health outcome

健康结果
  • 文章类型: Journal Article
    背景:在过去的十年中,有机食品(OF)的生产和消费受到越来越多的关注。科学研究表明,就营养素和农药含量而言,有机水果和蔬菜(FV)的质量更高,但与传统食品(CF)相比,这些产品是否有潜在更大的健康益处似乎很难得出结论。
    目的:确定当前的科学文献是否表明富含有机FV的饮食比常规产品的饮食更健康。
    方法:使用PubMed和WebofScience数据库对2003年1月至2022年12月之间发表的文章进行了系统搜索。文章由2名审稿人统一分析,使用特定的模板汇总表,得分从1到5。使用Jadad评分和法国国家卫生管理局方法评估了人类的证据水平和研究质量。
    结果:共纳入12项人体研究。研究经常报告矛盾甚至相反的结果,有方法论上的局限性。12项研究中只有6项发现OF与评估的健康结果之间存在显着关联。
    结论:目前的数据无法得出关于与传统农业相比,有机种植的产品富含FV的饮食具有更大的健康益处的确切结论。研究设计中缺乏可用数据和相当大的异质性(参与者,暴露,持续时间,健康结果,和残余混杂因素)。需要精心设计的介入研究。
    BACKGROUND: Over the past decade, the production and consumption of organic food (OF) have received increasing interest. Scientific studies have shown better quality of organic fruit and vegetables (FV) in terms of nutrients and pesticide contents, but it appears difficult to conclude if there are potentially greater health benefits of these products compared with conventional food (CF).
    OBJECTIVE: To determine whether the current scientific literature demonstrates that a diet rich in organic FV is healthier than 1 based on conventional produce.
    METHODS: A systematic search was conducted using the PubMed and Web of Science databases for articles published between January 2003 and December 2022. Articles were analyzed uniformly by 2 reviewer, using a specific template summary sheet, and scored from 1 to 5. The level of evidence and the quality of studies in humans were assessed using the Jadad score and the French National Authority for Health method.
    RESULTS: A total of 12 human studies were included. Studies often reported contradictory or even opposite results, with methodological limitations. Only 6 of the 12 studies found significant associations between OF and the health outcomes evaluated.
    CONCLUSIONS: The current data do not enable a firm conclusion about a greater health benefit for a diet rich in FV based on products grown organically compared with conventional farming. There is a paucity of available data and considerable heterogeneity in study designs (participants, exposures, durations, health outcomes, and residual confounding factors). Well-designed interventional studies are required.
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  • 文章类型: Journal Article
    背景:患者和工作人员的经验是评估远程患者监护(RPM)干预措施时要考虑的重要因素。然而,目前还没有全面概述可用的RPM患者和工作人员的经验测量方法和工具。
    目的:这篇综述旨在获得一套全面的经验构造和当代RPM研究中使用的相应测量仪器,并提出一套初步的指南,以改善该领域的方法学标准化。
    方法:全文文件报告患者或工作人员在RPM干预措施中的经验测量实例,用英语写的,并在2011年1月1日之后发布,被认为符合资格。通过“RPM干预,“我们提到了干预措施,包括用于临床决策的基于传感器的患者监测;因此,报告其他干预措施的论文被排除在外。描述初级保健干预措施的论文,涉及18岁以下的参与者,或侧重于态度或技术,而不是具体的干预措施也被排除在外。我们搜索了2个电子数据库,Medline(PubMed)和EMBASE,2021年2月12日我们通过对应分析对获得的语料库进行了探索和结构化,多元统计技术。
    结果:总计,包含158篇论文,涵盖了各个领域的RPM干预。从这些研究中,我们在RPM中报告了546个经验测量实例,涵盖使用160种独特的经验测量仪器来测量120种独特的经验结构。我们发现,在过去的十年中,研究领域有了相当大的增长,它受到相对缺乏对员工经验的关注的影响,收集的经验措施的总体语料库可以分为4个主要类别(服务系统相关,护理相关,使用和依从性相关,和健康结果相关)。根据收集到的调查结果,我们向RPM患者和工作人员经验评估人员提供了一组6个可操作的建议,在衡量什么和如何衡量方面。总的来说,我们建议RPM研究人员和从业人员将经验测量作为集成的一部分,用于连续RPM评估的跨学科数据策略。
    结论:目前,在用于测量RPM患者和工作人员经验的方法中缺乏共识和标准化,导致我们对RPM干预措施影响的理解存在严重的知识差距。本审查通过提供结构化、全面概述当代患者和工作人员的经验措施,以及一套提高该领域研究质量和标准化的实用指南。
    BACKGROUND: Patient and staff experience is a vital factor to consider in the evaluation of remote patient monitoring (RPM) interventions. However, no comprehensive overview of available RPM patient and staff experience-measuring methods and tools exists.
