Kane Kathleen, Kennedy Fiona, Absolom Kate L, Harley Clare, Velikova Galina
Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
BMJ Support Palliat Care. 2023 Dec 7;13(e2):e221-e234. doi: 10.1136/bmjspcare-2020-002820.
As treatments continue to progress, patients with advanced cancer are living longer. However, ongoing physical side-effects and psychosocial concerns can compromise quality of life (QoL). Patients and physicians increasingly look to the internet and other technologies to address diverse supportive needs encountered across this evolving cancer trajectory.
Relevant studies were identified through electronic database searches (MEDLINE, PsychINFO, Embase, CINAHL, CENTRAL, Web of Science and ProQuest) and handsearching. Findings were collated and explored through narrative synthesis.
Of 5274 identified records, 37 articles were included. Interventions were evaluated within studies targeting advanced cancer (13) or encompassing all stages (24). Five subtypes emerged: Interactive Health Communication Applications (n=12), virtual programmes of support (n=11), symptom monitoring tools (n=8), communication conduits (n=3) and information websites (n=3). Modes of delivery ranged from self-management to clinically integrated. Support largely targeted psychosocial well-being, alongside symptom management and healthy living. Most studies (78%) evidenced varying degrees of efficacy through QoL and psychosocial measures. Intervention complexity made it challenging to distinguish the most effective components. Incomplete reporting limited risk of bias assessment.
While complex and varied in their content, features and delivery, most interventions led to improvements in QoL or psychosocial well-being across the cancer trajectory. Ongoing development and evaluation of such innovations should specifically target patients requiring longer-term support for later-stage cancer.
CRD42018089153.
随着治疗方法不断进步，晚期癌症患者的生存期越来越长。然而，持续存在的身体副作用和心理社会问题会影响生活质量（QoL）。患者和医生越来越多地借助互联网和其他技术来满足这一不断演变的癌症病程中遇到的各种支持需求。
通过电子数据库检索（MEDLINE、PsychINFO、Embase、CINAHL、CENTRAL、Web of Science和ProQuest）及手工检索确定相关研究。通过叙述性综合分析对研究结果进行整理和探讨。
在检索到的5274条记录中，纳入了37篇文章。这些干预措施在针对晚期癌症的研究（13项）或涵盖所有阶段的研究（24项）中得到评估。出现了五种亚型：交互式健康交流应用程序（n = 12）、虚拟支持项目（n = 11）、症状监测工具（n = 8）、交流渠道（n = 3）和信息网站（n = 3）。提供方式从自我管理到临床整合不等。支持主要针对心理社会幸福感，同时也包括症状管理和健康生活。大多数研究（78%）通过生活质量和心理社会指标证明了不同程度的疗效。干预措施的复杂性使得难以区分最有效的组成部分。报告不完整限制了偏倚风险评估。
虽然这些干预措施在内容、特点和提供方式上复杂多样，但大多数干预措施在整个癌症病程中都能改善生活质量或心理社会幸福感。对此类创新的持续开发和评估应特别针对需要对晚期癌症进行长期支持的患者。
PROSPERO注册号：CRD42018089153。
