Royal Brompton & Harefield NHS Foundation Trust, London, UK.
J Clin Nurs. 2013 Sep;22(17-18):2444-55. doi: 10.1111/j.1365-2702.2012.04294.x. Epub 2012 Nov 27.
To explore the extent to which telemonitoring in patients with heart failure empowers them to self-care.
Telemonitoring is increasingly used to provide structured follow-up. In patients with heart failure it has been shown to reduce mortality. However there is limited knowledge of the extent to which it supports the patient to develop self-care skills.
A qualitative study including interviews with patients at 2 time-points.
Fifteen patients mean age 74, 11 (73%) male, 9 (60%) symptomatic on moderate activity, 6 (40%) symptomatic on mild exertion were interviewed at two time points: firstly following three months of telemonitoring and the second interview following six months of telemonitoring. Thematic analysis of the data was undertaken using constant comparison.
Patients undertook a variety of self-care actions. During the three-month interview technological skills featured highly in patients accounts and they used telemonitoring to facilitate professional monitoring. However, during the six-month interview patients described how they used telemonitoring to support their self-care actions. Such actions were based on the understanding of heart failure that patients developed from their personal experience of symptoms, and their interaction with the telemonitoring and the telemonitoring nurse. We found no difference in self-care actions regardless of patients age, severity of their heart failure, time since diagnosis with heart failure or living alone.
In summary, the majority of patients used telemonitoring daily and developed self-care skills in monitoring their heart failure. Such skills were developed over the six-month time-period of the study.
Our findings suggest how the nurse can help patients to use telemonitoring to develop their understanding of their heart failure and empower them for self- care decision making.
探讨远程监测在心力衰竭患者中自我护理能力的提升程度。
远程监测越来越多地用于提供结构化的随访。在心力衰竭患者中，它已被证明可以降低死亡率。然而，对于它在多大程度上支持患者发展自我护理技能，我们的了解有限。
包括两次访谈的定性研究，纳入患者。
15 名患者，平均年龄 74 岁，11 名（73%）男性，9 名（60%）在中度活动时出现症状，6 名（40%）在轻度活动时出现症状，分别在远程监测后 3 个月和 6 个月进行两次访谈。使用常数比较对数据进行主题分析。
患者采取了各种自我护理措施。在 3 个月的访谈中，患者的账户中高度强调了技术技能，他们利用远程监测来促进专业监测。然而，在 6 个月的访谈中，患者描述了他们如何利用远程监测来支持他们的自我护理行为。这些行动是基于患者从自身症状体验和与远程监测以及远程监测护士的互动中发展出来的心力衰竭理解。我们发现，无论患者的年龄、心力衰竭的严重程度、心力衰竭诊断后的时间长短或是否独居，自我护理行为都没有差异。
总之，大多数患者每天使用远程监测，并在监测心力衰竭方面发展出自我护理技能。这些技能是在研究的六个月期间发展起来的。
我们的研究结果表明，护士如何帮助患者利用远程监测来加深对心力衰竭的理解，并为他们的自我护理决策提供支持。