    OBJECTIVE: This review aimed at obtaining a comprehensive set of experience constructs and corresponding measuring instruments used in contemporary RPM research and at proposing an initial set of guidelines for improving methodological standardization in this domain.
    METHODS: Full-text papers reporting on instances of patient or staff experience measuring in RPM interventions, written in English, and published after January 1, 2011, were considered for eligibility. By \"RPM interventions,\" we referred to interventions including sensor-based patient monitoring used for clinical decision-making; papers reporting on other kinds of interventions were therefore excluded. Papers describing primary care interventions, involving participants under 18 years of age, or focusing on attitudes or technologies rather than specific interventions were also excluded. We searched 2 electronic databases, Medline (PubMed) and EMBASE, on February 12, 2021.We explored and structured the obtained corpus of data through correspondence analysis, a multivariate statistical technique.
    RESULTS: In total, 158 papers were included, covering RPM interventions in a variety of domains. From these studies, we reported 546 experience-measuring instances in RPM, covering the use of 160 unique experience-measuring instruments to measure 120 unique experience constructs. We found that the research landscape has seen a sizeable growth in the past decade, that it is affected by a relative lack of focus on the experience of staff, and that the overall corpus of collected experience measures can be organized in 4 main categories (service system related, care related, usage and adherence related, and health outcome related). In the light of the collected findings, we provided a set of 6 actionable recommendations to RPM patient and staff experience evaluators, in terms of both what to measure and how to measure it. Overall, we suggested that RPM researchers and practitioners include experience measuring as part of integrated, interdisciplinary data strategies for continuous RPM evaluation.
    CONCLUSIONS: At present, there is a lack of consensus and standardization in the methods used to measure patient and staff experience in RPM, leading to a critical knowledge gap in our understanding of the impact of RPM interventions. This review offers targeted support for RPM experience evaluators by providing a structured, comprehensive overview of contemporary patient and staff experience measures and a set of practical guidelines for improving research quality and standardization in this domain.
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  • 文章类型: Journal Article
    本研究旨在研究将患者报告的结果(PRO)整合到常规临床实践中对接受积极抗癌治疗的患者的潜在益处。
    我们对接受积极抗癌治疗的癌症患者的随机对照试验进行了全面的系统评价,跨越各种癌症类型和阶段。审查涵盖了四个电子数据库(Medline,EMBASE,科克伦图书馆,和CINAHL)截至2022年9月。关键的纳入标准侧重于将PRO纳入常规干预措施。偏差评估遵循Cochrane协作的标准,而结果的合成利用了效应大小测量(科恩的d)。该研究遵循系统评价和荟萃分析指南的首选报告项目。
    在最初筛选的1549条记录中,包含5300名患者的16项已发表的随机对照试验符合纳入标准。干预措施涉及18种不同的PRO测量,突出的工具是EORTCQLQ-C30(在四个试验中使用)和PRO-CTCAE(在四个试验中使用)。测量终点包括总体生活质量(12项试验),身体健康(11项试验),心理健康(7项试验),和社会健康(5项试验)。总的来说,这项研究揭示了有限数量的统计上显著的发现,与干预措施相关的效应大小主要是小到中等。
    研究结果表明,将PRO常规整合到临床实践中并不能在PRO方面产生明确的优势。显然,需要进一步努力来确定这些干预措施对患者健康的影响。
    审查方案已在PROSPERO上注册(ID:CRD4202236556)。
    UNASSIGNED: This study aims to investigate the potential benefits of integrating patient-reported outcomes (PROs) into routine clinical practice for patients undergoing active anticancer treatment.
    UNASSIGNED: We conducted a comprehensive systematic review of randomized controlled trials involving cancer patients undergoing active anticancer treatment, spanning various cancer types and stages. The review covered four electronic databases (Medline, EMBASE, Cochrane Library, and CINAHL) up to September 2022. Key inclusion criteria focused on the incorporation of PROs as a routine intervention. Bias assessment followed the Cochrane collaboration\'s criteria, while the synthesis of results utilized effect size measurements (Cohen\'s d). The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
    UNASSIGNED: Out of 1549 initially screened records, 16 published randomized controlled trials encompassing 5300 patients met the inclusion criteria. The interventions involved 18 different PROs measurements, with prominent tools being EORTC QLQ-C30 (utilized in four trials) and PRO-CTCAE (utilized in four trials). Measured endpoints included overall quality of life (12 trials), physical health (11 trials), mental health (7 trials), and social health (5 trials). Overall, the study revealed a limited number of statistically significant findings, with predominantly small to moderate effect sizes associated with the interventions.
