远程职业疗法服务通过远程医疗在乳腺癌康复计划中的可行性。
Feasibility of Remote Occupational Therapy Services via Telemedicine in a Breast Cancer Recovery Program.
机构信息
Lily L. Lai, MD, is Associate Clinical Professor, Department of Surgery, City of Hope, Duarte, CA;
Heather Player, MD, is Assistant Clinical Professor, Department of Surgery, City of Hope, Duarte, CA.
出版信息
Am J Occup Ther. 2021 Mar-Apr;75(2):7502205030p1-7502205030p9. doi: 10.5014/ajot.2021.042119.
IMPORTANCE
Access to perioperative breast surgery occupational therapy services remains limited in remote areas.
OBJECTIVE
To assess the feasibility and acceptance of occupational therapy services using a "hub-and-spoke" telemedicine model.
DESIGN
Prospective study using videoconferencing to connect the occupational therapist, located at the hub site, with the patient, located at the spoke site.
SETTING
National Cancer Institute Comprehensive Cancer Center (hub site) and affiliated community cancer center (spoke site). The sites are 75 mi apart.
PARTICIPANTS
Female breast cancer patients (N = 26) scheduled for breast surgery were asked to participate in telemedicine occupation therapy sessions. Patients lived in a geographically remote region and travelled a mean of 16 miles (range = 3-85) to the hub site. The majority (56%) of the patients had public insurance.
INTERVENTION
Perioperative occupational therapy sessions completed through videoconferencing.
OUTCOMES AND MEASURES
Outcome measures were participation in and completion rate for the sessions, number of sessions required to return to baseline, and time interval from surgery to return to baseline function. Patient satisfaction was assessed with a questionnaire.
RESULTS
Of the patients who enrolled in the study, 18 completed all postoperative sessions in which functional assessments, exercises, and education were provided. Patients regained baseline function within a mean of 42.4 days after surgery and after an average of three sessions. Patients reported high satisfaction with the sessions.
CONCLUSIONS AND RELEVANCE
Videoconference telemedicine in breast perioperative rehabilitation is feasible, effective, and acceptable to patients. This study adds to the emerging use of telemedicine for rehabilitative services.
WHAT THIS ARTICLE ADDS
This study, by demonstrating the acceptability, practicality, and efficacy of breast perioperative occupational therapy services offered through a videoconferencing platform, supports continued research to evaluate the value of telemedicine. Issues with access to medical care may be mitigated through creative use of technology.
重要性
在偏远地区，围手术期乳房外科职业治疗服务的获得仍然有限。
目的
评估使用“中心辐射”远程医疗模型的职业治疗服务的可行性和可接受性。
设计
前瞻性研究，使用视频会议将位于中心站点的职业治疗师与位于辐射站点的患者连接起来。
地点
国家癌症研究所综合癌症中心（中心站点）和附属社区癌症中心（辐射站点）。这些站点相距 75 英里。
参与者
接受乳房手术的女性乳腺癌患者（N=26）被要求参加远程医疗职业治疗会议。患者居住在地理偏远地区，前往中心站点的平均距离为 16 英里（范围= 3-85）。大多数（56%）患者拥有公共保险。
干预措施
通过视频会议完成围手术期职业治疗。
结果和措施
结果测量指标包括参与和完成治疗的比例、恢复基线所需的治疗次数、以及从手术到恢复基线功能的时间间隔。通过问卷调查评估患者的满意度。
结果
参加研究的患者中，18 人完成了所有术后治疗，包括功能评估、锻炼和教育。患者在手术后平均 42.4 天内恢复基线功能，平均需要三次治疗。患者对治疗非常满意。
结论和相关性
视频会议远程医疗在乳房围手术期康复中是可行的、有效的、并且能被患者接受。本研究增加了远程医疗在康复服务中的应用。
本文的重要意义
通过演示通过视频会议平台提供的乳房围手术期职业治疗服务的可接受性、实用性和疗效，本研究支持继续研究评估远程医疗的价值。通过创造性地使用技术，可以减轻获得医疗服务的障碍。
Zotero 插件