Saeidzadeh Seyedehtanaz, Kamalumpundi Vijayvardhan, Chi Nai-Ching, Nair Rajeshwari, Gilbertson-White Stephanie
College of Nursing, University of Iowa, Iowa City, IA, USA.
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Palliat Med. 2021 Jun;35(6):1020-1038. doi: 10.1177/02692163211006317. Epub 2021 Apr 12.
Symptom management is a critical aspect of comprehensive palliative care for people with advanced cancer. Web and mobile-based applications are promising e-Health modalities that can facilitate timely access to symptom management interventions for this population.
To evaluate the efficacy of web and mobile-based symptom management interventions in alleviating physical symptom burden in people with advanced cancer.
A systematic review and meta-analysis was conducted. PROSPERO ID = CRD42020155295.
We searched databases including PubMed, PsycINFO, and CINAHL from 1991 until 2019. Inclusion criteria were: adults with advanced cancer, web or mobile-based interventions targeting symptom management, and report of physical symptom data. Risk of bias was assessed using the ROBINS-I and RoB2. Using RevMan, standardized mean difference (SMD) and 95% confidence intervals were calculated. Heterogeneity was assessed using the statistic. An assessment of interventions was conducted by evaluating the delivery mode, duration, and evaluation of application feature and theoretical elements.
A total of 19 studies are included in the systematic review and 18 in the meta-analysis. Majority of the studies were deemed to have high risk of bias. Most of the interventions used a web-application for delivering their education ( = 17). While the interventions varied regarding duration and content, they were mainly guided by a symptom management theory. Web and mobile-based interventions significantly improved the overall physical symptom burden (SMD = -0.18; 95% CI = -0.28 to -0.09; = 0%; = 0.0002).
Web and mobile-based intervention are efficacious in decreasing the overall physical symptom burden in people with advanced cancer.
症状管理是晚期癌症患者综合姑息治疗的关键环节。基于网络和移动设备的应用程序是很有前景的电子健康模式，可为这一人群及时获得症状管理干预措施提供便利。
评估基于网络和移动设备的症状管理干预措施在减轻晚期癌症患者身体症状负担方面的疗效。
进行了一项系统评价和荟萃分析。国际前瞻性系统评价注册库（PROSPERO）注册号为CRD42020155295。
检索了1991年至2019年期间包括PubMed、PsycINFO和护理学与健康领域数据库（CINAHL）在内的数据库。纳入标准为：晚期癌症成年患者、针对症状管理的基于网络或移动设备的干预措施以及身体症状数据报告。使用“干预性研究的偏倚风险评估工具（ROBINS-I）”和“随机对照试验偏倚风险评估工具（RoB2）”评估偏倚风险。使用RevMan软件计算标准化均数差（SMD）和95%置信区间。使用卡方统计量评估异质性。通过评估交付模式、持续时间以及应用功能和理论要素的评价对干预措施进行评估。
系统评价共纳入19项研究，荟萃分析纳入18项研究。大多数研究被认为存在高偏倚风险。大多数干预措施使用网络应用程序进行教育（n = 17）。虽然干预措施在持续时间和内容方面各不相同，但主要以症状管理理论为指导。基于网络和移动设备的干预措施显著减轻了总体身体症状负担（SMD = -0.18；95%置信区间 = -0.28至-0.09；I² = 0%；P = 0.0002）。
基于网络和移动设备的干预措施在减轻晚期癌症患者的总体身体症状负担方面是有效的。
