Timmerman J G, Dekker-van Weering M G H, Stuiver M M, Groen W G, Wouters M W J M, Tönis T M, Hermens H J, Vollenbroek-Hutten M M R
Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands.
Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine Group, University of Twente, Enschede, The Netherlands.
J Cancer Surviv. 2017 Dec;11(6):720-731. doi: 10.1007/s11764-017-0611-6. Epub 2017 Apr 10.
The aim of this study is to evaluate the feasibility of a telehealthcare application for operable lung cancer (OLC) patients, consisting of ambulant symptom and physical activity monitoring (S&PAM) and a web-accessible home-based exercise program (WEP), and identify possible barriers for successful adoption and implementation.
A two-stage mixed methods design was used, in which 22 OLC patients and their treating healthcare professionals (HCPs) participated from pre-surgery to three (stage 1; n = 10) or six (stage 2; n = 12) months post-surgery. Actual use and acceptability (usability, usefulness, and satisfaction) were evaluated.
Seventeen OLC patients (age (SD): 59 (8) years; 8 female) actively used the modules. S&PAM use varied from 1 to 11 monitoring days prior to outpatient consultations. Patients used WEP most frequently during the first 5 weeks, with an average of four logins a week. Fifty-eight percent used WEP beyond 7 weeks. No adverse situations occurred, and patients felt confident using the applications. Perceived added value included active lifestyle promotion, decreased anxiety, and accessibility to specialized HCPs. Physiotherapists used WEP as intended. Contrarily, physicians scarcely used information from S&PAM. To promote future adoption, strategies should focus on high-level patient tailoring of the technology, and formalization of including the applications in the clinical workflow.
Ambulant monitoring and web-accessible home exercise is clinically feasible for OLC patients. However, low level of adoption by referring physicians may hamper successful implementation.
Patients perceived both ambulant monitoring and web-accessible exercise as an added value to regular care and feasible to use in the period before and after lung resection.
本研究旨在评估一种针对可手术肺癌（OLC）患者的远程医疗应用的可行性，该应用包括门诊症状和身体活动监测（S&PAM）以及基于网络的家庭锻炼计划（WEP），并确定成功采用和实施的可能障碍。
采用两阶段混合方法设计，22名OLC患者及其治疗医护人员（HCPs）从术前到术后三个月（第一阶段；n = 10）或六个月（第二阶段；n = 12）参与研究。评估实际使用情况和可接受性（可用性、有用性和满意度）。
17名OLC患者（年龄（标准差）：59（8）岁；8名女性）积极使用这些模块。S&PAM的使用情况在门诊咨询前从1天到11天不等。患者在最初5周内最频繁使用WEP，平均每周登录4次。58%的患者在7周后仍使用WEP。未发生不良情况，患者对使用这些应用程序感到自信。感知到的附加价值包括促进积极的生活方式、减轻焦虑以及能够联系到专科医护人员。物理治疗师按预期使用了WEP。相反，医生几乎未使用S&PAM的信息。为促进未来的采用，策略应侧重于对技术进行高水平的患者定制，以及将这些应用纳入临床工作流程的规范化。
门诊监测和基于网络的家庭锻炼对OLC患者在临床上是可行的。然而，转诊医生的低采用率可能会阻碍成功实施。
患者认为门诊监测和基于网络的锻炼都是常规护理的附加价值，并且在肺切除术前和术后期间使用是可行的。
