Research in the ICare group focus on Interaction, Information- and communication technology (ICT), Innovation, Intervention, and Implementation.
The research area
The research in the ICare group is based on the salutogenic idea of what, from the patient’s perspective, promotes health and wellbeing, inner strength and the pursuit for improvement. The emphasis is on the implication of the patient's own statements and the experience of living with a disease and how this is handled in order to improve health and well-being. The research covers method development, intervention studies and implementation in clinical practice carried out in close collaboration between researchers, patients and clinicians. Based on theories of patient participation, interventions are developed and tested from the patients, the care providers and the organizations perspectives.
Patients are today increasingly treated in outpatient care which requires the patient to be an expert on their own health but also the provision of safe care from the healthcare givers. In the context of mHealth (mobile health) it is assumed that people can use and be supported by digital technology. It comprises apps that allow mobility and increase the health care sector’s ability to meet the patient’s demands. The contact with patients will be more enhanced and effective – a contact that is controlled by the individual patient’s needs. mHealth can also contribute to enhanced knowledge about patients’ experiences in relation to disease and treatment.
We have developed an interactive app (Interaktor) based on theory, literature and in co-design with patients and health care professionals. Interaktor includes several components where
- patients report symptoms and concerns on a regular basis
- alerts are triggered to a nurse when symptoms or concerns are severe
- patients have access to evidence-based self-care advice
- symptoms and concerns are visualized over time in graphs
- professionals can follow the patients’ reports via a web-interface
The objective with the research program is to evaluate the effects of routine use of Interaktor assessment of diagnose/treatment related symptoms and concerns regarding symptom burden, quality of life, cost-effectiveness and survival. A further goal is to implement Interaktor in clinical practice.
Interaktor during cancer treatment
Interaktor has been tested in patients with pancreatic cancer after surgery, prostate cancer during radiotherapy and breast cancer during neoadjuvant chemotherapy. The results show that patients that use the app have significantly less symptom burden and higher self-care ability than patients in the control groups. The patients’ adherence to using the app is high and they perceive that by using the app they are seen as individual persons and feel secure. The use of Interaktor facilitates symptom management and meets the individual’s care needs. Analyses of health economic consequences are currently ongoing.
Gustavell T, Sundberg K, Langius-Eklöf A. Using an Interactive App for Symptom Reporting and Management Following Pancreatic Cancer Surgery Facilitates Person-Centered Care: A Descriptive Study, JIMR 2020, accepted.
Reduced symptom burden with the support of an interactive app during neoadjuvant chemotherapy for breast cancer - A randomized controlled trial.
Fjell M, Langius-Eklöf A, Nilsson M, Wengström Y, Sundberg K
Breast 2020 Jun;51():85-93
Decreased symptom burden following surgery due to support from an interactive app for symptom management for patients with pancreatic and periampullary cancer.
Gustavell T, Sundberg K, Segersvärd R, Wengström Y, Langius-Eklöf A
Acta Oncol 2019 Sep;58(9):1307-1314
Development and Feasibility of an Interactive Smartphone App for Early Assessment and Management of Symptoms Following Pancreaticoduodenectomy.
Gustavell T, Langius-Eklöf A, Wengström Y, Segersvärd R, Sundberg K
Cancer Nurs ;42(3):E1-E10
Adherence to Report and Patient Perception of an Interactive App for Managing Symptoms During Radiotherapy for Prostate Cancer: Descriptive Study of Logged and Interview Data.
Langius-Eklöf A, Christiansen M, Lindström V, Blomberg K, Hälleberg Nyman M, Wengström Y, et al
JMIR Cancer 2017 Oct;3(2):e18
Patients' Perspective on Participation in Care With or Without the Support of a Smartphone App During Radiotherapy for Prostate Cancer: Qualitative Study.
Hälleberg Nyman M, Frank C, Langius-Eklöf A, Blomberg K, Sundberg K, Wengström Y
JMIR Mhealth Uhealth 2017 Jul;5(7):e107
Effects of an interactive mHealth innovation for early detection of patient-reported symptom distress with focus on participatory care: protocol for a study based on prospective, randomised, controlled trials in patients with prostate and breast cancer.
Langius-Eklöf A, Crafoord MT, Christiansen M, Fjell M, Sundberg K
BMC Cancer 2017 Jul;17(1):466
Early detection and management of symptoms using an interactive smartphone application (Interaktor) during radiotherapy for prostate cancer.
