■在美国的整个医疗保健系统中,症状的认识不足和治疗不足很普遍。虽然原因很复杂,人们普遍认为,电子症状报告可以提高临床医生管理症状的能力。然而,电子症状报告尚未广泛实施。当针对特定患者群体或临床环境定制时,电子系统是最有效的。例如,在美国,已经为接受治疗的癌症患者开发了许多以肿瘤学为中心的电子症状报告系统.这项范围审查的目的是确定在肿瘤学临床实践中实施针对患者报告症状的电子系统所面临的挑战。以及为克服这些挑战而采取或建议采取的方法。
■这项范围审查涉及对Medline的全面搜索,CINAHL,和Cochrane中央控制试验登记册,共发表了3133篇文章。筛选后,20项研究符合纳入标准,纳入本综述。使用定性内容分析从文章中系统地提取数据。
■确定的挑战按主题分类为技术问题,系统可用性问题,患者缺乏舒适度/技术知识,不完整/缺失数据,缺乏患者使用该系统,其他病人问题,完成临床过程的困难,缺乏诊所工作人员的参与/参与,以及缺乏临床医生对使用患者报告的结果数据的舒适度/知识。
■本综述的发现强调了在为癌症患者实施电子症状报告系统时需要解决的挑战,以及克服这些挑战的潜在策略。这篇综述可以帮助医院管理者和临床医生准备和改进电子症状报告系统在临床实践中的实施。从而提供证据使其能够更广泛地使用。
UNASSIGNED: Under-recognition and under-treatment of symptoms are prevalent throughout the health care system in the United States. While the reasons for this are complex, it is widely recognized that electronic symptom reports can improve clinicians\' ability to manage symptoms. However, electronic symptom reporting has yet to be widely implemented. Electronic systems are most effective when tailored to the specific patient population or clinical setting. For example, numerous oncology-focused electronic symptom reporting systems have been developed for patients with cancer undergoing treatment in the United States. The objective of this scoping review was to identify challenges that arose in the implementation of electronic systems for patient-reported symptoms in oncology clinical practice, and approaches that were taken or recommended to overcome those challenges.
UNASSIGNED: This scoping review involved comprehensive searches of Medline, CINAHL, and the Cochrane Central Register of Controlled Trials, which yielded 3,133 articles. Following screening, 20 research studies met the inclusion criteria and were included in this review. Data were systematically extracted from the articles using a qualitative content analysis.
UNASSIGNED: Challenges identified were thematically categorized as technical issues, system usability issues, patient lack of comfort/knowledge of technology, incomplete/missing data, lack of patient use of the system, other patient issues, difficulties timing completion with clinical processes, lack of clinic staff involvement/engagement, and lack of clinician comfort/knowledge regarding the use of patient-reported outcome data.
UNASSIGNED: The findings of this review highlight challenges that need to be addressed when implementing an electronic symptom reporting system for patients with cancer, and potential strategies for overcoming these challenges. This review may help hospital administrators and clinicians prepare for and improve the implementation of electronic symptom reporting systems into clinical practice, thereby providing evidence to enable their broader use.