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Introducing the Comfort app: connecting patients and families in palliative care
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Background: Comfort is an important outcome for patients with life-threatening illness, and symptom management is crucial in this endeavour. But this could be difficult in some contexts, such as in home care. E-health can bring an opportunity in promoting comfort. Aim: To develop an app to monitor comfort remotely in PC home patients. Methods: Feasibility study, according to the Medical Research Council Framework for the development and evaluation of complex interventions. Conceptual framework included a systematic literature review and a qualitative study regarding comfort in PC settings. Content validity was discussed by a panel of experts in PC (n=5). A web-based custom domain, compatible with Android, iOS and Windows was used to the app design. The aesthetics was chosen through an online survey (n=120). Participants were recruited from two hospitals with home care visits. Eligibility criteria included lifethreatening illness diagnosed, be at home, and have a computer device with internet access. The study was approved by the ethics committee. Results: The Comfort app is a free and web-based app, which is intended to be completed by PC home patients through a smartphone, tablet or computer with internet access. It includes 11 symptoms in a Likert scale, based on the Portuguese Edmonton Symptom Assessment System and the Spiritual End of Life Portuguese Comfort Questionnaire. Preliminary results from the feasibility study conclude that the app is feasible, intuitive, and easy to use. Main problems are related with patient’s recruitment, due to the late referral to PC. Conclusions: This app promises to be a useful tool to monitor comfort as a compliment to PC teams work in improving communication, organization of care, and promoting early and individual comfort interventions.