基于移动医疗应用程序的干预措施，以改善正在接受化疗的乳腺癌患者的化疗相关症状自我管理：系统评价。
Mobile Health Application-Based Interventions to Improve Self-management of Chemotherapy-Related Symptoms Among People with Breast Cancer Who Are Undergoing Chemotherapy: A Systematic Review.
机构信息
School of Nursing, Dalian Medical University, Dalian, China.
School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
出版信息
Oncologist. 2023 Apr 6;28(4):e175-e182. doi: 10.1093/oncolo/oyac267.
BACKGROUND
Since the COVID-19 pandemic, there have been an increasing number of studies on using mobile health (mHealth) to support the symptom self-management of patients with breast cancer (BC). However, the components of such programs remain unexplored. This systematic review aimed to identify the components of existing mHealth app-based interventions for patients with BC who are undergoing chemotherapy and to uncover self-efficacy enhancement elements from among them.
METHODS
A systematic review was conducted for randomized controlled trials published from 2010 to 2021. Two strategies were used to assess the mHealth apps: The Omaha System, a structured classification system for patient care, and Bandura's self-efficacy theory, which assesses sources of influence that determine an individual's confidence in being able to manage a problem. Intervention components identified in the studies were grouped under the 4 domains of the intervention scheme of the Omaha System. Four hierarchical sources of self-efficacy enhancement elements were extracted from the studies using Bandura's self-efficacy theory.
RESULTS
The search uncovered 1,668 records. Full-text screening was conducted on 44 articles, and 5 randomized controlled trials (n = 537 participants) were included. Self-monitoring under the domain of "Treatments and procedure" was the most frequently used mHealth intervention for improving symptom self-management in patients with BC undergoing chemotherapy. Most mHealth apps used various "mastery experience" strategies including reminders, self-care advice, videos, and learning forums.
CONCLUSION
Self-monitoring was commonly utilized in mHealth-based interventions for patients with BC undergoing chemotherapy. Our survey uncovered evident variation in strategies to support self-management of symptoms and standardized reporting is required. More evidence is required to make conclusive recommendations related to mHealth tools for BC chemotherapy self-management.
背景
自 COVID-19 大流行以来，越来越多的研究使用移动健康（mHealth）来支持乳腺癌（BC）患者的症状自我管理。然而，这些项目的组成部分仍未得到探索。本系统评价旨在确定正在接受化疗的 BC 患者基于移动健康应用程序的干预措施的现有组成部分，并从中发现自我效能增强要素。
方法
对 2010 年至 2021 年发表的随机对照试验进行了系统评价。使用了两种策略来评估 mHealth 应用程序：奥马哈系统，这是一种针对患者护理的结构化分类系统，以及班杜拉的自我效能理论，该理论评估了确定个体管理问题的信心的影响来源。研究中确定的干预组成部分根据奥马哈系统的干预方案的 4 个领域进行了分组。使用班杜拉的自我效能理论，从研究中提取了四个层次的自我效能增强要素来源。
结果
搜索共发现 1668 条记录。对 44 篇文章进行了全文筛选，纳入了 5 项随机对照试验（n = 537 名参与者）。在“治疗和程序”领域进行自我监测是改善正在接受化疗的 BC 患者症状自我管理的最常用 mHealth 干预措施。大多数 mHealth 应用程序使用了各种“掌握经验”策略，包括提醒、自我护理建议、视频和学习论坛。
结论
在正在接受化疗的 BC 患者的基于 mHealth 的干预措施中，自我监测被广泛使用。我们的调查发现，支持症状自我管理的策略存在明显差异，需要进行标准化报告。需要更多的证据来提出关于 BC 化疗自我管理的 mHealth 工具的明确建议。
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