    UNASSIGNED: The findings suggest that the routine integration of PROs into clinical practice does not yield definitive advantages in terms of PROs. It is apparent that further efforts are necessary to ascertain the impact of these interventions on patient health.
    UNASSIGNED: The review protocol was registered on PROSPERO (ID: CRD42022365456).
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  • 文章类型: Journal Article
    识别并分类基于社区的水果和蔬菜处方计划的不同模型,为了确定方法上的差异,目标人群特征,和衡量的结果。应用范围审查方法,十个电子数据库被用来确定基于社区的水果和蔬菜奖励计划。结果由两名独立审核员进行评估,使用Covidence软件。使用PRISMA-ScR指南完成并记录所有全文审查。在Covidence软件中存储和审查搜索结果。从搜索中确定的40206中使用了30篇全文文章。目标人群主要是女性,非白色,和低收入。在研究设计和质量上都发现了相当大的异质性。63%(n19)的研究使用了水果和蔬菜券。处方主要由社区卫生中心(47%;n14)或非政府组织(307%;n9)提供,可以在农贸市场(40%;n12)或杂货店(27%;n8)兑换。测量时,饮食质量显著提高了94%(n16),健康结果显着改善了83%(n10),在82%(n=10)的研究中,粮食安全状况有所改善。提供财政奖励以抵消新鲜水果和蔬菜的成本可以增加消费,改善健康结果,改善粮食安全状况。大多数研究表明,至少一个结果有显著改善,展示以社区为基础的水果和蔬菜处方计划的有效性。然而,测量技术的多样性和设计的异质性,剂量,和持续时间阻碍了有意义的比较。需要进一步精心设计的研究来比较不同计划方法之间的影响程度。
    Identify and categorise different models of community-based fruit and vegetable prescription programs, to determine variation in terms of methodology, target population characteristics, and outcomes measured. Applying the scoping review methodology, ten electronic databases were utilised to identify community-based fruit and vegetable incentive programs. Results were evaluated by two independent reviewers, using Covidence software. All full-text reviews were completed and documented using the PRISMA-ScR guidelines. Search results were stored and reviewed within the Covidence software. Thirty full-text articles were utilised from the 40 206 identified in the search. Target populations were predominantly female, non-white, and low-income. Considerable heterogeneity was found in both study design and quality. Fruit and vegetable vouchers were utilised in 63 % (n 19) of the studies. Prescriptions were primarily provided by community health centres (47 %; n 14) or NGOs (307 %; n 9) and could be redeemed at farmers\' markets (40 %; n 12) or grocery stores (27 %; n 8). When measured, diet quality significantly improved in 94 % (n 16), health outcomes significantly improved in 83 % (n 10), and food security status improved in 82 % (n 10) of studies. Providing financial incentives to offset the cost of fresh fruits and vegetables can increase consumption, improve health outcomes, and improve food security status. The majority of studies showed significant improvements in at least one outcome, demonstrating the effectiveness of community-based fruit and vegetable prescription programs. However, the diversity of measurement techniques and heterogeneity of design, dosage, and duration impeded meaningful comparisons. Further well-designed studies are warranted to compare the magnitude of effects among different program methodologies.
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  • 文章类型: Journal Article
    背景:护士占全球卫生保健队伍的一半以上,他们提供的护理对全球人口的健康至关重要。高患者量和增加的医疗复杂性增加了护士的工作量和压力。因此,护士的健康往往受到负面影响。可穿戴设备在医疗保健环境中用于评估患者的结果;然而,综合使用专注于护士健康的可穿戴设备的努力是有限的。
    目的:我们综合审查的主要目的是综合有关可穿戴设备在评估或改善(或两者)护士健康方面的实用性的可用数据。
    方法:我们正在进行综合评估,综合可穿戴设备和护士健康的具体数据。这篇综述的研究问题旨在回答如何使用可穿戴设备来评估护士的健康结果。从成立到2022年7月,我们搜索了以下电子数据库:PubMed,Embase,CINAHL,WebofScience,IEEE探索,和AS&T。标题和摘要被导入到Covidence软件中,其中引用被筛选,重复被删除。标题和摘要筛选已经完成;但是,全文筛选尚未开始。进一步的筛选正在独立进行,一式两份,由2个小组组成,每个小组有2名评审员。这些审阅者将独立提取数据。
    结果:已经开发了搜索策略,并从6个数据库中提取数据。删除副本后,我们收集了8603项研究进行标题和摘要筛选.两名独立审稿人进行了标题和摘要审稿,在解决冲突之后,277条全文可供审查,以确定它们是否符合纳入标准。
    结论:这项综合审查将提供综合数据,以告知护士和其他利益相关者有关与护士一起完成的可穿戴设备相关工作的程度,并为未来的研究提供方向。
    DERR1-10.2196/48178。
    BACKGROUND: Nurses comprise over half of the global health care workforce, and the nursing care they provide is critical for the global population\'s health. High patient volumes and increased medical complexity have increased the workload and stress of nurses. As a result, the health of nurses is often negatively impacted. Wearables are used within the health care setting to assess patient outcomes; however, efforts to synthesize the use of wearable devices focusing on nurses\' health are limited.
