Limitations
cancer
CANCER
This study has the following limitations. First, it focused on patients with caregivers because caregiver availability is a mandate for discharge. However, some patients were ineligible because they lacked or had minimal caregiver support after discharge. Future research needs to bolster post-operative care strategies for cancer patients who independently manage ostomy and related care. Second, this proof-of-concept pilot RCT had a small sample size, in which most participants were white males, and most caregivers were females. The small sample size also negated the possibility of controlling for the confounding factors in the initial efficacy testing. A future RCT needs sufficient power to examine the effects of PRISMS in cancer patients and caregivers with diverse sociodemographic backgrounds. An adequately powered RCT would also allow for sub-group analyses and identify patients who would benefit the most from the program. Last, we only focused on testing PRISMS for patient-caregiver dyads and excluded patients without a caregiver. Currently, PRISMS is designed in a way that content and functionalities for patients and caregivers could be independent of each other. In other words, for patients without a caregiver or with only minimal support, PRISMS could provide the same education and skills training, personalized feedback based on the continuous monitoring of PRO and digital devices, professional support, as well as social support with other patients. Although it was not the scope of the current study, testing the use of PRISMS for patients without a caregiver is possible in the future.