Technology-Assisted mHealth Caregiver Support to Manage Cancer Patient Symptoms: A Randomized Controlled Trial.
Technology-Assisted mHealth Caregiver Support to Manage Cancer Patient Symptoms: A Randomized Controlled Trial.
复制标题
技术辅助移动医疗护理人员支持管理癌症患者症状：随机对照试验。
DOI：
10.1016/j.jpainsymman.2023.02.320
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发表时间：
2023
影响因子：
4.7
通讯作者：
Donaldson,Gary
中科院分区：
文献类型：
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作者：
Mooney,Kathi;Whisenant,MeaganS;Wilson,ChristinaM;Coombs,LorindaA;Lloyd,Jennifer;Alekhina,Natalya;Sloss,ElizabethA;Steinbach,Mary;Moraitis,AnnMarie;Berry,Patricia;Iacob,Eli;Donaldson,Gary
ContextCaregivers家庭临终关怀期间管理癌症的家庭成员的症状，往往觉得准备不足，需要病人的护理coaching.ObjectivesThis研究测试的自动化mHealth平台，包括照顾者辅导病人的症状护理和护士通知控制不良的症状的疗效。主要结果是在整个临终关怀期间以及第1、2、4和8周，护理人员对患者总体症状严重程度的感知。次要结果比较个别symptomssseverity.MethodsCaregivers（n= 298）被随机分配到症状护理在家里（SCH）干预（n= 144）或通常的临终关怀（UC）（n= 154）。所有护理人员每天都打电话给自动化系统，该系统评估了11种临终患者身体和心理社会症状的存在和严重程度。SCH护理人员根据报告的患者症状及其严重程度接受症状护理的自动指导。中度至重度症状也被转达给临终关怀nurs. ResultsSCH干预产生了平均整体症状减轻效益，超过UC，4.89严重程度点（95%CI 2.86-6.92）（P< 0.001），与中度效应大小（d= 0.55）。SCH获益也发生在每个时间点（P< 0.001- 0.020）。与UC相比，报告中度至重度患者症状的天数减少了38%（P< 0.001），与UC相比，SCH中10/11的症状显著减少。结论照顾者的自动mHealth症状报告，与针对症状管理和护士通知的量身定制的照顾者辅导相结合，减少了癌症患者在家庭临终关怀期间的身体和心理社会症状，提供了一种改进临终关怀的新颖而有效的方法。
ContextCaregivers managing symptoms of family members with cancer during home hospice care, often feel ill-prepared and need patient care coaching.ObjectivesThis study tested the efficacy of an automated mHealth platform that included caregiver coaching on patient symptom care and nurse notifications of poorly controlled symptoms. The primary outcome was caregiver perception of patients’ overall symptom severity throughout hospice care and at weeks one, two, four, and eight. Secondary outcomes compared individual symptom severity.MethodsCaregivers (n= 298) were randomly assigned to the Symptom Care at Home (SCH) intervention (n= 144) or usual hospice care (UC) (n= 154). All caregivers placed daily calls to the automated system that assessed the presence and severity of 11 end-of-life patient physical and psychosocial symptoms. SCH caregivers received automated coaching on symptom care based on reported patient symptoms and their severity. Moderate-to-severe symptoms were also relayed to the hospice nurse.ResultsThe SCH intervention produced a mean overall symptom reduction benefit, over UC, of 4.89 severity points (95% CI 2.86–6.92) (P< 0.001), with a moderate effect size (d= 0.55). The SCH benefit also occurred at each timepoint (P< 0.001– 0.020). There was a 38% reduction in days reporting moderate-to-severe patient symptoms compared to UC (P< 0.001) with 10/11 symptoms significantly reduced in SCH compared to UC.ConclusionAutomated mHealth symptom reporting by caregivers, paired with tailored caregiver coaching on symptom management and nurse notifications, reduces cancer patients’ physical and psychosocial symptoms during home hospice, providing a novel and efficient approach to improving end-of-life care.