    OBJECTIVE: The primary objective of our integrative review is to synthesize available data concerning the utility of wearable devices for evaluating or improving (or both) the health of nurses.
    METHODS: We are conducting an integrative review synthesizing data specific to wearable devices and nurses\' health. The research question for this review aims to answer how wearable devices are used to evaluate health outcomes among nurses. We searched the following electronic databases from inception until July 2022: PubMed, Embase, CINAHL, Web of Science, IEEE Explore, and AS&T. Titles and abstracts were imported into Covidence software, where citations were screened and duplicates removed. Title and abstract screening has been completed; however, full-text screening has not been started. Further screening is being conducted independently and in duplicate by 2 teams of 2 reviewers each. These reviewers will extract data independently.
    RESULTS: Search strategies have been developed, and data were extracted from 6 databases. After the removal of duplicates, we collected 8603 studies for title and abstract screening. Two independent reviewers conducted the title and abstract review, and after resolving conflicts, 277 full-text articles are available for review to determine whether they meet the inclusion criteria.
    CONCLUSIONS: This integrative review will provide synthesized data to inform nurses and other stakeholders about the extent of wearable device-related work done with nurses and provide direction for future research.
    UNASSIGNED: DERR1-10.2196/48178.
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  • 文章类型: Review
    背景:75%的精神疾病患者在12-24岁之间发病。这个年龄段的许多人报告说,在接受以青年为中心的优质精神保健服务方面存在重大障碍。随着科技的飞速发展,以及最近的COVID-19大流行,移动健康(mHealth)为青年心理健康研究提供了新的机会,实践,和政策。
    目的:研究目标是:1)综合当前证据,支持针对经历心理健康挑战的青年的mHealth干预措施;2)确定mHealth领域与青年心理健康服务获取和健康结果相关的当前差距。
    方法:以Arksey和O\'Malley的方法为指导,我们对使用mHealth工具改善青少年心理健康的同行评审研究进行了范围审查(2016年1月-2022年2月).使用MEDLINE,PubMed,PsycINFO,和Embase数据库,我们使用以下关键术语进行搜索:1)mHealth;2)青年和年轻人;3)心理健康。使用内容分析法分析了当前的差距。
    结果:搜索产生了4270条记录,其中151人符合纳入标准。纳入的文章强调了青年mHealth干预资源分配的全面方面,m健康交付方法,测量工具,mHealth干预评估,青年参与所有研究参与者的平均年龄为17岁(Q1:14;Q3:21)。只有三项研究(2%)涉及在二元期权之外报告自己的性别或性别的参与者。许多研究(n=68,45%)是在COVID-19爆发后发表的。研究类型和设计多种多样,其中60项(40%)被确定为随机对照试验(RCTs)。值得注意的是,151项研究中有143项(95%)来自发达国家,这表明在资源较低的环境中实施移动医疗服务的可行性存在证据不足。此外,结果突出了与薄弱的研究设计有关的担忧,专家参与以及为捕捉影响或随时间变化而选择的成果衡量标准类型。还缺乏为青年研究mHealth技术以及使用非青年为中心的方法来实施成果的标准化法规和准则。
    结论:这项研究可用于指导未来的工作,以及开发以青年为中心的移动健康工具,这些工具可以随着时间的推移为不同类型的青年实施和维持。需要优先考虑青年参与的实施科学研究,以增进对mHealth实施的当前理解。同样,核心成果集可能支持以青年为中心的衡量战略,以系统的方式捕捉成果,优先考虑公平,多样性,inclusion,和强大的测量科学。最后,这项研究表明,需要未来的实践和政策研究,以确保mHealth的风险最小化,并且这种创新的医疗保健服务随着时间的推移正在满足年轻人的新需求。
    背景:
    A total of 75% of people with mental health disorders have an onset of illness between the ages of 12 and 24 years. Many in this age group report substantial obstacles to receiving quality youth-centered mental health care services. With the rapid development of technology and the recent COVID-19 pandemic, mobile health (mHealth) has presented new opportunities for youth mental health research, practice, and policy.
    The research objectives were to (1) synthesize the current evidence supporting mHealth interventions for youths who experience mental health challenges and (2) identify current gaps in the mHealth field related to youth\'s access to mental health services and health outcomes.
