The Impact Of A Mobile Application For Chemotherapy Monitoringand Education (Chemond) On Distress In Cancer Patients Undergoing

Salwa Nada Agfi Arofah, Haryani

2026 | Tesis | S2 Magister Keperawatan

Background: Cancer remains a major global health burden, with incidence rates in Indonesia continuing to escalate. Chemotherapy remains a primary treatment modality, but its narrow therapeutic window frequently induces severe physical and psychological toxicities. Psychological distress and anxiety are highly prevalent in patients undergoing chemotherapy, often driven by a lack of access to structured, actionable information regarding symptom self-management. While mobile health (mHealth) applications offer an accessible solution to improve health literacy and patient outcomes, specialized digital health tools remain severely limited within Indonesian healthcare oncology settings. Objective: This study aims to evaluate the impact of a mobile application, Chemotherapy Monitoring Education (CheMond), on distress and anxiety levels among cancer patients undergoing active chemotherapy at RSUP Dr. Sardjito Yogyakarta. Methodology: A quasi-experimental research design utilizing a parallel-group, pre- test/post-test control design was implemented. The CheMond app provides interactive educational videos, narrative text, automated visit and medication reminders, a laboratory trend logger, and a symptom monitoring interface. Standardized psychological parameters were measured across four longitudinal time points: baseline (T0), week 1 (T1), week 2 (T2), and week 3 (T3) using the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) and the Visual Analog Scale for Anxiety (VAS-A). Baseline homogeneity, within-group longitudinal changes, inter-group variances, and the confounding effects of extraneous variables were analyzed using Independent-samples t- tests, Cochran’s Q tests, Repeated Measures ANOVA, Mixed ANOVA, and multiple linear regression models. Results: A total of 60 eligible cancer patients were assigned to either an intervention group (n = 30) receiving standard care supplemented by the CheMond application, or a control group (n = 30) receiving standard care. Despite a higher baseline psychological burden in the control cohort (1.51 ± 0.18 vs. 2.54 ± 0.20, p < 0 xss=removed> 0.05), but the digital application successfully mediated and alleviated overall perceived emotional suffering and anxiety trajectories over time. Conclusion: The clinical implementation of the CheMond mobile application significantly mitigates distress and anxiety levels in cancer patients during their chemotherapy cycles. This evidence supports the integration of digital supportive care solutions within oncology nursing frameworks to optimize symptom self-management, bridge remote provider- patient communication, and enhance the overall psychological well-being of patients navigating oncology treatments in developing nations.

Background: Cancer remains a major global health burden, with incidence rates in Indonesia continuing to escalate. Chemotherapy remains a primary treatment modality, but its narrow therapeutic window frequently induces severe physical and psychological toxicities. Psychological distress and anxiety are highly prevalent in patients undergoing chemotherapy, often driven by a lack of access to structured, actionable information regarding symptom self-management. While mobile health (mHealth) applications offer an accessible solution to improve health literacy and patient outcomes, specialized digital health tools remain severely limited within Indonesian healthcare oncology settings. Objective: This study aims to evaluate the impact of a mobile application, Chemotherapy Monitoring Education (CheMond), on distress and anxiety levels among cancer patients undergoing active chemotherapy at RSUP Dr. Sardjito Yogyakarta. Methodology: A quasi-experimental research design utilizing a parallel-group, pre- test/post-test control design was implemented. The CheMond app provides interactive educational videos, narrative text, automated visit and medication reminders, a laboratory trend logger, and a symptom monitoring interface. Standardized psychological parameters were measured across four longitudinal time points: baseline (T0), week 1 (T1), week 2 (T2), and week 3 (T3) using the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) and the Visual Analog Scale for Anxiety (VAS-A). Baseline homogeneity, within-group longitudinal changes, inter-group variances, and the confounding effects of extraneous variables were analyzed using Independent-samples t- tests, Cochran’s Q tests, Repeated Measures ANOVA, Mixed ANOVA, and multiple linear regression models. Results: A total of 60 eligible cancer patients were assigned to either an intervention group (n = 30) receiving standard care supplemented by the CheMond application, or a control group (n = 30) receiving standard care. Despite a higher baseline psychological burden in the control cohort (1.51 ± 0.18 vs. 2.54 ± 0.20, p < 0 xss=removed> 0.05), but the digital application successfully mediated and alleviated overall perceived emotional suffering and anxiety trajectories over time. Conclusion: The clinical implementation of the CheMond mobile application significantly mitigates distress and anxiety levels in cancer patients during their chemotherapy cycles. This evidence supports the integration of digital supportive care solutions within oncology nursing frameworks to optimize symptom self-management, bridge remote provider- patient communication, and enhance the overall psychological well-being of patients navigating oncology treatments in developing nations. 

Kata Kunci : Cancer, Chemotherapy, Distress, Anxiety, Mobile Health (mHealth), Patient Education, Oncology Nursing