Telecare for diabetes, CHF or COPD: effect on quality of life, hospital use and costs. A randomised controlled trial and qualitative evaluation.
Telecare for diabetes, CHF or COPD: effect on quality of life, hospital use and costs. A randomised controlled trial and qualitative evaluation.
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DOI：
10.1371/journal.pone.0116188
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Rea HH
中科院分区：
文献类型：
--
作者：
Kenealy TW;Parsons MJ;Rouse AP;Doughty RN;Sheridan NF;Hindmarsh JK;Masson SC;Rea HH
评估远程护理对健康相关生活质量、自我护理、医院使用、成本以及患者、非正式护理人员和卫生保健专业人员的体验的影响。患者被随机分配到常规护理或额外将其数据输入到市售电子设备中，该电子设备每天一次将数据上传到护士领导的监测站。患者患有充血性心力衰竭（部位A）、慢性阻塞性肺病（部位B）或任何长期疾病，主要是糖尿病（部位C）。研究中心C仅贡献了干预患者-他们认为常规护理方案不道德。该研究于2010年9月至2012年2月在新西兰进行，每例患者持续3至6个月。主要结局是健康相关生活质量（SF 36）。通过个人和小组访谈以及问卷调查收集经验数据。共有171例患者（98例干预，73例对照）。生活质量，自我效能和疾病特异性措施没有显着变化，而焦虑和抑郁都显着下降的干预。两组患者的入院率、住院天数、急诊就诊次数、门诊就诊次数和费用没有显著差异。所有研究中心的患者普遍呈阳性。许多人感到更安全，更受照顾，并表示他们和他们的家人已经学到了更多关于管理他们的病情。工作人员都可以看到远程护理的潜在好处，在经历了一些最初的技术问题后，许多工作人员认为远程护理使他们能够有效地监测更多的病人。患者和工作人员的积极体验和态度与小的或不显著的数量变化形成互补和对比。这导致患者和家属在自我管理方面发挥更积极的作用。很可能患者亚组的受益方式在定量数据中无法测量或可见，特别是安全感和被照顾感。澳大利亚和新西兰临床试验注册中心ACTRN 12610000269033
To assess the effect of telecare on health related quality of life, self-care, hospital use, costs and the experiences of patients, informal carers and health care professionals. Patients were randomly assigned either to usual care or to additionally entering their data into a commercially-available electronic device that uploaded data once a day to a nurse-led monitoring station. Patients had congestive heart failure (Site A), chronic obstructive pulmonary disease (Site B), or any long-term condition, mostly diabetes (Site C). Site C contributed only intervention patients – they considered a usual care option to be unethical. The study took place in New Zealand between September 2010 and February 2012, and lasted 3 to 6 months for each patient. The primary outcome was health-related quality of life (SF36). Data on experiences were collected by individual and group interviews and by questionnaire. There were 171 patients (98 intervention, 73 control). Quality of life, self-efficacy and disease-specific measures did not change significantly, while anxiety and depression both decreased significantly with the intervention. Hospital admissions, days in hospital, emergency department visits, outpatient visits and costs did not differ significantly between the groups. Patients at all sites were universally positive. Many felt safer and more cared-for, and said that they and their family had learned more about managing their condition. Staff could all see potential benefits of telecare, and, after some initial technical problems, many staff felt that telecare enabled them to effectively monitor more patients. Strongly positive patient and staff experiences and attitudes complement and contrast with small or non-significant quantitative changes. Telecare led to patients and families taking a more active role in self-management. It is likely that subgroups of patients benefitted in ways that were not measured or visible within the quantitative data, especially feelings of safety and being cared-for. Australian New Zealand Clinical Trials Registry ACTRN12610000269033
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影响因子：
39.2
作者：
Boutron, Isabelle;Moher, David;Ravaud, Philippe
通讯作者：
Ravaud, Philippe
影响因子：
4.8
作者：
Goldberg, LR;Piette, JD;Loh, E
通讯作者：
Loh, E
影响因子：
6.6
作者：
Greenhalgh, Trisha;Russell, Jill;Parsons, Wayne
通讯作者：
Parsons, Wayne
DOI：
10.1164/ajrccm/145.6.1321
发表时间：
1992-06-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
JONES, PW;QUIRK, FH;LITTLEJOHNS, P
通讯作者：
LITTLEJOHNS, P
影响因子：
6.7
作者：
Parsons, John;Rouse, Paul;Connolly, Martin J.
通讯作者：
Connolly, Martin J.