Nasopharyngeal carcinoma (NPC) is a head and neck malignant tumor originating from the nasopharyngeal epithelial cells (Chang & Adami, 2006),It has a high incidence in Guangxi of China, the annual crude incidence being 30–80/ 100,000 (Strazzulla, Barreca, Giancotti, Pisani, & Torti, 2015; Tang et al., 2016). Radiotherapy combined with chemotherapy is so far, the best treatment for NPC owing to characteristics like NPC cell differentiation and high sensitivity to radiation. The present 5-year overall survival rate in an NPC patient with such combinatorial treatment exceeds 80% (Jemal et al., 2011). However, chemoradiotherapy not only resists the tumor cells but also inevitably damages the normal tissues in the vicinity of the radiation field area, resulting in acute and chronic radiation injury symptoms such as the oropharyngeal acute mucosal injury, dry mouth, taste change, difficulty in opening the mouth and swallowing (Xiao et al., 2013; Yi & Qiang, 2017). These long-term toxicities and side effects syndrome tend to exist for a long time in the patients during the home rehabilitation period even after the treatment is terminated. It is during this post-treatment period that the body's symptoms group and the negative emotions cooperate and reinforce each other, aggravating the burden of cancer on the patients (Gift, Stommel, Jablonski, & Given, 2003). In addition, the non-standard follow-up management, as well as the lack of access to health knowledge, seriously jeopardize the quality of life(QOL) of the NPC patients outside the hospital. Therefore, there is an urgent need for systematic and effective continuous nursing services to improve the correctness of the health behavior as well as meet the needs of personalized care (Chow, Wong, Chan, Chung, & Lee, 2010; Shi et al., 2015). Therefore, the NPC patients not only need to prolong their survival time but also medical staff to provide long-term, professional and timely continuing nursing services to improve their QOL.
Continuous care is considered one of the essential elements of high-quality health services (Min, Guohong, & Yang, 2015). It refers to the systematic, continuous, coordinated, and professional health care behavior that is conducive to the home-based rehabilitation of the patients in the unusual medical service institutions or the same medical service institutions under different conditions (King, Jones, Mccarthy, Rogers, & Nazareth, 2009). China has established a continuous nursing mode, making initial progress in the field of chronic diseases based on the lessons drawn from the overseas extended service modes and combining them with the characteristics of the domestic medical resource system. For example, the 4C extension service mode and effect evaluation scheme has been constructed in Hong Kong and Taiwan (Shu-Hua, Ji-Jun, & Jian-Hua, 2007; WANG Shao-ling, 2009). In mainland China, continuous nursing services are widely executed through telephonic calls, (Jianbo & Haiying, 2009), QQ, WeChat (Lijun, Shuang, & Hui, 2018), mobile health app (GUO Ming juan, 2017), and other media. These discussion platforms provide practical and theoretical bases for continuing nursing in the future, and also expose the deficiencies of the current extended nursing service teams and intervention programs in China, like: (1) The diversified and single forms of continuous nursing exist side by side, while each form of continuous nursing is fraught with limitations (Qiao-Qin, Li, Shu-Xiao, Nursing, & University, 2013); (2) The implementation plan and operation process of continuous care in the hospital has no relevant theoretical guidance and standard, or unified evaluation system (Shi-Ying, Shu-Hua, Yi-Gang, & Jin-Hua, 2009); (3) Presently, the hospital discharge follow-up and community-based primary health care services constitute the common modes of implementing continuous care in China (Qiao-Qin et al., 2013),However, about 93.75% of the patients wish to receive extended care services and on-site services after discharge, and about 90% of expect the hospital to undertake this work (Hui et al., 2015). However, the continuous care link in hospitals is relatively weak, and the contradictions between the supply and demand of the extended nursing services is very prominent due to limitations such as uneven distribution of medical resources and insufficient development of communities. Therefore, this study mainly focused on optimizing the therapeutic resources to help hospitals in providing the patients with high -quality, effective, convenient, and rapid continuation of nursing services for ameliorating the current situation of unbalanced development of medical resources.
The robust development of the mobile Internet has solved the issue of hospital -based continuous care (Ying, 2017). The 43rd report of the China Internet Network Information Center (CNNIC) in 2018, as of December 2018 stated that the network penetration rate reached 59.6%, and the proportion of using mobile phones to connect to the Internet was as high as 98.6%, maintaining a benign growth trend. The WeChat public platform is present, the most widely used internet platform. It is extensively used for the hospital health knowledge release, online appointments, disease intervention, and other fields and can realize the comprehensive interaction of text, pictures, and sounds (Feng et al., 2017; Gao, Zhou, Liu, Wang, & Bowers, 2017). The 2016–2020 China nursing development planning document also encourages the use of mobile network technology for improving the level of hospital informatization, extending nursing services to the communities and families, and providing one-stop flexible extension services for the discharged patients to meet their health needs (China, 2017). The research has shown that the efficient and convenient use of the internet, the follow-up management system can overcome limitations of time and space in traditionally implementing continuous nursing, accelerating the dissemination of health knowledge, improving the enthusiasm of the individual behavior and user experience, and thus, enable the patients to achieve a higher quality and effective management (Luo Huiyu, 2017).
Therefore, our team has used the internet technology to build a mHealth platform for the NPC patients relying on the WeChat public platform to provide them with good familial extended care. The aim involved exploring the impact of the mobile health care model on the health outcomes of the discharged NPC patients in terms of radiotherapy, fatigue, and quality of life.