Objective

To describe the adaptations made to implement virtual cancer rehabilitation at the onset of the coronavirus disease 2019 pandemic, as well as understand the experiences of patients and providers adapting to virtual care.

Design

Multimethod study.

Setting

Cancer center.

Participants

A total of 1968 virtual patient visits were completed during the study period. Adult survivors of cancer (n=12) and oncology health care providers (n=12) participated in semi-structured interviews.

Interventions

Not applicable.

Main Outcome Measures

Framework-driven categorization of program modifications, qualitative interviews with patients and providers, and a comparison of process outcomes with the previous 90 days of in-person care via referrals, completed visits and attendance, method of delivery, weekly capacities, and wait times.

Results

The majority of program visits could be adapted to virtual delivery, with format, setting, and content modifications. Virtual care demonstrated an increase or maintenance in the number of completed visits by appointment type compared with in-person care, with attendance ranging from 80%-93%. For most appointment types, capacities increased, whereas wait times decreased slightly. Overall, 168 patients (11% of all assessments and follow-ups) assessed virtually were identified by providers as requiring an in-person appointment because of reassessment of musculoskeletal and/or neurologic impairment (n=109, 65%) and lymphedema (n=59, 35%). The interviews (n=24) revealed that virtual care was an acceptable alternative in some circumstances, with the ability to (1) increase access to care; (2) provide a sense of reassurance during a time of isolation; and (3) provide confidence in learning skills to self-manage impairments.

Conclusions

Many appointments can be successfully adapted to virtual formats to deliver cancer rehabilitation programming. Based on our findings, we provide practical recommendations that can be implemented by providers and programs to facilitate the adoption and delivery of virtual care.

中文翻译：

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在 COVID-19 大流行的前 90 天内提供虚拟癌症康复计划：一项多方法研究

 客观的

描述在 2019 年冠状病毒病大流行开始时为实施虚拟癌症康复所做的调整，并了解患者和提供者适应虚拟护理的经验。

 设计

 多方法研究。

 环境

 癌症中心。

 参加者

研究期间总共完成了 1968 次虚拟患者就诊。成年癌症幸存者 (n=12) 和肿瘤医疗保健提供者 (n=12) 参与了半结构化访谈。

 干预措施

 不适用。

 主要成果指标

框架驱动的项目修改分类、对患者和提供者的定性访谈，以及通过转诊、完成的就诊和出勤、交付方法、每周容量和等待时间与过去 90 天的面对面护理的流程结果进行比较。

 结果

大多数节目访问都可以通过修改格式、设置和内容来适应虚拟交付。与面对面护理相比，虚拟护理按预约类型完成的就诊数量有所增加或维持，出勤率在 80%-93% 之间。对于大多数预约类型，容量有所增加，而等待时间略有减少。总体而言，由于重新评估肌肉骨骼和/或神经系统损伤（n=109，65%）和淋巴水肿（n =59, 35%）。访谈 (n=24) 显示，在某些情况下，虚拟护理是一种可以接受的替代方案，能够 (1) 增加获得护理的机会； (2) 在隔离期间提供安心感； (3) 提供学习技能以应对自我管理障碍的信心。

 结论

许多预约可以成功地适应虚拟形式以提供癌症康复计划。根据我们的发现，我们提供了可供提供商和项目实施的实用建议，以促进虚拟护理的采用和提供。