    Guided by the methods of Arksey and O\'Malley, we conducted a scoping review of peer-reviewed studies that used mHealth tools to improve youth mental health (January 2016-February 2022). We searched MEDLINE, PubMed, PsycINFO, and Embase databases using the following key terms: (1) mHealth; (2) youth and young adults; and (3) mental health. The current gaps were analyzed using content analysis.
    The search produced 4270 records, of which 151 met inclusion criteria. Included articles highlight the comprehensive aspects of youth mHealth intervention resource allocation for targeted conditions, mHealth delivery methods, measurement tools, evaluation of mHealth intervention, and youth engagement. The median age for participants in all studies is 17 (IQR 14-21) years. Only 3 (2%) studies involved participants who reported their sex or gender outside of the binary option. Many studies (68/151, 45%) were published after the onset of the COVID-19 outbreak. Study types and designs varied, with 60 (40%) identified as randomized controlled trials. Notably, 143 out of 151 (95%) studies came from developed countries, suggesting an evidence shortfall on the feasibility of implementing mHealth services in lower-resourced settings. Additionally, the results highlight concerns related to inadequate resources devoted to self-harm and substance uses, weak study design, expert engagement, and the variety of outcome measures selected to capture impact or changes over time. There is also a lack of standardized regulations and guidelines for researching mHealth technologies for youths and the use of non-youth-centered approaches to implementing results.
    This study may be used to inform future work as well as the development of youth-centered mHealth tools that can be implemented and sustained over time for diverse types of youths. Implementation science research that prioritizes youths\' engagement is needed to advance the current understanding of mHealth implementation. Moreover, core outcome sets may support a youth-centered measurement strategy to capture outcomes in a systematic way that prioritizes equity, diversity, inclusion, and robust measurement science. Finally, this study suggests that future practice and policy research are needed to ensure the risk of mHealth is minimized and that this innovative health care service is meeting the emerging needs of youths over time.
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  • 文章类型: Journal Article
    背景:糖尿病是一种高负担的慢性疾病,需要终生积极管理,包括使用不同的工具和医疗保健资源来改善患者的健康结果。最近的研究表明,关于使用虚拟护理技术对慢性病治疗的影响,比如糖尿病。然而,目前还不清楚技术的使用,例如安全消息传递,提高医疗质量,降低与糖尿病相关的医疗费用。
    目的:我们范围审查的目的是探讨在初级保健环境中使用安全消息传递治疗糖尿病的已知情况,以及如何从患者和卫生系统的角度评估其影响。我们的评论旨在了解安全消息传递在多大程度上提高了糖尿病护理的质量。
    方法:我们的范围审查将遵循6步Arksey和O\'Malley方法框架,以及JoannaBriggsInstitute用于范围审查的方法及其推荐的工具。以结构化的方式指导审查的制定和报告的工具将包括人口,概念,和上下文框架以及PRISMA-ScR(系统审查的首选报告项目和范围审查的元分析扩展)指南和清单。搜索策略是与专业信息专家合作开发的。此外,独立人士还对电子搜索策略进行了同行审查,第三方,专业信息专家。将对数据库进行系统的文献检索,包括OvidMEDLINE所有,Embase,APAPsycINFO,Wiley的Cochrane图书馆,EBSCO上的CINAHL,和PubMed。灰色文献来源也将搜索相关文献。将包括有关在初级保健环境中治疗糖尿病(1型和2型)中使用安全消息传递的文献。两名审稿人将根据纳入标准对文献进行审查,分为以下两个步骤:(1)标题和摘要审查;(2)全文审查。在可能的情况下,将讨论差异以达成共识;否则,第三位审稿人将解决争端。
    结果:结果和最终报告预计将在6个月内完成并提交给同行评审的期刊。
    结论:本综述将研究现有文献,以确定安全信息在初级护理环境中糖尿病治疗中的影响。还将确定研究差距,以确定是否需要进一步研究。
    DERR1-10.2196/42339。
    BACKGROUND: Diabetes-a high-burden chronic disease-requires lifetime active management involving the use of different tools and health care resources to improve patient health outcomes. Recent studies have demonstrated promising results regarding the impact of the use of virtual care technology on the treatment of chronic diseases, such as diabetes. However, it is unclear whether the use of technologies, such as secure messaging, improves the quality of care and reduces diabetes-related costs to the health care system.
    OBJECTIVE: The purpose of our scoping review is to explore what is known about the use of secure messaging in the treatment of diabetes within the primary care setting and how its impact has been assessed from the patient and health system perspectives. Our review aims to understand to what extent secure messaging improves the quality of diabetes care.
