Views of Cancer Patients and Lay Caregivers of Tablet Use

Topic: Leveraging Technology

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Introduction: Tablet technologies offer new opportunities to bring the patient’s and caregiver’s voices into hospice and palliative care, but the acceptability of patients and caregivers using tablets as part of hospice care is not documented, especially for minorities. The purpose of this study was to describe tablet interface acceptability reported by adult hospice cancer patients and their lay caregivers.

Methods: From two hospices, we recruited patient/lay caregiver dyads. The demographic characteristics for 237 patients (mean age 68.3±14.2, ranged from 20-100 years, 49% male, 33% African American, 47% non-Hispanic white, 17% Hispanic, 3% other ethnicity) and 235 caregivers (mean age 53.2±15.0 years, 28% male, 35% African American, 41% non-Hispanic white, 19% Hispanic, 6% other ethnicity) are typical except for higher minority participation than is usual for hospice studies. In the patients’ homes, patients and caregivers used an Internet-enabled Samsung Tablet to complete the Computer Acceptability Scale (CAS, 0-9) after they used the tablet to complete pain and symptom questionnaires. Data were written to a secure server, extracted from the SQL (structured query language) database, and analyzed with statistical software R. 

Results: Patients reported severe worst pain in the past 24 hours (7.02±2.34 on 0-10 scale) and moderate current pain (4.68±2.64). For patients, the mean CAS score was 7.8±01.3. CAS item analysis indicated that 48.6% of the patients thought the tablet was hard or somewhat hard to use or did not answer (1.3%), 15.2% thought the touch screen was not easy to use, and 6.8% thought the programs should not be available to all hospice patients. For caregivers, the mean CAS score was 8.44±0.98. CAS item analysis indicated that 19% of the caregivers thought the tablet was hard or somewhat hard to use, 9% thought the touch screen was not easy to use, and 4% thought the programs should not be available to all hospice patients. Older caregivers ≥ 65 (8.15±0.99) reported statistically significantly lower acceptability scores than younger caregivers (8.52±0.96, p=.016).

Conclusions: Patients’ worst pain was higher than desirable. Patients were older than caregivers and had more difficulty using the tablet than caregivers, but both groups reported high acceptability of the tablet-based data collection process. The findings, however, point to the opportunity for improving the functionality of the tablet-based application to improve its acceptability. Additional usability research is warranted to improve the Android-based user interface for older adults. The overwhelmingly positive results support adoption of tablet technology in hospice care to improve cancer pain and symptom management. 

Author

  • Marie L. Suarez, PHD
  • Project Director
  • University of Illinois at Chicago College of Nursing
  • 845 South Damen Ave
  • Chicago, IL 60622
  • 312-996-7800

Co-authors

  • Anayza Gill
  • Angulo Veronica
  • Carrasco Jesus
  • Diana J. Wilkie
  • Ezenwa Miriam
  • Jacob Miller
  • Jessica Perez
  • Julie Glendenning
  • Karen Frank
  • Marie L. Suarez
  • Michael Murray
  • Molokie Robert
  • Nargis Nardi
  • Robert Shea
  • Tim McCurry
  • Yingwei Yao
  • Zaijie Wang

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