Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients
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DOI：
10.1007/s00520-018-4450-4
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发表时间：
2019-06-01
影响因子：
3.1
通讯作者：
Choi, Sung Won
中科院分区：
文献类型：
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作者：
Fauer, Alex J.;Hoodin, Flora;Choi, Sung Won
我们开发了BMT Roadmap，一个平板电脑上的健康信息技术（HIT）应用程序，以满足护理人员对电子健康记录中患者特定信息的未满足需求。我们在成人和儿童HSCT患者的照顾者中进行了BMT路线图的初步可行性研究。该研究注册在ClinicalTrials.gov（NCT 03161665; NCT 02409121）。MethodsBMT路线图交付给39个照顾者的成人和儿童患者接受首次HSCT在一个单一的研究网站。我们在基线时评估了个人报告的结局指标（PROM）（入院）、出院和第100天：BMT路线图的有用性（感知有用性）;激活（患者激活测量-护理者版本[PAM-C]）;心理健康（[POMS-2（R）]：抑郁、痛苦、活力和疲劳）;焦虑（状态-特质焦虑量表）和生活质量（癌症护理者生活质量指数[CQOLC]）。为了确定护理激活和生活质量的决定因素，我们使用线性混合models.ResultsBMT路线图被认为是有用的和激活增加从基线到出院（p=0.001）。此外，出院时负荷降低（p=0.007）。总体而言，从基线到出院，活力增加和抑郁、痛苦、疲劳和焦虑减少的模式是明显的。然而，整体生活质量下降后，占BMT路线图使用，抑郁，焦虑，疲劳（p=0.04）。ConclusionsBMT路线图是一个可行的HIT干预实施HSCT照顾者出院。BMT路线图与激活增加和负担减轻相关，但住院期间生活质量降低。研究结果支持需要进一步开发特定的自我导向的资源，并为他们提供住院和门诊HSCT的轨迹。
PurposeWe developed BMT Roadmap, a health information technology (HIT) application on a tablet, to address caregivers' unmet needs with patient-specific information from the electronic health record. We conducted a preliminary feasibility study of BMT Roadmap in caregivers of adult and pediatric HSCT patients. The study was registered on ClinicalTrials.gov (NCT03161665; NCT02409121).MethodsBMT Roadmap was delivered to 39 caregivers of adult and pediatric patients undergoing first-time HSCT at a single study site. We assessed person-reported outcome measures (PROMs) at baseline (hospital admission), discharge, and day 100: usefulness of BMT Roadmap (Perceived Usefulness); activation (Patient Activation Measure-Caregiver version [PAM-C]); mental health ([POMS-2 (R)]: depression, distress, vigor, and fatigue); anxiety (State-Trait Anxiety Inventory); and quality of life (Caregiver Quality of Life Index-Cancer [CQOLC]). To identify determinants of caregiver activation and quality of life, we used linear mixed models.ResultsBMT Roadmap was perceived useful and activation increased from baseline to discharge (p=0.001). Further, burden decreased through discharge (p=0.007). Overall, a pattern of increasing vigor and decreasing depression, distress, fatigue, and anxiety was apparent from baseline to discharge. However, overall quality of life lowered at discharge after accounting for BMTRoadmap use, depression, anxiety, and fatigue (p=0.04).ConclusionsBMT Roadmap was a feasible HIT intervention to implement in HSCT caregivers. BMT Roadmap was associated with increased activation and decreased burden, but quality of life lowered across hospitalization. Findings support the need to further develop caregiver-specific self-directed resources and provide them both inpatient and outpatient across the HSCT trajectory.