventions

Background. Stress-related problems are an increasing challenge within nurse education since it affects learning, professional development, and mental health negatively. Despite this, knowledge is scarce regarding nursing students’ experiences of being in stress management interventions. Aim. This study aimed to describe how nursing students experienced a preventive cognitive behavioral therapy–based stress management intervention. Method. Data were collected through 14 semistructured interviews with nursing students who had participated in a stress management intervention, and analyzed using inductive qualitative content analysis. Results. The analysis yielded one theme, Turning points, which consisted of four categories: (1) more in touch with reality, (2) increased self-confidence, (3) improved communication skills, and (4) a new way of reflecting. Discussion. Findings emphasize the importance of both theoretical and structural aspects when planning a stress management training intervention. A group format delivery in combination with a multicomponent cognitive behavioral intervention can be interrelated elements for positive stress–related changes. Conclusion. Our findings indicate that participants developed new and more adaptive coping strategies, which were attributed to the intervention. The participants expressed that they had increased their ability to reflect, which led to increased insight and self-reflection. The intervention constitutes an example of a contribution to stress management research and provides information for stress management training initiatives in nurse education.

scholarly journals A Feasibility Study Of A Cognitive Behavioral Based Stress Management Intervention For Nursing Students: Results, Challenges, And Implications For Research And Practice

2020 ◽  
Author(s):  
Ulrik Terp ◽  
Birgitta Bisholt ◽  
Fredrik Hjärthag
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Stress Management ◽  
Nurse Education ◽  
Cognitive Behavioral ◽  
Preliminary Evaluation ◽  
Stress Management Training ◽  
Management Intervention ◽  
Stress Management Intervention ◽  
Management Interventions

Abstract Background: Stress related psychological problems are growing in nursing education and constitute an essential challenge for educators. This makes research about strategies and interventions to meet these problems important. Before implementing stress management interventions, they need to be tested for feasibility and acceptability before conducting large scale RCTs. The objective of our study was to assess the feasibility and acceptability of a newly developed cognitive behavioral stress management intervention for nursing students. Methods: Data were collected using a combination of standardized measurements and newly created questionnaires in combination with qualitative data. Our data included recruitment capability, sample characteristics, intervention acceptability and preliminary evaluation of participant psychological changes. Results: Findings suggested that the feasibility of conducting a full-scale evaluation was confirmed for recruitment, acceptability, data collection, and adherence to the intervention. However, difficulties relating to homework were also identified. The intervention was found feasible and acceptable to nursing students and a potential intervention for the nurse education context. Conclusions: Overall, this study provides an insight into the challenges and complexities of developing and evaluating a new brief cognitive behavioral based stress management training intervention in a nurse education setting. Support in the organization and scheduling are important aspects of implementation. In order to deal with the challenge of stress-related problems in nursing education, the thresholds for participation in effective interventions need to be low.

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