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数字健康和远程医疗在癌症护理中的应用:系统评价综述。

Digital health and telehealth in cancer care: a scoping review of reviews.

机构信息

Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA.

Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.

出版信息

Lancet Digit Health. 2023 May;5(5):e316-e327. doi: 10.1016/S2589-7500(23)00049-3.

Abstract

The COVID-19 pandemic necessitated remote cancer care delivery via the internet and telephone, rapidly accelerating an already growing care delivery model and associated research. This scoping review of reviews characterised the peer-reviewed literature reviews on digital health and telehealth interventions in cancer published from database inception up to May 1, 2022, from PubMed, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Reviews, and Web of Science. Eligible reviews conducted a systematic literature search. Data were extracted in duplicate via a pre-defined online survey. Following screening, 134 reviews met the eligibility criteria. 77 of those reviews were published since 2020. 128 reviews summarised interventions intended for patients, 18 addressed family caregivers, and five addressed health-care providers. 56 reviews did not target a specific phase of the cancer continuum, whereas 48 reviews tended to address the active treatment phase. 29 reviews included a meta-analysis, with results showing positive effects on quality of life, psychological outcomes, and screening behaviours. 83 reviews did not report intervention implementation outcomes but when reported, 36 reported acceptability, 32 feasibility, and 29 fidelity outcomes. Several notable gaps were identified in these literature reviews on digital health and telehealth in cancer care. No reviews specifically addressed older adults, bereavement, or sustainability of interventions and only two reviews focused on comparing telehealth to in-person interventions. Addressing these gaps with rigorous systematic reviews might help guide continued innovation in remote cancer care, particularly for older adults and bereaved families, and integrate and sustain these interventions within oncology.

摘要

COVID-19 大流行需要通过互联网和电话提供远程癌症护理,这迅速加速了已经在增长的护理提供模式和相关研究。本范围综述对从数据库建立到 2022 年 5 月 1 日在 PubMed、Cumulated Index to Nursing and Allied Health Literature、PsycINFO、Cochrane Reviews 和 Web of Science 上发表的关于数字健康和远程医疗干预在癌症中的应用的同行评审文献综述进行了特征描述。合格的综述进行了系统的文献检索。通过预先定义的在线调查,对数据进行了重复提取。筛选后,有 134 篇综述符合资格标准。其中 77 篇综述发表于 2020 年之后。有 128 篇综述总结了针对患者的干预措施,18 篇综述涉及家庭照顾者,5 篇综述涉及医疗保健提供者。56 篇综述没有针对癌症连续体的特定阶段,而 48 篇综述倾向于解决主动治疗阶段。29 篇综述包括荟萃分析,结果显示对生活质量、心理结果和筛查行为有积极影响。83 篇综述没有报告干预实施结果,但当报告时,36 篇报告了可接受性,32 篇报告了可行性,29 篇报告了保真度结果。在这些关于癌症护理中数字健康和远程医疗的文献综述中,发现了几个值得注意的差距。没有综述专门针对老年人、丧亲或干预措施的可持续性,只有两篇综述关注远程医疗与面对面干预的比较。通过严格的系统综述来解决这些差距可能有助于指导远程癌症护理的持续创新,特别是对于老年人和丧亲家庭,并将这些干预措施整合和维持在肿瘤学中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/292f/10124999/cb0b32b593f2/gr1_lrg.jpg

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