6つの米国保健システムにおける電子患者報告結果のモニタリングの正常化と持続に関するスタッフの見解
Roshan Paudel1, Hajime Uno1, Christine Cronin1
1Dana-Farber Cancer Institute, Boston, MA.
JCO oncology practice
|September 5, 2025
まとめ
電子症状管理 (eSyM) は,臨床スタッフの間で適度な正常化と持続性を示しています. 看護師とAPPは持続可能性が低いと報告し,症状管理を支援する改善されたワークフローとツールの必要性を強調しました.
科学分野:
- 医療情報学
- 臨床実務の改善
- 患者の症状管理
背景:
- 電子症状管理 (eSyM) プログラムは,化学療法や手術後の患者をサポートするために,医療システムにますます統合されています.
- このようなデジタルヘルスツールの標準化と持続可能性の評価は,その長期的な成功と臨床実践への影響にとって極めて重要です.
研究 の 目的:
- 電子症状管理 (eSyM) プログラムの正常化と持続可能性に関する医療スタッフの見解を評価する.
- eSyMをさまざまなヘルスケア・ロールのルーティン・ワークフローに統合する要因を特定する.
主な方法:
- eSyMを臨床実践に統合するために,クラスターランダム化ステップドキドキ試験の設計が採用されました.
- 標準化対策開発 (NoMAD) と臨床持続可能性評価ツール (CSAT) を用いた横断調査は,さまざまな医療スタッフ (医師,看護師,APP,管理者,IT,研究) に実施されました.
主要な成果:
- 211人の職員のうち,合計169人 (80%) が調査を完了し,eSyMの適度な熟知度 (平均5.90/10) と統合度 (平均4.84/10) を報告した.
- 看護師は医師と比較して熟知度が高くても 協調性,認知参加,反射的モニタリングのスコアは低いと報告した.
- 全体的に穏やかな持続可能性 (平均4.52/7) が観察され,役割によって著しい変動がありました (例えば,APPは低い,ITスタッフは高い).
結論:
- 臨床スタッフは,eSyMを適度に標準化され,持続可能だと見ていますが,役割特有の違いがあります.
- 医療従事者の持続可能性の低い点数は 対象を絞った支援が必要であることを示唆しています
- 将来の研究は,症状管理における臨床スタッフのサポートを強化するための革新的なワークフローとツールの開発に重点を置くべきです.
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