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基于网络的化疗引起的周围神经病变评估与管理系统的试点测试

Pilot Testing a Web-Based System for the Assessment and Management of Chemotherapy-Induced Peripheral Neuropathy.

作者信息

Knoerl Robert, Dudley William N, Smith Gloria, Bridges Celia, Kanzawa-Lee Grace, Lavoie Smith Ellen M

机构信息

Author Affiliations: University of Michigan School of Nursing (Mr Knoerl, Mss Bridges and Kanzawa-Lee, and Dr Lavoie Smith), Ann Arbor; School of Health and Human Sciences, University of North Carolina at Greensboro (Dr Dudley); and University of Michigan Health System (Ms Smith), Ann Arbor.

出版信息

Comput Inform Nurs. 2017 Apr;35(4):201-211. doi: 10.1097/CIN.0000000000000320.

Abstract

Because numerous barriers hinder the assessment and management of chemotherapy-induced peripheral neuropathy in clinical practice, the Carevive Care Planning System, a novel Web-based platform, was developed to address these barriers. It provides patients an opportunity to report their symptoms before their clinic visit and generates customizable care plans composed of evidence-based management strategies. The purpose of this study was to evaluate patient and provider perspectives of feasibility, usability, acceptability, and satisfaction with the Carevive platform. We used a single-arm, pretest/posttest, prospective design and recruited 25 women with breast cancer who were receiving neurotoxic chemotherapy and six advanced practice providers from an academic hospital. At three consecutive clinical visits, patients reported their neuropathy symptoms on a tablet via the Carevive system. The Diffusion of Innovations Theory served as an overarching evaluation framework. The Carevive platform was feasible to use. However, patients had higher ratings of usability, acceptability, and satisfaction with the platform than did the providers, who disliked the amount of time required to use the platform and had difficulty logging into Carevive. If issues regarding provider dissatisfaction can be addressed, the Carevive platform may aid in the screening of neuropathy symptoms and facilitate the use of evidence-based management strategies.

摘要

由于在临床实践中存在众多障碍阻碍了对化疗引起的周围神经病变的评估和管理,因此开发了一种新型的基于网络的平台Carevive护理计划系统来解决这些障碍。它为患者提供了在门诊就诊前报告症状的机会,并生成由循证管理策略组成的可定制护理计划。本研究的目的是评估患者和医疗服务提供者对Carevive平台的可行性、易用性、可接受性和满意度。我们采用单臂、测试前/测试后前瞻性设计,招募了25名正在接受神经毒性化疗的乳腺癌女性患者以及一家学术医院的6名高级执业医疗服务提供者。在连续三次门诊就诊时,患者通过Carevive系统在平板电脑上报告他们的神经病变症状。创新扩散理论作为总体评估框架。Carevive平台使用起来是可行的。然而,患者对该平台的易用性、可接受性和满意度评分高于医疗服务提供者,医疗服务提供者不喜欢使用该平台所需的时间量,并且登录Carevive存在困难。如果能够解决医疗服务提供者不满的问题,Carevive平台可能有助于筛查神经病变症状,并促进循证管理策略的使用。

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