癌症护理中的跨部门视频会诊对患者感知协调性的挑战:随机对照试验

IF 3.3 Q2 ONCOLOGY
JMIR Cancer Pub Date : 2025-02-11 DOI:10.2196/60158
Fereshteh Baygi, Theis Bitz Trabjerg, Lars Henrik Jensen, Maria Munch Storsveen, Sonja Wehberg, Jeffrey James Sisler, Jens Søndergaard, Dorte Gilså Hansen
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引用次数: 0

摘要

背景:癌症患者需要治疗和并发健康状况的协调护理。这要求在使用远程医疗服务时专家之间进行协作,强调护理连续性的重要性。目的:本研究旨在探讨肿瘤学家、全科医生和癌症患者参与的跨部门视频会诊与常规会诊相比,对患者感知护理协调的影响。方法:本研究描述了一项随机临床试验伙伴关系项目患者7个月随访的主要结果。干预组的患者随机接受“合作咨询”,除了常规护理外,还与肿瘤学家、全科医生和患者共享视频咨询。两组在基线和第7个月完成问卷,以评估主要结果,“跨部门合作的全球评估”,来自丹麦问卷“患者对卫生保健服务的态度”。问卷还包括2个单项和5个指标量表,考察患者对医疗系统合作的态度。使用线性回归模型中的广义估计方程比较意向治疗组从基线到7个月的感知全局协调性的变化。结果:278名受试者按1:1的比例随机分组,其中80例患者接受干预。此外,210名患者在基线时完成了问卷调查,而118名患者在7个月的随访中做出了回应。常规护理(-0.13,95% CI -0.38至0.12)和干预(0.11,95% CI -0.11至0.34)的主要结局估计差异为0.24 (95% CI -0.09至0.58),无统计学意义(P= 0.15)。结论:低干预完成率和高水平的数据缺失损害了我们研究的可解释性。虽然我们观察到对协调的整体评估水平很高,但估计的干预效果比预期的要小,对照组和干预组之间的感知协调没有显著差异。未来的研究应探索诸如患者激励等策略,以提高响应率,并改进对这种创新医疗模式的评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Challenges of Cross-Sectoral Video Consultation in Cancer Care on Patients' Perceived Coordination: Randomized Controlled Trial.

Background: Patients with cancer need coordinated care for both treatment and concurrent health conditions. This requires collaboration among specialists when using telemedicine services, emphasizing the importance of care continuity.

Objective: This study aimed to explore the effects of cross-sectorial video consultation involving oncologists, general practitioners, and patients with cancer on patients' perceived coordination of care, compared with usual care.

Methods: This study describes the primary outcomes from a 7-month follow-up of patients in the Partnership Project, a randomized clinical trial. Patients in the intervention group were randomized to receive a "partnership consultation," a shared video consultation with an oncologist, general practitioners, and the patient, in addition to their usual care. Questionnaires were completed for both groups at baseline and 7 months to assess the primary outcome, "global assessment of inter-sectorial cooperation," from the Danish questionnaire "Patients' attitude to the health care service." The questionnaire also included 2 single items and 5 index scales, examining patients' attitude toward cooperation in the health care system. Change in perceived global coordination from baseline to 7 months was compared between intention-to-treat groups using generalized estimating equations in a linear regression model.

Results: A total of 278 participants were randomized with 1:1 allocation, with 80 patients receiving the intervention. Further, 210 patients completed the questionnaire at baseline, while 118 responded at 7-month follow-up. The estimated difference in the primary outcome between usual care (-0.13, 95% CI -0.38 to 0.12) and intervention (0.11, 95% CI -0.11 to 0.34) was 0.24 (95% CI -0.09 to 0.58) and not statistically significant (P=.15).

Conclusions: Low rates of intervention completion and high levels of missing data compromised the interpretability of our study. While we observed a high level of global assessment of coordination, the estimated intervention effect was smaller than anticipated, with no significant difference in perceived coordination between control and intervention groups. Future studies should explore strategies like patient incentives to increase response rate and improve the evaluation of this innovative health care model.

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来源期刊
JMIR Cancer
JMIR Cancer ONCOLOGY-
CiteScore
4.10
自引率
0.00%
发文量
64
审稿时长
12 weeks
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