Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Support Care Cancer. 2021 Dec;29(12):7617-7626. doi: 10.1007/s00520-021-06357-9. Epub 2021 Jun 16.
This study assessed adherence to, feasibility of, and barriers and facilitators of implementation of an app developed to monitor and follow-up with pain in children with cancer at home.
Children (8-18 years) receiving cancer treatment (all diagnoses) or their parents (of children aged 0-7 years) used the KLIK Pain Monitor app for 3 weeks. Pain was assessed twice daily using an 11-point numeric rating scale (NRS-11) (ranging from 0 to 10). Healthcare professionals (HCP's) from the hospital's Pediatric Pain Service were instructed to follow-up with clinically significant pain scores (≥ 4) within 120 min (scores 4-6) or 30 min (scores 7-10). Adherence, feasibility, and implementation outcomes were assessed using questionnaires, app log data, and interviews.
Twenty-seven children (M age = 7.3 years, 51.8% male) and six HCP's participated. Sixty-three percent (N = 17) of families used the app on a daily basis during three weeks, and 18.5% (N = 5) reported pain scores twice daily during that time (family adherence). Twelve out of 27 children (44.4%) reported a clinically significant pain score at least once. In 70% (14/20) of clinically significant pain scores, HCP's followed-up with families within the set timeframe (HCP adherence). Outcomes reveal feasibility for the majority of app functions (i.e., positive evaluation by ≥ 70% families/HCP's), and non-feasible aspects could be resolved. Identified barriers and facilitators were used to improve future implementation efforts.
Use of the KLIK Pain Monitor app seems feasible. Future research will determine its effectiveness in reducing pain in children with cancer at home.
本研究评估了一款应用程序的依从性、实施的可行性以及实施过程中的障碍和促进因素,该应用程序旨在用于在家中监测和随访癌症儿童的疼痛。
接受癌症治疗的儿童(8-18 岁)或其父母(年龄在 0-7 岁的儿童)使用 KLIK 疼痛监测应用程序 3 周。使用 11 点数字评分量表(NRS-11)(范围为 0 到 10)每天两次评估疼痛。医院儿科疼痛服务的医疗保健专业人员(HCP)被指示在 120 分钟内(评分 4-6)或 30 分钟内(评分 7-10)对临床显著疼痛评分(≥4)进行随访。使用问卷、应用程序日志数据和访谈评估依从性、可行性和实施结果。
27 名儿童(M 年龄=7.3 岁,51.8%为男性)和 6 名 HCP 参与了研究。63%(N=17)的家庭在三周内每天使用该应用程序,18.5%(N=5)在这段时间内每天报告两次疼痛评分(家庭依从性)。27 名儿童中有 12 名(44.4%)至少报告了一次临床显著疼痛评分。在 20 次临床显著疼痛评分中,70%(14/20)的 HCP 在设定的时间内对家庭进行了随访(HCP 依从性)。研究结果表明,该应用程序的大多数功能具有可行性(即,≥70%的家庭/HCP 给予积极评价),并且可以解决一些不可行的方面。确定的障碍和促进因素将用于改进未来的实施工作。
使用 KLIK 疼痛监测应用程序似乎是可行的。未来的研究将确定其在家中减轻癌症儿童疼痛的有效性。