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为准备接受大型癌症手术的患者实施远程医疗康复教育课程。

Implementing a telehealth prehabilitation education session for patients preparing for major cancer surgery.

机构信息

Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.

Department of Physiotherapy, The University of Melbourne, Melbourne, Australia.

出版信息

BMC Health Serv Res. 2021 May 10;21(1):443. doi: 10.1186/s12913-021-06437-w.

Abstract

BACKGROUND

Prehabilitation services assist patients in preparing for surgery, yet access to these services are often limited by geographical factors. Enabling rural and regional patients to access specialist surgical prehabilitation support with the use of telehealth technology has the potential to overcome health inequities and improve post-operative outcomes.

AIM

To evaluate the current and likely future impact of a telehealth preoperative education package for patients preparing for major abdominal cancer surgery.

METHODS

A telehealth alternative to a hospital based pre-operative education session was developed and implemented at a dedicated cancer hospital. Adult patients (≥18 years) scheduled for elective major cancer surgery were offered this telehealth alternative. Impact evaluation was conducted using the RE-AIM framework.

RESULTS

To date, 35 participants have consented to participate in the study. Thirty-one participants attended the intervention; 24 (69%) residing in rural or regional areas. Twenty-four (77%) reported that if given a choice they would prefer the online session as opposed to attending the hospital in person. The majority (97%) reported they would recommend the intervention to others preparing for surgery. Session information was recalled by all 26 participants and 77% of participants reported acting on recommendations 2 weeks after the session. Lessons learnt and recommendations for providers implementing similar programs are reported.

CONCLUSION

Telehealth alternatives to hospital based pre-operative education are well received by patients preparing for major cancer surgery. We make seven recommendations to improve implementation. Further evaluation of implementation strategies alongside clinical effectiveness in future studies is essential.

TRIAL REGISTRATION

ACTRN12620000096954 , 04/02/2020.

摘要

背景

康复服务可帮助患者为手术做准备,但由于地理位置的限制,这些服务往往难以获得。利用远程医疗技术使农村和地区患者能够获得专业的外科康复支持,有可能克服健康不平等问题并改善术后结果。

目的

评估一种针对准备接受大型腹部癌症手术的患者的远程医疗术前教育包目前和未来可能产生的影响。

方法

在一家专门的癌症医院开发并实施了一种替代传统医院术前教育课程的远程医疗方法。为计划接受择期大型癌症手术的成年患者(≥18 岁)提供这种远程医疗替代方案。使用 RE-AIM 框架进行影响评估。

结果

迄今为止,已有 35 名参与者同意参与该研究。31 名参与者参加了干预措施;24 名(69%)居住在农村或地区。24 名(77%)参与者表示,如果有选择,他们更愿意选择在线课程而不是亲自去医院。大多数(97%)参与者表示他们会向准备接受手术的其他人推荐该干预措施。所有 26 名参与者都回忆起了课程信息,77%的参与者表示在课程结束后两周内会根据建议采取行动。报告了为实施类似计划的提供者提供的经验教训和建议。

结论

准备接受大型癌症手术的患者对远程医疗替代传统医院术前教育的方法接受度较高。我们提出了七点建议以改进实施方法。在未来的研究中,有必要进一步评估实施策略及其对临床效果的影响。

试验注册

ACTRN12620000096954,2020 年 4 月 2 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b853/8111723/ae4222220c7f/12913_2021_6437_Fig1_HTML.jpg

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