    METHODS: Our scoping review will follow the 6-step Arksey and O\'Malley methodological framework, as well as the Joanna Briggs Institute methodology for scoping reviews and their recommended tools. The tools to guide the development and reporting of the review in a structured way will include the Population, Concept, and Context framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines and checklist. The search strategy was developed iteratively in collaboration with a professional information specialist. Furthermore, a peer review of electronic search strategies was also conducted by an independent, third-party, professional information specialist. A systematic literature search will be conducted against databases, including Ovid MEDLINE ALL, Embase, APA PsycINFO, Cochrane Library on Wiley, CINAHL on EBSCO, and PubMed. Grey literature sources will also be searched for relevant literature. Literature on the use of secure messaging in the treatment of diabetes (types 1 and 2) within a primary care setting will be included. Two reviewers will review the literature based on the inclusion criteria in the following two steps: (1) title and abstract review and (2) full-text review. Discrepancies will be discussed to reach consensus where possible; otherwise, a third reviewer will resolve the dispute.
    RESULTS: The results and a final report are expected to be completed and submitted to a peer-reviewed journal in 6 months.
    CONCLUSIONS: The review will examine existing literature to identify the impact of secure messaging in diabetes treatment within primary care settings. Research gaps will also be identified to determine if there is a need for further studies.
    UNASSIGNED: DERR1-10.2196/42339.
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  • 文章类型: Journal Article
    背景:远程医疗是使用技术以虚拟形式提供医疗保健。COVID-19大流行促使远程医疗的使用增加。
    目的:仅在COVID-19大流行期间至少有一组儿科患者和/或其护理人员接受远程医疗服务以及至少一个对照组接受非远程医疗服务的研究中,对儿科护理的满意度进行审查。
    方法:我们搜索了以英文发表的同行评审研究,这些研究比较了在COVID-19大流行期间接受远程医疗服务的儿科患者和/或其护理人员与接受非远程医疗服务的儿科患者和/或其护理人员对儿科护理的满意度。因为家里的命令,在大流行之前或期间进行的非远程医疗服务的比较组研究符合资格.我们于2023年1月5日在PubMed进行了搜索,EMBASE,CINAHL,和PsycInfo数据库。我们遵循系统评价和荟萃分析指南的首选报告项目。在审阅其余文章的全文之前,两名审阅者独立地筛选了标题和摘要。从每项符合条件的研究中提取了以下信息:国家,按比较组划分的参与者特征,研究设计,远程医疗方法,评估满意度的测量工具,以及对照组的发现。
    结果:所有符合条件的14项研究评估了在COVID-19大流行期间参与视频和/或电话访问的护理人员和/或儿科患者与在大流行之前或期间亲自预约的患者的满意度。在14项研究中的5项,比较非远程医疗服务发生在大流行之前,在其余9项调查中,非远程医疗服务发生在大流行期间。13项研究是采用不同设计的观察性调查,一项研究是采用3个比较组的视频进行准实验干预,面对面,混合参观。在14项研究中的9项,与面对面就诊相比,对远程医疗服务的满意度更高。护理人员对视频访问感到满意的原因是易于使用和减少了运输需求。护理人员对远程护理不满意的原因包括与提供者的个人互动有限和技术挑战。参加远程医疗的护理人员对缺乏体检表示担忧。参加非远程医疗服务的人表示,面对面的互动促进了治疗的依从性。只有一项研究评估了青少年完成自己调查的患者的满意度;与使用面对面访问的患者相比,使用远程医疗的青少年报告与提供者进行有效沟通的比例更高。
    结论:在大多数研究中,远程医疗服务往往比面对面就诊获得更有利或相当的满意度评分。远程医疗的需要改进包括应对技术挑战和在患者/护理人员和医疗提供者之间发展更好的融洽关系的策略。与儿科非远程医疗服务相比,对儿科远程医疗的有效性进行干预对于提高满意度和健康结果将是有价值的。
    背景:
    BACKGROUND: Telehealth refers to the use of technology to deliver health care remotely. The COVID-19 pandemic has prompted an increase in telehealth services.
    OBJECTIVE: This study aimed to review satisfaction with pediatric care in studies that had at least one group of pediatric patients and their caregivers receiving telehealth services during the COVID-19 pandemic and at least one comparison group of those receiving nontelehealth services.
    METHODS: We searched for peer-reviewed studies published in the English language that compared the satisfaction with pediatric care between pediatric patients and their caregivers receiving telehealth services during the COVID-19 pandemic and those receiving nontelehealth services. Owing to stay-at-home orders, studies with comparison groups for nontelehealth services that took place either before or during the pandemic were eligible. We searched the PubMed, Embase, CINAHL, and PsycINFO databases on January 5, 2023. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 2 reviewers independently screened the titles and abstracts before reviewing the full text of the remaining articles. The following information was extracted from each eligible study: country, participant characteristics by comparison group, study design, telehealth approach, measurement tools to assess satisfaction, and findings by comparison group.
