使用数字工具增强腹部癌症手术后的康复移动性的可行性——一项非随机对照试验。
The feasibility of using a digital tool to enhance mobilisation following abdominal cancer surgery-a non-randomised controlled trial.
发表日期:2023 Aug 23
作者:
Patrik Karlsson, Malin Nygren-Bonnier, Lars Henningsohn, Elisabeth Rydwik, Maria Hagströmer
来源:
PHYSICAL THERAPY & REHABILITATION JOURNAL
摘要:
建议腹部癌症手术后进行早期活动,但如何组织早期活动以改善结果并支持患者依从性的证据不足。Pedatim®(Phystec)是一种新型的数字工具,旨在通过在平板电脑上提供指定活动和目标来支持医院环境下的活动能力。本研究旨在评估Pedatim平板电脑在腹部癌症手术后促进患者活动能力的可行性。通过非随机可行性试验设计,于2022年1月至5月在瑞典卡罗琳斯卡大学医院招募了参与者。参与者从术后第1天(POD 1)开始使用Pedatim平板电脑,直到出院。主要目标是评估招募、依从性和可接受性的过程可行性。招募通过纳入可用患者的百分比、资格标准是否充分和退出人数来衡量。依从性通过使用平板电脑的患者数与未使用平板电脑的患者数来衡量。可接受性采用系统可用性评分进行衡量。次要目标是评估科学可行性,即评估活动能力的治疗效果指标,使用活动计步器来评估患者的体育活动。还记录与平板电脑相关的意外事件。根据预先确定的可行性标准,整体研究设计在招募方面被确定为可行,因为接受参与的患者达到了69%(n = 20),依从性达到了95%,可接受性平均得分较高(77/100)。资格标准不可行,因为79%的可用患者(n = 108)被排除在外。干预措施被认为在科学上是可行的,平均每天步行步数从623(SD 766)增加到1823(SD 1446),每天起座转换次数从11(SD 8)增加到29(SD 12)POD 1-4。出现了技术问题,强调了需要提供可用的技术支持和病房内的“用户冠军”的需求。使用Pedatim平板电脑来提高腹部癌症手术后的活动能力被认为是可行的,但需要进行一项随机对照试验来确定该工具的有效性。研究过程被认为是可行的,未来试验需要修订资格标准。与医疗专业人员合作并提供可用的技术支持对于未来的实施至关重要。© 2023. BioMed Central Ltd., part of Springer Nature.
Early mobilisation is strongly recommended following abdominal cancer surgery, but evidence on how to structure early mobilisation to improve outcomes and support patient adherence is lacking. Pedatim® (Phystec) is a novel digital tool designed to support mobilisation in hospital settings using prescribed activities and goals on a tablet. The aim of this study was to evaluate the feasibility of the Pedatim tablet to enhance mobilisation following abdominal cancer surgery.In a non-randomised feasibility trial design, participants were recruited between January and May 2022 at Karolinska University Hospital, Sweden. Participants used a Pedatim tablet from postoperative day 1 (POD 1) until hospital discharge. The primary objective was to evaluate process feasibility, regarding recruitment, compliance, and acceptability. Recruitment was measured by percentage of available patients included, eligibility criteria sufficiency, and number of dropouts. Compliance was measured by number of patients using versus not using the board. Acceptability was measured using the System Usability Scale. The secondary objective was to evaluate scientific feasibility, defined as an indication of treatment effects where physical activity was assessed using an activPAL accelerometer. Unforeseen events relating to the tablet were also registered.Based on predetermined feasibility criteria, the overall study design was determined to be feasible regarding recruitment as 69% accepted participation (n = 20), compliance was 95%, and the acceptability mean score was high (77/100). Eligibility criteria were not feasible as 79% (n = 108) of available patients were excluded. The intervention was determined to be scientifically feasible, mean steps per day increased from 623 (SD 766) to 1823 (SD 1446), and mean sit-to-stand transitions per day increased from 11 (SD 8) to 29 (SD 12) POD 1-4. Technical issues emerged, highlighting the need for available technical support and "user champions" among healthcare professionals on the ward.Using the Pedatim tablet to enhance mobilisation following abdominal cancer surgery was deemed feasible, but a randomised controlled trial is needed to determine the tool's effectiveness. The study process was determined to be feasible with revisions of the eligibility criteria needed before a future trial. Involving healthcare professionals and providing available technical support are important for future implementation.© 2023. BioMed Central Ltd., part of Springer Nature.