Web-based cancer communication and decision making systems: connecting patients, caregivers, and clinicians for improved health outcomes.
Web-based cancer communication and decision making systems: connecting patients, caregivers, and clinicians for improved health outcomes.
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DOI：
10.1177/0272989x10386382
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发表时间：
2010-11
期刊：
影响因子：
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通讯作者：
Cleary JF
中科院分区：
文献类型：
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作者：
DuBenske LL;Gustafson DH;Shaw BR;Cleary JF
在癌症疾病的发展轨迹中，从诊断和治疗到缓解或生命结束，患者及其家人面临着艰难的决定。提供最相关的信息和支持可以优化癌症决策和应对。交互式健康沟通系统（IHCS）提供了弥合患者、家庭和临床医生之间沟通差距的可能性，并使每个人都能积极参与癌症护理和共同决策。这是一份报告的作者的经验（与相关文献的讨论），在开发和测试一个基于Web的综合健康增强支持系统（CHESS）的晚期肺癌患者和他们的家庭照顾者。CHESS提供信息、沟通和辅导资源，以及向临床团队报告健康状况的症状跟踪系统。制定综合健康状况调查包括对目标受众的需求评估，以及通过利益相关者持续参与早期测试而获得的应用理论。IHCS实施的关键问题包括：1）需要适应各种格式偏好和技术舒适度范围的干预措施; 2）IHCS用户培训; 3）临床医生对IHCS推广的投资; 4）IHCS与现有医疗系统的集成。在建立这种综合系统时，发展战略需要以人口需求为基础，适当使用为目标用户服务的技术，包括病人/家庭、临床团队和卫生保健组织。实施战略应考虑时间、人员和环境因素，以促进持续使用IHCS并从中受益。交互式健康沟通系统（IHCS）提供了一个平台，为癌症患者及其家属提供了解疾病、寻求支持、发展决策和应对技能所需的信息、沟通和指导资源。综合健康促进支持系统（CHESS）就是这样一种综合健康促进支持系统，它在过去20年中不断发展。根据我们最近的经验，创建和测试一个新版本的国际象棋-“应对肺癌：支持网络”-本文概述了在癌症背景下开发和实施这样一个系统所面临的问题。
Over the cancer disease trajectory, from diagnosis and treatment to remission or end of life, patients and their families face difficult decisions. The provision of information and support when most relevant can optimize cancer decision making and coping. An interactive health communication system (IHCS) offers the potential to bridge the communication gaps that occur among patients, family, and clinicians and to empower each to actively engage in cancer care and shared decision making. This is a report of the authors' experience (with a discussion of relevant literature) in developing and testing a Web-based IHCS—the Comprehensive Health Enhancement Support System (CHESS)—for patients with advanced lung cancer and their family caregivers. CHESS provides information, communication, and coaching resources as well as a symptom tracking system that reports health status to the clinical team. Development of an IHCS includes a needs assessment of the target audience and applied theory informed by continued stakeholder involvement in early testing. Critical issues of IHCS implementation include 1) need for interventions that accommodate a variety of format preferences and technology comfort ranges; 2) IHCS user training, 3) clinician investment in IHCS promotion, and 4) IHCS integration with existing medical systems. In creating such comprehensive systems, development strategies need to be grounded in population needs with appropriate use of technology that serves the target users, including the patient/family, clinical team, and health care organization. Implementation strategies should address timing, personnel, and environmental factors to facilitate continued use and benefit from IHCS. An interactive health communication system (IHCS) offers one platform for providing the information, communication, and coaching resources that cancer patients and their families need to understand the disease, find support, and develop decision-making and coping skills. One such IHCS—the Comprehensive Health Enhancement Support System (CHESS)—has evolved over the past 20 years. Based on our recent experience creating and testing a new version of CHESS—“Coping with Lung Cancer: A Network of Support”—this article outlines the issues faced in developing and implementing such a system within the cancer context.