A survey of cancer care institutions in Nepal to inform design of a pain management mobile application.
A survey of cancer care institutions in Nepal to inform design of a pain management mobile application.
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DOI：
10.1186/s12904-021-00824-0
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发表时间：
2021-11-05
影响因子：
3.1
通讯作者：
Dutta Paudel B
中科院分区：
文献类型：
--
作者：
LeBaron V;Adhikari A;Bennett R;Chapagain Acharya S;Dhakal M;Elmore CE;Fitzgibbon K;Gongal R;Kattel R;Koirala G;Maurer M;Munday D;Neupane B;Sagar Sharma K;Shilpakar R;Shrestha S;Thapa U;Zhang H;Dillingham R;Dutta Paudel B
改善中低收入国家肿瘤姑息治疗的一种方法是利用移动技术支持医疗保健提供者实施疼痛管理指南（PMG）。然而，PMG通常是在资源较高的环境中开发的，可能不适合中低收入国家的资源和文化背景。这项研究代表了弗吉尼亚大学和尼泊尔姑息治疗协会（NAPCare）之间的合作，设计了一个移动健康应用程序（“应用程序”），以扩大现有当地开发的PMG的实施。我们对尼泊尔的临床医生进行了横断面调查，为应用程序的设计提供信息。问题集中在管理癌症疼痛的知识、信念和信心方面；癌症疼痛管理的障碍；对NAPCare PMG的认识和使用；来自尼泊尔四家不同癌症护理机构的97名姑息治疗和/或肿瘤医疗保健提供者完成了调查。49.5% （n = 48）接受过姑息治疗/癌症疼痛管理方面的培训，大多数（63.9%,n = 62）报告了在管理癌症疼痛方面的高信心水平（得分为8或更高/10）。排名最高的癌症疼痛管理障碍包括国家/文化层面的障碍，例如护理和医学院课程缺乏关于姑息治疗和疼痛管理的足够内容，以及生活在农村地区的患者难以获得医疗保健服务（总体平均值= 6.36/10）。大多数护士和医生使用Android智能手机（82%,n = 74），听说过NAPCare PMG (96%, n = 88)，并报告经常使用应用程序提供临床护理（平均= 6.38/10,n = 92）。使用智能手机的主要障碍因学科而异，护士报告更担心的是数据访问成本（70%,n = 45）和禁止在工作中使用手机（61%,n = 39）。智能手机应用程序可以帮助实施PMG，并支持医疗保健提供者在尼泊尔和类似的环境中管理癌症疼痛。然而，这些工具的设计必须符合文化和背景，并解决疼痛管理和应用程序使用的感知障碍。
One way to improve the delivery of oncology palliative care in low and middle-income countries (LMICs) is to leverage mobile technology to support healthcare providers in implementing pain management guidelines (PMG). However, PMG are often developed in higher-resourced settings and may not be appropriate for the resource and cultural context of LMICs. This research represents a collaboration between the University of Virginia and the Nepalese Association of Palliative Care (NAPCare) to design a mobile health application (‘app’) to scale-up implementation of existing locally developed PMG. We conducted a cross-sectional survey of clinicians within Nepal to inform design of the app. Questions focused on knowledge, beliefs, and confidence in managing cancer pain; barriers to cancer pain management; awareness and use of the NAPCare PMG; barriers to smart phone use and desired features of a mobile app. Surveys were completed by 97 palliative care and/or oncology healthcare providers from four diverse cancer care institutions in Nepal. 49.5% (n = 48) had training in palliative care/cancer pain management and the majority (63.9%, n = 62) reported high confidence levels (scores of 8 or higher/10) in managing cancer pain. Highest ranked barriers to cancer pain management included those at the country/cultural level, such as nursing and medical school curricula lacking adequate content about palliative care and pain management, and patients who live in rural areas experiencing difficulty accessing healthcare services (overall mean = 6.36/10). Most nurses and physicians use an Android Smart Phone (82%, n = 74), had heard of the NAPCare PMG (96%, n = 88), and reported frequent use of apps to provide clinical care (mean = 6.38/10, n = 92). Key barriers to smart phone use differed by discipline, with nurses reporting greater concerns related to cost of data access (70%, n = 45) and being prohibited from using a mobile phone at work (61%; n = 39). Smart phone apps can help implement PMG and support healthcare providers in managing cancer pain in Nepal and similar settings. However, such tools must be designed to be culturally and contextually congruent and address perceived barriers to pain management and app use.
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影响因子：
45.3
作者：
Ferrell, Betty R.;Temel, Jennifer S.;Smith, Thomas J.
通讯作者：
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影响因子：
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影响因子：
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作者：
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