University of Michigan School of Nursing, Ann Arbor, MI, United States.
University of Texas Health Science Center at Houston School of Biomedical Informatics, Houston, TX, United States.
J Med Internet Res. 2021 Mar 12;23(3):e24638. doi: 10.2196/24638.
Electronic symptom self-reporting systems (e-SRS) have been shown to improve symptoms and survival in patients with cancer. However, patient engagement in using e-SRS for voluntary symptom self-reporting is less optimal. Multiple factors can potentially affect patients' acceptance and engagement in using home-based e-SRS. However, such factors have not been fully explored in cancer populations.
The aim of this study is to understand the acceptance and use of home-based e-SRS by patients with cancer and identify associated facilitators and barriers.
PubMed, CINAHL, Scopus, and PsycINFO (January 2010 to March 2020) were searched using a combination of Medical Subject Headings (MeSH) terms and keywords such as symptom self-reporting, electronic/technology, cancer, and their synonyms. Included studies focused on the use of home-based e-SRS by patients with cancer and their families. Studies on patients' use of e-SRS in clinical settings only were excluded. Of the 3740 papers retrieved, 33 were included in the final review. Factors associated with patient acceptance and use of e-SRS were extracted and synthesized.
Most e-SRS were web based (22/33, 66%) or mobile app based (9/33, 27%). The e-SRS initial acceptance, represented by patient enrollment rates, ranged from 40% (22/55) to 100% (100/100). High e-SRS acceptance was rated by 69% (59/85) to 77.6% (337/434) of the patients after they used the system. The e-SRS use, measured by patients' response rates to questionnaires (ranging from 1596/3521, 45.33% to 92%) or system log-on rates (ranging from 4/12, 33% to 99/100, 99%), declined over time in general patterns. Few studies (n=7) reported e-SRS use beyond 6 months, with the response rates ranging from 62% (40/64) to 85.1% (541/636) and the log-on rates ranging from 63.6% (103/162) to 77% (49/64). The availability of compatible devices and technical support, interactive system features, information accessibility, privacy, questionnaire quality, patient physical/psychosocial status, and age were associated with patient acceptance and use of home-based e-SRS.
Acceptance and use of home-based e-SRS by patients with cancer varied significantly across studies, as assessed by a variety of approaches. The lack of access to technology has remained a barrier to e-SRS adoption. Interactive system features and personalized questionnaires may increase patient engagement. More studies are needed to further understand patients' long-term use of home-based e-SRS behavior patterns to develop personalized interventions to support symptom self-management and self-reporting of patients with cancer for optimal health outcomes.
电子症状自我报告系统（e-SRS）已被证明可以改善癌症患者的症状和生存。然而，患者在使用 e-SRS 进行自愿症状自我报告方面的参与度并不理想。多种因素可能会影响患者对使用基于家庭的 e-SRS 的接受程度和参与度。然而，这些因素在癌症患者中尚未得到充分探讨。
本研究旨在了解癌症患者对基于家庭的 e-SRS 的接受程度和使用情况，并确定相关的促进因素和障碍。
使用医学主题词（MeSH）和关键词（如症状自我报告、电子/技术、癌症及其同义词）组合，在 PubMed、CINAHL、Scopus 和 PsycINFO（2010 年 1 月至 2020 年 3 月）中进行搜索。纳入的研究重点是癌症患者及其家属对基于家庭的 e-SRS 的使用情况。仅在临床环境中研究患者使用 e-SRS 的研究被排除在外。在检索到的 3740 篇论文中，有 33 篇被纳入最终综述。提取并综合了与患者接受和使用 e-SRS 相关的因素。
大多数 e-SRS 是基于网络的（22/33，66%）或基于移动应用程序的（9/33，27%）。e-SRS 的初始接受程度，以患者登记率表示，范围从 40%（22/55）到 100%（100/100）。在患者使用系统后，有 69%（59/85）到 77.6%（337/434）的患者对 e-SRS 给予了高度评价。e-SRS 的使用情况，通过患者对问卷的应答率（范围从 1596/3521，45.33%到 92%）或系统登录率（范围从 4/12，33%到 99/100，99%）来衡量，总体呈下降趋势。很少有研究（n=7）报告 e-SRS 的使用时间超过 6 个月，应答率范围从 62%（40/64）到 85.1%（541/636），登录率范围从 63.6%（103/162）到 77%（49/64）。兼容设备和技术支持的可用性、互动系统功能、信息可及性、隐私、问卷质量、患者的身体/心理社会状况和年龄与患者对基于家庭的 e-SRS 的接受和使用有关。
评估方法不同，癌症患者对基于家庭的 e-SRS 的接受程度和使用情况存在显著差异。缺乏获得技术的机会仍然是采用 e-SRS 的障碍。互动系统功能和个性化问卷可能会增加患者的参与度。需要进一步开展更多研究，以更好地了解患者长期使用基于家庭的 e-SRS 的行为模式，从而制定个性化干预措施，以支持癌症患者的症状自我管理和自我报告，从而实现最佳健康结果。
