Gynecological cancer patients’ experiences with eHealth technology and partly nurse-led consultations in a follow-up setting: A qualitative study

Background: In the last decade, there has been a move toward personalized care, with a focus on the diversity of survivorship needs after initial cancer treatment. Empowering patients to actively participate in their own health management and survivorship care is encouraged. Consequently, a new follow-up model, called Lifestyle and Empowerment Techniques in Survivorship of Gynecologic Oncology (LETSGO), for gynecological cancer patients was developed and piloted at a Norwegian hospital. In LETSGO, a dedicated nurse replaced the physician in every second follow-up consultation. The nurse provided the patients with self-management techniques following cancer treatment, reinforced with eHealth technology (a specially designed app). Encouragement of behavioral change and evaluation of the late effects of treatment and recurrence symptoms were central aspects of the self-management techniques. The app further encouraged physical activity and positive lifestyle change, helped identify recurrence-related symptoms, and provided reminders on activity goals. This study aimed to investigate the views on alternating nurse-led and physician-led care supported by eHealth technology among participants who piloted the LETSGO intervention. Methods Semi-structured qualitative interviews were conducted to analyze how the participants experienced the LETSGO intervention 6–7 months after the intervention onset. Results All LETSGO pilot study’s participants felt safe and well taken care of. They perceived the nurses as being less busy than doctors, which made it easy for them to bring up any cancer-related challenges. Most participants reported increased empowerment and confidence in being able to recognize symptoms of cancer recurrence. Half of the participants used the app regularly and were motivated to increase their levels of physical activity. Some experienced technical errors with the app. Conclusions Overall, partly nurse-led consultations and eHealth technology were well-received among the participants. An intervention study is required for further evaluation. The reported technical app errors should be resolved and tested prior to eHealth application implementation. This study reports gynecological cancer patients’ perspectives of nurse-led follow-up and the use of eHealth technology, and is expected to be useful in personalized survivorship care planning. Trial registration: ClinicalTrials.gov, NCT03453788. Registration 5 March 2018, https://clinicaltrials.gov/ct2/show/NCT03453788