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群组医疗咨询(GMCs)和基于平板电脑的在线支持小组会议在乳腺癌随访中的应用:一项多中心随机对照试验。

Group medical consultations (GMCs) and tablet-based online support group sessions in the follow-up of breast cancer: A multicenter randomized controlled trial.

机构信息

Department of Medical Psychology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.

Department of Surgery, Diakonessenhuis Utrecht, P.O. Box 80250, 3508 TG Utrecht, The Netherlands.

出版信息

Breast. 2018 Aug;40:181-188. doi: 10.1016/j.breast.2018.05.012. Epub 2018 Jun 12.

Abstract

OBJECTIVE

Group medical consultations (GMCs) provide individual medical visits in the presence of ≤7 peer-patients. In the follow-up of breast cancer, we evaluated the efficacy of a new type of blended care My-GMC, a GMC combined with a tablet-based online app, consisting of three online support group sessions (SGS) and additional information.

METHODS

This randomized controlled trial compared the effect of My-GMC (n = 59) with one individual medical visit (n = 50) (care as usual). Between-group differences on the outcomes distress and empowerment were analyzed 1 week, 3 and 6 months after the visit.

RESULTS

No between-group differences were found for the primary outcomes distress and empowerment. More themes were discussed in GMCs compared to individual visits. Significantly more patients experienced peer-support in GMCs (78%) than via the online app (29%). Satisfaction with the online app was low.

CONCLUSIONS

My-GMC did not result in improvements in distress or empowerment, which might partly be explained by low baseline distress levels. This paper provides valuable information concerning factors on organizational level as well as individual level influencing the evaluation of a blended care intervention.

PRACTICE IMPLICATIONS

My-GMC provided an innovative alternative, combining professional and peer-support in face-to-face and online SGS, resulting in additional information provision and peer-support. Further improvement of the apps is needed to improve user satisfaction.

NETHERLANDS TRIAL REGISTER

NTR3771.

摘要

目的

小组医疗咨询(GMC)在≤7 名同伴患者在场的情况下提供个体医疗访问。在乳腺癌随访中,我们评估了一种新型混合护理 My-GMC 的效果,这是一种将 GMC 与基于平板电脑的在线应用程序相结合的方法,包括三个在线支持小组会议(SGS)和其他信息。

方法

这项随机对照试验比较了 My-GMC(n=59)与一次个体医疗访问(n=50)(常规护理)的效果。在访问后 1 周、3 个月和 6 个月分析了结局痛苦和赋权的组间差异。

结果

在主要结局痛苦和赋权方面,组间没有差异。与个体就诊相比,GMC 中讨论了更多的主题。GMC 中(78%)比在线应用程序中(29%)有更多的患者体验到同伴支持。对在线应用程序的满意度较低。

结论

My-GMC 并未改善痛苦或赋权,这可能部分解释了基线痛苦水平较低的原因。本文提供了有关影响混合护理干预评估的组织层面和个体层面因素的有价值信息。

实践意义

My-GMC 提供了一种创新的替代方案,将专业和同伴支持结合在面对面和在线 SGS 中,从而提供了更多的信息和同伴支持。需要进一步改进应用程序以提高用户满意度。

荷兰试验注册

NTR3771。

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