Gitonga, Isaiah (2024) The Role of Connected Health Technologies in Supporting the Psychosocial Wellbeing and Quality of Life of People Living with and Beyond Cancer. PhD thesis, National University of Ireland Maynooth.
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Abstract
The number of people living with and beyond cancer (PLWBC) has been steadily increasing in recent years. This growth brings a parallel rise in the demand for ongoing care for the physical and psychosocial challenges associated with cancer diagnosis and treatment. However, access to care and support is limited. Connected Health (CH), defined as the use of technology to gather, analyse, and interpret user data to improve health outcomes, offers a promising solution for bridging healthcare gaps and expanding access to vital support services. While CH holds potential for improving cancer survivorship care, limited evidence exists on how CH interventions are experienced and adopted by PLWBC in Ireland. This thesis examines the potential of CH to support the psychosocial wellbeing and Quality of Life (QoL) of PLWBC, guided by three key objectives namely (i) to examine the role of CH in supporting psychosocial well-being and QoL of PLWBC, (ii) to identify the factors influencing the adoption and utilization of CH technologies among PLWBC and (iii) to explore the barriers and facilitators to CH implementation within the Irish context of cancer survivorship.
This research comprises six interconnected studies to achieve these objectives. Study 1, a systematic literature review and meta-analysis (n = 33 studies), establishes the positive but mixed impact of CH interventions on psychosocial outcomes, in particular anxiety and depression symptoms, and QoL in PLWBC. Study 2, a secondary data analysis of the US-based, population level Health Information National Trends Survey, focused on individuals who self-identified as having has a cancer diagnosis (n = 626). This study identified factors associated with CH use among PLWBC, offering a broad population-level snapshot of access, usage and potential digital disparities, and provided a macro-context for more focused Irish-based studies that followed. The subsequent empirical studies (studies 3a, 3b, and 4) utilised the setting of the Cancer Thriving and Surviving (CTS) programme, a nationwide cancer survivorship programme in Ireland, to explore the PLWBC’s experiences with its online delivery. Study 3a (n = 44) utilised a mixed methods cross sectional design and demonstrated high usability and user satisfaction with CH technologies to deliver the programme in its online format, while also highlighting varying motivations for CH, and the need for tailored approaches. A further analysis of this dataset (Study 3b) revealed that unmet needs may remain among PLWBC even after participating in the programme, highlighting the importance of
providing ongoing care and support to this cohort. Study 4 (n = 43) utilising a cross sectional post-test design compared post programme outcomes and experiences between participants who completed the CTS programme online versus in-person, examining modality preference and associated psychosocial outcomes. Results showed that both modalities are well received and could be utilised in supporting psychosocial wellbeing QoL in PLWBC. This study also highlighted the influence of individual, contextual and geographical factors on delivery mode selection and experience, rather than treating CH as a neutral or uniform medium. Finally, drawing upon insights from the preceding quantitative studies, the fifth study, a qualitative descriptive study, uses in-depth interviews with PLWBC (n=15) to provide richer insights into their lived experiences, challenges and enablers of CH, adding depth and personal context to the preceding studies. Findings showed that, while convenience and improved access to support are highly valued, digital divide concerns and the impersonal nature of virtual interactions are notable barriers to CH use.
Taken together, this research demonstrates the potential of CH technologies in expanding access to survivorship support while also acknowledging the limitations, complexities and contextual factors that influence their adoption and impact in practice. This research underscores the need for personalised, patient-centric CH services that directly address the identified barriers while leveraging facilitating factors. These findings offer valuable insights into improving the adoption and utilisation of CH technologies, ultimately enhancing the accessibility of care and support for PLWBC. This is particularly crucial in the Irish context, where rapid digitalization presents a significant opportunity to improve patient outcomes.
| Item Type: | Thesis (PhD) |
|---|---|
| Keywords: | Connected Health Technologies; Supporting; Psychosocial Wellbeing; Quality of Life; Cancer; |
| Academic Unit: | Faculty of Science and Engineering > Psychology |
| Item ID: | 20816 |
| Depositing User: | IR eTheses |
| Date Deposited: | 06 Nov 2025 15:03 |
| Use Licence: | This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here |
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