Video-Enhanced Care Management for Medically Complex Older Adults with Cognitive Impairment.
Video-Enhanced Care Management for Medically Complex Older Adults with Cognitive Impairment.
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DOI：
10.1111/jgs.16819
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发表时间：
2021-01
影响因子：
6.3
通讯作者：
Oddone E
中科院分区：
文献类型：
--
作者：
Hastings SN;Mahanna EP;Berkowitz TSZ;Smith VA;Choate AL;Hughes JM;Pavon J;Robinson K;Hendrix C;Van Houtven C;Gentry P;Rose C;Plassman BL;Potter G;Oddone E
这项试点研究评估了视频增强护理管理的可行性，复杂的老年退伍军人怀疑轻度认知障碍（CI）和他们的护理伙伴，与电话交付相比。试点随机对照试验。达勒姆退伍军人事务部医疗保健系统。参与者被招募为二人组，由65岁或以上的退伍军人组成，他们患有复杂的医疗条件（护理评估需求评分≥90）和疑似轻度CI（教育调整的认知状态改良电话访谈评分20-31）及其护理伴侣。为期12周的护理管理干预包括每月一次的研究护士电话，内容包括药物管理、心血管疾病风险降低、身体活动和睡眠行为，通过视频与电话进行比较。Dyads完成了基线和随访评估，以评估可行性、可接受性和可用性。招募了40名退伍军人（平均（标准差（SD））年龄= 72.4（6.1）岁; 100%男性; 37.5%黑人）及其护理伙伴（平均（SD）年龄= 64.7（10.8）岁），并随机接受电话或视频增强护理管理。大约三分之一的资深参与者表示熟悉相关技术（定期使用平板电脑和/或视频会议经验）; 53.6%的互联网用户使用互联网感到舒适或非常舒适。总体而言，视频组完成了43次（71.7%）护理管理呼叫，电话组完成了52次（86.7%）。对于已经熟悉用于提供干预的技术的参与者，视频远程医疗平台的可用性评分较高（平均（SD）系统可用性量表评分：65.0（17.0）vs 55.6（19.6））。退伍军人，护理合作伙伴，研究护士报告更大的参与，沟通和互动的视频arm. Video-delivered护理管理电话是可行的，首选一些复杂的老年人轻度CI和他们的护理合作伙伴的电话。未来的研究应侧重于了解如何评估和纳入患者和家庭的喜好有关的摄取和维持视频远程保健干预措施。
This pilot study assessed feasibility of video-enhanced care management for complex older veterans with suspected mild cognitive impairment (CI) and their care partners, compared with telephone delivery. Pilot randomized controlled trial. Durham Veterans Affairs Health Care System. Participants were enrolled as dyads, consisting of veterans aged 65 years or older with complex medical conditions (Care Assessment Need score ≥90) and suspected mild CI (education-adjusted Modified Telephone Interview for Cognitive Status score 20–31) and their care partners. The 12-week care management intervention consisted of monthly calls from a study nurse covering medication management, cardiovascular disease risk reduction, physical activity, and sleep behaviors, delivered via video compared with telephone. Dyads completed baseline and follow-up assessments to assess feasibility, acceptability, and usability. Forty veterans (mean (standard deviation (SD)) age = 72.4 (6.1) years; 100% male; 37.5% Black) and their care partners (mean (SD) age = 64.7 (10.8) years) were enrolled and randomized to telephone or video-enhanced care management. About a third of veteran participants indicated familiarity with relevant technology (regular tablet use and/or experience with videoconferencing); 53.6% of internet users were comfortable or very comfortable using the internet. Overall, 43 (71.7%) care management calls were completed in the video arm and 52 (86.7%) were completed in the telephone arm. Usability of the video telehealth platform was rated higher for participants already familiar with technology used to deliver the intervention (mean (SD) System Usability Scale scores: 65.0 (17.0) vs 55.6 (19.6)). Veterans, care partners, and study nurses reported greater engagement, communication, and interaction in the video arm. Video-delivered care management calls were feasible and preferred over telephone for some complex older adults with mild CI and their care partners. Future research should focus on understanding how to assess and incorporate patient and family preferences related to uptake and maintenance of video telehealth interventions.
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影响因子：
2.8
作者：
Hawkins, Lee Ann;Kilian, Shirley;Silvet, Helme
通讯作者：
Silvet, Helme
影响因子：
6.3
作者：
Alessi C;Martin JL;Fiorentino L;Fung CH;Dzierzewski JM;Rodriguez Tapia JC;Song Y;Josephson K;Jouldjian S;Mitchell MN
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影响因子：
2.1
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通讯作者：
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影响因子：
5.8
作者：
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通讯作者：
Bauer, Mark S.