Digital Health Technology Empowers Patients, Caregivers in Symptom Management

Patients with cancer and their family caregivers tend to develop a bond with the digital health technology (DHT) used to manage their symptoms. They also experience a sense of abandonment when discontinuing its use that eventually becomes a greater confidence in self-care, according to study results published in Seminars in Oncology Nursing. 

Participants were recruited from the eSMART clinical trial, a larger, nurse-led multicenter randomized controlled trial that examined the effectiveness of electronic symptom management, using a remote technology system. 

This study focused on patients in the intervention group who were required to report their chemotherapy symptoms daily to a cancer care nursing team using a smartphone-based program. The participants were patients older than 18 years with newly diagnosed Stage I-III colorectal cancer who were undergoing active chemotherapy and their adult caregivers. 

Each participant was interviewed twice: while using the DHT during chemotherapy and after they returned the technology to the research team while still undergoing chemotherapy. They were asked to describe their experience using DHT, including its impact on their symptom management and their psychological response during treatment and after returning the device. 

The patients’ responses were examined to explore their feelings of attachment to the devices, anticipatory anxiety when contemplating returning the device, and their eventual adjustment to life without the device. 

The caregivers’ relationship to DHT use was examined to explore how they helped their loved ones adjust to using the technology and to accurately report symptom information. The caregivers also described their own unique relationships with the technology and how vulnerable they felt after the patients returned the technology. 

Patients became accustomed to using the technology, even if they had reservations beforehand, and many developed a trusting relationship with the DHT after a period of time. Although participants compared it to a comfort object that gave them a sense of safety in an uncertain time, that feeling was grounded in the knowledge that their cancer care team was regularly checking in on them and responding to their symptom reports. 

However, they underwent a period of adjustment after giving up the device. Despite an initial sense of abandonment, as time passed, the patients became aware of their increased knowledge and experience with managing their symptoms as a result of having used the technology, eventually becoming more confident in their ability to deal with symptom management on their own. 

Some caregivers also expressed a sense of heightened anxiety about the added burden of caring for the patient without the help of DHT. 

“The findings bring awareness to how DHT is not simply an intervention to improve health outcomes, but people with cancer and their family caregivers develop personal connections to it,” the researchers wrote in conclusion. 

“More specifically, this research demonstrates how symptom management technologies have a great potential to elicit strong attachments in adults and fulfil some of the functions of a transitional object following a recent cancer diagnosis and receiving treatment. DHT can educate and promote self-efficacy among people with cancer and their family caregivers which means they can successfully self-manage their symptoms without it.”