In Situ Monitoring of Health in Older Adults: Technologies and Issues
In Situ Monitoring of Health in Older Adults: Technologies and Issues
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DOI：
10.1111/j.1532-5415.2010.02959.x
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发表时间：
2010-08-01
影响因子：
6.3
通讯作者：
Lipsitz, Lewis A.
中科院分区：
文献类型：
--
作者：
Kang, Hyun Gu;Mahoney, Diane F.;Lipsitz, Lewis A.
随着即将到来的医疗体系改革以及对家庭和其他生活环境护理的更加重视，老年医疗服务提供者将需要替代方法来监测疾病、活动、治疗反应和患者安全。目前对慢性疾病的动态性质、它们随时间对健康的影响以及在社区中管理它们的能力的理解仅限于测量离散时间点的一组变量，这并不能解释生理系统和日常生活环境之间的动态相互作用。传感器、数据记录仪和通信网络的最新发展使得前所未有的生理和社会学数据测量能够用于老年护理。本文确定并讨论了有关在老年患者中使用监测技术的重要问题。目标有四个方面。首先，重点介绍了一些可能改善老年人生活和改善护理的新兴技术。其次，讨论了技术在老年医学领域的可能应用，重点是急性跌倒、痴呆和心脏病。第三，确定并解决使用监测技术的实际和感知问题，包括老年人对技术的采用；污名;社会接触的减少；隐私、自主和同意的伦理问题；临床医生的担忧，包括信息超载、许可和责任；目前使用技术的补偿计划；以及监控技术所需的可靠性和基础设施。第四，建议今后采取措施，使监测技术在老年病学中有用和可用。
With the upcoming reform of the healthcare system and the greater emphasis on care in the home and other living environments, geriatric providers will need alternate ways of monitoring disease, activity, response to therapy, and patient safety. Current understanding of the dynamic nature of chronic illnesses, their effects on health over time, and the ability to manage them in the community are limited to measuring a set of variables at discrete points in time, which does not account for the dynamic interactions between physiological systems and the environments of daily life. Recent developments of sensors, data recorders, and communication networks allow the unprecedented measurements of physiological and sociological data for use in geriatrics care. This article identifies and discusses the important issues regarding the use of monitoring technologies in elderly patients. The goals are fourfold. First, some emerging technology that may improve the lives of older adults and improve care are highlighted. Second, the possible applications of technology in geriatrics settings are discussed, with a focus on acute falls, dementia, and cardiac conditions. Third, real and perceived concerns in using monitoring technology are identified and addressed, including technology adoption by elderly people; stigma; and the reduction in social contact; ethical concerns of privacy, autonomy, and consent; concerns of clinicians, including information overload, licensure, and liability; current reimbursement schemes for using technology; and the reliability and infrastructure needed for monitoring technology. Fourth, future approaches to make monitoring technology useful and available in geriatrics are recommended.