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儿科癌症关爱连接——支持儿童白血病的家庭管理

Pediatric Cancer CareLink--supporting home management of childhood leukemia.

作者信息

Goldsmith D M, Silverman L B, Safran C

机构信息

Clinician Support Technology, Framingham, MA, USA.

出版信息

Proc AMIA Symp. 2002:290-4.

Abstract

We conducted a descriptive evaluation of an Internet-based system designed to support home management of childhood leukemia (Pediatric Cancer CareLink). Twenty-five parents of children with ALL and thirty-four clinicians were interviewed to identify functional requirements and to demonstrate the system's potential to improve the experience and outcomes of children with acute lymphoblastic leukemia (ALL). Parental interviews focused on: medication and side effect management in the home; communication with the health care team; and the use of a computer for ALL home management. Results from these interviews provide strong evidence that parents of children with ALL are struggling to manage the complexity of their children's care in the home. Parents revealed an urgent need for tools that would help them to safely organize the medicines that their children receive while on ALL protocols. Forty percent of parents needed to know more about what to expect during their child's therapy and how to be prepared for it. Clinician interviews focused on the clinical impact and workflow issues associated with such a system. Decision support, prescription refill management, and educational and emotional support functions were considered key components. Clinicians were concerned that such a system would increase their already overburdened workload. Conversely, parents believed that access to such a system would eliminate unnecessary phone calls to the care team. Our findings show that parents would embrace collaborative Internet-based tools that would help with the home management of their child's leukemia.

摘要

我们对一个旨在支持儿童白血病家庭管理的基于互联网的系统(儿科癌症护理链接)进行了描述性评估。我们采访了25名急性淋巴细胞白血病(ALL)患儿的家长和34名临床医生,以确定功能需求,并展示该系统改善急性淋巴细胞白血病(ALL)患儿就医体验和治疗结果的潜力。家长访谈聚焦于:家中药物及副作用管理;与医疗团队的沟通;以及使用电脑进行ALL家庭管理。这些访谈结果提供了有力证据,表明ALL患儿的家长在努力应对家中孩子护理的复杂性。家长们表示迫切需要工具来帮助他们安全整理孩子在接受ALL治疗方案期间所服用的药物。40%的家长需要更多了解孩子治疗期间的预期情况以及如何为此做好准备。临床医生访谈聚焦于与该系统相关的临床影响和工作流程问题。决策支持、处方续开管理以及教育和情感支持功能被视为关键组成部分。临床医生担心这样一个系统会增加他们本已负担过重的工作量。相反,家长们认为使用这样一个系统可以避免给护理团队打不必要的电话。我们的研究结果表明,家长们会欣然接受有助于孩子白血病家庭管理的基于互联网的协作工具。

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