乳腺癌自我管理的行为机制及移动医疗智能管理模式的实证研究

项目名称： 乳腺癌自我管理的行为机制及移动医疗智能管理模式的实证研究

项目编号： No.71473262

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 管理科学

项目作者： 袁长蓉

作者单位： 复旦大学

项目金额： 58万元

中文摘要： 在医疗资源有限的现实情况下，移动医疗（M-health）以其便捷性和低成本成为21世纪最具潜力的创新卫生管理模式。乳腺癌救治过程中患者自我管理行为的必要性和复杂性，使其成为移动医疗智能管理模式的适宜人群。本课题采用混合研究（Mixed Method）设计，第一阶段通过利益人群焦点访谈和个体纵向追踪等质性研究，探索乳腺癌救治全程患者的体验及照护需求；借助Delphi咨询和专家工作组法，确定和研发乳腺癌移动医疗智能手机应用程序，构建基于该程序的乳腺癌移动医疗智能管理模式；第二阶段通过随机对照量性研究进行管理模式干预的有效性验证，采用发展混合模型得到乳腺癌自我管理行为随时间变化的不同纵向发展轨迹，并分析干预模式对不同轨迹的影响差异。研究结果不仅可以帮助乳腺癌人群提高自我管理行为，而且对今后探索结合单病种特质开展针对性的移动医疗管理积累有益的经验，推动移动医疗在我国卫生事业管理中的快速发展。

中文关键词： 移动医疗；乳腺癌；自我管理；行为机制；发展混合模型

英文摘要： Facing the limited medical resource, mobile health (M-health) has being quickly becoming a promising innovative health management because of its convenience and low cost. M-health intelligent management models appropriate to women with breast cancer because of the necessity and complexity of self-management in the process of cancer treatment and rehabilitation. We propose to develop an intervention based on M-health intelligent management model targeting patients with breast cancer in China. A mixed methods approach will be applied in the proposed study. First, qualitative studies, such as focus-group interviews and individual longitudinal tracking based on perceived needs record card, will be applied to better understand our target population (i.e., patients with breast cancer) in regard to their experience and care needs during cancer treatment. Second, based on the information collected in Stage 1 of our study, we will apply the method of Delphi consulting and expert working groups to determine and develop appropriate Breast Cancer Mobile Health Smart Phone Applications in Android system. Based on applications of the cell-phone software, we will develop a breast cancer M-health intelligent management model. Once the management model has been pilot tested, a longitudinal study will be conducted to evaluate the efficacy of the management model. Participants will be randomly assigned into the intervention (i.e., self-management model) and control groups, and then followed up four times at different stages of cancer treatment. An advanced statistical model - growth mixture model (GMM) will be applied to examine possible heterogeneity of changes in individual self-management behaviors over time; identify the patterns of the outcome changes and determine the factors that influence such patterns; and evaluate how our intervention would help patients improve their self-management behaviors and quality of life. The results of the study will provide important implications for further development and implementation of the individualized comprehensive M-health intelligent management pertinent to specific diseases, and promote the rapid development of the M-health in cancer management in China.

英文关键词： mobile health;breast cancer;self-management;behavioral mechanisms;Growth Mixture Modeling