Nasi Greta, Cucciniello Maria, Guerrazzi Claudia
Department of Policy Analysis and Public Management, Bocconi University, Milano, Italy.
J Med Internet Res. 2015 Feb 12;17(2):e26. doi: 10.2196/jmir.3757.
Health care systems are gradually moving toward new models of care based on integrated care processes shared by different care givers and on an empowered role of the patient. Mobile technologies are assuming an emerging role in this scenario. This is particularly true in care processes where the patient has a particularly enhanced role, as is the case of cancer supportive care.
This paper aims to review existing studies on the actual role and use of mobile technology during the different stages of care processes, with particular reference to cancer supportive care.
We carried out a review of literature with the aim of identifying studies related to the use of mHealth in cancer care and cancer supportive care. The final sample size consists of 106 records.
There is scant literature concerning the use of mHealth in cancer supportive care. Looking more generally at cancer care, we found that mHealth is mainly used for self-management activities carried out by patients. The main tools used are mobile devices like mobile phones and tablets, but remote monitoring devices also play an important role. Text messaging technologies (short message service, SMS) have a minor role, with the exception of middle income countries where text messaging plays a major role. Telehealth technologies are still rarely used in cancer care processes. If we look at the different stages of health care processes, we can see that mHealth is mainly used during the treatment of patients, especially for self-management activities. It is also used for prevention and diagnosis, although to a lesser extent, whereas it appears rarely used for decision-making and follow-up activities.
Since mHealth seems to be employed only for limited uses and during limited phases of the care process, it is unlikely that it can really contribute to the creation of new care models. This under-utilization may depend on many issues, including the need for it to be embedded into broader information systems. If the purpose of introducing mHealth is to promote the adoption of integrated care models, using mHealth should not be limited to some activities or to some phases of the health care process. Instead, there should be a higher degree of pervasiveness at all stages and in all health care delivery activities.
医疗保健系统正逐步朝着基于不同护理人员共享的综合护理流程以及患者赋权角色的新型护理模式发展。在这种情况下,移动技术正发挥着越来越重要的作用。在患者角色尤为突出的护理流程中,情况更是如此,比如癌症支持性护理。
本文旨在回顾现有关于移动技术在护理流程不同阶段的实际作用和应用的研究,尤其以癌症支持性护理为参考。
我们进行了文献综述,目的是识别与移动健康在癌症护理和癌症支持性护理中的应用相关的研究。最终样本量包括106条记录。
关于移动健康在癌症支持性护理中的应用的文献很少。更广泛地看癌症护理,我们发现移动健康主要用于患者开展的自我管理活动。主要使用的工具是手机和平板电脑等移动设备,但远程监测设备也发挥着重要作用。短信技术(短消息服务,SMS)的作用较小,中等收入国家除外,在这些国家短信发挥着重要作用。远程医疗技术在癌症护理流程中仍很少使用。如果我们审视医疗保健流程的不同阶段,可以看到移动健康主要在患者治疗期间使用,尤其是用于自我管理活动。它也用于预防和诊断,尽管程度较小,而在决策和随访活动中似乎很少使用。
由于移动健康似乎仅在护理流程的有限用途和有限阶段使用,它不太可能真正有助于创建新的护理模式。这种利用不足可能取决于许多问题,包括需要将其嵌入更广泛的信息系统。如果引入移动健康的目的是促进综合护理模式的采用,使用移动健康不应仅限于医疗保健流程的某些活动或某些阶段。相反,在所有阶段和所有医疗保健提供活动中都应具有更高程度的普及性。