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Breast cancer app developed by ZGT and UT nominated for care award: Vote now

While undergoing treatment, many breast cancer patients develop a self-image that revolves around fatigue. This is an impediment to recovery and performance in everyday life. With the IVY app – a joint project of ZGT and the University of Twente – the self-image with regard to vitality is positively influenced in an easy and accessible manner, from the earliest stages of the treatment process. Together with two other care innovations, this innovative app, which has been developed in consultation with patients, has been nominated for Roche’s Patient Innovation Award. You can vote until 15 September via Roche's website.

“While undergoing treatment, patients develop a self-image that revolves around fatigue,” internist-oncologist Ester Siemerink explains. “Among breast cancer patients, fatigue is the most common cause for deterioration of the patient’s well-being. This causes patients to become less active, which results in loss of fitness and muscle power. As a result, patients often get lost in a vicious cycle, which means the fatigue is maintained and keeping up socially becomes increasingly difficult.”

“And that is what we want to prevent,” Siemerink emphasises. “There are many rehabilitation programmes with a special focus on dealing with the fatigue that patients experience. These rehabilitation  programmes are deployed at a late stage of the process, when the patient is no longer feeling sufficiently vital. The IVY app is meant to prevent loss of physical vitality by maintaining mental vitality.”

Use the unconscious capacity for recovery

“Currently we do not make use of an important part of our psychological capacity for recovery, which is a waste. The use of implicit influencing of fatigue really offers opportunities, as we know from other research, but is still in its infancy. This is why we have developed the IVY (Implicit Vitality) app together with patients and healthcare professionals. At the moment, we are testing it in a pilot study.”

Roos Wolbers, health psychologist and junior researcher at the University of Twente, explains how it works: “The IVY-app consists of a training. Words relating to vitality and fatigue appear in the middle of the screen. The patient is asked to drag words related to vitality, such as ‘alert’ and ‘strong’ towards themselves on the screen and drag the words related to fatigue, such as ‘tired’ and ‘weak’, away from themselves. By repeating this often, we enforce the association between the self and vitality in the brain, with the purpose of enabling patients to see themselves as a more vital person and, as a result, to make other choices and display more vital behaviour.”  

“Just as you can train your muscles with strength exercises, you can train you brain using the IVY app to acquire a different thought pattern. The training in the IVY-app uses an innovative, computer-controlled mental training technique, Cognitive Bias Modification (CBM), to influence unconscious processes and learning experiences. It could be compared to hearing that you look alert or fit. If you are told this on a daily basis, you will actually start feeling more alert and fit.”

“Winning the prize money connected with this award will enable us to realise a great follow-up to the IVY project, in which we will further personalise the app and test its effectivity more extensively. This is why we want to call on everyone to vote for our project and make it possible for breast cancer patients to continue seeing themselves as vital persons!”

Preventing a vicious cycle

Mirjam Velting, Quality of Life programme manager at the Dutch Breast Cancer Association (Dutch BVN), also emphasises the importance of the vitality project for a further rollout of the IVY app: “Fatigue during treatment is the most common complaint of patients we speak with. Fatigue has an impact on everything and it is often a vicious cycle. A disrupted rhythm results in loss of sleep, loss of sleep results in irritation and mood swings, and this stress in turn results in more fatigue. It would be wonderful if all patients could already work on this during their treatment, without having to expend too much effort. Especially at a time when you have so little control over your own life.”


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