Division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation, National University of Singapore, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
J Med Internet Res. 2022 Mar 29;24(3):e28724. doi: 10.2196/28724.
Cancer is likely to remain the most prevalent noncommunicable disease in high-income countries with an older population. Interestingly, no review of attitudes toward telemedicine among older adults has been performed. This is likely to be the group most affected by both cancer and the increasing use of technology in health care.
We aimed to map research on the acceptance of telemedicine among older adults who are cancer patients.
We conducted a scoping review. PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to September 2020. Articles were included if the study population had a mean or median age ≥65 years, with cancer diagnoses and if the study assessed patients' acceptance of a telemedicine intervention. Quantitative, qualitative, and mixed method studies were included.
Out of a total of 887 articles that were identified, 19 were included in the review. Interventions were delivered via telephone, videoconference, web portal, mobile app, wearable technology, and text messaging and included teleconsultation, monitoring and follow-up, psychosocial support and nursing care, and prompts. The most often cited facilitating factor was convenience. Other facilitators included an increase in telemedicine care accessibility, previous positive experiences of telemedicine, appropriate technical knowledge and support, decreased cost, physician recommendations, and privacy conferred by the telemedicine intervention. Barriers include a preference for conventional care along with negative perceptions of telemedicine, concerns about technical difficulties, and confidentiality concerns in the adoption of telemedicine.
None of the studies explored the ability of tailored interventions to address facilitators and barriers of the acceptance of telemedicine in order to increase its adoption by older adults. Facilitators and barriers will likely differ across different cultural contexts and by type of telemedicine; however, this is a gap in current knowledge. In-depth studies are necessary to determine if interventions could potentially address the barriers identified in this review, to increase acceptability.
癌症很可能仍然是高收入国家人口老龄化的最常见的非传染性疾病。有趣的是，目前尚未对老年人对远程医疗的态度进行综述。这很可能是受癌症和医疗保健中技术应用日益普及影响最大的群体。
我们旨在绘制癌症老年患者对远程医疗接受程度的研究图谱。
我们进行了范围综述。从创建到 2020 年 9 月，系统地检索了 PubMed、EMBASE、PsycINFO、CINAHL 和 Cochrane 对照试验中心注册库。如果研究人群的平均或中位年龄≥65 岁，患有癌症诊断，并且研究评估了患者对远程医疗干预的接受程度，则纳入研究。纳入了定量、定性和混合方法研究。
在总共确定的 887 篇文章中，有 19 篇文章被纳入综述。干预措施通过电话、视频会议、网络门户、移动应用程序、可穿戴技术和短信传递，包括远程咨询、监测和随访、心理社会支持和护理以及提示。最常被引用的促进因素是便利性。其他促进因素包括远程医疗护理可及性的提高、远程医疗的先前积极体验、适当的技术知识和支持、降低成本、医生推荐以及远程医疗干预带来的隐私。障碍包括对传统护理的偏好以及对远程医疗的负面看法、对技术困难的担忧以及对远程医疗采用的保密性担忧。
没有一项研究探讨量身定制的干预措施是否有能力解决接受远程医疗的促进因素和障碍，以增加老年人对远程医疗的采用。在不同的文化背景和远程医疗类型下，促进因素和障碍可能会有所不同；但是，这是当前知识的一个空白。需要进行深入研究，以确定干预措施是否有可能解决本综述中确定的障碍，从而提高可接受性。
