Construction And Clinical Application Of Symptom Assessment WeChat Platform Based On Ecological Momentary Assessment For Breast Cancer

Objective This study aims to construct the Symptom Assessment We Chat Platform based on ecological momentary assessment in the context of mobile health through literature review,expert working group meetings,and patients’ experience feedback to reach real-time monitoring of symptom under the scenario.We verify the effectiveness and feasibility of the platform through the dynamic correlation between sleep status and symptoms during chemotherapy in breast cancer patients,and apply ecological momentary assessment to the domestic symptom assessment and nursing field to improve the accuracy and immediacy of symptom assessment and to provide a theoretical basis and platform support for the accuracy of patients’ symptom care.Methods This study mainly consists of two parts.The first part is to build the Symptom Assessment We Chat Platform based on ecological momentary assessment.We prepare the first draft of the symptom assessment platform through the literature review and brainstorming.After two rounds of expert working group meetings and patients’ experience feedback,the platform content and framework are revised and improved,and the platform construction scheme was finally determined.The second part is to verify and apply the platform for the correlation research between sleep and related symptoms during chemotherapy in breast cancer patients.We use ecological momentary assessment to analyze sleep status and fatigue,anxiety,depression,nausea and vomiting,pain and sleepiness of breast cancer patients during the week based on the platform.By analyzing the self-reporting,dynamic correlation and trends of sleep and related symptoms in breast cancer patients,the validity and accuracy of the data collected by the platform are reflected,and the feasibility of the platform is verified.Results Based on the symptom time experience model and social support theory,this study revised and improved the construction of the Symptom Assessment We Chat Platform based on ecological momentary assessment through literature review,brainstorming,two rounds of expert working group meetings and patient experience feedback.The program ensures the scientific and complete construction of the platform.The platform takes the symptom assessment as the main module,and realizes the research methods of event-based and time-based monitoring,and provides information support,social support and professional support resources for patients.The platform is divided into two parts: user front end and back office management.The user side includes disease category,questionnaire selection,questionnaire parameter setting,health information,patient communication,professional consultation,my news and personal center.The management system can manage users,questionnaire,professional consultation response,health knowledge,communication group,data import and export.We investigate sleep status and fatigue,anxiety,depression,nausea and vomiting,pain and sleepiness of 60 breast cancer patients during chemotherapy based on this platform.The self-report rate of sleep status and each symptom were 93.57% and 91.75%.The daily self-reporting rate showed a downward trend,but both were higher than 80%,indicating that the platform’s usage and acceptability were high,and real-time self-reporting based on the symptoms of the platform was feasible.In one week after chemotherapy,breast cancer patients had the most severe fatigue symptoms and lasted for a long time;sleep and fatigue,nausea and vomiting,sleepiness,anxiety,depression and pain all showed a tendency to worsen and then improve;sleep quality and sleepiness within one week after chemotherapy(r=0.165,p < 0.05)was mildly correlated,and was slightly negatively correlated with anxiety and depression(r=-0.401,p<0.001).The number of wake-ups was slightly correlated with fatigue(r=0.238,p<0.05).There was a mild correlation between sleepiness and pain(r=0.174,p<0.001)and fatigue(r=0.222,p<0.05).There was a correlation between each symptom.It was found by analysis of sleep and symptoms on different days after chemotherapy,the sleep efficiency was slightly negatively correlated with nausea and vomiting on the first day(r=-0.274,p<0.05)and anxiety and depression(r=-0.470,p<0.05)on the second day.The quality of sleep was moderately and severely correlated with anxiety and depression on the second and third days(r=-0.424,p<0.05;r=-0.401,p<0.05).The number of wake-ups at night was moderately correlated with pain on the first day(r=0.612,p<0.05)and fatigue on the seventh day(r=0.789,p<0.001).This study is similar to previous studies and can accurately reflect the dynamic correlation and trends between sleep and related symptoms during chemotherapy in breast cancer patients,indicating that the data collected by the symptom assessment We Chat platform is highly reliable and accurate.It can reflect the characteristics of ecological momentary assessment research.Conclusions The construction process of the Symptom Assessment We Chat Platform based on ecological momentary assessment has certain scientific and rationality.Through the initial application of the platform,the patient’s symptom reporting rate is high,and the collected data can reflect the dynamic changes and correlations of sleep and symptoms during chemotherapy in breast cancer patients,which indicate that the platform is feasible and acceptable and achieves a certain degree of accurate assessment of symptoms.It is worth further promotion and research.