Application progress on mobile health technology inout-of-hospital management for cancer survivors LIU Shuo,QIAO Yuanjing\",ZHU Yaoyao,YU Yuehai,PEI Hao,ZHU Qingyang,WANG Yuting SchoolofNursing,ShandongUniversityofTCM,Shandong25o355China
*Corresponding Author QIAO Yuanjing,E-mail: threeqiao379o@163.com
AbstractThisticlerevieedteaplicationfs,tatusuoxistingchalengesandrecommendatosofobilealthtcologyin out-of-ospitalaagentfoancrsurvivoeiastprovieeferecfothifciplementatioofobilealhteolgy in the out-of-hospital management of cancer survivors in China.
Keywordsmobile health technology; cancer survivors; out-of-hospital management; nursing; review
全球癌癥統(tǒng)計(jì)數(shù)據(jù)顯示,2020年全球有1930萬例新發(fā)病例,其中我國有457萬例,約占全球新發(fā)病例的 24%[1] 。隨著癌癥篩查、診斷和治療技術(shù)的提升以及院外延續(xù)、康復(fù)護(hù)理的相繼開展,癌癥病人5年生存率普遍提高。完成手術(shù)、放化療等常規(guī)治療并進(jìn)入隨訪期的癌癥病人被稱為癌癥幸存者,但其在出院后常面臨身體功能障礙、疼痛、疲勞等不適,生存質(zhì)量及健康結(jié)局受到嚴(yán)重影響[3-4],如何有效地對(duì)癌癥幸存者進(jìn)行院外管理成為延長其生存期和改善生存質(zhì)量的重要內(nèi)容。我國發(fā)布的《數(shù)字中國建設(shè)整體布局規(guī)劃》指出,要大力推進(jìn)數(shù)字中國建設(shè),在醫(yī)療等重點(diǎn)領(lǐng)域加快數(shù)字技術(shù)創(chuàng)新應(yīng)用,發(fā)展數(shù)字健康5。近年來,隨著移動(dòng)互聯(lián)網(wǎng)的快速發(fā)展,移動(dòng)健康技術(shù)在幫助癌癥幸存者減輕癥狀負(fù)擔(dān)、加強(qiáng)自我管理、提供心理支持和改善生存質(zhì)量等方面取得良好效果[6-8]?,F(xiàn)就移動(dòng)健康技術(shù)在癌癥幸存者院外管理中的應(yīng)用進(jìn)行綜述,旨在為我國今后開展相關(guān)研究以及癌癥幸存者優(yōu)化院外管理提供參考。
1移動(dòng)健康技術(shù)在癌癥幸存者院外管理中的應(yīng)用形式
1.1移動(dòng)健康應(yīng)用程序
隨著移動(dòng)健康技術(shù)的進(jìn)步、智能手機(jī)的普及,癌癥相關(guān)應(yīng)用程序數(shù)量逐漸增多,Adam等在AppStore和GooglePlay應(yīng)用程序商店識(shí)別出癌癥幸存者可使用的151款應(yīng)用程序,移動(dòng)健康應(yīng)用程序極大提高了癌癥幸存者院外管理的可及性及延續(xù)性。Borosund等[10]開發(fā)了一款包含壓力管理10個(gè)學(xué)習(xí)教育模塊的StressProffenApp,通過提供積極自我對(duì)話、深呼吸、漸進(jìn)式肌肉放松、引導(dǎo)想象、正念和冥想等功能以支持出院后癌癥幸存者壓力管理,結(jié)果表明,該App在緩解幸存者壓力、抑郁、疲勞以及提高生活質(zhì)量方面有明顯效果,同時(shí),該App還可實(shí)時(shí)追蹤幸存者學(xué)習(xí)進(jìn)度和軌跡數(shù)據(jù),并允許即時(shí)反饋[11]。
