开发一种可行且可接受的数字化术前康复路径，以改善择期手术的结果。

Development of a feasible and acceptable digital prehabilitation pathway to improve elective surgical outcomes.

作者信息

Linedale Ecushla C, Bills Eleanor, Dimopoulos Anastasia, Yeoh Jackie, Nolan Mandy, Hume Vicki, Coles Sharyn, Andrews Jane M

机构信息

Health Translation SA, South Australian Health and Medical Research Institute, Adelaide, Australia.

Faculty of Health Sciences, School of Medicine, The University of Adelaide, Adelaide, Australia.

出版信息

Front Digit Health. 2023 Feb 9;5:1054894. doi: 10.3389/fdgth.2023.1054894. eCollection 2023.

DOI:10.3389/fdgth.2023.1054894

PMID:36845335

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9947781/

Abstract

OBJECTIVES

To codesign and assess the feasibility, acceptability, and appropriateness of a hospital-initiated, community delivered approach to health optimization (prehab) prior to planned surgery.

DESIGN

Participatory codesign combined with a prospective, observational cohort study (April-July 2022).

SETTING

A large metropolitan tertiary referral service with 2 participating hospitals.

PARTICIPANTS

All people referred for orthopaedic assessment for joint replacement surgery (hip or knee) triaged as category 2 or 3. Exclusions: category 1; no mobile number. Response rate 80%.

INTERVENTION

is a digitally enabled pathway that screens participants for modifiable risk factors for post-operative complications and provides tailored information to enable health optimization prior to surgery with the help of their regular doctor.

OUTCOME MEASURES

Acceptability, feasibility, appropriateness, and engagement with the program.

RESULTS

36/45 (80%) registered for the program (ages 45-85 yrs.), completed the health-screening survey and had ≥1 modifiable risk factor. Eighteen responded to the consumer experience questionnaire: 11 had already seen or scheduled an appointment with their General Practitioner and 5 planned to. 10 had commenced prehab and, 7 planned to. Half indicated they were likely ( = 7) or very likely ( = 2) to recommend to others. The scored an average 3.4 (SD 0.78) for acceptability, 3.5 (SD 0.62) for appropriateness, and 3.6 (SD 0.61) for feasibility, out of a score of 5.

CONCLUSIONS

This digitally delivered intervention is acceptable, appropriate, and feasible to support a hospital-initiated, community-based prehab program.

摘要

目的

共同设计并评估一种由医院发起、社区实施的术前健康优化（术前康复）方法的可行性、可接受性和适宜性。

设计

参与式共同设计结合前瞻性观察队列研究（2022年4月至7月）。

地点

一家拥有两家参与医院的大型都市三级转诊服务机构。

参与者

所有因关节置换手术（髋关节或膝关节）接受骨科评估且被分诊为2类或3类的患者。排除标准：1类；无手机号码。回复率80%。

干预措施

是一种数字化途径，对参与者进行术后并发症可改变风险因素的筛查，并在其常规医生的帮助下提供量身定制的信息，以实现术前的健康优化。

结局指标

该项目的可接受性、可行性、适宜性和参与度。

结果

45名参与者中有36名（80%）注册了该项目（年龄在45 - 85岁之间），完成了健康筛查调查，且有≥1个可改变的风险因素。18人回复了消费者体验问卷：11人已经看过全科医生或已预约，5人计划预约。10人已开始术前康复，7人计划开始。一半的人表示他们很可能（n = 7）或非常可能（n = 2）会向其他人推荐。该项目在5分制中的可接受性平均得分为3.4（标准差0.78），适宜性得分为3.5（标准差0.62），可行性得分为3.6（标准差0.61）。