Holmen Heidi, Riiser Kirsti, Winger Anette
Oslo Metropolitan University, Oslo, Norway.
J Med Internet Res. 2020 Feb 28;22(2):e16248. doi: 10.2196/16248.
Children and families in pediatric palliative care depend on close contact with health care personnel, and electronic health (eHealth) is suggested to support care at home by facilitating their remote interactions.
This study aimed to identify and review the use of eHealth to communicate and support home-based pediatric palliative care and appraise the methodological quality of the published research.
We conducted a convergent, systematic mixed methods review and searched Medical Literature Analysis and Retrieval System Online (Medline), EMBASE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Scopus for eligible papers. Studies evaluating 2-way communication technology for palliative care for children aged ≤18 years and applying quantitative, qualitative, or mixed methods from 2012 to 2018 were eligible for inclusion. Quantitative and qualitative studies were equally valued during the search, screening, extraction, and analysis. Quantitative data were transformed into qualitative data and analyzed using a thematic analysis. Overall, 2 independent researchers methodologically appraised all included studies.
We identified 1277 citations. Only 7 papers were eligible for review. Evaluating eHealth interventions in pediatric palliative care poses specific methodological and ethical challenges. eHealth to facilitate remote pediatric palliative care was acknowledged both as an intrusion and as a support at home. Reluctance toward eHealth was mainly identified among professionals.
The strengths of the conclusions are limited by the studies' methodological challenges. Despite the limitless possibilities held by new technologies, research on eHealth in home-based pediatric palliative care is scarce. The affected children and families appeared to hold positive attitudes toward eHealth, although their views were less apparent compared with those of the professionals.
PROSPERO CRD42018119051; https://tinyurl.com/rtsw5ky.
儿科姑息治疗中的儿童及其家庭依赖与医护人员的密切接触，建议通过促进远程互动的电子健康（eHealth）来支持居家护理。
本研究旨在识别和综述电子健康在沟通和支持居家儿科姑息治疗中的应用，并评估已发表研究的方法学质量。
我们进行了一项收敛性、系统性混合方法综述，并在医学文献分析和检索系统在线数据库（Medline）、EMBASE、心理学文摘数据库（PsycINFO）、考克兰图书馆、护理学与健康相关文献累积索引数据库（CINAHL）、科学引文索引数据库（Web of Science）和Scopus中检索符合条件的论文。纳入2012年至2018年期间评估针对18岁及以下儿童姑息治疗的双向通信技术并采用定量、定性或混合方法的研究。在检索、筛选、提取和分析过程中，定量研究和定性研究受到同等重视。定量数据被转化为定性数据并采用主题分析法进行分析。总体而言，两名独立研究人员对所有纳入研究进行了方法学评估。
我们识别出1277篇文献。仅有7篇论文符合综述条件。评估儿科姑息治疗中的电子健康干预措施面临特定的方法学和伦理挑战。电子健康促进远程儿科姑息治疗既被视为一种干扰，也被视为居家护理的一种支持。对电子健康的抵触主要在专业人员中被发现。
结论的优势受到研究方法学挑战的限制。尽管新技术具有无限可能性，但居家儿科姑息治疗中电子健康的研究却很匮乏。受影响的儿童及其家庭似乎对电子健康持积极态度，尽管与专业人员相比他们的观点不太明显。
国际前瞻性系统评价注册库（PROSPERO）注册号CRD42018119051；https://tinyurl.com/rtsw5ky 。
