Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
Department of Nursing, The University of Melbourne, Australia; Melbourne Health, Australia.
Int J Nurs Stud. 2015 May;52(5):963-9. doi: 10.1016/j.ijnurstu.2015.01.016. Epub 2015 Feb 8.
Respiratory rate is an important sign that is commonly either not recorded or recorded incorrectly. Mobile phone ownership is increasing even in resource-poor settings. Phone applications may improve the accuracy and ease of counting of respiratory rates.
The study assessed the reliability and initial users' impressions of four mobile phone respiratory timer approaches, compared to a 60-second count by the same participants.
Three mobile applications (applying four different counting approaches plus a standard 60-second count) were created using the Java Mobile Edition and tested on Nokia C1-01 phones. Apart from the 60-second timer application, the others included a counter based on the time for ten breaths, and three based on the time interval between breaths ('Once-per-Breath', in which the user presses for each breath and the application calculates the rate after 10 or 20 breaths, or after 60s). Nursing and physiotherapy students used the applications to count respiratory rates in a set of brief video recordings of children with different respiratory illnesses. Limits of agreement (compared to the same participant's standard 60-second count), intra-class correlation coefficients and standard errors of measurement were calculated to compare the reliability of the four approaches, and a usability questionnaire was completed by the participants.
There was considerable variation in the counts, with large components of the variation related to the participants and the videos, as well as the methods. None of the methods was entirely reliable, with no limits of agreement better than -10 to +9 breaths/min. Some of the methods were superior to the others, with ICCs from 0.24 to 0.92. By ICC the Once-per-Breath 60-second count and the Once-per-Breath 20-breath count were the most consistent, better even than the 60-second count by the participants. The 10-breath approaches performed least well. Users' initial impressions were positive, with little difference between the applications found.
This study provides evidence that applications running on simple phones can be used to count respiratory rates in children. The Once-per-Breath methods are the most reliable, outperforming the 60-second count. For children with raised respiratory rates the 20-breath version of the Once-per-Breath method is faster, so it is a more suitable option where health workers are under time pressure.
呼吸频率是一个重要的体征，但在资源匮乏的环境中，通常要么未被记录，要么记录不准确。即使在资源匮乏的环境中，手机的拥有量也在增加。手机应用程序可以提高呼吸频率计数的准确性和易用性。
本研究评估了四种手机呼吸计时器方法的可靠性和初始用户印象，将其与同一参与者的 60 秒计数进行了比较。
使用 Java 移动版创建了三个移动应用程序（应用了四种不同的计数方法，外加一个 60 秒的标准计时器），并在诺基亚 C1-01 手机上进行了测试。除了 60 秒计时器应用程序外，其他应用程序还包括基于 10 次呼吸时间的计数器，以及基于呼吸间隔时间的三个计数器（“一次呼吸”，用户每次呼吸都按一下，应用程序在 10 或 20 次呼吸后或 60 秒后计算出呼吸频率）。护理和理疗学生使用这些应用程序在一系列不同呼吸系统疾病儿童的简短视频记录中计算呼吸频率。通过与同一参与者的标准 60 秒计数进行比较，计算了一致性限、组内相关系数和测量标准误差，以比较四种方法的可靠性，并由参与者完成了一份可用性问卷。
计数结果差异较大，其中很大一部分与参与者和视频以及方法有关。没有一种方法是完全可靠的，一致性限没有比 -10 到 +9 次/分钟好。一些方法比其他方法更优越，组内相关系数从 0.24 到 0.92 不等。根据组内相关系数，一次呼吸 60 秒计数和一次呼吸 20 次计数是最一致的，甚至比参与者的 60 秒计数还要好。10 次呼吸方法的效果最差。用户的初步印象是积极的，不同应用程序之间没有发现明显差异。
本研究提供了证据，表明运行在简单手机上的应用程序可以用于计算儿童的呼吸频率。一次呼吸方法是最可靠的，优于 60 秒计数。对于呼吸频率升高的儿童，一次呼吸 20 次的方法更快，因此在卫生工作者时间紧迫的情况下，是一种更合适的选择。
