Nguyen Nam, Leveille Etienne, Guadagno Elena, Kalisya Luc Malemo, Poenaru Dan
Faculty of Medicine, McGill University, Canada.
Department of Paediatric Surgery, McGill University Health Centre, Canada.
J Telemed Telecare. 2022 Jun;28(5):331-341. doi: 10.1177/1357633X20934682. Epub 2020 Jun 30.
Mobile health (mHealth) is the use of mobile communication devices such as smartphones, wireless patient monitoring devices and tablet computers to deliver health services. Paediatric surgery patient care could potentially benefit from these technologies. This systematic review summarises the current literature on the use of mHealth for postoperative care after children's surgery.
Seven databases were searched by a senior medical librarian. Studies were included if they reported the use of mHealth systems for postoperative care for children <18 years old. Data extraction and risk of bias assessment were performed in duplicate.
A total of 18 studies were included after screening. mHealth use was varied and included appointment or medication reminders, postoperative monitoring and postoperative instruction delivery. mHealth systems included texting systems and mobile applications, and were implemented for a wide range of surgical conditions and countries.
Studies showed that mHealth systems can increase the postoperative follow-up appointment attendance rate ( < 0.001), decrease the rate of postoperative complications and returns to the emergency department and reliably monitor postoperative pain. mHealth systems were generally appreciated by patients. Most non-randomised and randomised studies had many methodological problems, including lack of appropriate control groups, lack of blinding and a tendency to devote more time to the care of the intervention group. mHealth systems have the potential to improve postoperative care, but the lack of high-quality research evaluating their impact calls for further studies exploring evidence-based mHealth implementation.
移动医疗(mHealth)是指利用智能手机、无线患者监测设备和平板电脑等移动通信设备来提供医疗服务。小儿外科患者护理可能会从这些技术中受益。本系统综述总结了目前关于使用移动医疗进行儿童手术后护理的文献。
一位资深医学图书馆员检索了七个数据库。如果研究报告了使用移动医疗系统对18岁以下儿童进行术后护理,则纳入研究。数据提取和偏倚风险评估由两人独立进行。
筛选后共纳入18项研究。移动医疗的使用方式多种多样,包括预约或用药提醒、术后监测和术后指导提供。移动医疗系统包括短信系统和移动应用程序,并在广泛的手术情况和国家得到应用。
研究表明,移动医疗系统可以提高术后随访预约出勤率(<0.001),降低术后并发症发生率和返回急诊科的比率,并可靠地监测术后疼痛。移动医疗系统总体上受到患者的赞赏。大多数非随机和随机研究存在许多方法学问题,包括缺乏适当的对照组、缺乏盲法以及倾向于将更多时间用于干预组的护理。移动医疗系统有改善术后护理的潜力,但缺乏评估其影响的高质量研究,需要进一步开展探索基于证据的移动医疗实施的研究。