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头颈部癌症随访中远程监测应用的评估。

Evaluation of a remote monitoring app in head and neck cancer follow-up care.

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.

Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.

出版信息

Cancer Med. 2023 Jul;12(14):15552-15566. doi: 10.1002/cam4.6202. Epub 2023 Jun 9.

Abstract

BACKGROUND

A remote monitoring app was developed for head and neck cancer (HNC) follow-up during the SARS-CoV-2 pandemic. This mixed-methods study provides insight in the usability and patients' experiences with the app to develop recommendations for future use.

METHODS

Patients were invited to participate if they were treated for HNC, used the app at least once and were in clinical follow-up. A subset was selected for semi-structured interviews through purposive sampling considering gender and age. This study was conducted between September 2021-May 2022 at a Dutch university medical center.

RESULTS

135 of the 216 invited patients completed the questionnaire, resulting in a total mHealth usability score of 4.72 (± 1.13) out of 7. Thirteen semi-structured interviews revealed 12 barriers and 11 facilitators. Most of them occurred at the level of the app itself. For example, patients received no feedback when all their answers were normal. The app made patients feel more responsible over their follow-up, but could not fulfill the need for personal contact with the attending physician. Patients felt that the app could replace some of the outpatient follow-up visits.

CONCLUSIONS

Our app is user-friendly, makes patients feel more in control and remote monitoring can reduce the frequency of outpatient follow-up visits. The barriers that emerged must be resolved before the app can be used in regular HNC follow-up. Future studies should investigate the appropriate ratio of remote monitoring to outpatient follow-up visits and the cost-effectiveness of remote monitoring in oncology care on a larger scale.

摘要

背景

在 SARS-CoV-2 大流行期间,开发了一款用于头颈部癌症(HNC)随访的远程监测应用程序。这项混合方法研究深入了解了该应用程序的可用性和患者体验,为未来的使用提出了建议。

方法

邀请接受 HNC 治疗、至少使用过一次应用程序且正在临床随访的患者参与。通过目的抽样,根据性别和年龄选择一部分患者进行半结构化访谈。这项研究于 2021 年 9 月至 2022 年 5 月在荷兰一所大学医学中心进行。

结果

216 名受邀患者中有 135 名完成了问卷,总体 mHealth 可用性评分为 7 分中的 4.72(±1.13)。13 次半结构化访谈揭示了 12 个障碍和 11 个促进因素。其中大部分发生在应用程序本身的层面。例如,当所有答案都正常时,患者没有收到反馈。该应用程序使患者对随访更加负责,但无法满足与主治医生进行个人接触的需求。患者认为该应用程序可以替代部分门诊随访。

结论

我们的应用程序易于使用,使患者感到更能掌控自己的病情,远程监测可以减少门诊随访的频率。出现的障碍在该应用程序可用于常规 HNC 随访之前必须得到解决。未来的研究应在更大规模上调查远程监测与门诊随访的适当比例以及远程监测在肿瘤学护理中的成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec75/10417106/4482288fa581/CAM4-12-15552-g001.jpg

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