Alexander Wünsch’s research while affiliated with Inselspital, Universitätsspital Bern and other places

BACKGROUND: The prevalence of cancer is rising continuously worldwide. Relatives play an important role in caring for cancer patients and are at the same time affected by the illness and treatment of their loved ones. They have often been referred to as a forgotten group. Advances in digital technology offer various opportunities to enhance the well-being of and care for relatives. OBJECTIVES: The aim of the study was to investigate the utility of a mobile application to support the relatives of palliative cancer patients in Switzerland, the potential content elements of such an app, and its optimal functional and structural design. METHOD: Using a purposive sampling strategy, three focus group discussions were conducted at the University Hospital of Bern. The 15 participants included both relatives and experts. Data was analysed using content structuring qualitative content analysis according to Kuckartz and Rädiker. RESULTS: Statements from the focus groups were summarised in four main categories. These included statements from participants about the need for and potential benefits of an app, such as resource gains or easier access to care. Statements regarding possible content components of the app, such as tools for professional support and coordination or the provision of information, were also summarised. Statements were also included on the necessary functional features and the structural embedding of the app. CONCLUSIONS: The results indicate a need for a caregivers app in Switzerland. The app should reduce gaps in care, focus on family members, and strengthen their empowerment and access to resources. In terms of content, bundled information, low-threshold support offers, coordination tools, and self-care options should be guaranteed. The modular and simply structured app should be designed in a needs-oriented manner to be used safely throughout Switzerland.

Zusammenfassung Hintergrund Die psychosoziale Versorgung von Krebspatienten nimmt über den gesamten Verlauf der onkologischen Behandlung einen wichtigen Stellenwert ein. Seit 2015 ist das psychosoziale Screening in den Ambulanzen des Hauttumorzentrums in Freiburg implementiert. Wir präsentieren hier eine Post-hoc-Analyse im Rahmen der Qualitätssicherung. Fragestellung Akzeptanz, psychosoziale Belastung und Inanspruchnahme wurden evaluiert. Explorativ untersuchten wir, welche Patienten- und Krankheitsmerkmale mit einer erhöhten subjektiven Belastung zusammenhängen. Material und Methoden In einer Vollerhebung von 06/2015 bis 12/2015 wurden die Akzeptanz, die psychosoziale Belastung mittels Distress-Thermometer (DT) und der Beratungswunsch ausgewertet. Ergebnisse Von 753 Patienten haben 345 (45,8 %) am psychosozialen Screening teilgenommen und Daten von 310 (m:w 174:136; 89,7 % Melanompatienten, mittlere Zeit seit Erstdiagnose 4,7 ± 3,9 Jahre) konnten ausgewertet werden. Die mittlere Belastung auf dem DT betrug 2,97 ± 2,83 (Median 2, Range 0 bis 10). Eine überschwellige Belastung (DT ≥ 5) wurde von 84 Patienten (28,8 %) angegeben; 34 Patienten (11 %) gaben einen Beratungswunsch an, und 23 Patienten nahmen das Beratungsangebot in Anspruch. Patienten mit überschwelliger Belastung waren jünger, befanden sich häufiger unter laufender oder kürzlich abgeschlossener medikamentöser Therapie und hatten häufiger einen Beratungswunsch. Diskussion Neben der Erhebung der Belastung mit validierten Screeninginstrumenten stellt die Erhebung des subjektiven Betreuungswunsches einen wichtigen Parameter zur Identifikation von betreuungsbedürftigen Patienten dar. Junge Patienten und Patienten unter Systemtherapie sollten in den Fokus der Aufmerksamkeit rücken.

The advance of digitalization is constantly bringing new solutions to various areas of life in our society. The COVID-19 pandemic, among other things, brought increased attention to the application and support of treatments through digital solutions in the healthcare sector due to contact restrictions. However, the development of digital solutions comes at a high cost in terms of time and expenses. Mobile app development requires the development of two separate apps for the two respective market-leading mobile operating systems, iOS and Android. Cross-platform frameworks make it possible to develop apps for both operating systems on a single code base, thus saving the development and maintenance of two separate codes. Flutter is currently the most popular cross-platform framework for the development of mobile apps. This paper has evaluated Flutter based on an existing criteria catalogue. As a usage context for the evaluation, a prototype for Cancer Counselling App of the University Medical Center Freiburg was implemented. According to the gained own prototyping experience with Flutter and a thorough literature analysis in this area, the criteria catalogue was filled out and the result was compared with other mobile App development paradigms.