1.2 互聯(lián)網(wǎng)網(wǎng)站
互聯(lián)網(wǎng)網(wǎng)站作為向癌癥幸存者提供信息支持及健康管理的在線平臺(tái),可為其提供多層次的院外康復(fù)及管理指導(dǎo)。Diefenbach等12設(shè)計(jì)了癌癥資源和信息支持網(wǎng)站(CRIS),旨在促進(jìn)膀胱癌幸存者術(shù)后康復(fù)及提高其與照顧者的生活質(zhì)量,為了確保內(nèi)容易于瀏覽和理解及增加用戶參與度,在CRIS開發(fā)過程中采用了可以多種方式訪問網(wǎng)站、大字體、大段落間距以及背景顏色高度對(duì)比等設(shè)計(jì),訪談結(jié)果顯示病人對(duì)該網(wǎng)站滿意度較高。此外,為提高乳腺癌幸存者出院后口服藥物治療的依從性,Yanez等[3]開發(fā)了名為My Journey的網(wǎng)站,為乳腺癌幸存者提供居家口服藥物知識(shí)、堅(jiān)持長期用藥重要性以及相關(guān)藥物副作用處理方法等健康教育指導(dǎo),并提供冥想、專注等正念干預(yù)技能教學(xué),以提高藥物依從性、減少用藥偏差。
1.3智能可穿戴設(shè)備
智能可穿戴設(shè)備是指可植入衣物或附件佩戴在身體上的便捷式電子設(shè)備,可在相關(guān)軟件支持下對(duì)數(shù)據(jù)進(jìn)行實(shí)時(shí)監(jiān)測(cè)和傳輸[14],與傳統(tǒng)技術(shù)相比,智能可穿戴設(shè)備的實(shí)時(shí)監(jiān)測(cè)、自動(dòng)提示等功能便于對(duì)癌癥幸存者更及時(shí)、有效地居家隨訪??纱┐髟O(shè)備常與應(yīng)用程序或軟件相連接,為癌癥幸存者提供健康監(jiān)測(cè)和反饋,Ha等15將包括體育鍛煉、肌肉力量、久坐行為和健身等模塊在內(nèi)的移動(dòng)健康教育計(jì)劃iBounce應(yīng)用于兒童癌癥幸存者,在完成每個(gè)模塊后將可穿戴式活動(dòng)追蹤器與應(yīng)用程序iEngage同步,以監(jiān)測(cè)兒童癌癥幸存者居家運(yùn)動(dòng)情況。
1.4虛擬現(xiàn)實(shí)(virtualreality,VR)技術(shù)
虛擬現(xiàn)實(shí)作為一種新興的人機(jī)交互技術(shù),可融合視覺、聽覺、觸覺以及運(yùn)動(dòng)覺等多種感覺為一體構(gòu)建三維虛擬環(huán)境[16],具有參與性強(qiáng)、互動(dòng)性高的特點(diǎn)。虛擬現(xiàn)實(shí)技術(shù)可以更好地讓癌癥幸存者融人情境,提高干預(yù)效果。Huang等[7]以乳腺癌幸存者為研究對(duì)象實(shí)施基于虛擬現(xiàn)實(shí)的虛擬教學(xué)廚房方案(SOAR),模擬真實(shí)烹飪環(huán)境對(duì)乳腺癌幸存者進(jìn)行正念飲食訓(xùn)練,參與者可在虛擬環(huán)境中學(xué)習(xí)降低癌癥風(fēng)險(xiǎn)食物的烹飪技術(shù)、與不同學(xué)科專家進(jìn)行互動(dòng)培養(yǎng)正念飲食習(xí)慣,提高正念飲食意識(shí)。目前,虛擬現(xiàn)實(shí)技術(shù)在腫瘤癥狀管理中取得了良好的應(yīng)用效果,在癌癥幸存者中有較好的應(yīng)用潛力,但相關(guān)研究仍不足,還需加強(qiáng)對(duì)虛擬現(xiàn)實(shí)技術(shù)的進(jìn)一步探索,更好地為癌癥幸存者院外管理提供技術(shù)支持。
2移動(dòng)健康技術(shù)在癌癥幸存者院外管理中的應(yīng)用現(xiàn)狀
