Feasibility and Acceptability of an iPad Application to Assess Symptom Clusters in Adolescents with Cancer

Tuesday, 23 July 2013: 3:30 PM

Lauri Linder, PhD, APRN, CPON
College of Nursing and Hematology/Oncology/Transplant Service Line, University of Utah and Primary Children's Medical Center, Salt Lake City, UT
Kristin Stegenga, PhD, RN, CNS, CPON
Pediatric Hematology/Oncology, Children's Mercy Hospital, Kansas City, MO
Catherine Fiona Macpherson, PhD, RN, CPON
Seattle Children's Hospital, University of Washington School of Nursing and Seattle Children's Hospital, Seattle, WA
Suzanne Ameringer, PhD, RN, CPON
School of Nursing, Virginia Commonwealth University, Richmond, VA
Jeanne Erickson, PhD, RN, AOCN
School of Nursing, University of Virginia, Charlottesville, VA
Pamela Hinds, PhD, RN, FAAN
Department of Nursing Research, Children's National Medical Center, Washington, DC
Nancy Fugate Woods, PhD, RN, FAAN
Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA

Learning Objective 1: Discuss the feasibility and acceptability of a newly developed iPad application to explore symptom clusters in adolescents with cancer

Learning Objective 2: Describe adolescentsí perspectives of using an iPad application to communicate their symptom experience

Purpose: Adolescents with cancer (AWC) experience multiple co-occurring interrelated disease- and treatment-related symptoms. A newly-developed iPad application, the Computerized Symptom Capture Tool (C-SCAT) uses a heuristics approach to explore symptom clusters. The C-SCAT combines graphical images and free text responses, empowering individuals to identify symptom clusters from their unique perspectives. This approach shifts the paradigm for studying symptom clusters to an inductive approach that considers how individuals interpret and give meaning to their clusters of symptoms. We present the feasibility and acceptability of the C-SCAT among AWC receiving chemotherapy.

Methods: 32 AWC at three United States institutions who had completed at least one cycle of chemotherapy completed the C-SCAT 24 to 96 hours following initiation of a chemotherapy cycle. Feasibility was measured via C-SCAT completion rates and AWC’s evaluation of accuracy of their final drawing as a representation of their symptoms. Acceptability was evaluated with an investigator-developed questionnaire administered to the adolescents following C-SCAT completion. 

Results: All adolescents completed the C-SCAT successfully and indicated that the final image was an accurate representation of their symptoms. Adolescents reported increased self-awareness and appreciation for the ability to create a pictorial representation of their experience. They endorsed a preference for use of technology over paper and pencil instruments, citing familiarity with the technology, appreciation of its speed, flexibility for editing responses, and novelty of the application. Suggestions for improvement included: ability to add additional symptoms, more engaging color graphics, and more focused questions. 

Conclusion: The C-SCAT demonstrated feasibility and acceptability in these AWC receiving chemotherapy. This technology has global potential in future descriptive and intervention-based research including facilitation of patient-provider communication regarding the symptom experience and the development of symptom cluster-focused interventions. The C-SCAT also has potential use with other age groups, across the cancer treatment continuum, and in other disease states.