Postoperative Prognosis Management Service Based mHealth for Colon Cancer Patients

Change of Quality of life (EORTC-QLQ-C30)

comparison between groups in change of quality of life between baseline (postoperative 2-3days) and postoperative day 6 months This questionnaire contains 30 items regarding general health status, five functional scales (ie, physical, role, cognitive, emotional, and social functioning), three symptom scales (ie, fatigue, pain, and nausea or vomiting), and six single-item scales (ie, dyspnea, appetite loss, constipation, diarrhea, financial difficulties, and insomnia). Each scale includes a different set of items, which are calculated using specific coding procedures. Higher scores for the general health status and the functional scales imply positive results, whereas the symptom and the single-item scales are interpreted inversely.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month

Pain (Numeric rating scale, NRS)

According to time frame with between-group and within group, trends will be found. NRS score (11 point scales) ranges from 0 (no pain) to 10 (possible to image maximum pain). Higher score indicates higher pain.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month

Change of Quality of life (EORTC-QLQ-C29)

The Multi-Attribute Scale Analysis module evaluates four scales to evaluate urine frequency, stool leakage, stool consistency, and body image, as well as other common problems after treatment for colorectal cancer.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month

Physical activity (IPAQ-SF)

According to time frame with between-group and within group, trends will be found. There are two forms of output from scoring the IPAQ. Results can be reported in categories (low activity levels, moderate activity levels or high activity levels) or as a continuous variable (MET minutes a week). MET minutes represent the amount of energy expended carrying out physical activity. Higher METs or category level indicates higher physical activity.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month

Grip strength

According to time frame with between-group and within group, trends will be found. Using a grip dynamometer, take three measurements on both hands. Higher value (kg) indicates higher grip strength. Since this test is judged to have a mild effect of abdominal pain after surgery, it is evaluated from enrollment.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month

Lower extremity muscle endurance (30seconds chair stands test)

According to time frame with between-group and within group, trends will be found. It measures the number of times you sit and stand up in a chair for 30 seconds. Higher value (number) indicates higher lower extremity muscle endurance. It is judged that the 30seconds chair stands test will be difficult due to abdominal pain after surgery, so the evaluation is performed only at the other F/U points excluding the enrollment date.

Time frame: postoperative 1month, 3month, 6month, 12month

2 Minute walk test (2MWT, evaluation of cardiopulmonary endurance)

According to time frame with between-group and within group, trends will be found. The 2MWT is a measurement of endurance that assesses walking distance over two minutes. It is judged that the 2MWT will be difficult due to abdominal pain after surgery, so the evaluation is performed only at the other F/U points excluding the enrollment date.

Time frame: postoperative 1month, 3month, 6month, 12month

Nutrition assessment (Mini-nutrition assessment, MNA)

According to time frame with between-group and within group, trends will be found. The short form of the MNA (MNA-SF) is a screening tool consisting of six questions on food intake, weight loss, mobility, psychological stress, or acute disease, the presence of dementia or depression, and body mass index (BMI). The maximum score for this part is equal to 14. A score equal to or higher than 12 indicates that the subject under study has an acceptable nutritional status thus excluding malnutrition and/or malnutrition risk, meanwhile, a score ≤ 11 implicates to proceed with the complete version of the MNA (MNA-LF). This version consists of 12 additional items and provides a maximum possible overall assessment of 30 scores: a score of fewer than 17 indicates malnutrition, a score of 17-23.5 indicates a risk for malnutrition and a score higher 23.5 indicates well-nourishment.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month

LARS(Low Anterior Rectal Resection Syndrome) score questionnaire

Developed under the leadership of S. Laurberg to initially assess the severity of symptoms after anterior resection of the rectum for cancer, it can be used to assess the disability caused in multiple situations (isolated anorectal irradiation, rectosigmoid resection, prolapse surgery…). It is correlated with the quality of life.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month

The Wexner score

This score, very easy to use, is most frequently used when a summary assessment of the severity of anal incontinence is necessary.

Time frame: Enrollment (postoperative 2-3days), postoperative 1month, 3month, 6month, 12month