University of Michigan School of Nursing, MI, USA.
University of Michigan School of Nursing, MI, USA.
J Geriatr Oncol. 2023 Nov;14(8):101652. doi: 10.1016/j.jgo.2023.101652. Epub 2023 Oct 21.
Digital health interventions (DHIs) are promising to support older adults with cancer in managing their conditions and improving their health outcomes. However, there is a lack of overall understanding of various DHIs for the aging population with cancer. Specifically, it is unclear how personalization components are included in those DHIs to promote engagement in the interventions among older adults with cancer. This study aimed to provide a comprehensive overview of existing DHIs for older adults with cancer and identify the intervention components, especially personalized features, and effectiveness of these DHIs for improving self-management and psychosocial health.
A scoping review was conducted following Joanna Briggs Institute guidelines, focusing on older adults diagnosed with cancer who participated in DHIs to improve self-management and psychosocial health. Studies using an experimental design and published from 2000 to January 2023 were retrieved from four databases: PubMed, Embase, CINAHL, and Scopus. After primary data extraction of study characteristics, participants, interventions, and outcomes, DHIs were categorized according to personalized features.
Out of 9,750 articles, 20 were eligible for this scoping review. The main personalized features of DHIs were categorized into four domains: goal setting, adjusting the plan, data-driven approaches, and motivating behavioral changes. Self-management outcomes were focused on physical activity, diet, and symptom management. Quality of life, depression, and anxiety were addressed as psychosocial health-related outcomes. Although no consistent results were reported on the effectiveness, DHIs with a combination of multiple personalized features, more than three domains, were likely to be more effective in improving self-management outcomes.
This review enhances the understanding of personalized DHIs for older adults with cancer by identifying intervention components, personalized features, and effectiveness on self-management and psychosocial health. Several gaps were identified, including the absence of targeted studies exclusively focusing on older adults, a relative scarcity of personalized features for improving patient engagement, a lack of understanding of the mechanism of effective personalized features, and the necessity for more experimental studies. Addressing these gaps can contribute to improving health outcomes and the quality of care for older adults with cancer by providing the direction for developing effective DHIs.
数字健康干预(DHIs)有望帮助癌症老年患者管理病情并改善健康结局。然而,对于癌症老年患者的各种 DHI 缺乏全面了解。具体来说,尚不清楚这些 DHI 中包含哪些个性化组件来促进癌症老年患者参与干预。本研究旨在提供癌症老年患者现有 DHI 的全面概述,并确定干预组件,特别是个性化功能,以及这些 DHI 改善自我管理和心理社会健康的效果。
根据 Joanna Briggs 研究所指南进行了范围综述,重点关注参与改善自我管理和心理社会健康的 DHI 的癌症确诊老年患者。从四个数据库(PubMed、Embase、CINAHL 和 Scopus)中检索到 2000 年至 2023 年 1 月期间采用实验设计并发表的研究。在对研究特征、参与者、干预措施和结果进行初步数据提取后,根据个性化特征对 DHI 进行分类。
在 9750 篇文章中,有 20 篇符合本范围综述的标准。DHIs 的主要个性化特征分为四个领域:目标设定、调整计划、数据驱动方法和促进行为改变。自我管理结果侧重于身体活动、饮食和症状管理。生活质量、抑郁和焦虑是心理社会健康相关的结果。尽管没有报告关于有效性的一致结果,但具有多种个性化特征、超过三个领域的 DHI 更有可能改善自我管理结果。
本综述通过确定干预组件、个性化特征以及对自我管理和心理社会健康的有效性,增进了对癌症老年患者个性化 DHI 的理解。研究还确定了一些差距,包括缺乏专门针对老年患者的针对性研究、改善患者参与度的个性化特征相对较少、对有效个性化特征的作用机制缺乏了解以及需要更多的实验研究。解决这些差距可以通过为开发有效的 DHI 提供方向来改善癌症老年患者的健康结局和护理质量。