Perceptions of Adolescents With Cancer Related to a Pain Management App and Its Evaluation: Qualitative Study Nested Within a Multicenter Pilot Feasibility Study

Lindsay A Jibb; Bonnie J Stevens; Paul C Nathan; Emily Seto; Joseph A Cafazzo; Donna L Johnston; Vanessa Hum; Jennifer N Stinson

doi:10.2196/mhealth.9319

Perceptions of Adolescents With Cancer Related to a Pain Management App and Its Evaluation: Qualitative Study Nested Within a Multicenter Pilot Feasibility Study

JMIR Mhealth Uhealth. 2018 Apr 6;6(4):e80. doi: 10.2196/mhealth.9319.

Authors

Lindsay A Jibb^{1

2}, Bonnie J Stevens^{3

4}, Paul C Nathan^{3

5

6}, Emily Seto^{6

7}, Joseph A Cafazzo^{6

7}, Donna L Johnston^{2

8

9}, Vanessa Hum¹⁰, Jennifer N Stinson^{3

4

11}

Affiliations

¹ School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
² Evidence-to-Practice Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
³ Child Health Evaluative Sciences Program, Hospital for Sick Children, Toronto, ON, Canada.
⁴ Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
⁵ Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.
⁶ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
⁷ eHealth Innovation, University Health Network, Toronto, ON, Canada.
⁸ Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
⁹ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹⁰ Think Research Corporation, Toronto, ON, Canada.
¹¹ Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada.

Abstract

Background: Pain in adolescents with cancer is common and negatively impacts health-related quality of life. The Pain Squad+ smartphone app, capable of providing adolescents with real-time pain management support, was developed to enhance pain management using a phased approach (ie, systematic review, consensus conference and vetting, iterative usability testing cycles). A 28-day Pain Squad+ pilot was conducted with 40 adolescents with cancer to evaluate the feasibility of implementing the app in a future clinical trial and to obtain estimates of treatment effect.

Objective: The objective of our nested qualitative study was to elucidate the perceptions of adolescents with cancer to determine the acceptability and perceived helpfulness of Pain Squad+, suggestions for app improvement, and satisfaction with the pilot study protocol.

Methods: Post pilot study participation, telephone-based, semistructured, and audio-recorded exit interviews were conducted with 20 adolescents with cancer (12-18 years). All interviews were transcribed and independently coded by 2 study team members. Content analysis was conducted to identify data categories and overarching themes.

Results: Five major themes comprising multiple categories and codes emerged. These themes focused on the acceptability of the intervention, acceptability of the study, the perceived active ingredients of the intervention, the suitability of the intervention to adolescents' lives, and recommendations for intervention improvement.

Conclusions: Overall, Pain Squad+ and the pilot study protocol were acceptable to adolescents with cancer. Suggestions for intervention and study improvements will be incorporated into the design of a future randomized clinical trial (RCT) aimed at assessing the effectiveness of Pain Squad+ on adolescents with cancer health outcomes.

Keywords: adolescent; cancer; mHealth; pain; qualitative; supportive care.

©Lindsay A Jibb, Bonnie J Stevens, Paul C Nathan, Emily Seto, Joseph A Cafazzo, Donna L Johnston, Vanessa Hum, Jennifer N Stinson. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 06.04.2018.