A Theory-Based, Multidisciplinary Approach to Cocreate a Patient-Centric Digital Solution to Enhance Perioperative Health Outcomes among Colorectal Cancer Patients and Their Family Caregivers: Development and Evaluation Study
Artikel i vetenskaplig tidskrift, 2021

Background: Elective colorectal cancer (CRC) surgeries offer enhanced surgical outcomes but demand high self-efficacy in prehabilitation and competency in self-care and disease management postsurgery. Conventional strategies to meet perioperative needs have not been pragmatic, and there remains a pressing need for novel technologies that could improve health outcomes. Objective: The aim of this paper was to describe the development of a smartphone-based interactive CRC self-management enhancement psychosocial program (iCanManage) in order to improve health outcomes among patients who undergo elective CRC surgeries and their family caregivers. Methods: A multidisciplinary international team comprising physicians, specialist nurses, a psychologist, software engineers, academic researchers, cancer survivors, patient ambassadors, and ostomy care medical equipment suppliers was formed to facilitate the development of this patient-centric digital solution. The process occurred in several stages: (1) review of current practice through clinic visits and on-site observations; (2) review of literature and findings from preliminary studies; (3) content development grounded in an underpinning theory; (4) integration of support services; and (5) optimizing user experience through improving interface aesthetics and customization. In our study, 5 participants with CRC performed preliminary assessments on the quality of the developed solution using the 20-item user version of the Mobile App Rating Scale (uMARS), which had good psychometric properties. Results: Based on the collected uMARS data, the smartphone app was rated highly for functionality, aesthetics, information quality, and perceived impact, and moderately for engagement and subjective quality. Several limiting factors such as poor agility in the adoption of digital technology and low eHealth literacy were identified despite efforts to promote engagement and ensure ease of use of the mobile app. To overcome such barriers, additional app-training sessions, an instruction manual, and regular telephone calls will be incorporated into the iCanManage program during the trial period. Conclusions: This form of multidisciplinary collaboration is advantageous as it can potentially streamline existing care paths and allow the delivery of more holistic care to the CRC population during the perioperative period. Should the program be found to be effective and sustainable, hospitals adopting this digital solution may achieve better resource allocation and reduce overall health care costs in the long run.

Smartphone app

Digital solutions


Mobile health

Colorectal cancer


Mobile phone app


Su Wei Wan

National University Health System

Yong Loo Lin School of Medicine

Choon Seng Chong

National University Hospital, Singapore

National University Health System

Yong Loo Lin School of Medicine

Ee Lin Toh

Duke-NUS Medical School

Singapore General Hospital

Yong Loo Lin School of Medicine

Siew Hoon Lim

Singapore General Hospital

Carol T.T. Loi

Singapore Red Cross Academy

Yuen Foong Henry Lew

Singapore University of Social Sciences

Matthew Chin Heng Chua

Universiti Kebangsaan Singapura (NUS)

Xin Pei Jee

National University Health System

National University Hospital, Singapore

Guangyu Liu

Yong Loo Lin School of Medicine

Lixia Zhu

Yong Loo Lin School of Medicine

Minna Pikkarainen

Chalmers, Elektroteknik, Signalbehandling och medicinsk teknik

Oulun Yliopisto

OsloMet – storbyuniversitetet

Hong Gu He

National University Health System

Yong Loo Lin School of Medicine

Journal of Medical Internet Research

14388871 (eISSN)

Vol. 23 12 e31917


Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi

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