    RESULTS: All 14 eligible studies assessed satisfaction among caregivers and pediatric patients participating in video or telephone visits during the COVID-19 pandemic compared with those having in-person appointments either before or during the pandemic. In 5 of the 14 studies, a comparison of nontelehealth services took place before the pandemic, and in the remaining 9 investigations, nontelehealth services took place during the pandemic. A total of 13 studies were observational investigations with different designs, and 1 study was a quasi-experimental intervention with 3 comparison groups for video, in-person, and hybrid visits. In 9 of the 14 studies, satisfaction with telehealth services was higher than during in-person visits. Caregivers were satisfied with video visits for the ease of use and reduced need for transportation. Reasons caregivers were not satisfied with remote care included limited personal interaction with the provider, technological challenges, and a lack of physical examination. Those participating in nontelehealth services expressed that in-person interactions promoted treatment adherence. Only 1 study assessed satisfaction where adolescent patients completed their own surveys; a higher percentage of adolescents using telehealth services reported effective communication with the provider compared with patients using in-person visits.
    CONCLUSIONS: In most studies, telehealth services received more favorable or comparable satisfaction ratings than in-person visits. Needed improvements in telehealth services included strategies to address technological challenges and develop better rapport among the patient, caregiver, and medical provider. Interventions may investigate the influence of telehealth services on access to and quality of care.
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  • 文章类型: Journal Article
    Community health workers (CHWs) have become essential to the promotion of healthy behaviors, yet their work is complicated by challenges both within and beyond their control. These challenges include resistance to the change of existing behaviors, disbelief of health messages, limited community health literacy, insufficient CHW communication skills and knowledge, lack of community interest and respect for CHWs, and CHWs\' lack of adequate supplies. The rising penetration of \"smart\" technology (eg, smartphones and tablets) in low- and middle-income countries facilitates the use of portable electronic devices in the field.
    This scoping review examines to what extent mobile health in the form of smart devices may enhance the delivery of public health messages in CHW-client interactions, thereby addressing the aforementioned challenges and inducing client behavior change.
    We conducted a structured search of the PubMed and LILACS databases using subject heading terms in 4 categories: technology user, technology device, use of technology, and outcome. Eligibility criteria included publication since January 2007, CHWs delivering a health message aided by a smart device, and face-to-face communication between CHWs and clients. Eligible studies were analyzed qualitatively using a modified version of the Partners in Health conceptual framework.
    We identified 12 eligible studies, 10 (83%) of which used qualitative or mixed methods approaches. We found that smart devices mitigate challenges encountered by CHWs by improving their knowledge, motivation, and creativity (eg, through self-made videos); their status within the community; and the credibility of their health messages. The technology stimulated interest in both CHWs and clients-and sometimes even in bystanders and neighbors. Media content produced locally or reflecting local customs was strongly embraced. Yet, the effect of smart devices on the quality of CHW-client interactions was inconclusive. Interactions suffered as CHWs were tempted to replace educational conversations with clients by passively watching video content. Furthermore, a series of technical difficulties experienced especially by older and less educated CHWs compromised some of the advantages brought about by mobile devices. Adequate CHW training ameliorated these difficulties. Only 1 study (8%) considered client health behavior change as an end point, thus revealing a major research gap.
    Smart mobile devices may augment CHWs\' field performance and enhance face-to-face interactions with clients, yet they also generate new challenges. The available evidence is scarce, mostly qualitative, and focused on a limited range of health outcomes. Future research should include larger-scale interventions across a wide range of health outcomes and feature client health behavior change as an end point.
