Gardner Cubby L, Flanagan Michael C, Franklin Cathy, John-Swayers Cherly, Walsh-Pouch Stacy, Bryant F Joyce, Romano Carol A, Gibbons Susanne, De Jong Marla, Hoang Albert, Becher Dorothy, Burke Harry B
Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Cardiology Clinic, Walter Reed National Military Medical Center, Bethesda, MD, United States.
Int J Med Inform. 2016 Sep;93:42-8. doi: 10.1016/j.ijmedinf.2016.06.001. Epub 2016 Jun 3.
The current approach to the outpatient management of heart failure involves patients recollecting what has happened to them since their last clinic visit. But patients' recollection of their symptoms may not be sufficiently accurate to optimally manage their disease. Most of what is known about heart failure is related to patients' diurnal symptoms and activities. Some mobile electronic technologies can operate continuously to collect data from the time patients go to bed until they get up in the morning. We were therefore interested to evaluate if patients would use a system of selected patient-facing devices to collect physiologic and subjective state data in and around the patients' period of sleep, and if there were differences in device use and perceptions of usability at the device level
This descriptive observational study of home-dwelling patients with heart failure, between 21 and 90 years of age, enrolled in an outpatient heart failure clinic was conducted between December 2014 and June 2015. Patients received five devices, namely, body weight scale, blood pressure device, an iPad-based subjective states assessment, pulse oximeter, and actigraph, to collect their physiologic (body weight, blood pressure, heart rate, blood oxygen saturation, and physical activity) and subjective state data (symptoms and subjective states) at home for the next six consecutive nights. Use was defined as the ratio of observed use over expected use, where 1.0 is observed equals expected. Usability was determined by the overall System Usability Scale score.
Participants were 39 clinical heart failure patients, mean age 68.1 (SD, 12.3), 72% male, 62% African American. The ratio of observed over expected use for the body weight scale, blood pressure device, iPad application, pulse oximeter and actigraph was 0.8, 1.0, 1.1, 0.9, and 1.9, respectively. The mean overall System Usability Scale score for each device were 84.5, 89.7, 85.7, 87.6, and 85.2, respectively.
Patients were able to use all of the devices and they rated the usability of all the devices higher than expected. Our study provides support for at-home patient-collected physiologic and subjective state data. To our knowledge, this is the first study to assess the use and usability of electronic objective and subjective data collection devices in heart failure patients' homes overnight.
目前心力衰竭门诊管理的方法是让患者回忆自上次门诊就诊以来自己的情况。但患者对自身症状的回忆可能不够准确，无法对疾病进行最佳管理。目前已知的关于心力衰竭的大多数信息都与患者的日间症状和活动有关。一些移动电子技术可以持续运行，从患者上床睡觉到早上起床这段时间收集数据。因此，我们有兴趣评估患者是否会使用一套选定的面向患者的设备来收集患者睡眠期间及前后的生理和主观状态数据，以及在设备层面上设备使用情况和对可用性的认知是否存在差异。
2014年12月至2015年6月，对一家门诊心力衰竭诊所中年龄在21至90岁之间的居家心力衰竭患者进行了这项描述性观察研究。患者收到五台设备，即体重秤、血压计、基于iPad的主观状态评估设备、脉搏血氧仪和活动记录仪，用于在接下来连续六个晚上在家中收集他们的生理数据（体重、血压、心率、血氧饱和度和身体活动）和主观状态数据（症状和主观状态）。使用情况定义为观察到的使用量与预期使用量的比率，其中1.0表示观察到的使用量等于预期使用量。可用性由系统可用性量表的总体得分确定。
参与者为39名临床心力衰竭患者，平均年龄68.1岁（标准差12.3），72%为男性，62%为非裔美国人。体重秤、血压计、iPad应用程序、脉搏血氧仪和活动记录仪的观察使用量与预期使用量的比率分别为0.8、1.0、1.1、0.9和1.9。各设备的系统可用性量表总体平均得分分别为84.5、89.7、85.7、87.6和85.2。
患者能够使用所有设备，并且他们对所有设备可用性的评分高于预期。我们的研究为患者在家中收集生理和主观状态数据提供了支持。据我们所知，这是第一项评估心力衰竭患者家中电子客观和主观数据收集设备的使用情况和可用性的研究。
