研究远程监测系统对老年慢性心力衰竭患者的活动、自我护理及生活质量的影响。
Examining the effects of remote monitoring systems on activation, self-care, and quality of life in older patients with chronic heart failure.
作者信息
Evangelista Lorraine S, Lee Jung-Ah, Moore Alison A, Motie Marjan, Ghasemzadeh Hassan, Sarrafzadeh Majid, Mangione Carol M
机构信息
Lorraine S. Evangelista, PhD, RN, FAHA, FAAN Associate Professor, Program of Nursing Science, University of California Irvine. Jung-Ah Lee, PhD, RN Assistant Professor, Program of Nursing Science, University of California Irvine. Alison A. Moore, MD, MPH Professor of Medicine and Psychiatry, David Geffen School of Medicine, University of California, Los Angeles. Marjan Motie, PhD Project Director, Pro-HEART, Program of Nursing Science, University of California Irvine. Hassan Ghasemzadeh, PhD Research Manager, Computer Science Department, University of California, Los Angeles. Majid Sarrafzadeh, PhD Professor, Computer Science Department, & Director, UCLA Wireless Health Institute, University of California, Los Angeles. Carol M. Mangione, MD, MSPH Program Director, Resource Center for Minority Aging Research, Center for Health Improvement of Minority Elderly (RCMAR/CHIME), Los Angeles, California.
出版信息
J Cardiovasc Nurs. 2015 Jan-Feb;30(1):51-7. doi: 10.1097/JCN.0000000000000110.
BACKGROUND
The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited.
OBJECTIVE
The aim of this study was to compare the effects of a 3-month RMS intervention on activation, self-care, and QOL of older patients versus a reference group matched on age, gender, race, and functional status (ie, New York Heart Association classification) who received standard discharge instructions after an acute episode of HF exacerbation requiring hospitalization.
METHODS
A total of 21 patients (mean age, 72.7 ± 8.9 years; range, 58-83 years; 52.4% women) provided consent and were trained to measure their weight, blood pressure, and heart rate at home with an RMS device and transmit this information every day for 3 months to a centralized information system. The system gathered all data and dispatched alerts when certain clinical conditions were met.
RESULTS
The baseline sociodemographic and clinical characteristics of the 2 groups were comparable. Over time, participants in the RMS group showed greater improvements in activation, self-care, and QOL compared with their counterparts. Data showed moderately strong associations between increased activation, self-care, and QOL.
CONCLUSION
Our preliminary data show that the use of an RMS is feasible and effective in promoting activation, self-care, and QOL. A larger-scale randomized clinical trial is warranted to show that the RMS is a new and effective method for improving clinical management of older adults with chronic HF.
背景
医疗保健领域中远程监测系统（RMS）的使用呈指数级增长，改善了患者接受强化治疗的可及性和能力。然而，描述RMS对老年心力衰竭（HF）患者的活动、自我护理和生活质量（QOL）影响的研究有限。
目的
本研究的目的是比较为期3个月的RMS干预对老年患者的活动、自我护理和QOL的影响，与在因急性HF加重发作需住院治疗后接受标准出院指导的、在年龄、性别、种族和功能状态（即纽约心脏协会分级）相匹配的参照组进行比较。
方法
共有21名患者（平均年龄72.7±8.9岁；范围58 - 83岁；52.4%为女性）提供了知情同意，并接受培训以在家中使用RMS设备测量体重、血压和心率，并在3个月内每天将这些信息传输至一个集中信息系统。该系统收集所有数据，并在满足某些临床条件时发出警报。
结果
两组的基线社会人口统计学和临床特征具有可比性。随着时间的推移，与对照组相比，RMS组的参与者在活动、自我护理和QOL方面有更大改善。数据显示活动增加、自我护理和QOL之间存在中度强关联。
结论
我们的初步数据表明，使用RMS在促进活动、自我护理和QOL方面是可行且有效的。有必要进行更大规模的随机临床试验，以证明RMS是改善老年慢性HF患者临床管理的一种新的有效方法。
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