168 Summary and Discussion SUMMARY OF MAIN FINDINGS This thesis, entitled “Mobile applications in colorectal surgery: digitally advancing patient care,” aimed to (part I) provide insights into the current perspectives on the use and development of medical mobile applications, (part II) assess patients’ perspectives on stoma care, and (part III) evaluate the clinical effectiveness of patient-centred mobile applications in colorectal surgical care. Current perspectives on medical mobile applications The literature review in Chapter 1 emphasised the importance of compliance with the General Data Protection Regulation and Medical Device Regulation to ensure data privacy and safety of medical mobile applications. This chapter provided the most practical considerations that medical professionals should know when using or building a medical mobile application. In Chapter 2, a systematic review was conducted to identify mobile applications used in gastrointestinal surgical care and to evaluate their prospects for surgical care provision. Although over 150 gastrointestinal surgical mobile applications are available in app stores, only a limited number can be retrieved from the scientific literature. The 29 identified mobile applications were classified into seven categories: monitoring, weight loss, postoperative recovery, education, communication, prognosis, and clinical decision making. Most identified mobile applications were assessed for their usage, usability, satisfaction, and feasibility. This review showed that most studies using mobile applications have failed to provide high-level evidence on effectiveness or safety. Patient perspectives on stoma care Chapter 3 assessed patients’ satisfaction with stoma care and their attitudes towards a supporting mobile application. The web-based survey involving 1868 patients revealed that patients were only moderately satisfied with their received stoma care, as the overall satisfaction score was 6.6 out of 10. The study showed that patient satisfaction was mostly influenced by being unaware of the chance of getting a stoma or being in an acute situation. However, additional care was most desired after hospital discharge. The perioperative clinical condition and mental state may also negatively impact patients’ perception of the actual received stoma care in the immediate pre- and post-operative phases. The most frequently reported potential improvements were provision of preoperative information (16.9%), stoma site selection (14.1%), information about stoma-related problems (20.3%), and stoma materials (19.4%). Of the patients with a stoma of less than three years, 64.8% stated that they consulted the internet at least once a month for stoma-related information. Although there was a preference for information in a conventional manner, 59.5% of the patients with a stoma for less than three years expressed the potentially added value of a supportive
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