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dc.contributor.authorMikolasek, M.
dc.contributor.authorWitt, C.M.
dc.contributor.authorBarth, J.
dc.date.accessioned2019-04-05T13:55:14Z
dc.date.available2019-04-05T13:55:14Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85060346226&doi=10.2196%2f11271&partnerID=40&md5=db3899ee87e6fee71ec9f984408899cd
dc.identifier.urihttp://hdl.handle.net/10713/8835
dc.description.abstractBackground: Cancer is highly prevalent worldwide and can cause high levels of distress in patients, which is often neglected in medical care. Smartphone apps are readily available and therefore seem promising to deliver distress-reducing interventions such as mindfulness and relaxation programs. Objective: This study aimed to evaluate the feasibility of a mindfulness and relaxation app for cancer patients. We looked at characteristics of participating patients in a mobile health (mHealth) study, including adherence to the app intervention, predictors for adherence, and patients' feedback regarding the app. Methods: In this prospective observational study with a mixed-methods approach, cancer patients received a mindfulness and relaxation self-care app. Cancer patients were recruited online and through hospitals in Switzerland. We assessed self-reported measures (eg, quality of life, anxiety, depressive symptoms, openness to experience, resistance to change) at baseline, and the app gathered data on patients' practicing time. With 8 semistructured interviews, we obtained patients' feedback about the app and recommendations for improvements. We looked at 3 dimensions of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (reach, adoption, and maintenance) and analyzed data for adherence for the first 10 weeks of the app intervention. We report descriptive statistics for patient characteristics and app use. For the prediction of adherence, we used Kaplan-Meier analyses with log-rank tests and a Cox proportional hazards regression. Results: Data from 100 cancer patients (74 female) showed that 54 patients were using the app exercises continuously until week 10. In continuous app users, the median number of exercises per week dropped from 4 (interquartile range, IQR 1-7) at week 1 to a median of 2 (IQR 1-4) at week 10. Our analyses revealed 4 significant predictors for better adherence: female gender, higher openness to experience, higher resistance to change, and more depressive symptoms. Interviews revealed that the patients generally were satisfied with the app but also made suggestions on how to improve it. Conclusions: Our study indicates that a mindfulness and relaxation mHealth intervention for cancer patients is feasible with acceptable adherence and largely positive feedback from patients. Trial Registration: German Clinical Trials Register DRKS00010481; https://www.drks.de/drks_web/navigate.do?navigation Id=trial.HTML&TRIAL_ID=DRKS00010481 (Archived by WebCite at http://www.webcitation.org/73xGE1B0P). Copyright Michael Mikolasek, Claudia M Witt, Jurgen Barth.en_US
dc.description.sponsorshipThis study was funded by the Swiss Cancer League (KLS-3564-02-2015). The authors acknowledge and thank the contribution of Isabelle Werninger, who supported the project in both administration and data entry.en_US
dc.description.urihttps://dx.doi.org/10.2196/11271en_US
dc.language.isoEnglishen_US
dc.publisherJMIR Publicationsen_US
dc.relation.ispartofJMIR mHealth and uHealth
dc.subjectCanceren_US
dc.subjectMindfulnessen_US
dc.subjectMobile appen_US
dc.subjectPatient complianceen_US
dc.subjectRelaxationen_US
dc.titleAdherence to a mindfulness and relaxation self-care app for cancer patients: Mixed-methods feasibility studyen_US
dc.typeArticleen_US
dc.identifier.doi10.2196/11271


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