The prostate cancer version includes 14 symptom questions regarding bladder and bowel function, fatigue, pain, worry, depression, sleep, and flushing. They are included as a result of a literature review, interviews with patients and healthcare providers [
] and a feasibility study [
]. Furthermore, there is an open question, providing the patient with an opportunity to add comments;
“Other symptoms or concerns to report?”
Patients are asked about the symptoms’ occurrence, frequency, and distress level during the day, for example:
“Do you experience urinary difficulties?”
If the answer is yes, the patient is asked about the frequency, which can be rated as: almost never, sometimes, rather often, or very often. Next follows a question on distress level, which can be rated as: not at all, a little, somewhat, or very much. The symptoms of fatigue, insomnia, constipation and blood in stool are only assessed by the distress level and not by frequency. Specific symptoms are set to generate an alert to the registered nurses, via text messages (SMS), on appointed levels of frequency or distress. The level for each symptom has been decided based on a risk assessment model, in collaboration with clinicians. There are two kinds of alerts: yellow alerts that request a nurse to contact the patient during the day, and red alerts, requiring contact within one hour. Severe symptoms regarded as a potential risk for the patients’ health and well-being trigger a red alert. A symptom considered to be less severe triggers a yellow alert. The symptoms set to trigger alerts are: urinary urgency (very often; yellow alert), difficulties urinating (very often; red alert), haematuria (very often; yellow alert), diarrhoea (very often; yellow alert), blood in stool (very much; red alert), obstipation (very much; yellow alert), pain (very often; red alert) and depression, worry (very often; red alert).