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肿瘤学中的移动健康:一项关于应用程序辅助癌症护理的患者调查。

Mobile Health in Oncology: A Patient Survey About App-Assisted Cancer Care.

作者信息

Kessel Kerstin Anne, Vogel Marco Me, Kessel Carmen, Bier Henning, Biedermann Tilo, Friess Helmut, Herschbach Peter, von Eisenhart-Rothe Rüdiger, Meyer Bernhard, Kiechle Marion, Keller Ulrich, Peschel Christian, Schmid Roland M, Combs Stephanie E

机构信息

Klinikum rechts der Isar, Department of Radiation Oncology, Technical University of Munich (TUM), Munich, Germany.

Institute for Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, Germany.

出版信息

JMIR Mhealth Uhealth. 2017 Jun 14;5(6):e81. doi: 10.2196/mhealth.7689.

Abstract

BACKGROUND

In the last decade, the health care sector has been enriched by numerous innovations such as apps and connected devices that assist users in weight reduction and diabetes management. However, only a few native apps in the oncological context exist, which support patients during treatment and aftercare.

OBJECTIVE

The objective of this study was to analyze patients' acceptance regarding app use and to investigate the functions of an oncological app that are most required, and the primary reasons for patients to refuse app-assisted cancer care.

METHODS

We designed and conducted a survey with 23 questions, inquiring patients about their technical knowledge and equipment, as well as the possible advantages and disadvantages, data transfer, and general functionality of an app.

RESULTS

A total of 375 patients participated; the participation rate was 60.7% (375/618). Gender distribution was about 3:4 (female:male) with a median age of 59 years (range 18-92 years). Whereas 69.6% (261/375) of patients used mobile devices, 16.3% (61/375) did not own one, and 9.1% (34/375) only used a personal computer (PC). About half of the patients rated their usability skills as very good and good (18.9% 71/375; 35.2% 132/375), 23.5% (88/375) described their skills as intermediate, and 14.4% (54/375) as bad. Of all patients, 182 (48.5%, 182/375) were willing to send data to their treating clinic via an app, that is, to a server (61.0% 111/182) or as email (33.5%, 61/182). About two-thirds (68.7%, 125/182) believed that additional and regularly sent data would be an ideal complement to the standard follow-up procedure. Additionally, 86.8% (158/182) wished to be contacted by a physician when entered data showed irregularities. Because of lack of skills (34.4%, 56/163), concerns about the use of data (35.0%, 57/163), lack of capable devices (25.8%, 42/163), and the wish for personal contact with the treating physician (47.2%, 77/163), a total of 163 (43.5%, 163/375) patients refused to use an app. Pearson correlation showed a significant but mild relationship between age and app use (P=.03, r=-.12), favoring younger age; male gender correlated as well (P=.04; r=-.11).

CONCLUSIONS

The results show that the introduction of mobile apps needs to follow different strategies depending on the patients' attitude. Age and gender seem to be the strongest predictive factors. For oncology patients, our survey showed that about half of the patients were willing to send data via an app supporting their treatment. In the future, clinical data such as quality of life and treatment satisfaction recorded by mobile health (mHealth) devices could be used to evaluate and improve therapy workflow. Furthermore, apps could support classical visits, document adverse effects, and remind patients of treatment dates or drug intake.

摘要

背景

在过去十年中,医疗保健领域因众多创新而更加丰富,例如帮助用户减轻体重和管理糖尿病的应用程序和连接设备。然而,在肿瘤学领域,仅有少数原生应用程序,它们在治疗和后续护理期间为患者提供支持。

目的

本研究的目的是分析患者对应用程序使用的接受程度,调查最需要的肿瘤学应用程序的功能,以及患者拒绝应用程序辅助癌症护理的主要原因。

方法

我们设计并开展了一项包含23个问题的调查,询问患者的技术知识和设备情况,以及应用程序可能的优缺点、数据传输和一般功能。

结果

共有375名患者参与;参与率为60.7%(375/618)。性别分布约为3:4(女性:男性),中位年龄为59岁(范围18 - 92岁)。69.6%(261/375)的患者使用移动设备,16.3%(61/375)没有移动设备,9.1%(34/375)仅使用个人电脑(PC)。约一半的患者将自己的使用技能评为非常好和良好(18.9% 71/375;35.2% 132/375),23.5%(88/375)表示技能为中等,14.4%(54/375)表示技能较差。在所有患者中,182名(48.5%,182/375)愿意通过应用程序将数据发送到他们的治疗诊所,即发送到服务器(61.0% 111/182)或作为电子邮件发送(33.5%,61/182)。约三分之二(68.7%,125/182)的患者认为额外且定期发送的数据将是标准随访程序的理想补充。此外,86.8%(158/182)的患者希望在输入的数据显示异常时能收到医生的联系。由于缺乏技能(34.4%,56/163)、对数据使用的担忧(35.0%,57/163)、缺乏可用设备(25.8%,42/163)以及希望与主治医生进行个人接触(47.2%,77/163),共有163名(43.5%,163/375)患者拒绝使用应用程序。Pearson相关性分析显示年龄与应用程序使用之间存在显著但较弱的关系(P = 0.03,r = -0.12),年龄较小者更倾向使用;男性也存在相关性(P = 0.04;r = -0.11)。

结论

结果表明,移动应用程序的引入需要根据患者的态度采取不同策略。年龄和性别似乎是最强的预测因素。对于肿瘤患者,我们的调查显示约一半的患者愿意通过支持其治疗的应用程序发送数据。未来,移动健康(mHealth)设备记录的生活质量和治疗满意度等临床数据可用于评估和改善治疗流程。此外,应用程序可以支持传统就诊、记录不良反应,并提醒患者治疗日期或药物服用情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78b5/5489709/5cb0a0ca8d64/mhealth_v5i6e81_fig1.jpg

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