Sundberg K, Wengström Y, Blomberg K, Hälleberg-Nyman M, Frank C, Langius-Eklöf A
Support Care Cancer 2017 07;25(7):2195-2204
Symptoms and self-care following pancreaticoduodenectomy: Perspectives from patients and healthcare professionals - Foundation for an interactive ICT application.
Gustavell T, Sundberg K, Frank C, Wengström Y, Browall M, Segersvärd R, et al
Eur J Oncol Nurs 2017 Feb;26():36-41
Symptoms and self-care strategies during and six months after radiotherapy for prostate cancer - Scoping the perspectives of patients, professionals and literature.
Blomberg K, Wengström Y, Sundberg K, Browall M, Isaksson AK, Nyman MH, et al
Eur J Oncol Nurs 2016 Apr;21():139-45
Langius-Eklöf, A., Sundberg, K. (2015). En interaktiv applikation för mobil och läsplatta. Omsorg, 4, 53-59.
Feasibility of an interactive ICT-platform for early assessment and management of patient-reported symptoms during radiotherapy for prostate cancer.
Sundberg K, Eklöf AL, Blomberg K, Isaksson AK, Wengström Y
Eur J Oncol Nurs 2015 Oct;19(5):523-8
Interaktor after cancer treatment
Studies that focus on the first survival year after treatment for prostate or breast cancer are currently ongoing. In these studies, the use of Interaktor is combined with supportive survivorship care in the primary health care setting.
Interaktor has been evaluated in elderly living in their own home, receiving home care. The results show that Interaktor was a complement for communication between elderly and nurses. The elderly used the Interaktor as intended and experienced that the app gave them a sense of security and self-confidence as well as being a support for self-care. The use of Interaktor resulted in increased health literacy mainly by increasing their consciousness too seek and use information about health.
Self-care ability and sense of security among older persons when using an app as a tool for support.
Göransson C, Wengström Y, Ziegert K, Langius-Eklöf A, Blomberg K
Scand J Caring Sci 2019 Nov;():
Testing an app for reporting health concerns-Experiences from older people and home care nurses.
Göransson C, Eriksson I, Ziegert K, Wengström Y, Langius-Eklöf A, Brovall M, et al
Int J Older People Nurs 2018 Jun;13(2):e12181
Perspectives of health and self-care among older persons-To be implemented in an interactive information and communication technology-platform.
Göransson C, Wengström Y, Ziegert K, Langius-Eklöf A, Eriksson I, Kihlgren A, et al
J Clin Nurs 2017 Dec;26(23-24):4745-4755
An interactive ICT platform for early assessment and management of patient-reported concerns among older adults living in ordinary housing - development and feasibility.
Algilani S, Langius-Eklöf A, Kihlgren A, Blomberg K
J Clin Nurs 2017 Jun;26(11-12):1575-1583
An important research question is how perceptions and experiences differ between people and whether it can be explained by the individual's ability to handle stressful situations, mainly based on the concept of sense of coherence (SOC). The research includes methodological studies of the questionnaire that measures SOC and its predictive value for recovery, relapse and survival. One of our studies shows that low SOC in women with breast cancer as an independent factor predicted recurrence and 10-year death after diagnosis. With the purpose to describe the use of the SOC-scale in clinical nursing research a literature review of over 300 publications is under preparation.
Sense of coherence is a predictor of survival: A prospective study in women treated for breast cancer.
Lindblad C, Langius-Eklöf A, Petersson LM, Sackey H, Bottai M, Sandelin K
Psychooncology 2018 06;27(6):1615-1621
Stability of the 13-item sense of coherence (SOC) scale: a longitudinal prospective study in women treated for breast cancer.
Lindblad C, Sandelin K, Petersson LM, Rohani C, Langius-Eklöf A
Qual Life Res 2016 Mar;25(3):753-60
Health-related quality of life and the predictive role of sense of coherence, spirituality and religious coping in a sample of Iranian women with breast cancer: a prospective study with comparative design.
Rohani C, Abedi HA, Omranipour R, Langius-Eklöf A
Health Qual Life Outcomes 2015 Mar;13():40
Measurement properties of the 13-item sense of coherence scale using Rasch analysis.
Holmefur M, Sundberg K, Wettergren L, Langius-Eklöf A
Qual Life Res 2015 Jun;24(6):1455-63
Lower sense of coherence, negative religious coping, and disease severity as indicators of a decrease in quality of life in Iranian family caregivers of relatives with breast cancer during the first 6 months after diagnosis.
Khanjari S, Oskouie F, Langius-Eklöf A
Cancer Nurs ;35(2):148-56