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远程患者视频教育干预改善农村癌症患者护理协调的可行性

Feasibility of a Remote Patient Video Education Intervention to Improve Care Coordination for Rural Cancer Patients.

作者信息

Okado Izumi, Braun-Inglis Christa, Matsumoto Kehau, Elhajj Carry, Cassel Kevin, Berenberg Jeffrey, Holcombe Randall F

机构信息

University of Hawai'i Cancer Center, 701 Ilalo St., Honolulu, HI, 96813, USA.

University of Vermont Cancer Center, Burlington, VT, USA.

出版信息

J Cancer Educ. 2024 Dec 5. doi: 10.1007/s13187-024-02550-6.

Abstract

Cancer patients residing in rural areas experience substantial barriers to care and suboptimal care coordination. To date, there is a paucity of interventions to improve care coordination for rural cancer patients. In this study, we conducted a pilot trial to assess the feasibility and efficacy of a remote, tablet-based patient video education intervention focused on cancer care coordination among rural patients in Hawaii. The pilot trial utilized a single-arm, pre-post intervention design. Our TED-talk style video education intervention included talks on cancer basics, care coordination, and self-advocacy. Eligible participants were rural patients newly diagnosed with early-stage cancer receiving adjuvant therapy. Validated instruments were administered at baseline and post-intervention to assess patients' perceptions of care coordination and self-advocacy. Acceptability and satisfaction were assessed using semi-structured interviews. Descriptive statistics were used to describe study outcomes. From January 2022 to December 2022, 19 patients enrolled on the study; the mean age was 52.2. Participants were racially diverse. A total of 71.4% of eligible patients completed all assessments. No changes were observed in the overall perceptions of care coordination. However, improved scores were observed for the care coordination instrument communication domain (Cohen's d =  - 0.76, 95% CI: - 1.45, - 0.03). There was a trend for improved scores on navigation and self-advocacy. All participants reported high satisfaction with the intervention. Results support the feasibility, satisfaction, and acceptability of this intervention among rural cancer patients in Hawaii. Further study is needed to evaluate the intervention in other rural areas. Clinical Trial Registration: NCT05162404.Registration Date: 12/17/2021.

摘要

居住在农村地区的癌症患者在获得医疗服务和进行优化的医疗协调方面面临重大障碍。迄今为止,改善农村癌症患者医疗协调的干预措施很少。在本研究中,我们进行了一项试点试验,以评估一种基于平板电脑的远程患者视频教育干预措施在夏威夷农村患者中进行癌症医疗协调的可行性和有效性。该试点试验采用单组前后干预设计。我们的TED演讲风格的视频教育干预包括关于癌症基础知识、医疗协调和自我维权的讲座。符合条件的参与者是新诊断为早期癌症并接受辅助治疗的农村患者。在基线和干预后使用经过验证的工具来评估患者对医疗协调和自我维权的认知。使用半结构化访谈评估可接受性和满意度。描述性统计用于描述研究结果。从2022年1月到2022年12月,19名患者参与了该研究;平均年龄为52.2岁。参与者种族多样。共有71.4%的符合条件的患者完成了所有评估。在医疗协调的总体认知方面未观察到变化。然而,在医疗协调工具的沟通领域观察到得分有所提高(科恩d值=-0.76,95%置信区间:-1.45,-0.03)。在导航和自我维权方面有得分提高的趋势。所有参与者对该干预措施都表示高度满意。结果支持了该干预措施在夏威夷农村癌症患者中的可行性、满意度和可接受性。需要进一步研究以评估该干预措施在其他农村地区的效果。临床试验注册:NCT05162404。注册日期:2021年12月17日。

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