Gustafson D H, Hawkins R, Boberg E, Pingree S, Serlin R E, Graziano F, Chan C L
Department of Industrial Engineering and Preventive Medicine, Center for Health Systems Research and Analysis, University of Wisconsin-Madison 53705, USA.
Am J Prev Med. 1999 Jan;16(1):1-9. doi: 10.1016/s0749-3797(98)00108-1.
Consumer health information systems potentially improve a patient's quality of life and activate patient self-care.
Test a computerized system (CHESS: Comprehensive Health Enhancement Support System), which, in this application, provided HIV-positive patients with information, decision support, and connections to experts and other patients. Would patients given in-home access to computers use the system, improve their quality of life, reduce health-risk behaviors, and use medical services more efficiently?
Randomized controlled trial: CHESS computers in experimental subjects' homes in Madison or Milwaukee, Wisconsin, for 3 or 6 months; controls received no intervention. Subjects were compensated for self-report surveys completed before, during, and after CHESS installation.
Of 204 HIV-positive patients recruited (90% male, 84% white, average education some college, and 65% experiencing HIV-related symptoms), 90% completed the study.
Self-reports of quality of life and frequency and duration of use of medical services.
CHESS was used daily with little difference between demographic subgroups. While CHESS was in the home, its users reported quality-of-life improvements: active life, negative emotions, cognitive function, social support, and participation in health care. They also reported spending less time during ambulatory care visits, making more phone calls to providers, and experiencing fewer and shorter hospitalizations.
A computer-based personal health support system can improve a patient's quality of life and promote more efficient use of health care.
消费者健康信息系统有可能改善患者的生活质量并激发患者的自我护理能力。
测试一个计算机系统（CHESS：综合健康增强支持系统），在本应用中，该系统为艾滋病毒呈阳性的患者提供信息、决策支持，并建立与专家及其他患者的联系。在家中能够使用计算机的患者会使用该系统吗？他们的生活质量会得到改善吗？健康风险行为会减少吗？医疗服务的使用会更高效吗？
随机对照试验：在威斯康星州麦迪逊或密尔沃基的实验对象家中放置CHESS计算机3或6个月；对照组不接受干预。对在安装CHESS之前、期间和之后完成的自我报告调查的受试者给予补偿。
在招募的204名艾滋病毒呈阳性的患者中（90%为男性，84%为白人，平均受教育程度为大专，65%有与艾滋病毒相关的症状），90%完成了研究。
生活质量的自我报告以及医疗服务使用的频率和时长。
CHESS被每日使用，不同人口统计学亚组之间差异不大。在CHESS进入家庭期间，其用户报告生活质量得到改善：积极生活、负面情绪、认知功能、社会支持以及参与医疗保健。他们还报告门诊就诊时间减少、给医疗服务提供者打电话增多，住院次数减少且住院时间缩短。
基于计算机的个人健康支持系统可以改善患者的生活质量并促进医疗保健的更有效利用。
