Nicolas L, Franco A, Provost H, Amico L, Berenguer M, Lombard F, Tyrrell J, Couturier P, Bosson J L, Wernert S, Schnee D, Basset D, Chemarin A, Frossard M
Réseau d'Hospitalisation Domicile, Département de Médecine Gériatrique, CHU, Grenoble (38).
Presse Med. 2005 Sep 10;34(15):1059-64. doi: 10.1016/s0755-4982(05)84116-8.
The purpose of this project was to study the clinical feasibility of videophone-based communication between patients in their homes, and the care teams who work in the Home Hospitalization department (HH).
This pilot study of videophone users compared them with a group of control patients also in HH. They came from either the adult, maternity or pediatric departments. Patients who met the inclusion criteria and consented to participate in the study were randomly assigned to one of two groups: those who had a videophone installed in their homes (telemedicine group), and those who received the standard HH care (control group). Sixteen patients in the telemedicine group were matched with 16 from the control group, according to age, Karnofsky Index score, and the reason for HH admission.
The mean videophone call lasted six minutes, and patients averaged 23 calls each over the study period (0.7 calls per patient per working day). The videophone enabled better follow-up of wounds: for example, the nurse could transmit photos from the patient's home for real-time coordination. It was also useful for following patients suffering from pain, for technical nursing care, and for educating patients and their caregivers. Anxiety (measured with the Hospital Anxiety and Depression Scale) diminished during the study period for the telemedicine patients, compared with the control group (p=0.048). Within the telemedicine group, all patients and their families were very satisfied or satisfied with their care and with the communication (15/15), although the staff's level of satisfaction was slightly lower (14/16); there were no significant differences between groups.
The ViSaDom program indicates that videophone communication is feasible and acceptable and could be a useful tool for improving the quality, efficiency and effectiveness of care.
本项目旨在研究患者在家中通过可视电话与居家住院部（HH）护理团队进行沟通的临床可行性。
本可视电话用户的试点研究将他们与另一组同样来自HH的对照患者进行比较。这些患者来自成人科、产科或儿科。符合纳入标准并同意参与研究的患者被随机分为两组：在家中安装了可视电话的患者（远程医疗组）和接受标准HH护理的患者（对照组）。根据年龄、卡氏功能状态评分和HH入院原因，远程医疗组的16名患者与对照组的16名患者进行了匹配。
可视电话通话平均时长为6分钟，在研究期间患者平均每人通话23次（每个工作日每位患者通话0.7次）。可视电话有助于更好地跟进伤口情况：例如，护士可以从患者家中传输照片以进行实时协调。它对于跟进疼痛患者、进行技术护理以及对患者及其护理人员进行教育也很有用。与对照组相比，远程医疗组患者在研究期间的焦虑程度（用医院焦虑抑郁量表测量）有所降低（p = 0.048）。在远程医疗组中，所有患者及其家属对护理和沟通都非常满意或满意（15/15），尽管工作人员的满意度略低（14/16）；两组之间无显著差异。
ViSaDom项目表明可视电话沟通是可行且可接受的，并且可能是提高护理质量、效率和效果的有用工具。
