Morgan Deidre D, Swetenham Kate, To Timothy H M, Currow David C, Tieman Jennifer J
Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide 5001, Australia.
Southern Adelaide Palliative Services, Daw Park, Adelaide 5041, Australia.
Healthcare (Basel). 2017 Aug 31;5(3):51. doi: 10.3390/healthcare5030051.
Continuous monitoring and management of a person's symptoms and performance status are critical for the delivery of effective palliative care. This monitoring occurs routinely in inpatient settings; however, such close evaluation in the community has remained elusive. Patient self-reporting using telehealth offers opportunities to identify symptom escalation and functional decline in real time, and facilitate timely proactive management. We report the case of a 57-year-old man with advanced non-small cell lung cancer who participated in a telehealth trial run by a community palliative care service. This gentleman was able to complete self-reporting of function and symptoms via iPad although at times he was reticent to do so. Self-reporting was perceived as a means to communicate his clinical needs without being a bother to the community palliative care team. He also participated in a videoconference with clinical staff from the community palliative care service and his General Practitioner. Videoconferencing with the nurse and GP was highly valued as an effective way to communicate and also because it eliminated the need for travel. This case report provides important information about the feasibility and acceptability of palliative care telehealth as a way to better manage clinical care in a community setting.
持续监测和管理患者的症状及身体状况对于提供有效的姑息治疗至关重要。这种监测在住院环境中是常规操作；然而，在社区环境中进行如此密切的评估却一直难以实现。利用远程医疗进行患者自我报告，为实时识别症状加重和功能衰退提供了机会，并有助于及时进行主动管理。我们报告了一名57岁晚期非小细胞肺癌男性患者的病例，他参与了由社区姑息治疗服务机构开展的一项远程医疗试验。这位先生能够通过iPad完成功能和症状的自我报告，尽管有时他不太愿意这样做。自我报告被视为一种传达其临床需求的方式，而不会给社区姑息治疗团队带来麻烦。他还与社区姑息治疗服务机构的临床工作人员以及他的全科医生参加了一次视频会议。与护士和全科医生进行视频会议被高度评价为一种有效的沟通方式，而且还省去了出行的必要。本病例报告提供了关于姑息治疗远程医疗在社区环境中更好地管理临床护理方面的可行性和可接受性的重要信息。
