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基于远程医疗的癌症康复干预对残疾的影响:系统评价。

The influence of telehealth-based cancer rehabilitation interventions on disability: a systematic review.

机构信息

Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.

VA Central Office, Health Services Research and Development, 1100 1st St NE, Suite 6, Washington, DC, 20002, USA.

出版信息

J Cancer Surviv. 2023 Dec;17(6):1725-1750. doi: 10.1007/s11764-022-01181-4. Epub 2022 Feb 26.

Abstract

PURPOSE

To characterize delivery features and explore effectiveness of telehealth-based cancer rehabilitation interventions that address disability in adult cancer survivors.

METHODS

A systematic review of electronic databases (CINAHL Plus, Cochrane Library: Database of Systematic Reviews, Embase, National Health Service's Health Technology Assessment, PubMed, Scopus, Web of Science) was conducted in December 2019 and updated in April 2021.

RESULTS

Searches identified 3,499 unique studies. Sixty-eight studies met inclusion criteria. There were 81 unique interventions across included studies. Interventions were primarily delivered post-treatment and lasted an average of 16.5 weeks (SD = 13.1). They were most frequently delivered using telephone calls (59%), administered delivered by nursing professionals (35%), and delivered in a one-on-one format (88%). Risk of bias of included studies was primarily moderate to high. Included studies captured 55 measures of disability. Only 54% of reported outcomes had data that allowed calculation of effect sizes ranging -3.58 to 15.66.

CONCLUSIONS

The analyses suggest small effects of telehealth-based cancer interventions on disability, though the heterogeneity seen in the measurement of disability makes it hard to draw firm conclusions. Further research using more diverse samples, common measures of disability, and pragmatic study designs is needed to advance telehealth in cancer rehabilitation.

IMPLICATIONS FOR CANCER SURVIVORS

Telehealth-based cancer rehabilitation interventions have the potential to increase access to care designed to reduce disability across the cancer care continuum.

摘要

目的

描述基于远程医疗的癌症康复干预措施的传递特征,并探讨其在解决成年癌症幸存者残疾问题方面的有效性。

方法

我们对电子数据库(CINAHL Plus、Cochrane 图书馆:系统评价数据库、Embase、英国国家医疗服务体系的卫生技术评估、PubMed、Scopus、Web of Science)进行了系统回顾,检索工作于 2019 年 12 月进行,并于 2021 年 4 月进行了更新。

结果

搜索共确定了 3499 项独特的研究。68 项研究符合纳入标准。纳入的研究中有 81 项独特的干预措施。干预措施主要在治疗后进行,平均持续 16.5 周(标准差=13.1)。它们最常通过电话(59%)、护理专业人员(35%)和一对一形式(88%)提供。纳入研究的偏倚风险主要为中等到高度。纳入的研究共纳入了 55 项残疾评估指标。只有 54%的报告结果有数据可以计算效应大小,范围为-3.58 至 15.66。

结论

分析结果表明,基于远程医疗的癌症干预措施对残疾有较小的影响,但残疾评估的异质性使得难以得出明确的结论。需要进一步开展使用更广泛的样本、常见残疾评估指标和实用研究设计的研究,以推动癌症康复中的远程医疗。

对癌症幸存者的意义

基于远程医疗的癌症康复干预措施有可能增加在癌症护理连续体中提供旨在减少残疾的护理的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0875/8881759/c78365aa0442/11764_2022_1181_Fig1_HTML.jpg

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