远程医疗的有效性：为低收入高血压老年人提供视频会议服务。
Effectiveness of telemedicine: videoconferencing for low-income elderly with hypertension.
作者信息
Choi Hanna, Kim Jeongeun
机构信息
College of Nursing, Seoul National University , Seoul, South Korea .
出版信息
Telemed J E Health. 2014 Dec;20(12):1156-64. doi: 10.1089/tmj.2014.0031.
OBJECTIVES
Develop educational materials and a classification system for remote consultations and home-based healthcare through videoconferencing, manage the blood pressure of patients through a ubiquitous-health (u-health) service, and identify its effects on the blood pressure and level of depression of the service recipients (i.e., low-income elderly patients with hypertension).
MATERIALS AND METHODS
This study is a nonequivalent control group pre-test-post-test, quasi-experimental study. Low-income essential hypertensive patients above 65 years of age living in public rental housing were our target group. They were divided into two groups: an experimental group of 25 who had received blood pressure monitoring as well as inbound-outbound remote video consultation and a control group of 24 who received blood pressure monitoring through u-health equipment but no other management. In total, 16 sessions were conducted twice a week for 8 weeks.
RESULTS
(1) The hypothesis that there would be a difference in the level of depression between the control group and the experimental group who received the u-health service was rejected because of the lack of a significant statistical difference (t=-0.142, p=0.889). However, there was a significant difference before and after the service in the experimental group (t=2.49, p=0.021). (2) Concerning the second hypothesis-that there would be a difference in systolic and diastolic blood pressure between the control group and the experimental group-there was a statistically significant decrease in systolic blood pressure (F=10.26, p=0.003), but diastolic blood pressure showed no significant difference (F=2.802, p=0.101). Thus, the hypothesis was partially adopted. (3) The third hypothesis stated that the rates of sleep (p=0.012) and hobbies (p=0.036) as aspects of a healthy lifestyle in the experimental group would be significantly higher than those of the control group.
CONCLUSIONS
These findings confirm that the u-health nursing service via videoconferencing made a measurable contribution to a healthier lifestyle by reducing systolic blood pressure levels compared with those who were only monitored for high blood pressure. Therefore, this service is recommended as part of a hypertension management regimen for low-income elderly people as an effective means of nursing intervention.
目的
开发用于远程会诊和基于家庭的视频会议医疗保健的教育材料和分类系统，通过泛在健康（u-health）服务管理患者血压，并确定其对服务对象（即低收入老年高血压患者）血压和抑郁水平的影响。
材料与方法
本研究为非等效对照组前后测准实验研究。居住在公共租赁住房中的65岁以上低收入原发性高血压患者为目标群体。他们被分为两组：25名接受血压监测以及双向远程视频会诊的实验组，和24名通过u-health设备接受血压监测但无其他管理措施的对照组。总共进行了16次会诊，每周两次，共8周。
结果
（1）由于缺乏显著的统计学差异（t=-0.142，p=0.889），接受u-health服务的对照组和实验组之间抑郁水平存在差异的假设被拒绝。然而，实验组在服务前后存在显著差异（t=2.49，p=0.021）。（2）关于第二个假设，即对照组和实验组之间收缩压和舒张压会存在差异，收缩压有统计学意义的下降（F=10.26，p=0.003），但舒张压无显著差异（F=2.802，p=0.101）。因此，该假设被部分采纳。（3）第三个假设表明，实验组作为健康生活方式方面的睡眠率（p=0.012）和爱好率（p=0.036）将显著高于对照组。
结论
这些发现证实，与仅接受高血压监测的患者相比，通过视频会议的u-health护理服务通过降低收缩压水平，对更健康的生活方式做出了可衡量的贡献。因此，建议将此服务作为低收入老年人高血压管理方案的一部分，作为一种有效的护理干预手段。
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