移动健康对口腔颌面肿瘤患者术后生活质量、自我管理及功能障碍的影响:非随机对照试验
Impact of mHealth on Postoperative Quality of Life, Self-Management, and Dysfunction in Patients With Oral and Maxillofacial Tumors: Nonrandomized Controlled Trial.
作者信息
Li Yufei, Wang Yueping, Wu Yifan, Yu Hong, Yao Hua, Wang Yuqun, Yin Yulan, Wang Lan, Hou Lili
机构信息
School of Nursing, Shanghai JiaoTong University, Shanghai, China.
Department of Nursing, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Bldg 8, 2nd Fl, 639 Manufacturing Bureau Road, Huangpu district, Shanghai, China, 86 13816033620.
出版信息
JMIR Mhealth Uhealth. 2025 Jun 25;13:e59926. doi: 10.2196/59926.
BACKGROUND
With a focus on postoperative dysfunctions that may occur after maxillofacial tumor resection and the difficulties faced during home rehabilitation, we developed a mobile health app based on nurse-patient cooperation. The app extends rehabilitation care from hospital to home with the help of artificial intelligence, Internet of Things, and other technologies, thus helping patients to better carry out their home functional rehabilitation and meet their health needs.
OBJECTIVE
The primary objective of this quasi-experimental study is to evaluate the impact of the Intelligent Home Rehabilitation Care Platform on the quality of life, self-management, and functional impairment in patients with oral and maxillofacial head and neck tumors. We aim to determine whether the intervention through this platform can lead to significant improvements in these areas compared with traditional postdischarge care methods.
METHODS
In this study, patients with oral and maxillofacial head and neck tumors who had undergone surgery were recruited from allied hospitals in the Yangtze River Delta region, divided into an experimental group (n=138) and a control group (n=123), and received either the Intelligent Home Rehabilitation Care Platform intervention or the conventional health care and guidance, respectively. The intervention lasted 3 months, and the patients' quality of life, self-management efficacy, and improvement in dysfunction were assessed at 1 week (baseline), 1 month (T1), and 3 months (T2) postoperatively. SPSS software (IBM Corp) was used to perform the chi-square test, rank sum test, t test, repeated-measures ANOVA, and generalized estimation equation for data analysis.
RESULTS
We analyzed the effects of the quality of life and self-management using the generalized estimating equation method. The generalized estimating equation results showed that after adjusting for age, sex, pathological histology, cancer stage, and primary site, the intervention group had a significantly higher improvement in quality of life than the control group at the T2 (regression coefficient, β=-68.020, 95 % CI -116.639 to -19.412; P=.006) stage. The degree of improvement in self-management efficacy was significantly higher in the T1 (regression coefficient, β =-7.030, 95 % CI -9.540 to -4.520; P<.001) and T2 (regression coefficient, β =-13.245, 95 % CI -16.923 to -9.566; P<.001) stages than in the control group. The results of repeated-measures ANOVA and rank sum test showed that the experimental group showed improvements in shoulder function, dysphagia, and trismus after mHealth intervention; however, the differences were not significant.
CONCLUSIONS
The Intelligent Home Rehabilitation Care Platform interventions can effectively enhance patients' self-management efficacy, improving quality of life and facilitate recovery from dysfunctions. Therefore, mHealth may be used in oncology care to provide smarter home self-care for patients.
背景
针对颌面肿瘤切除术后可能出现的功能障碍以及家庭康复中面临的困难,我们开发了一款基于护患合作的移动健康应用程序。该应用借助人工智能、物联网等技术,将康复护理从医院延伸至家庭,从而帮助患者更好地进行家庭功能康复,满足其健康需求。
目的
本准实验研究的主要目的是评估智能家庭康复护理平台对口腔颌面头颈肿瘤患者生活质量、自我管理能力和功能障碍的影响。我们旨在确定通过该平台进行干预与传统出院后护理方法相比,是否能在这些方面带来显著改善。
方法
在本研究中,从长江三角洲地区的联盟医院招募接受过手术的口腔颌面头颈肿瘤患者,分为实验组(n = 138)和对照组(n = 123),分别接受智能家庭康复护理平台干预或常规医疗保健与指导。干预持续3个月,在术后1周(基线)、1个月(T1)和3个月(T2)评估患者的生活质量、自我管理效能以及功能障碍改善情况。使用SPSS软件(IBM公司)进行卡方检验、秩和检验、t检验、重复测量方差分析和广义估计方程进行数据分析。
结果
我们使用广义估计方程方法分析了生活质量和自我管理的效果。广义估计方程结果显示,在调整年龄、性别、病理组织学、癌症分期和原发部位后,干预组在T2阶段的生活质量改善显著高于对照组(回归系数,β = -68.020,95%CI -116.639至-19.412;P = 0.006)。自我管理效能的改善程度在T1(回归系数,β = -7.030,95%CI -9.540至-4.520;P < 0.001)和T2(回归系数,β = -13.245,95%CI -16.923至-9.566;P < 0.001)阶段显著高于对照组。重复测量方差分析和秩和检验结果显示,移动健康干预后实验组的肩部功能、吞咽困难和张口受限有所改善;然而,差异不显著。
结论
智能家庭康复护理平台干预可有效提高患者的自我管理效能,改善生活质量并促进功能障碍的恢复。因此,移动健康可用于肿瘤护理,为患者提供更智能的家庭自我护理。
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本文引用的文献
CA Cancer J Clin. 2024
Healthc Inform Res. 2022-10
J Patient Exp. 2022-4-13
J Oral Biol Craniofac Res. 2022