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儿童癌症幸存者的共享护理:一项远程医疗可行性研究。

Shared Care of Childhood Cancer Survivors: A Telemedicine Feasibility Study.

作者信息

Costello Aimee G, Nugent Bethany D, Conover Noelle, Moore Amanda, Dempsey Kathleen, Tersak Jean M

机构信息

1 Division of Hematology, Oncology, and Blood and Marrow Transplant, Children's Hospital of Pittsburgh of UPMC , Pittsburgh, Pennsylvania.

2 School of Nursing, University of Pittsburgh , Pittsburgh, Pennsylvania.

出版信息

J Adolesc Young Adult Oncol. 2017 Dec;6(4):535-541. doi: 10.1089/jayao.2017.0013. Epub 2017 Jun 28.

Abstract

PURPOSE

With an increasing number of childhood cancer survivors (CCSs), determining the best model of survivorship transition care is becoming a growing priority. Shared care between pediatric oncology and adult primary care is often necessary, making survivorship a time of transition, but effective standard models are lacking. We sought to provide a more integrated approach to transition using telemedicine.

METHODS

Recruited primary care provider/CCS dyads were instructed to log-in to a password-protected virtual meeting room using telemedicine equipment at the time or a regularly scheduled office visit. Dyads were joined by a pediatric survivorship clinic team member who conducted the telemedicine portion of the transition visit, which consisted of the review of an individualized treatment summary and care plan. Postquestionnaires were developed to evaluate key points such as fund of knowledge, satisfaction with the visit, and effectiveness of this electronic tool.

RESULTS

There were 19 transition visits conducted, 13 of which used the telemedicine equipment as planned. Those that did not use the equipment were primarily unable to due to technical difficulties. Postquestionnaires were overall positive, confirming increased knowledge, comfort and abilities, and patient satisfaction in survivorship care. Negative comments were primarily related to equipment difficulties.

CONCLUSIONS

A gap still remains in helping CCSs transition from oncology to primary care and this pilot study offered insights into how we might better bridge that gap through the use of telemedicine. Further research is needed to refine the transition process for CCSs, including evaluation and testing models for standard of care.

摘要

目的

随着儿童癌症幸存者(CCSs)数量的增加,确定最佳的生存过渡护理模式正变得越来越重要。儿科肿瘤学与成人初级护理之间的共享护理通常是必要的,这使得生存成为一个过渡时期,但缺乏有效的标准模式。我们试图通过远程医疗提供一种更综合的过渡方法。

方法

招募的初级护理提供者/CCSs二元组被指示在预定的办公室就诊时间使用远程医疗设备登录到一个受密码保护的虚拟会议室。二元组由儿科生存诊所团队成员加入,该成员进行过渡就诊的远程医疗部分,包括审查个性化治疗总结和护理计划。开发了问卷后测来评估关键要点,如知识储备、对就诊的满意度以及这种电子工具的有效性。

结果

共进行了19次过渡就诊,其中13次按计划使用了远程医疗设备。那些未使用设备的主要是由于技术困难而无法使用。问卷后测总体呈积极态度,证实了在生存护理方面知识增加、舒适度和能力提高以及患者满意度。负面评论主要与设备困难有关。

结论

在帮助CCSs从肿瘤学过渡到初级护理方面仍然存在差距,这项试点研究为我们如何通过使用远程医疗更好地弥合这一差距提供了见解。需要进一步研究来完善CCSs的过渡过程,包括护理标准的评估和测试模型。

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