The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: A quasi-experimental study
The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: A quasi-experimental study
复制标题
DOI：
10.1016/j.ijnurstu.2012.04.013
复制
发表时间：
2012-10-01
影响因子：
8.1
通讯作者：
Ho, Yi-Lwun
中科院分区：
文献类型：
--
作者：
Chiang, Li-Chi;Chen, Wan-Chou;Ho, Yi-Lwun
背景：远程医疗的发展是为了向慢性病患者提供基于家庭的监测和支持。对于从医院过渡到家的心力衰竭患者，其对家庭照顾者和家庭功能的影响已有报道；然而，需要更多的证据。目的：评价护理主导的过渡性护理与传统的出院计划相比，对心力衰竭患者的家庭照顾者负担、压力掌握和家庭功能的有效性。设计：这是一项准实验研究设计。方法：从2010年5月至10月，对63名心力衰竭患者进行资格评估，并邀请他们参加远程医疗或标准护理。三个家庭拒绝参与数据收集。30个出院后选择远程医疗的家庭为试验组，其他接受出院计划的家庭仅为对照组。远程护理专家通过24小时远程监测患者的健康状况和电话咨询，提供必要的家庭护理干预，帮助家庭护理员成功地从医院过渡到家里。在出院前和一个月后在家中收集关于照顾者负担、压力控制和家庭功能的数据。结果：与出院前相比，两组家庭照料者在1个月的随访期内均有较低的负担、较高的压力掌握能力和较好的家庭功能。在后测中，实验组家庭照顾者在照顾者负担、压力掌握和家庭功能方面的总分显著高于对照组。家庭功能的两个子量表--家庭与子系统关系和家庭与社会关系--实验组较对照组有所改善，但家庭与家庭成员之间的关系无明显差异。结论：研究结果为心力衰竭患者出院后30天内远程保健结合出院计划能减轻家庭照顾者负担、改善压力掌握、改善家庭功能提供了证据。远程护理专家向照顾者提供过渡性护理的概念，帮助他们成功度过关键的过渡期。(C)2012爱思唯尔有限公司。保留所有权利。
Background: Telehealth care was developed to provide home-based monitoring and support for patients with chronic disease. The positive effects on physical outcome have been reported; however, more evidence is required concerning the effects on family caregivers and family function for heart failure patients transitioning from the hospital to home.Objective: To evaluate the effectiveness of nursing-led transitional care combining discharge plans and telehealth care on family caregiver burden, stress mastery and family function in family caregivers of heart failure patients compared to those receiving traditional discharge planning only.Design: This is a quasi-experimental study design.Methods: Sixty-three patients with heart failure were assessed for eligibility and invited to participate in either telehealth care or standard care in a medical centre from May to October 2010. Three families refused to participate in data collection. Thirty families who chose telehealth care after discharge from the hospital to home comprised the experimental group: the others families receiving discharge planning only comprised the comparison group. Telenursing specialist provided the necessary family nursing interventions by 24-h remote monitoring of patients' health condition and counselling by telephone, helping the family caregivers successfully transition from hospital to home. Data on caregiver burden, stress mastery and family function were collected before discharge from the hospital and one month later at home. Effects of group, time, and group x time interaction were analysed using Mixed Model in SPSS (17.0).Results: Family caregivers in both groups had significantly lower burden, higher stress mastery, and better family function at one-month follow-up compared to before discharge. The total score of caregiver burden, stress mastery and family function was significantly improved for the family caregivers in the experimental group compared to the comparison group at posttest. Two subscales of family function-Relationships between family and subsystems and Relationships between family and society were improved in the experimental group compared to the comparison group, but Relationships between family and family members was not different.Conclusions: The results provide evidence that telehealth care combined with discharge planning could reduce family caregiver burden, improve stress mastery, and improve family function during the first 30 days at home after heart failure patients are discharged from the hospital. Telenursing specialists cared caregivers with the concepts of providing transitional care to help them successful cross the critical transition stage. (C) 2012 Elsevier Ltd. All rights reserved.