2.1 監(jiān)測(cè)及管理癥狀
癌癥幸存者雖已完成手術(shù)或放化療等常規(guī)治療,但出院后還會(huì)遭受癌癥診斷、治療以及相關(guān)并發(fā)癥等帶來的負(fù)面影響[4,基于智慧醫(yī)療平臺(tái)的移動(dòng)健康系統(tǒng)通過結(jié)合移動(dòng)技術(shù)與醫(yī)療服務(wù),可有效對(duì)癌癥幸存者伴隨癥狀進(jìn)行監(jiān)測(cè)和管理。Mobili-T是一款用于存在吞咽功能障礙的頭頸癌幸存者的移動(dòng)健康系統(tǒng)[18],該系統(tǒng)由測(cè)量吞咽及類似吞咽運(yùn)動(dòng)時(shí)下頜肌肉活動(dòng)的表面肌電圖傳感器和應(yīng)用程序組成,使用時(shí)將帶有傳感器的一次性黏合貼片貼在下頜皮膚上,吞咽動(dòng)作以視覺生物反饋的形式呈現(xiàn)給用戶,同時(shí)該系統(tǒng)還會(huì)對(duì)用戶達(dá)標(biāo)的吞咽次數(shù)進(jìn)行記錄反饋,以校準(zhǔn)幸存者吞咽方式。疼痛是癌癥病人治療前后較為嚴(yán)重的癥狀負(fù)擔(dān),隨著生存周期延長,遠(yuǎn)程居家鎮(zhèn)痛管理成為可供癌癥幸存者選擇的有效疼痛管理手段之一,Masiero等[19]研發(fā)了包括painrellife平臺(tái)(病人端)及云技術(shù)Nu平臺(tái)(醫(yī)生端)的painrellife移動(dòng)健康生態(tài)系統(tǒng),用于乳腺癌幸存者慢性疼痛的監(jiān)測(cè)及管理,病人端具有疼痛監(jiān)測(cè)、身體狀況和心理評(píng)估、疼痛和情緒-身體映射練習(xí)等功能,醫(yī)生端醫(yī)護(hù)人員可查看癥狀監(jiān)測(cè)數(shù)據(jù),有利于為病人制訂整體、個(gè)性化的干預(yù)措施,結(jié)果顯示,病人使用該系統(tǒng)的頻率與其3個(gè)月后的疼痛減輕程度呈正相關(guān)。通過對(duì)癌癥幸存者院外癥狀遠(yuǎn)程追蹤和數(shù)據(jù)分析,醫(yī)護(hù)人員及時(shí)調(diào)整治療方案,可實(shí)現(xiàn)醫(yī)療服務(wù)從院內(nèi)到院外的延伸。
2.2支持未滿足需求
已有研究結(jié)果顯示,癌癥幸存者常見的未滿足需求包括信息支持、情感支持、社會(huì)支持以及身體健康、經(jīng)濟(jì)、教育、工作等方面需求,且持續(xù)存在的未滿足需求會(huì)對(duì)康復(fù)產(chǎn)生不利影響[20]。相關(guān)需求得不到醫(yī)療及同伴支持的癌癥幸存者更渴望尋求在線支持,在線健康社區(qū)可作為向癌癥幸存者提供信息、情感等支持的重要來源[21]。Olivia等[22]開發(fā)了eLARS應(yīng)用程序,旨在為患有低位前切除術(shù)綜合征(LARS)的直腸癌幸存者提供信息和情感支持,該應(yīng)用程序具有LARS信息、病人論壇、日記、視頻、病人感言、聯(lián)系LARS團(tuán)隊(duì)6項(xiàng)核心功能,幸存者不僅可以學(xué)習(xí)LARS相關(guān)知識(shí),還可以與其他直腸癌幸存者及專家團(tuán)隊(duì)成員溝通以獲得情感支持。此外,癌癥幸存者在重返工作中常接受來自單位領(lǐng)導(dǎo)及同事、家人及同伴等提供的社會(huì)支持,移動(dòng)健康技術(shù)的應(yīng)用可更好地促進(jìn)癌癥幸存者融入社會(huì)。Romero-Ayuso等23通過橫斷面調(diào)查發(fā)現(xiàn),睡眠、休息、社交、情感等對(duì)乳腺癌幸存者職業(yè)需求影響較大,其開發(fā)了一款支持乳腺癌幸存者未滿足職業(yè)需求的移動(dòng)應(yīng)用程序—MAIA,該應(yīng)用程序通過實(shí)時(shí)隨訪幸存者在工作中遇到的困難以及情緒、疼痛、疲勞和上肢功能障礙對(duì)職業(yè)的影響,幫助職業(yè)治療師為乳腺癌幸存者提供個(gè)性化建議并實(shí)時(shí)更新,以支持其重返工作崗位。
