E 化癌症存活者存活照護計畫之系統性文獻回顧

A Systematic Review of E-based Cancer Survivorship Care Plan

癌症存活者日增，在有限醫療照護人力和時間提供符合癌症存活者期待之存活照護是一大挑戰。運用E化做為癌症存活照護介入的方式，可針對不同需求及特性的個案，提供個別化資訊和照護支持。利用E化給予癌症存活照護之研究逐漸發展及測試，統整分析各研究介入措施與成效，可做為未來E化設計癌症存活照護計畫之參考，探討以E化科技設計的癌症存活者存活照護計畫對病人自述成果的成效。以系統性文獻統整方式，使用關鍵字癌症、科技、E化、e化、電子、行動裝置、存活照護，搜尋2017年3月前發表的文章；實證相關資料庫：Pubmed、MEDLINE、CINAHL、Cochrane、psycINFO和CEPS，包含9篇隨機控制實驗與2篇類實驗研究。用E化網頁可利用在不同癌症別存活者做介入，需求評估搭配個別化、自動化與回饋警示設計下的存活照護，能夠增加個案對其生、心理症狀需求之陳述，有效降低憂鬱與疲勞程度，提昇生活品質中的情緒與社交功能，並增加健康生活相關行為。雖使用者對E化所提供的資訊感到滿意，然而使用E化提供癌症存活者之存活照護計畫無法降低其對健康照護資源之使用率。E化設計的癌症存活者存活照護計畫，能有效改善預後較佳癌症存活者的心理情緒困擾與生活品質，仍宜隨時更新資訊，與強化E化功能吸引癌症存活者持續利用E化存活照護。

As cancer survivorship care needs increase, it's a big challenge to provide an appropriate care for cancer survivorship under the limited health professional staffing with the increasing number of cancer survivorship. Web could be an alternative tool to provide individualized information for cancer survivors. Additionally, using E-based cancer survivorship care plan in cancer survivors are gradually developed and tested recently. It's necessary to integrate and analyze these interventions to provide more evidences to support future intervention. To evaluate the effectiveness of E-based cancer survivorship care plan on patients reported outcomes. A systematic review was conducted. Search term included cancer / neoplasm, technology / web / Internet/ e-health / mobile health / mobile application and survivorship care. A comprehensive search was from the Electronic databases, PubMed, MEDLINE, CINAHL, Cochrane Library, psycINFO and CEPS before March 2017. Nine randomized-controlled trails and two quasi-experimental studies were recruited. E-based survivorship care plan could apply on different kinds of cancer survivor, using needs assessment with tailored, automated and feedback function can increase physical and psychology symptoms reported by survivors, also reduce level of depression and fatigue as well as increase emotional, social function domain of quality of life and health-related lifestyle. Although patients were satisfied with the information web page provided, health care resource using could not be reduced. Using E-based survivorship care plan could improve psychological distress and quality of life in cancer survivors with better prognosis, however it should continue to update information and strengthen the function of web to meet needs of survivors.