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针对上消化道癌的多学科康复计划的远程医疗服务:居家康复(ReStOre@Home)可行性研究

Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study.

作者信息

Brennan Louise, Sadeghi Fatemeh, O'Neill Linda, Guinan Emer, Smyth Laura, Sheill Grainne, Smyth Emily, Doyle Suzanne L, Timon Claire M, Connolly Deirdre, O'Sullivan Jacintha, Reynolds John V, Hussey Juliette

机构信息

Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, D08 W9RT Dublin, Ireland.

Trinity St. James's Cancer Institute, D08 NHY1 Dublin, Ireland.

出版信息

Cancers (Basel). 2022 May 30;14(11):2707. doi: 10.3390/cancers14112707.

Abstract

BACKGROUND

Telehealth has enabled access to rehabilitation throughout the pandemic. We assessed the feasibility of delivering a multi-disciplinary, multi-component rehabilitation programme (ReStOre@Home) to cancer survivors via telehealth.

METHODS

This single-arm mixed methods feasibility study recruited participants who had completed curative treatment for oesophago-gastric cancer for a 12-week telehealth rehabilitation programme, involving group resistance training, remotely monitored aerobic training, one-to-one dietetic counselling, one-to-one support calls and group education. The primary outcome was feasibility, measured by recruitment rates, attendance, retention, incidents, acceptability, Telehealth Usability Questionnaire (TUQ) and analysis of semi-structured interviews.

RESULTS

Characteristics of the twelve participants were: 65.42 ± 7.24 years; 11 male; 10.8 ± 3.9 months post-op; BMI 25.61 ± 4.37; received neoadjuvant chemotherapy 7/12; received adjuvant chemotherapy 4/12; hospital length of stay 16 days (median). Recruitment rate was 32.4%, and retention rate was 75%. Mean attendance was: education 90%; dietetics 90%; support calls 84%; resistance training 78%. Mean TUQ score was 4.69/5. Adaptations to the planned resistance training programme were required. Participants reported that ReStOre@Home enhanced physical and psychological wellbeing, and online delivery was convenient. Some reported a preference for in-person contact but felt that the online group sessions provided adequate peer support.

CONCLUSION

Telehealth delivery of ReStOre@Home was most feasible in individuals with moderate to high levels of digital skills. Low level of digitals skills was a barrier to recruitment and retention. Participants reported high levels of programme adherence and participant satisfaction. Adaptations to future programmes, including introducing elements of in-person contact, are required.

摘要

背景

在整个疫情期间,远程医疗使癌症幸存者能够获得康复治疗。我们评估了通过远程医疗为癌症幸存者提供多学科、多组成部分康复计划(居家康复计划)的可行性。

方法

这项单臂混合方法可行性研究招募了完成食管癌和胃癌根治性治疗的参与者,参加为期12周的远程医疗康复计划,该计划包括团体抗阻训练、远程监测的有氧训练、一对一的饮食咨询、一对一的支持电话和团体教育。主要结果是可行性,通过招募率、出勤率、留存率、事件发生率、可接受性、远程医疗可用性问卷(TUQ)以及对半结构化访谈的分析来衡量。

结果

12名参与者的特征如下:年龄65.42±7.24岁;男性11名;术后10.8±3.9个月;体重指数25.61±4.37;12人中有7人接受了新辅助化疗;12人中有4人接受了辅助化疗;住院时间16天(中位数)。招募率为32.4%,留存率为75%。平均出勤率为:教育课程90%;饮食咨询90%;支持电话84%;抗阻训练78%。TUQ平均得分为4.69/5。需要对计划的抗阻训练计划进行调整。参与者报告称,居家康复计划增强了身心健康,并且在线提供方式很方便。一些人表示更喜欢面对面接触,但觉得在线团体课程提供了足够的同伴支持。

结论

居家康复计划通过远程医疗实施,对数字技能水平中等至较高的个体最为可行。数字技能水平低是招募和留存的障碍。参与者报告称对该计划的依从性和满意度很高。未来的计划需要进行调整,包括引入面对面接触的元素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e18/9179413/e5d1384a7d12/cancers-14-02707-g001.jpg

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