2.3減輕癌癥復(fù)發(fā)恐懼
癌癥復(fù)發(fā)恐懼是指對(duì)癌癥復(fù)發(fā)、進(jìn)展或發(fā)生轉(zhuǎn)移可能性的恐懼、擔(dān)心或憂慮,約一半的癌癥幸存者會(huì)經(jīng)歷具有臨床意義的癌癥復(fù)發(fā)恐懼[24-25]。較嚴(yán)重的癌癥復(fù)發(fā)恐懼難以隨時(shí)間推移而消失,不僅嚴(yán)重影響癌癥幸存者的生活質(zhì)量,加重焦慮、抑郁,還會(huì)導(dǎo)致醫(yī)療資源的過度使用及潛在醫(yī)療成本增加。生態(tài)瞬時(shí)評(píng)估法(ecologicalmomentaryassessment,EMA)是一種密集型縱向數(shù)據(jù)收集方法,通過個(gè)體對(duì)當(dāng)下行為、體驗(yàn)、癥狀等變量的自我報(bào)告,獲取實(shí)時(shí)評(píng)估數(shù)據(jù)。Heathcote等[26將生態(tài)瞬時(shí)評(píng)估法用于動(dòng)態(tài)監(jiān)測(cè)兒童癌癥幸存者的壓力、掃描焦慮癥以及癌癥復(fù)發(fā)恐懼,結(jié)果顯示動(dòng)態(tài)評(píng)估效果較好。Sebri等[27在乳腺癌幸存者中實(shí)施虛擬現(xiàn)實(shí)干預(yù)方案,乳腺癌幸存者佩戴虛擬現(xiàn)實(shí)眼鏡和可穿戴式無線傳感器沉浸于虛擬環(huán)境中并接受一系列視覺、聽覺刺激,感知身體形象變化,通過積極自我評(píng)價(jià)和情緒調(diào)節(jié),以減輕癌癥復(fù)發(fā)恐懼。移動(dòng)健康技術(shù)對(duì)癌癥復(fù)發(fā)恐懼有較好的評(píng)估和管理效果,與傳統(tǒng)面對(duì)面的干預(yù)形式相比,具有更加靈活便捷的特性。
2.4干預(yù)身體活動(dòng)
2022年,美國癌癥協(xié)會(huì)發(fā)布的《癌癥幸存者營養(yǎng)和身體活動(dòng)指南》指出,癌癥幸存者每周應(yīng)進(jìn)行 150~ 300min 的中等強(qiáng)度運(yùn)動(dòng)或 75~150min 的高強(qiáng)度運(yùn)動(dòng),然而大多數(shù)癌癥幸存者缺乏運(yùn)動(dòng)鍛煉動(dòng)機(jī)且依從性較差[28]。已有研究表明,運(yùn)動(dòng)鍛煉可改善癌癥幸存者疲勞、癌癥相關(guān)的認(rèn)知障礙,促進(jìn)身體功能恢復(fù),降低癌癥死亡風(fēng)險(xiǎn)[29]。ATOPE + 移動(dòng)健康系統(tǒng)可遠(yuǎn)程評(píng)估乳腺癌幸存者的自主神經(jīng)平衡、運(yùn)動(dòng)恢復(fù)感知、睡眠滿意度和情緒困擾[3],進(jìn)而幫助專業(yè)康復(fù)治療師為乳腺癌幸存者制訂個(gè)性化的運(yùn)動(dòng)處方。移動(dòng)健康運(yùn)動(dòng)干預(yù)不僅可以為癌癥幸存者提供運(yùn)動(dòng)指導(dǎo),在提高癌癥幸存者運(yùn)動(dòng)依從性及居家運(yùn)動(dòng)管理等方面也具有一定效果。Steps2Health是一種將游戲化設(shè)計(jì)元素與可穿戴設(shè)備相結(jié)合的移動(dòng)健康技術(shù),Robertson等31將缺乏身體活動(dòng)的78例癌癥幸存者隨機(jī)分為干預(yù)組和對(duì)照組,干預(yù)組癌癥幸存者在虛擬旅程中通過腕戴式FibitAlta設(shè)備將行走里程同步到數(shù)據(jù)云分析平臺(tái),機(jī)器算法技術(shù)根據(jù)參與者的實(shí)時(shí)步數(shù)以文本、圖片或超鏈接等形式呈現(xiàn)該虛擬旅程沿線照片、肌肉強(qiáng)化鍛煉視頻以及當(dāng)前虛擬位置的健康食譜,增加參與者探索體驗(yàn)和真實(shí)性,結(jié)果顯示,干預(yù)組幸存者每日步數(shù)增加。