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  • 文章类型: Systematic Review
    背景:慢性疼痛(CP)是全球残疾的主要原因之一,对个人构成重大负担,社会,和经济方面。潜在工具,如移动健康(mHealth)系统,正在出现CP患者的自我管理。
    目的:进行了系统评价,以分析mHealth干预措施对CP管理的影响,根据疼痛强度,生活质量(QoL),和功能残疾评估,与常规治疗或非干预相比。
    方法:遵循PRISMA(系统评价和荟萃分析的首选报告项目)指南,对PubMed上发表的随机对照试验(RCT)进行系统评价,WebofScience,Scopus,和物理治疗证据数据库(PEDro)数据库从2月到2022年3月。没有使用过滤器。资格标准为成人(≥18岁)CP的RCT,使用基于移动应用程序的移动健康系统进行干预,以监测疼痛和健康相关结果,疼痛和行为自我管理,为了进行治疗方法,与常规治疗相比(物理,职业,和心理治疗;常规医疗;和教育)或非干预,报告疼痛强度,QoL,功能性残疾。方法学质量和偏倚风险(RoB)使用质量测量清单进行评估,牛津循证医学中心的证据水平,和CochraneRoB2.0工具。
    结果:总计,22项随机对照试验,涉及2641名患有国际疾病分类第11修订版(ICD-11)中列出的不同CP状况的患者,包括慢性腰痛(CLBP),慢性肌肉骨骼疼痛(CMSP),慢性颈痛(CNP),未指定CP,慢性盆腔疼痛(CPP),纤维肌痛(FM),间质性膀胱炎/膀胱疼痛综合征(IC/BPS),肠易激综合征(IBS),骨关节炎(OA)。总共使用了23个mHealth系统来执行各种CP自我管理策略,其中最常用的是监测疼痛和症状以及基于家庭的锻炼计划。使用mHealth系统降低疼痛强度的有益效果(CNP,FM,IC/BPS,和OA),QoL(CLBP,CNP,IBS,和OA),和功能障碍(CLBP,CMSP,CNP,和OA)被发现。大多数纳入的研究(18/22,82%)报告了中等的方法学质量,被认为是高度推荐的;此外,7/22(32%)研究的RoB较低,10/22(45%)有一些担忧,5/22(23%)的RoB较高。
    结论:使用mHealth系统对CNP的疼痛强度有积极影响,FM,IC/BPS,和OA;对于CLBP中的QoL,CNP,IBS,和OA;对于CLBP的功能障碍,CMSP,CNP,和OA。因此,mHealth似乎是改善疼痛相关结局和QoL的替代方法,并且可能是CP自我管理的多模式策略的一部分。需要高质量的研究来合并使用mHealth系统进行CP管理的证据和建议。
    背景:PROSPERO国际系统评价前瞻性注册CRD42022315808;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=315808。
    Chronic pain (CP) is 1 of the leading causes of disability worldwide and represents a significant burden on individual, social, and economic aspects. Potential tools, such as mobile health (mHealth) systems, are emerging for the self-management of patients with CP.
    A systematic review was conducted to analyze the effects of mHealth interventions on CP management, based on pain intensity, quality of life (QoL), and functional disability assessment, compared to conventional treatment or nonintervention.
    PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed to conduct a systematic review of randomized controlled trials (RCTs) published in PubMed, Web of Science, Scopus, and Physiotherapy Evidence Database (PEDro) databases from February to March 2022. No filters were used. The eligibility criteria were RCTs of adults (≥18 years old) with CP, intervened with mHealth systems based on mobile apps for monitoring pain and health-related outcomes, for pain and behavioral self-management, and for performing therapeutic approaches, compared to conventional treatments (physical, occupational, and psychological therapies; usual medical care; and education) or nonintervention, reporting pain intensity, QoL, and functional disability. The methodological quality and risk of bias (RoB) were assessed using the Checklist for Measuring Quality, the Oxford Centre for Evidence-Based Medicine Levels of Evidence, and the Cochrane RoB 2.0 tool.
    In total, 22 RCTs, involving 2641 patients with different CP conditions listed in the International Classification of Diseases 11th Revision (ICD-11), including chronic low back pain (CLBP), chronic musculoskeletal pain (CMSP), chronic neck pain (CNP), unspecified CP, chronic pelvic pain (CPP), fibromyalgia (FM), interstitial cystitis/bladder pain syndrome (IC/BPS), irritable bowel syndrome (IBS), and osteoarthritis (OA). A total of 23 mHealth systems were used to conduct a variety of CP self-management strategies, among which monitoring pain and symptoms and home-based exercise programs were the most used. Beneficial effects of the use of mHealth systems in reducing pain intensity (CNP, FM, IC/BPS, and OA), QoL (CLBP, CNP, IBS, and OA), and functional disability (CLBP, CMSP, CNP, and OA) were found. Most of the included studies (18/22, 82%) reported medium methodological quality and were considered as highly recommendable; in addition, 7/22 (32%) studies had a low RoB, 10/22 (45%) had some concerns, and 5/22 (23%) had a high RoB.
    The use of mHealth systems indicated positive effects for pain intensity in CNP, FM, IC/BPS, and OA; for QoL in CLBP, CNP, IBS, and OA; and for functional disability in CLBP, CMSP, CNP, and OA. Thus, mHealth seems to be an alternative to improving pain-related outcomes and QoL and could be part of multimodal strategies for CP self-management. High-quality studies are needed to merge the evidence and recommendations of the use of mHealth systems for CP management.
    PROSPERO International Prospective Register of Systematic Reviews CRD42022315808; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315808.
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