臺灣癌症應用程式使用現況之初探-以癌症希望護照App為例

Abstract

背景：癌症患者的數量呈現不減反增的趨勢，不論是癌症本身或治療所衍生的症狀，都需要得到更好的照護處置。隨著時間的推移，醫療技術進步的同時，資訊科技也日益興盛，近年來無線寬頻通訊與網路普及率提升，因此發展出了各式癌症相關應用程式。但目前尚未有研究針對臺灣現有癌症應用程式進行功能評估，故希望藉由此研究瞭解癌症患者對於應用程式功能的接受度及偏好，以滿足癌症患者的需求與期望。 目的：本研究旨在通過對癌症應用程式的評估，瞭解癌症患者對癌症應用程式的偏好及所需的功能，並探討癌症患者對癌症應用程式的可接受性及應用程式帶來的影響。 方法：本研究為質性研究，以半結構式(semi-structured)的訪談大綱進行一對一的深度訪談(individual in-depth interview)。訪談大綱的建構係透過Web of Science、Scopus以及PubMed等資料庫蒐集並整理癌症應用程式評估的相關文獻，訪談預計進行1次，每次約30至40分鐘不等。訪談前會取得受訪者錄音同意，以便詳細記錄訪談內容，於訪談後將內容轉為逐字稿，並使用內容分析法搭配質性分析軟體NVivo進行訪談資料的歸納分析，最後說明研究發現並提出結論與建議。 結果：27位受訪者中，包含乳癌19位、大腸癌4位、子宮頸癌1位以及口腔癌3位。研究結果發現，癌症患者對於《癌症希望護照APP》的看法，願意使用的原因，多半是因為受到基金會推薦，而有部分癌症患者擔心個人資訊外洩持保留態度。對於《癌症希望護照APP》的功能，「記錄病理狀況」、「查看新資訊」以及「提醒機制」是較常使用的。而關於《癌症希望護照APP》應增加或改進的功能，少數患者認為功能已足夠，多數患者希望字體可以做到放大縮小的調整，還有像是體重、日期等數值輸入的方式可以更為彈性，另外也有患者建議應用程式可以與健康存摺做結合。關於癌症患者對於《癌症希望護照APP》的感知可接受性中，有些患者認為與3C產品的熟悉程度以及心態積極度有關，部分患者提出家人、朋友不會想使用的原因是不會想知道患者的狀況，會想使用的原因則是可以多接觸癌症相關資訊；其他癌症患者不會想使用的原因是癌友間不會分享數值相關的紀錄，比較多是口頭上的分享，而會想使用的原因是可以藉由檢視紀錄看看自己有無進步以及瞭解癌症相關資訊。在癌症患者對於應用程式易用性的看法中，有部分患者認為介面清楚好使用，但因受訪者的平均年齡偏高，因此更多的是提出需要基金會提供教學步驟會更容易使用。最後是癌症患者認為《癌症希望護照APP》能帶來的影響，對於本人的影響是可以更加容易檢視自我紀錄；對家屬的影響則是可以透過接收癌症資訊來瞭解疾病的前兆；對於醫師的影響中，有部分患者認為醫師診斷的參考應來自院內本身的紀錄，因此認為使用應用程式並無帶來影響，但大多數患者認為應用程式可作為患者與醫師之間的溝通工具，達到病患自主管理，使得醫病溝通更加有效率。 結論：本研究目的其一為探討癌症患者對癌症應用程式的偏好及所需的功能，對此，《癌症希望護照APP》在功能上仍有改善空間，而使用者的年齡確實會影響癌症患者對於行動醫療的接受程度，因此建議將年齡作為功能開發的考量因素。而目的其二則為探討癌症患者對癌症應用程式的可接受性及應用程式帶來的影響，根據本研究結果顯示，《癌症希望護照APP》是可以被接受且便於使用的自主管理工具，因此可作為後續癌症應用程式功能制定之參考，以使臺灣癌症照護更趨完善。

Background: The number of cancer patients is increasing, and cancer and the symptoms derived from the treatment need better care. However, no study has been conducted to evaluate the functions of existing cancer applications in Taiwan. Therefore, we hope to understand the acceptance and preference of cancer patients for the functions of cancer applications to meet their needs and expectations. Objective: This study aims to understand cancer patients' preferences and desired functions of cancer Apps through the evaluation and to investigate the acceptability, impact of cancer Apps for cancer patients. Methods: This research is qualitative, using a semi-structured outline to conduct one-on-one in-depth interviews (individual in-depth interviews). The interview outlines are constructed by collecting and organizing relevant literature on cancer App assessment through databases such as Web of Science, Scopus, and PubMed. The interview is expected to be conducted once, each time ranging from 30 to 40 minutes. Before the interview, the interviewee's consent will be obtained to record the content of the interview in detail. After the interview, the content will be converted verbatim, and use the content analysis method with the qualitative analysis software NVivo to analyze the data, and finally, write the research findings and put forward conclusions and recommendations. Results: This study finds that most cancer patients are willing to use the App 'HOPE CARE PASS' because of the foundation's recommendation. Only a few people have reservations for fear of personal information leakage. There are 27 respondents in our study, 19 have breast cancer, 4 have colorectal cancer, 1 have cervical cancer, and 3 have oral cancer. Pathological recording conditions, viewing new information, and reminder mechanism are the most popular functions of the App, 'HOPE CARE PASS.' Regarding functions that may be added or enhanced, most people desire that fonts are enlarged and reduced, and the form of entering values such as weight and date is more flexible. Moreover, combining the App 'My Health Bank' is also considered an advantageous improvement. About the perceived acceptability of the App 'HOPE CARE PASS' by cancer patients, some consider it related to their familiarity with 3C products and their positive attitude. For their family and friends, having more access to cancer information is an incentive to use the App. Other patients consider that their cancer friends do not share data related to numerical values, and more of them are communicated verbally, reducing their willingness to use. However, they review the records to confirm that making progress themself and learning about new cancer-related information is why they intend to use it. As for the operation of the App, from cancer patients' views, some people consider the interface design intuitive and do not require the introduction of functions. Nevertheless, the foundation needs to provide appropriate teaching steps due to the high average age of the respondents. Whether the application is uncomplicated to operate is also one of the concerns. Finally, the following are the benefits cancer patients believe the App 'HOPE CARE PASS' brings. First, it is easier for patients to review their records, and family members can also realize the precursors of the disease by receiving cancer information. Furthermore, the App is a communication tool between the patient and the doctor. The patient records the condition as soon as possible, which can achieve the patient's self-management, making the communication between doctors and patients more efficient. Few people feel that there is no significant impact on the App. For instance, doctors' diagnoses should be based on the records of the hospital, not the records in the App. Conclusion: The first purpose of this study is to explore cancer patients' preferences and the required functions of the cancer App. In this regard, there is still room for improvement in the functionality of the “HOPE CARE PASS”. Cancer patients' acceptance of mobile health is affected by age, recommended as the priority consideration for functional development. The second purpose is to research cancer patients' acceptability and impact of cancer Apps. According to the results of this study, the “HOPE CARE PASS” is a user-friendly self-management tool that can be used as a reference for the subsequent development of a cancer App to improve Taiwan's cancer care.