摘要
Objective:Pediatric cancer patients endure multiple symptoms during treatment and also in survivorship.Digital health technologies provide an innovative way to support their symptom management.This review aimed to examine the effect of digital health technologies on managing symptoms among across pediatric cancer continuum.Methods:A systematic literature search of six English and three Chinese electronic databases was combined with hand searching,to identify eligible research studies from database establishment to November 30,2019.Two reviewers carried out data selection,data extraction,and quality appraisal independently.A narrative approach was taken to summarize data.Results:Four randomized control trials,two quasi-experiments,and five one group pre-posttest designed studies,were included in the review with a total of 425 participants.The methodological quality of the studies was generally fair.Seven symptoms(anxiety,depression,pain,anger,fatigue,fear,distress)and seven digital health technologies(visual reality,website,humanoid robot,app,wearable devices,short messages and videoconference)were reported in the included studies.Conclusions:Current evidence supports the effect of digital health technologies is generally mixed and inconclusive.There is a trend of positive effects found in the interventions that feature digital health technologies’interactive function.This review highlights the need for further investigation with rigorous research designs and the consideration of influencing factors from the symptoms,participants,and context levels to inform a better digital health implementation.
目的癌症患儿在治疗和生存期间都会出现多种症状。数字健康技术提供了一种症状管理创新性服务方式。这篇综述旨在探讨应用数字医疗技术对癌症患儿进行症状管理的干预效果。方法系统检索英文数据库(Cochrane Library,Joanna Briggs Institute Library,PubMed,CINAHL,EMBASE,Web of Science)和中文数据库(万方数据库、中国期刊全文数据库、中国生物医学数据库)建库至2019年11月30日的相关文章。采用Downs等提出的随机和非随机研究评估工具评价文章质量,对符合纳入标准的文献进行资料提取和分析。结果最终纳入11篇文章,425例研究对象。研究包括4项随机对照试验、3项类实验和5项前后对照试验。方法质量等级为中等。研究共涉及7种症状(焦虑、抑郁、疼痛、愤怒、疲乏、恐惧、心理痛苦)和7种数字医疗技术(虚拟现实、网站、机器人、应用程序、可穿戴设备、短信、视频会议)。因干预措施之间存在显著异质性,对资料采用描述性分析。结论本研究显示,当前有关支持数字健康技术对癌症患儿症状管理效果的证据并不明确,但趋势显示交互功能的数字健康技术有积极的干预效果。需开展更多设计严谨的研究来明确数字健康技术对癌症患儿症状管理的效果,需从症状、参与者和环境水平等多方面考虑相关影响因素,促进开发更好的应用数字健康技术的干预措施。
作者
Lei Cheng
Mingxia Duan
Xiaorong Mao
Youhong Ge
Yanqing Wang
Haiying Huang
成磊;段明霞;毛孝容;葛友红;王燕青;黄海英(School of Nursing,Fudan University,Shanghai,China;Anhui Provincial Children’s Hospital,Hefei,Anhui,China;Sichuan Academy of Medical Science&Sichuan Provincial People’s Hospital,Chengdu,Sichuan,China;Children’s Hospital of Fudan University,Shanghai,China;Children’s Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang,China;Guangzhou Women and Children’s Medical Center,Guangzhou,Guangdong,China)
基金
supported by the China National Natural Science Foundation of China Youth Science Foundation(71904030)
Shanghai Pujiang Talent Program(2019PJC006).
