A visualized nurse-led ePRO system for chemotherapy toxicity: Content design and validation

Area of Science:

• Oncology nursing
• Digital health
• Patient-reported outcomes

Background:

• Chemotherapy commonly causes toxicities, impacting treatment adherence and quality of life.
• Traditional text-heavy monitoring tools can lead to visual fatigue and reduced patient engagement.
• Effective post-discharge monitoring is crucial for managing chemotherapy-induced side effects.

Purpose of the Study:

• To design and validate a visualized chemotherapy toxicity self-assessment system.
• To integrate patient-reported outcomes (PROs) with severity grading and graphic interventions.
• To enable systematic post-discharge monitoring of chemotherapy toxicities.

Main Methods:

• Developed the Chemotherapy Toxicity Self-Assessment Questionnaire (CTSAQ) for 12 symptoms with a four-grade scale.
• Used Delphi consensus with 11 multidisciplinary experts to refine symptoms and interventions.
• Assessed reliability (internal consistency, test-retest) and construct validity; evaluated feasibility in a patient cohort.

Main Results:

• CTSAQ showed excellent content validity (S-CVI 0.98) and high test-retest reliability (ρ=0.788-1.000).
• Acceptable internal consistency (Cronbach's α=0.744) was observed in 56 patients.
• Identified five symptom clusters; weekly completion rates exceeded 90% with a 10-12 minute completion time.

Conclusions:

• The CTSAQ is a valid and feasible nurse-led electronic PRO instrument for post-discharge monitoring.
• Visualized guidance aims to improve symptom self-assessment and patient security at home.
• Further studies are needed to confirm clinical efficacy and user burden.