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远程监测改善社区居住老年人营养状况:一项非随机对照试验的过程和效果评价的设计和方法。

Telemonitoring to improve nutritional status in community-dwelling elderly: design and methods for process and effect evaluation of a non-randomized controlled trial.

机构信息

Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, The Netherlands.

Habitat&Santé, 373 Chemin Plate-Rousset, F 38330, Biviers, France.

出版信息

BMC Geriatr. 2018 Nov 16;18(1):284. doi: 10.1186/s12877-018-0973-2.

Abstract

BACKGROUND

A good nutritional status is key for maintaining health and quality of life in older adults. In the Netherlands, 11 to 35% of the community-dwelling elderly are undernourished. Undernutrition or the risk of it should be signalled as soon as possible to be able to intervene at an early stage. However, in the context of an ageing population health care resources are scarce, evoking interest in health enabling technologies such as telemonitoring. This article describes the design of an intervention study focussing at telemonitoring and improving nutritional status of community-dwelling elderly.

METHODS

The PhysioDom Home Dietary Intake Monitoring intervention was evaluated using a parallel arm pre-test post-test design including 215 Dutch community-dwelling elderly aged > 65 years. The six-month intervention included nutritional telemonitoring, television messages, and dietary advice by a nurse or a dietician. The control group received usual care. Measurements were performed at baseline, after 4.5 months, and at the end of the study, and included the primary outcome nutritional status and secondary outcomes behavioural determinants, diet quality, appetite, body weight, physical activity, physical functioning, and quality of life. Furthermore, a process evaluation was conducted to provide insight into intervention delivery, feasibility, and acceptability.

DISCUSSION

This study will improve insight into feasibility and effectiveness of telemonitoring of nutritional parameters in community-dwelling elderly. This will provide relevant insights for health care professionals, researchers, and policy makers.

TRIAL REGISTRATION

The study was retrospectively registered at Clinical-Trials.gov (identifier NCT03240094 ) since August 3, 2017.

摘要

背景

良好的营养状况是维持老年人健康和生活质量的关键。在荷兰,有 11%至 35%的社区居住老年人存在营养不良。应该尽快发现营养不良或存在营养不良的风险,以便能够及早进行干预。然而,在人口老龄化的背景下,医疗保健资源稀缺,这引发了对健康促进技术(如远程监测)的兴趣。本文描述了一项针对社区居住老年人的远程监测和改善营养状况的干预研究的设计。

方法

使用平行臂预测试后测试设计评估 PhysioDom Home 膳食摄入监测干预,包括 215 名年龄在 65 岁以上的荷兰社区居住老年人。为期六个月的干预措施包括营养远程监测、电视信息和护士或营养师提供的饮食建议。对照组接受常规护理。在基线、4.5 个月后和研究结束时进行测量,包括主要结局营养状况和次要结局行为决定因素、饮食质量、食欲、体重、身体活动、身体机能和生活质量。此外,还进行了过程评估,以了解干预措施的实施、可行性和可接受性。

讨论

本研究将提高对社区居住老年人营养参数远程监测的可行性和有效性的了解。这将为医疗保健专业人员、研究人员和政策制定者提供相关的见解。

试验注册

自 2017 年 8 月 3 日起,该研究在 Clinical-Trials.gov(标识符 NCT03240094)中进行了回顾性注册。

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