Winters Jill M, Winters Jack M
Office of Nursing Research and Scholarship, College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, USA.
J Cardiovasc Nurs. 2007 Jan-Feb;22(1):51-7. doi: 10.1097/00005082-200701000-00008.
Cardiovascular disease remains a significant chronic healthcare problem in this country, with considerable associated economic and quality-of-life challenges. Along with these challenges, there is high demand for healthcare provider time, particularly in the areas of management of complex healthcare needs and patient education. At the same time, a critical nursing shortage exists. Telehealth technologies provide opportunities to meet the rapidly growing needs of consumers and healthcare practitioners. Many in need of services have limited access to high-end technologies. An argument has been made that the lowest level of technology needed to carry out a task should be used, if it is capable of providing the necessary services. Videoconferencing capabilities allow healthcare practitioners to engage in virtual face-to-face encounters with patients or other healthcare providers. A variety of levels of sophistication in these videoconferencing systems are available. In an effort to evaluate the effectiveness and consumer satisfaction with videoconferencing, 3 pilot studies were conducted to compare face-to-face, low-bandwidth, and high-bandwidth approaches to performing common assessments and patient education activities. In one study, a variety of experienced healthcare practitioners performed functional assessments of stroke subjects using a collection of validated scales by varying approaches (face-to-face, low-bandwidth, and high-bandwidth videoconferencing) in a randomized order. In a second study, undergraduate nursing students performed similar performance measures and taught an unfamiliar individual how to program and use an intravenous pump device, take a tympanic temperature, or to draw up insulin in a syringe. In the third study, advanced practice nursing students assessed vital signs and performed cardiopulmonary assessments on community-dwelling subjects using low-bandwidth and face-to-face approaches. Healthcare practitioners and students generally preferred high-bandwidth approaches over low-bandwidth alternatives when videoconferencing was performed; however, most participants and practitioners were satisfied with the encounters, regardless of the level of technology used.
心血管疾病仍是该国一个严重的慢性医疗保健问题，伴随着相当多相关的经济和生活质量挑战。除了这些挑战外，对医疗保健提供者的时间需求也很高，尤其是在复杂医疗需求管理和患者教育领域。与此同时，存在严重的护理短缺问题。远程医疗技术为满足消费者和医疗从业者迅速增长的需求提供了机会。许多需要服务的人难以获得高端技术。有一种观点认为，如果某项技术能够提供必要的服务，那么应使用执行该任务所需的最低技术水平。视频会议功能使医疗从业者能够与患者或其他医疗提供者进行虚拟面对面交流。这些视频会议系统有各种复杂程度可供选择。为了评估视频会议的有效性和消费者满意度，开展了3项试点研究，以比较进行常见评估和患者教育活动的面对面、低带宽和高带宽方法。在一项研究中，多名经验丰富的医疗从业者通过不同方法（面对面、低带宽和高带宽视频会议）以随机顺序使用一系列经过验证的量表对中风患者进行功能评估。在第二项研究中，本科护理专业学生进行了类似的操作，并向一个不熟悉的人教授如何编程和使用静脉输液泵设备、测量鼓膜温度或用注射器抽取胰岛素。在第三项研究中，高级实践护理专业学生使用低带宽和面对面方法对社区居住的受试者进行生命体征评估和心肺评估。进行视频会议时，医疗从业者和学生通常更喜欢高带宽方法而非低带宽方法；然而，无论使用何种技术水平，大多数参与者和从业者对这些交流都感到满意。
