Feasibility of a mobile and web-based intervention to support self-management in outpatients with cancer pain
Feasibility of a mobile and web-based intervention to support self-management in outpatients with cancer pain
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DOI：
10.1016/j.ejon.2016.03.009
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发表时间：
2016-08-01
影响因子：
2.8
通讯作者：
de Witte, Luc P.
中科院分区：
文献类型：
--
作者：
Hochstenbach, Laura M. J.;Zwakhalen, Sandra M. G.;de Witte, Luc P.
目的：癌症疼痛是一种普遍而痛苦的症状。为了加强门诊病人的自我管理，我们开发了一种多成分干预措施，通过医疗保健技术将病人的自我管理和专业护理结合起来。本文描述了日常实践中干预的可行性。方法：中重度癌性疼痛患者（n = 11）和专门从事疼痛和姑息治疗的注册护士（n = 3）参加为期四周的研究。干预措施包括日常监测、图形化反馈、教育和建议，通过患者的移动应用程序和护士的网络应用程序进行。采用20项问卷（1-5量表）对患者的易学性、可用性和可取性进行测量，得分越高说明可行性越好。患者的依从性基于服务器日志的完成率。对患者的单一半结构化访谈和对护士的焦点小组访谈提供了对经验的深入了解。结果：问卷调查结果证实了患者应用程序的易学性（4.8），可用性（4.8）和可取性（4.6）。疼痛监测的平均完成率为76.8%，药物监测为50.4%，教育课程为100%。采访显示，患者对移动应用程序的简单性感到满意，并欣赏不同的组件。护士们同意这种附加价值，并且对网络应用的可能性大多持积极态度。患者和护士对干预的内容和技术表现提出了改进意见。结论：研究结果表明干预在日常实践中是可行的。只要在内容和技术上进行调整，干预可以使癌症疼痛患者进行自我管理，护士可以远程支持这些患者。(C) 2016年作者。Elsevier Ltd.出版。
Purpose: Cancer pain is a prevalent and distressing symptom. To enhance self-management in outpatients, a multi-component intervention was developed, integrating patient self-management and professional care through healthcare technology. This article describes feasibility of the intervention in everyday practice.Method: Patients with moderate to severe cancer pain (n = 11) and registered nurses specialized in pain and palliative care (n = 3) participated in a four-week study. The intervention involved daily monitoring, graphical feedback, education, and advice by means of a mobile application for patients and a web application for nurses. Learnability, usability and desirability were measured in patients with a 20-item questionnaire (1-5 scale), higher scores indicating better feasibility. Patients' adherence was based on completion rates from server logs. Single semi-structured interviews with patients and a focus group interview with nurses provided insight into experiences.Results: Questionnaire findings confirmed learnability (4.8), usability (4.8) and desirability (4.6) of the application for patients. Average completion rates were 76.8% for pain monitoring, 50.4% for medication monitoring and 100% for education sessions. Interviews revealed that patients were pleased with the simplicity of the mobile application and appreciated different components. Nurses agreed upon the added value and were mostly positive about the possibilities of the web application. Patients and nurses provided ideas for improvements relating to the content and technical performance of the intervention.Conclusions: Study results demonstrate feasibility of the intervention in everyday practice. Provided that content-related and technical adjustments are made, the intervention enables patients with cancer pain to practice self-management and nurses to remotely support these patients. (C) 2016 The Authors. Published by Elsevier Ltd.