2.5管理癌因性疲乏
癌因性疲乏是指與癌癥或癌癥治療有關(guān)的疲乏感或疲憊感,是一種痛苦、持續(xù)、主現(xiàn)感受,與近期活動(dòng)量不成正比且睡眠或休息無法緩解[32]。癌因性疲乏在乳腺癌、結(jié)直腸癌、宮頸癌等幸存者中持續(xù)存在[33]。移動(dòng)健康技術(shù)可收集反映病人生理或健康狀況的特征合集即數(shù)字生物標(biāo)志物來監(jiān)測(cè)疾病進(jìn)展甚至預(yù)后,Sada等[34研究證明,可穿戴懸吊式傳感器測(cè)量的數(shù)字生物標(biāo)志物可用于評(píng)估癌癥幸存者癌因性疲乏,有利于完善現(xiàn)有的癌因性疲乏評(píng)估方法,提高評(píng)估的準(zhǔn)確性。此外,Untire[35]每周可通過視覺模擬量表評(píng)估癌癥幸存者的疲勞程度、疲勞負(fù)擔(dān)、滿意度和幸福感,進(jìn)而幫助幸存者對(duì)癌因性疲乏進(jìn)行管理,共包含我的主題、我的鍛煉、身體活動(dòng)、提示4個(gè)部分,研究結(jié)果顯示,其應(yīng)用可使癌癥幸存者疲勞嚴(yán)重程度、生活質(zhì)量等方面有所改善[36]
2.6提升自我效能感
已有研究結(jié)果顯示,自我效能感越高的癌癥幸存者,急診就診率和住院率越低[37]。自我效能感是指人們對(duì)其組織或?qū)嵤┻_(dá)到特定成就目標(biāo)所需行動(dòng)過程的能力信念,是自我管理行為改變的先導(dǎo)[38]。移動(dòng)健康技術(shù)是癌癥幸存者提升自我效能感、強(qiáng)化自我管理技能的有效工具。Yoon等39為結(jié)直腸癌幸存者開發(fā)了一款包括信息、情感和評(píng)估支持3個(gè)模塊的應(yīng)用程序,其可每周根據(jù)幸存者信息需求、心理狀況評(píng)估結(jié)果監(jiān)測(cè)病人的自我管理狀況,并向幸存者提供個(gè)性化健康指導(dǎo)。一項(xiàng)隨機(jī)對(duì)照試驗(yàn)將176例癌癥幸存者隨機(jī)分為干預(yù)組和對(duì)照組,干預(yù)組可訪問由美國癌癥協(xié)會(huì)和研究所共同開發(fā)的SpringboardBeyondCancer(SBC)網(wǎng)站,包括癥狀管理、壓力和情緒管理、改善健康、獲得支持以及經(jīng)濟(jì)困難等模塊,并通過發(fā)送自我管理信息,幫助幸存者制訂個(gè)性化的行動(dòng)計(jì)劃,結(jié)果顯示,干預(yù)組病人自我效能感和自我管理能力增強(qiáng)[40]。移動(dòng)健康技術(shù)的應(yīng)用可提高癌癥幸存者自我效能感,有利于受地域限制的病人實(shí)施居家自我管理,對(duì)病人整體的健康水平和生存質(zhì)量有積極影響。
2.7緩解心理痛苦
癌癥幸存者普遍存在負(fù)性心理(如自卑感、病恥感和歧視知覺等),導(dǎo)致社會(huì)融人感較低,社會(huì)疏離感加重,幸存者及其家庭成員心理痛苦[41],因此,提供心理支持、緩解心理痛苦是癌癥幸存者院外延續(xù)護(hù)理的重要內(nèi)容。移動(dòng)健康技術(shù)不僅有利于增加癌癥幸存者健康信息的可及性,還有利于減輕癌癥幸存者心理困擾、緩解心理痛苦。Salsman等42針對(duì)青年癌癥幸存者建立了EMPOWER移動(dòng)醫(yī)療積極情緒干預(yù)網(wǎng)站,在EMPOWER中教授病人注意、利用或品味日常積極事件以及感恩、正念、注重個(gè)人優(yōu)勢(shì)、設(shè)定并努力實(shí)現(xiàn)可實(shí)現(xiàn)目標(biāo)等8項(xiàng)技能,使用短信、電子郵件和電話等方式提醒幸存者按時(shí)學(xué)習(xí),結(jié)果顯示,與基線相比,干預(yù)8周后幸存者心理痛苦程度降低,幸福感提高。
