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评估远程医疗在乳腺癌手术后淋巴水肿和肩部功能障碍的教育和监测中的应用。

Evaluating telehealth for the education and monitoring of lymphoedema and shoulder dysfunction after breast cancer surgery.

机构信息

Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia.

Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.

出版信息

Support Care Cancer. 2023 Mar 28;31(4):239. doi: 10.1007/s00520-023-07693-8.

Abstract

PURPOSE

The primary aim of this study was to compare the attendance rates at a group lymphoedema education and same-day individual surveillance appointment between telehealth (TH) and in-person (IP) care for participants following breast cancer (BC) surgery. Secondary aims included evaluating participant satisfaction and costs between the two service models, while also determining the extent of technical issues and clinician satisfaction towards TH.

METHODS

Participants following axillary lymph node dissection surgery attended a group lymphoedema education and same-day 1:1 monitoring session via their preferred mode (TH or IP). Attendance rates, satisfaction and costs were recorded for both cohorts, and technical disruption and clinician satisfaction for the TH cohort.

RESULTS

Fifty-five individuals participated. All 28 participants who nominated the IP intervention attended, while 22/27 who nominated the TH intervention attended an appointment. Overall reported participant experience was positive with no significant differences between cohorts. All TH appointments were successfully completed. Clinicians reported high satisfaction for delivery of education (median = 4[IQR 4-5]) and individual assessment (median = 4[IQR 3-4]) via TH. Median attendance costs per participant were Australian $39.68 (Q1-Q3 $28.52-$68.64) for TH and Australian $154.26 (Q1-Q3 $81.89-$251.48) for the IP cohort.

CONCLUSION

Telehealth-delivered lymphoedema education and assessment for individuals following BC surgery was associated with favourable satisfaction, cost savings and minimal technical issues despite lower attendance than IP care. This study contributes to the growing evidence for TH and its potential applicability to other populations where risk for cancer-related lymphoedema exists.

摘要

目的

本研究的主要目的是比较乳腺癌(BC)手术后接受群组淋巴水肿教育和同日个人监测预约的患者在远程医疗(TH)和面对面(IP)护理之间的就诊率。次要目标包括评估两种服务模式之间的患者满意度和成本,同时确定 TH 技术问题和临床医生满意度的程度。

方法

接受腋窝淋巴结清扫术的参与者通过他们首选的模式(TH 或 IP)参加群组淋巴水肿教育和同日 1:1 监测。记录了两组的就诊率、满意度和成本,以及 TH 组的技术中断和临床医生满意度。

结果

共有 55 名参与者。所有提名 IP 干预的 28 名参与者都参加了,而提名 TH 干预的 22/27 名参与者参加了预约。所有 TH 预约均成功完成。临床医生报告说,通过 TH 提供教育(中位数=4[IQR 4-5])和个人评估(中位数=4[IQR 3-4])的满意度很高。每名参与者的 TH 就诊费用中位数为澳大利亚 39.68 美元(Q1-Q3 28.52-68.64 美元),而 IP 组的中位数为 154.26 美元(Q1-Q3 81.89-251.48 美元)。

结论

尽管与 IP 护理相比,TH 组的就诊率较低,但对于接受 BC 手术后的个体进行远程医疗淋巴水肿教育和评估与良好的满意度、成本节约和最小的技术问题相关。本研究为 TH 的不断发展的证据做出了贡献,并且其可能适用于存在癌症相关淋巴水肿风险的其他人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ecd/10042668/fe4b30d2f13c/520_2023_7693_Fig1_HTML.jpg

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