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开展肿瘤外科候选者和患者远程康复的成功与挑战:回顾性试点队列研究。

Successes and challenges of implementing teleprehabilitation for onco-surgical candidates and patients' experience: a retrospective pilot-cohort study.

机构信息

Department of Anaesthesia, McGill University, Montreal, QC, Canada.

Department of Experimental Surgery, McGill University, Montreal, QC, Canada.

出版信息

Sci Rep. 2022 Apr 26;12(1):6775. doi: 10.1038/s41598-022-10810-y.

Abstract

This study documents the implementation of a multimodal teleprehabilitation program (e.g., completion rate, exercise metrics, and program successes and challenges) for cancer patients undergoing surgery. It also documents the patients' experience of the program. This pilot-cohort study included adults scheduled for elective thoracic and abdominal cancer resection surgery, referred to the prehabilitation clinic to engage in physical activity, and received a teleprehabilitation program between August 1st, 2020, and February 28th, 2021. The technology platform provided to the patients included a tablet and a wearable device to facilitate communication and data collection. Data collected for this article were acquired through virtual physical activity monitoring in addition to patient charts. Qualitative data collected comprised of successes and challenges of implanting a teleprehabilitation program, in addition to patients' perspectives of the program. Quantitative data collected comprised of the exercise metrics, perioperative functional outcomes, in addition to the surgical and postoperative outcomes. Ten patients (8 males and 2 females; mean age: 68.3 years, SD 11.96) diagnosed with various thoracoabdominal malignancies were included in the current descriptive study. The successes identified were related to recruitment and assessment, improvement in functional capacity, clinic scheduling and interventions, and optimal medical follow-up. The challenges identified were related to the adoption of the technologies by patients and the multidisciplinary team, the accurate acquisition of patient physical activity data, and the initial costs to acquire the new technologies. Patients were satisfied with the teleprehabilitation program (i.e., services delivered; average appreciation: 96%), and they perceived the technologies provided to be 90% user-friendly. The findings of the current study highlight important concepts in view of the current international health paradigm changes prioritizing remote interventions facilitated through digital communication technologies. It provides important insight into the clinical application of telehealth in elderly populations, notably in the context of acute preoperative cancer care. This article may provide guidance for other cancer care facilities aiming to implement teleprehabilitation programs.

摘要

本研究记录了多模式远程康复计划(例如,完成率、运动指标以及计划的成功和挑战)在接受手术的癌症患者中的实施情况。它还记录了患者对该计划的体验。这项试点队列研究包括计划接受择期胸部和腹部癌症切除术的成年人,他们被转介到康复诊所进行体育活动,并在 2020 年 8 月 1 日至 2021 年 2 月 28 日期间接受远程康复计划。提供给患者的技术平台包括平板电脑和可穿戴设备,以促进沟通和数据收集。本文中收集的数据除了患者图表外,还通过虚拟体力活动监测获得。收集的定性数据包括实施远程康复计划的成功和挑战,以及患者对该计划的看法。收集的定量数据包括运动指标、围手术期功能结果以及手术和术后结果。目前的描述性研究包括 10 名(8 名男性和 2 名女性;平均年龄:68.3 岁,标准差 11.96)被诊断患有各种胸腹恶性肿瘤的患者。确定的成功与招募和评估、功能能力的提高、诊所的安排和干预以及最佳的医疗随访有关。确定的挑战与患者和多学科团队对技术的采用、患者体力活动数据的准确获取以及获取新技术的初始成本有关。患者对远程康复计划(即提供的服务)表示满意(平均满意度:96%),他们认为提供的技术有 90%的用户友好性。本研究的结果强调了在当前国际卫生范式转变的背景下,优先考虑通过数字通信技术进行远程干预的重要概念。它为远程保健在老年人群中的临床应用提供了重要的见解,特别是在急性术前癌症护理的背景下。本文可为其他旨在实施远程康复计划的癌症护理机构提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edfc/9042918/8e461416a78b/41598_2022_10810_Fig1_HTML.jpg

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