97 4 Supporting stoma patients’ self-efficacy with a mobile application - a focus group interview stud Representative 3 (FG3): “…What is the moment you have to contact someone, so, what are dangerous situations? In that way, patients can be more aware and if they have a problem, they can see in the app: ‘If you have this problem, you should immediately contact a healthcare professional, and if you have this problem, you can wait and see.” Participants suggested a ‘search function’ which helps patients to easily find desired information without searching through the entire app, and an index list from A to Z. One patient suggested that the search function should include a ‘descriptive function’ that enables patients to describe the word or concept they are trying to find. However, one surgeon explained that implementing this function is difficult and expensive. Patient 5 (FG 4): “Suppose you have ‘skin irritation’, and you type ‘skin irritation ‘ and the color of the skin. That can be searched through the text in the app.” 1.4 Timing of information: Participants discussed that the timing and quantity of information in the app should be carefully considered and ideally, triggered when most likely to be relevant. Some recommended that patients receive information up to 6 months prior to surgery, while others recommended a timeline of only a few weeks before surgery, arguing that patients would most likely forget information when given too early. Information provided just before surgery (‘just in time’) was considered problematic too, as patients reported considerable stress just before surgery. Participants agreed that general information such as ‘what is a stoma’ and ‘importance of exercise before surgery’ could be given weeks or months before surgery, and topics such as stoma care, stoma materials, and fluid intake could be given only a few days before and after surgery. In this way, the information provided will be more relevant to the patient’s situation and will therefore be more beneficial. Patients who undergo emergency surgery cannot be provided with information weeks or months before surgery. For these patients, the information provision after surgery must be different. During hospital admission, emergency patients must be able to receive a limited amount of essential information, whereas less essential information should be provided later. Participants agreed that only important topics should be provided during the hospital phase, such a basic information of a stoma (‘what is a stoma’, and ‘what does it look like’), and information on stoma care. All other information would be better to provide over the next few weeks. Participants emphasised that the information should be repeated multiple times. Patient 3 (FG2): “It is the own choice of patients what to with it, but…. It is a great start if patients can be notified with information or exercises before or after their surgery, or when they are back home.”
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