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一个针对患有癌症的儿童和青少年的以患者为中心的症状监测与报告系统(SyMon-SAYS)。

A patient-centered symptom monitoring and reporting system for children and young adults with cancer (SyMon-SAYS).

作者信息

Lai Jin-Shei, Yount Susan, Beaumont Jennifer L, Cella David, Toia Jacquie, Goldman Stewart

机构信息

Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.

Department of Pediatrics, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.

出版信息

Pediatr Blood Cancer. 2015 Oct;62(10):1813-8. doi: 10.1002/pbc.25550. Epub 2015 Apr 9.

Abstract

BACKGROUND

This study evaluated the feasibility of implementing a patient-centered, technology-based symptom monitoring and reporting system (SyMon-SAYS) in pediatric oncology clinics using fatigue as a prototypic symptom. Timely identification of symptoms related to multi-modal therapy for children with cancer is fundamental to the overall success of cancer treatment. SyMon-SAYS was developed to address this need.

PROCEDURE

Patients with a cancer diagnosis, ages 7-21 years, currently on treatment, or off treatment within 6 months, were eligible. Patients/parents completed weekly fatigue assessments over 8 weeks via the internet or interactive voice response (IVR) by phone. Alert emails were generated when pre-defined fatigue score thresholds were met, and fatigue reports were forwarded to clinicians accordingly. Clinicians and parents/patients received cumulative graphic reports of fatigue scores prior to clinic visits at 4 and 8 weeks post-baseline to facilitate discussion. Parents/patients completed an exit survey at their last visit.

RESULTS

Fifty-seven patients/parents completed the study. The majority of patients (93%) and parents (78%) felt it was very/extremely easy to complete SyMon-SAYS; 95% of parents were satisfied with the system; 60% reported it helped deal with their child's fatigue; 70% reported that clinicians didn't discuss fatigue with them; 81% would be willing to use SyMon-SAYS to manage fatigue and other symptoms. Clinicians reported insufficient time to review reports, yet 71% were willing to receive the report on a monthly basis.

CONCLUSION

SyMon-SAYS is feasible and acceptable to patients and parents. Future efforts should focus on better integrating the system into the clinical workflow to improve clinicians' acceptance.

摘要

背景

本研究评估了在儿科肿瘤诊所实施以患者为中心、基于技术的症状监测与报告系统(SyMon-SAYS)的可行性,以疲劳作为典型症状。及时识别与癌症患儿多模式治疗相关的症状是癌症治疗总体成功的基础。SyMon-SAYS就是为满足这一需求而开发的。

程序

年龄在7至21岁、目前正在接受治疗或在6个月内结束治疗的癌症确诊患者符合条件。患者/家长通过互联网或电话交互式语音应答(IVR)在8周内每周完成一次疲劳评估。当达到预定义的疲劳评分阈值时会生成提醒电子邮件,并相应地将疲劳报告转发给临床医生。临床医生和家长/患者在基线后4周和8周的门诊就诊前会收到疲劳评分的累积图表报告,以促进讨论。家长/患者在最后一次就诊时完成退出调查。

结果

57名患者/家长完成了研究。大多数患者(93%)和家长(78%)认为完成SyMon-SAYS非常/极其容易;95%的家长对该系统满意;60%的家长表示它有助于应对孩子的疲劳;70%的家长表示临床医生没有与他们讨论过疲劳问题;81%的家长愿意使用SyMon-SAYS来管理疲劳和其他症状。临床医生表示没有足够时间查看报告,但71%的临床医生愿意每月接收报告。

结论

SyMon-SAYS对患者和家长来说是可行且可接受的。未来的努力应集中在更好地将该系统整合到临床工作流程中,以提高临床医生的接受度。

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