3移動(dòng)健康技術(shù)在癌癥幸存者院外管理應(yīng)用中存在的問題及建議
3.1癌癥幸存者移動(dòng)健康技術(shù)應(yīng)用依從性較差
已有研究結(jié)果顯示,癌癥幸存者對(duì)移動(dòng)健康技術(shù)表現(xiàn)出強(qiáng)烈意愿,同時(shí)也存在依從性較差等問題,使用率隨干預(yù)時(shí)間延長而降低,原因可能與擔(dān)心隱私泄露而缺乏信任感以及使用成本較高、難度較大等有關(guān)[43-44]。Ivankova等[45]研究表明,中老年癌癥幸存者在移動(dòng)健康技術(shù)干預(yù)的質(zhì)量、易用性、隱私、設(shè)計(jì)吸引力以及與專家互動(dòng)等方面有較高的關(guān)注度。對(duì)此,首先可在技術(shù)開發(fā)前進(jìn)行半結(jié)構(gòu)化訪談或橫斷面調(diào)查,以滿足不同癌種、不同年齡癌癥幸存者對(duì)院外延續(xù)護(hù)理的個(gè)性化需求,提高使用體驗(yàn)感;其次,在數(shù)字化健康干預(yù)手段開發(fā)過程中應(yīng)遵循多元化設(shè)計(jì)理念,盡量操作簡(jiǎn)單并增加提示、技巧及互動(dòng)功能;再次,應(yīng)加強(qiáng)多學(xué)科合作,即專業(yè)技術(shù)人員、醫(yī)護(hù)人員及相關(guān)領(lǐng)域?qū)<夜餐瑓⑴c開發(fā)、應(yīng)用、實(shí)踐,以提高可用性和有效性;此外,還需大力發(fā)展和健全網(wǎng)絡(luò)安全相關(guān)法律法規(guī),確保用戶數(shù)據(jù)的保密性和安全性。
3.2癌癥幸存者數(shù)字健康素養(yǎng)有待提升
癌癥幸存者數(shù)字健康素養(yǎng)水平普遍較低,受年齡、性別、受教育水平、居住地差異等影響,還與獲得使用移動(dòng)設(shè)備的可能性、個(gè)人態(tài)度偏好以及家人朋友支持等因素有關(guān)[46]。Zhou等[47]研究表明,癌癥幸存者可通過在線健康社區(qū)(OHCs)提供的信息和情感支持以及幸存者間的積極互動(dòng)提高電子健康素養(yǎng),在線健康社區(qū)可以解決農(nóng)村癌癥幸存者獲取支持較差的問題。建議幸存者不僅要提高自身獲取移動(dòng)健康技術(shù)支持的主動(dòng)性和可及性,還需增強(qiáng)信息評(píng)估能力以區(qū)分信息的真?zhèn)魏涂煽啃?;護(hù)理人員和家庭成員要幫助其樹立對(duì)各種形式移動(dòng)健康技術(shù)的正確認(rèn)識(shí)和積極信念,鼓勵(lì)幸存者多接觸、多嘗試,在實(shí)踐中感受移動(dòng)技術(shù)對(duì)癌癥治療后院外管理的幫助;還需通過講座、培訓(xùn)等多種形式提供社會(huì)支持,并消除癌癥幸存者移動(dòng)技術(shù)使用障礙問題。
4小結(jié)
移動(dòng)健康技術(shù)作為一種新興健康干預(yù)手段,近年來在醫(yī)療及相關(guān)領(lǐng)域的應(yīng)用逐漸受到重視,在癌癥幸存者院外管理及延續(xù)護(hù)理中具有巨大應(yīng)用潛力。但移動(dòng)健康技術(shù)在我國尚未成熟,還需開展大樣本、多中心、高質(zhì)量的移動(dòng)健康技術(shù)驗(yàn)證性研究,并借鑒先進(jìn)經(jīng)驗(yàn),研發(fā)適合我國的移動(dòng)健康技術(shù)形式,從而為我國存在不同癥狀及需求的癌癥幸存者提供更加高效、便捷的延續(xù)護(hù)理服務(wù)。
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