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[新型冠状病毒肺炎大流行期间慢性和急性肺部疾病患者的数字护理经验]

[Experiences with digital care of patients with chronic and acute lung diseases during the SARS-CoV-2 pandemic].

作者信息

Braun Marcel, Schmidt Olaf, Schultz Thomas, Woehrle Holger, Sundrup Martina Große, Schöbel Christoph

机构信息

Universitätsmedizin Essen, Ruhrlandklinik - Westdeutsches Lungenzentrum, Klinik für Pneumologie, Lehrstuhl für Schlaf- und Telemedizin, Universität Duisburg-Essen, Essen, Deutschland.

KPPK Studienzentrum Koblenz/Pneumologische Gemeinschaftspraxis Koblenz, Koblenz, Deutschland.

出版信息

Internist (Berl). 2022 Mar;63(3):255-265. doi: 10.1007/s00108-022-01266-3. Epub 2022 Feb 18.

Abstract

BACKGROUND

Management of patients with respiratory disorders, such as asthma or chronic obstructive pulmonary disease (COPD), became challenging during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic due to infection prevention measures. To maintain care, a remote monitoring program was initiated, comprising a smartphone app and a Bluetooth spirometry device.

OBJECTIVE

To assess patient- and physician-related experience with remote monitoring.

MATERIAL AND METHODS

Structured questionnaires were developed to rate experiences from the patient or physician perspective on six-level Likert scales. Interactions between patients and physicians via the digital platform and overall utilization was analyzed.

RESULTS

A total of 745 patients with asthma, COPD, post-coronavirus disease 2019 (COVID-19) and other respiratory diseases were enrolled from 31 centers in Germany. Mean follow-up was 49.4 ± 12.6 weeks. Each participant submitted on average 289 measurements. Patient-reported experience with the remote monitoring program was positive, with the highest satisfaction reported for "Experience with home measurement" (1.4 ± 0.5; 99% positive), followed by "Communication/interaction" (1.8 ± 0.9; 83% positive) and "Overall satisfaction with program" (1.8 ± 0.8; 87% positive). In all, 70% reported subjective quality of life improvements related to participation in the program. Physician satisfaction with the program was also high with a mean rating of 2.2 ± 1.2.

DISCUSSION

App-based remote monitoring was successfully implemented in routine care during the SARS-CoV‑2 pandemic and demonstrated potential for improvements in care. Patient-relevant experience was positive in all dimensions and remote monitoring was well accepted. Physicians who participated in the program also expressed positive experiences, as demonstrated by a high level of interaction with the platform and positive evaluations of effects from the program.

摘要

背景

在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行期间,由于感染预防措施,哮喘或慢性阻塞性肺疾病(COPD)等呼吸系统疾病患者的管理变得具有挑战性。为了维持护理,启动了一项远程监测计划,该计划包括一个智能手机应用程序和一个蓝牙肺功能仪设备。

目的

评估患者和医生对远程监测的相关体验。

材料与方法

开发了结构化问卷,从患者或医生的角度在六级李克特量表上对体验进行评分。分析了患者和医生通过数字平台的互动以及总体利用率。

结果

从德国31个中心招募了总共745名患有哮喘、COPD、2019冠状病毒病(COVID-19)和其他呼吸系统疾病的患者。平均随访时间为49.4±12.6周。每位参与者平均提交了289次测量数据。患者报告的远程监测计划体验是积极的,“家庭测量体验”的满意度最高(1.4±0.5;99%为积极),其次是“沟通/互动”(1.8±0.9;83%为积极)和“对计划的总体满意度”(1.8±0.8;87%为积极)。总体而言,70%的人报告参与该计划后主观生活质量有所改善。医生对该计划的满意度也很高,平均评分为2.2±1.2。

讨论

基于应用程序的远程监测在SARS-CoV-2大流行期间的常规护理中成功实施,并显示出改善护理的潜力。与患者相关的体验在各个方面都是积极的,远程监测得到了很好的接受。参与该计划的医生也表达了积极的体验,这体现在与平台的高度互动以及对该计划效果的积极评价上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/633c/8885560/ebb821ddf7fb/108_2022_1266_Fig1_HTML.jpg

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