The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
Int J Med Inform. 2012 Oct;81(10):674-82. doi: 10.1016/j.ijmedinf.2012.06.003. Epub 2012 Jul 11.
To investigate the feasibility, acceptance and potential effectiveness of delivering a telecare service on the health outcomes and hospital service utilization of community-dwelling patients with chronic obstructive pulmonary disease.
Eligible participants were older people, with moderate or severe chronic obstructive pulmonary disease, and who had been admitted to hospital at least once for exacerbation during the previous year. The participants were randomly assigned to the intervention or control group. Participants in the intervention group received a telecare device kit and they were asked to monitor their oxygen saturation, pulse rate and respiration rate using the device and to transmit the data to an online network platform. A medication and purse-lip breathing reminder with a feedback function is also provided in the device kit. A community nurse monitors changes in the physiological parameters and takes immediate action to address the patients' needs. Participants in the control group received no other extra care. Study outcomes include user satisfaction, health-related quality of life, pulmonary function, hospital re-admission and use of emergency room services.
Twenty-two participants in the intervention group and 18 in the control group were included in the analysis. The mean age of all 40 participants was 72.93 years. Overall, the participants in the intervention group expressed satisfaction with the telecare service. Some patients reported difficulty in reading the screen of the mobile phone and manipulating the tiny key-in buttons. No significant differences were found between the two time points (baseline and post-test period) with regard to health-related quality of life. No significant differences in pulmonary function and in the number of emergency department visits and hospital re-admissions between the study groups were found.
The high level of user satisfaction indicated the feasibility of conducting a large-scale randomized control trial to evaluate the effects of a telecare service on health outcomes of patients with chronic obstructive pulmonary disease.
调查远程护理服务对慢性阻塞性肺疾病(COPD)社区患者健康结局和医院服务利用的可行性、可接受性和潜在效果。
符合条件的参与者为年龄较大、患有中度或重度 COPD 且在过去一年中因加重而至少住院一次的老年人。参与者被随机分配到干预组或对照组。干预组的参与者收到了远程护理设备包,并被要求使用该设备监测他们的血氧饱和度、脉搏率和呼吸率,并将数据传输到在线网络平台。设备包中还提供了具有反馈功能的药物和钱包唇呼吸提醒。社区护士监测生理参数的变化,并立即采取行动满足患者的需求。对照组的参与者未接受其他额外护理。研究结果包括用户满意度、健康相关生活质量、肺功能、医院再入院和急诊室服务使用情况。
干预组 22 名参与者和对照组 18 名参与者纳入分析。所有 40 名参与者的平均年龄为 72.93 岁。总体而言,干预组的参与者对远程护理服务表示满意。一些患者报告说阅读手机屏幕和操作微小的键入按钮有困难。两组在健康相关生活质量方面,在两个时间点(基线和测试后期间)没有发现显著差异。两组在肺功能以及急诊室就诊和医院再入院次数方面也没有发现显著差异。
高水平的用户满意度表明,开展一项大规模随机对照试验来评估远程护理服务对 COPD 患者健康结局的影响是可行的。