Kamei Tomoko, Yamamoto Yuko, Kanamori Takuya, Nakayama Yuki, Porter Sarah E
Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan.
Tokyo Healthcare University, Chiba, Japan.
Nurs Health Sci. 2018 Sep;20(3):313-322. doi: 10.1111/nhs.12563. Epub 2018 Sep 4.
Chronic diseases, such as chronic obstructive pulmonary disease, amyotrophic lateral sclerosis, and diabetes mellitus, require long-term management, which daily telenurse monitoring can provide. The aim of the present feasibility study was to determine if using a telenursing protocol with home monitoring during a 12 week implementation could also identify early signs of deterioration and factors correlated with participants' change in status, while attaining patient acceptance and satisfaction. The purposive sample of 43 participants provided 4533 combined days of monitoring. Outcome feasibility indicators were the range of triggering protocol alerts (70100%) and diagnoses with exacerbations (2029.3%). Highly correlated were participants' activity limitation and palpitations with chronic obstructive pulmonary disease, activity limitation and ineffective sputum clearance with amyotrophic lateral sclerosis, and fatigue with diabetes. Acceptance and adherence were high with daily monitoring, including "feelings of safety," and "understanding own condition". Telenursing with home monitoring indicated a trend to accurately detect early-stage changes. Participant acceptance was acceptable. It would be feasible to conduct a randomized, controlled trial using this model with some modifications.
慢性疾病，如慢性阻塞性肺疾病、肌萎缩侧索硬化症和糖尿病，需要长期管理，而每日远程护士监测可以提供这种管理。本可行性研究的目的是确定在12周的实施过程中使用带有家庭监测的远程护理方案是否还能识别病情恶化的早期迹象以及与参与者状态变化相关的因素，同时获得患者的接受度和满意度。43名参与者的目的抽样提供了4533天的综合监测数据。结果可行性指标是触发方案警报的范围（70%100%）和病情加重的诊断率（20%29.3%）。慢性阻塞性肺疾病患者的活动受限和心悸、肌萎缩侧索硬化症患者的活动受限和痰液清除无效以及糖尿病患者的疲劳之间存在高度相关性。包括“安全感”和“了解自身状况”在内，每日监测的接受度和依从性都很高。带有家庭监测的远程护理显示出准确检测早期变化的趋势。参与者的接受度尚可。对该模型进行一些修改后开展随机对照试验是可行的。
