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成人重症监护及危重症康复中的数字健康干预措施,以促进生存护理。

Digital health interventions in adult intensive care and recovery after critical illness to promote survivorship care.

作者信息

da Silva Alisha A, Merolli Mark, Fini Natalie A, Granger Catherine L, Gustafson Owen D, Parry Selina M

机构信息

Department of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.

Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, VIC, Australia.

出版信息

J Intensive Care Soc. 2025 Jan 4;26(1):96-104. doi: 10.1177/17511437241311105. eCollection 2025 Feb.

Abstract

Digital health refers to the field of using and developing technology to improve health outcomes. Digital health and digital health interventions (DHIs) within the area of intensive care and critical illness survivorship are rapidly evolving. Digital health interventions refer to technologies in clinical interventional format. A DHI could support clinicians with increasing clinical demands to have improved oversight of their patients' recovery trajectory or potential for deterioration, improve efficiency of healthcare delivery, and/or predict patient outcomes. In this narrative review, DHIs are explored across the continuum from in the ICU (recognising and managing clinical deterioration, identifying individuals at risk of poor recovery outcomes, tailoring care of the ICU patient and supporting the emotional needs of their family) through to integration in the primary care setting (adjuncts to ICU follow-up clinics and tracking, coaching and remote monitoring). Some of the DHIs discussed in this narrative review (to name a few) include interventions delivered via: Telehealth, artificial intelligence, wearable devices, virtual reality, and mobile phone applications (apps). Additionally, exploration of DHIs used successfully in other health fields are discussed to highlight potential opportunities for adaptation to the ICU context. Finally, the review provides an overview of considerations needed in the development of new DHIs. Development should consider the intended user, barriers to technology engagement and design. In the implementation of a new DHI, the World Health Organization (WHO) Global Strategy on Digital Health and appropriate evaluation should be considered prior to scaling up. Optimal implementation of DHIs could help address the key challenges of the ICU field.

摘要

数字健康是指利用和开发技术以改善健康结果的领域。重症监护和危重症幸存者领域内的数字健康及数字健康干预措施(DHI)正在迅速发展。数字健康干预措施是指临床干预形式的技术。一项数字健康干预措施可以帮助临床医生应对不断增加的临床需求,更好地监督患者的康复轨迹或恶化可能性,提高医疗服务效率,和/或预测患者预后。在这篇叙述性综述中,我们探讨了从重症监护病房(识别和管理临床恶化情况、识别康复结果不佳风险个体、为重症监护病房患者量身定制护理并满足其家属的情感需求)到初级保健环境整合(重症监护病房随访诊所的辅助手段以及跟踪、指导和远程监测)整个连续过程中的数字健康干预措施。这篇叙述性综述中讨论的一些数字健康干预措施(仅举几例)包括通过以下方式实施的干预措施:远程医疗、人工智能、可穿戴设备、虚拟现实和手机应用程序(应用)。此外,还讨论了在其他健康领域成功应用的数字健康干预措施,以突出适用于重症监护病房环境的潜在机会。最后,该综述概述了开发新的数字健康干预措施所需考虑的因素。开发应考虑目标用户、技术应用障碍和设计。在实施一项新的数字健康干预措施时,扩大规模之前应考虑世界卫生组织(WHO)的数字健康全球战略和适当的评估。数字健康干预措施的最佳实施有助于应对重症监护病房领域的关键挑战。

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